The Quality Corner Show welcomes back the Pharmacy Technician Certification Board (PTCB) to talk about what is next for pharmacy technicians. This time Host Nick Dorich, PharmD, PQS Associate Director of Pharmacy Accounts sits down with William Schimmel, Executive Director & CEO at PTCB.
Schimmel talks about how the role of pharmacy technicians has evolved pre-pandemic to post-pandemic, and what lies ahead in the form of new opportunities.
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Yeah. So let me start here. We conducted a workforce survey last year and, you know, we know a lot of technicians. Obviously, we got a really strong sample. More than 20,000 technicians responded. You know, the big flashing light in that mountains of survey data was 84% reporting that they are somewhat or very satisfied with their job now coming out of the pandemic.
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We were worried and I was worried. I did not expect to see a number like that. So I was almost proud. Right. Because technicians stepped up. They, at a really high percentage, reported that their jobs were more meaningful to them now that they were able to do more for patients.
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Welcome to the Pharmacy Quality Solutions Quality Corner Show where quality measurement leads to better patient outcomes. This show will be your go to source for all things related to quality improvement and medication use and health care. We will hit on trending topics as they relate to performance measurements and find common ground for payers and practitioners. We will discuss how the platform can help you with your performance goals.
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We will also make sure to keep you up to date on pharmacy quality news. Please note that the topics discussed are based on the information available at the date and time of reporting. Information or guidelines are updated periodically and we will always recommend that our listeners research and review any guidelines that are newly published. Buckle up and put your thinking cap on.
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The Quality Corner show starts now.
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Hello. Quality Corner Show listeners, welcome to the Peaks podcast, where we focus on medication use quality improvement and how we can utilize pharmacists to improve patient health outcomes. I'm your host, Nick Dorich. Today's episode is focusing on an essential member of the pharmacy team, the pharmacy technician. We've all been there in the pharmacy and know that the pharmacy does not and cannot operate without a team of talented and motivated pharmacy technicians.
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Now, in recent years, opportunities for pharmacy technicians have also expanded. This may have been catalyzed in some degree due to the pandemic. However, many states were already accelerating the roles and responsibilities afforded to properly trained and supervised pharmacy technicians for long time blisters of the listeners of the show. You already know that we have included multiple episodes about pharmacy technicians in our four years of the podcast.
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Most recently in August of 2022, we had an episode featuring Liza Chapman and Ryan Burke from the Pharmacy Technician Certification Board, or PTCB. Now we are back with the PTCB for this episode, but with a new guest. And that new guest is Bill Schimmel, CEO and executive director of PTCB. Bill, welcome to the show. And how are you doing today?
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Great, thank you, Nick.
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Well, Bill, before we begin, we need to know about you. So what's your background in health care? And then what is it that you do in your current role at TCB?
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Yes. So I am not a pharmacist. My my background is actually really heavy in credentialing assessment. I've been doing it for over 20 years now. I you know, I got a computer science degree in college, and I can promise you and, you know, in 1997, I did not think this is where I would be today. I was a management consultant for about five years, but I kind of took a sidestep.
00:03:48:00 - 00:04:14:08
I'm pretty sure I didn't want to do that for the rest of my career. And I learned about credentialing. And I joined PDC in 2010, not as the CEO, but as more of a CEO, very focused on operations, our assessments, how we actually created the credential. At that point, you know, our staff started to grow. We realized that we wanted to in-source a lot of what we were doing.
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We had a lot of subcontractors back then because we wanted to own what we were doing in the quality of the credentials that we created. So we spent a lot of time doing that over a number of years. I became CEO in 2017, the first non pharmacists in that role. And it's been you know, it's been amazing. We spent the last five, six years expanding those credentials.
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Right. Recognizing all the roles the technicians were already playing. We knew they were playing and we had to just pick which credentials we thought were most important to kind of recognize what technicians are doing right. They're already doing it. These credentials gives them a chance to have that recognition and also for their patients and employers kind of have that confidence, right?
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They have credentials behind what they're already doing.
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Bill Schimmel, thank you for the introduction. And I will say myself, speaking as a pharmacist, we appreciate having non pharmacists that help us proceed in the wide world of health care. And we as pharmacists are trained in many, many different facets of health care and in medication use. But there's a lot of things that need to make the wheels on the bus turn and a lot of additional skill sets.
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So we appreciate folks like yourself that are coming from the non pharmacy background to bring in some new insight, some new skill sets to really help things get rounded out. Now, Bill, we're going to go in, we're going to jump into today's conversation. But before we do before we do that, we've got a quick message to cover from my teammates at PXP.
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So we'll pause for a moment and we'll be right back with questions after the breakdown.
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Now it's time for the breakdown as quality corner show host little as three main topic questions. Our guests will have a chance to respond and there will be some discussion to summarize the key points. This process worksheet for the second and third questions, which will wrap up the primary content for this the 14th. After that, I expect to end on the closing summary, usually containing a bonus question.
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Now that we have the start of the process, let's jump into the questions.
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All right, Bill, we're ready to begin with the questions for today's episode. And I want to start off with specific addressing the Prep Act changes that came with the Prep Act or now that it's being kind of sunsetted, if you will. You know, what did it allow pharmacy technicians to do? What were new services or new opportunities? And then are these changes being made permanent now that the pandemic has been declared over by the Federal government?
00:06:42:22 - 00:07:07:07
Great. Yeah. So I wanted to start with regard to the Prep Act by remembering like when COVID 19 kind of descended on the United States. Technicians, like so many other frontline workers, they stepped forward during a very uncertain and scary time. Right. And the staff at PTB, we were able to work from home immediately. They didn't have that choice.
00:07:07:11 - 00:07:30:00
You know, 95% of technicians and American did not have that choice. Just like all those other workers. Right. And, you know, in that intervening time, you know, the estimates I've seen reported that over 270 million COVID vaccines were administered by pharmacy teams. Right. Not just technicians, pharmacists, pharmacy technicians, along with about 50 million more for flip through the flu.
00:07:30:02 - 00:08:03:22
Right. That's across about an 18 month period that I was looking at data for that was over half the vaccinations delivered in the U.S. And a lot of that was because of the Déclare patients that came from the Prep Act. Right. Prep actors from 2005 Public Readiness and Preparedness Act, and then declarations that came at HHS. They mostly centered on technicians being allowed to vaccinate and eventually in the flu and children down to about the age of three.
00:08:03:24 - 00:08:26:09
Now, again, before the Prep Act declarations happened, and this specific one was in October of 2020 that allowed Texas to participate in vaccinations. It's not like they weren't doing extra things right just like everybody else. They were involved in the testing in any of the technical tasks that are part of that work. In one way, this was unprecedented, right?
00:08:26:09 - 00:08:52:04
This was the federal government for, I think, the first time in my career recognizing and acknowledging the skills and dedication that technicians had. Right. I don't want to get to get lost. The criteria for you to be allowed as a technician to do this was to be licensed or registered in your state. That makes complete sense, right? Somewhat surprisingly, not every state has a regulatory structure that includes technicians, right?
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There are a couple that still do not. In those cases, a tech needed to be nationally certified from someone like PTC be. And I and I you know, we appreciate that recognition because we've been doing this for so long. Right. It's been, you know, 25 years. Over 700,000 technicians have earned this credential. Right. Right now, almost 300,000 are still actively certified.
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So yet, when it comes to the Prep act, the good news now is that states, you know, the emergency is over and states have started to make it permanent. Right. 31 states have made some or all of those changes permanent. And that's great, right? Either from a regulatory perspective or statutory and more good news, almost every other state is considering it.
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Right. Again, taking the long view. And I think that just means there's now widespread recognition, you know, regarding technicians skills, knowledge and dedication to patients. Right. We've known this for a long time, that P.T.S.D. You don't normally see, at least within pharmacy regulatory changes happen at this speed. Right. It's usually talking about a decade rolled out at different speeds in different states.
00:10:12:23 - 00:10:34:06
Right. And ultimately, you know, this the ability for techs to immunize in the long term, in other technical tasks, it's going to free up time for pharmacists. Right. They can concentrate on more clinical things. Ultimately, I think just raising the level of patient care. Right. 95% of the U.S. population, you priority know this. They live within five miles of the pharmacy.
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Right. And then those technicians are often the face. Right. The first in the last person to meet that patient. Sorry. Go ahead.
00:10:43:18 - 00:11:16:00
Yeah. So, Bill, when we're talking about these these topics you already mentioned, you know, some of the states and some of the activities where where things are really allowed and just kind of ready to change. Are there states that, you know, PTCB looks at or that, you know, for the pharmacy operators, for the pharmacy technicians, are there are there certain states or maybe even regions that are seeing being seen as more expansive in what they allow pharmacy technicians to do or that are really kind of the leaders in continuing to push for pharmacy technician provided services?
00:11:16:02 - 00:11:34:05
Yeah, No, that's a that's a great question. You know, sometimes we sit back and we wish that like the federal government could just make all the changes of one, right. Because that it would be simple. But there's 300 plus million people in the United States. So the states working as actual laboratories of democracy in this case, You know, I think you're exactly right.
00:11:34:05 - 00:12:01:00
It's a great question. I'll start maybe with Idaho. Back in 2016, they were the first to recognize that they had an opportunity with technicians in immunization. Right. I can start there again. They ran a trial and across 25,000 immunizations provided by technicians, there were zero adverse events. Right. That gave them the confidence to make it permanent in 2018.
00:12:01:02 - 00:12:25:20
And a couple states followed them. Prior to the pandemic, only two on it. Right? We were at three then, obviously now, like we were just talking about, we're well over 30 states and counting. Right. Idaho is looking at not just immunization. Right. They were looking at a broad restructuring of their pharmacy regulations. So, again, it wasn't just immunizations.
00:12:25:20 - 00:12:53:18
It was other things essentially trusting, you know, pharmacists who we know are well trained but really good and dedicated. They're very detail oriented, trusting them to delegate technical tasks to technicians so that they can concentrate on more clinical things. They know it was their license at risk. So you want to make sure that you've got these really well trained and educated technicians, which they're somewhat responsible for, and and then delegating those tasks.
00:12:53:20 - 00:13:13:10
A couple of other states are, I'd say, more than a couple at this point, because enough time has passed to kind of use that as a model. Right. You know what? Let's open up our regulations and go through it line by line. Are there other opportunities? So those things are happening. Another one and this is also pre pre-pandemic is Iowa.
00:13:13:12 - 00:13:43:14
This is my probably my favorite example, Right. The state board working with the Iowa Pharmacy Association, they studied allowing technicians to perform a final verification for refill prescriptions right after an extensive pilot. And they found that the accuracy rates on that final verification were indistinguishable between pharmacists and techs. The pharmacists in the study more importantly, they reported that their time spent on dispensing the activities went way, way down.
00:13:43:14 - 00:14:08:13
Right? It went from 62% down to 14%. They were able to take that time, move it to patient care activities. And again, in this pilot study, it went from 26% of their time on patient care up to 59. The board made the change permanent and they were kind of off and running. This has not spread at the same speed that, you know, someone like me would have liked it to.
00:14:08:15 - 00:14:34:15
But again, PTCB is having conversations with state boards of pharmacy all the time. I like to remind people this study. Tennessee and I believe Wisconsin soon followed. And there's probably a couple of other states there's a lot of is a lot of technicians have their product verification in health systems. But I think that there's so many opportunities in community pharmacy to grow that.
00:14:34:17 - 00:14:54:05
Excellent will Bill I'm going to pivot now really to our second topic or question for this. And you already talked a bit about boards of pharmacy and opportunities where, you know, changes have been made, but I would have to think that there's also active changes with pharmacy technicians and how involved they are with boards and pharmacies and really being agents of change.
00:14:54:05 - 00:15:03:11
So, you know, can you expand upon that and perhaps gives us some opportunities and ways that pharmacy technicians are being more involved with decision making and regulatory efforts?
00:15:03:13 - 00:15:31:08
Sure. Yeah. So let me start here. We conducted a workforce survey last year and, you know, we know a lot of technicians. Obviously, if got a really strong sample, more than 20,000 technicians responded. You know, the big flashing light in that mountains of survey data was 84% reporting that they are somewhat too very satisfied with their job Now coming out of the pandemic.
00:15:31:11 - 00:15:59:08
We were worried. I was worried. I did not expect to see a number like that. So I was almost proud. Right. Because technicians stepped up. They at a really high percentage, reported that their jobs were more meaningful to them now that they were able to do more for patients. And that was, again, a really pleasant surprise. But yeah, back to your original question.
00:15:59:10 - 00:16:26:13
There's still a lot more that needs to be done when it comes to work environment compensation and what technicians are allowed to do. Right. So what we've seen as we are up to 16 state boards of pharmacy now have a permanent at least one technician on them. Right. That there's a long way to go, but that a lot of progress has happened in just the last few years.
00:16:26:15 - 00:17:04:12
PTCB is working with a small, dedicated group of members of the National Association of Boards of Pharmacy. Right. These are technicians who currently sit on state boards and knows 16 states, and they're actively working to get that number up to 50 right at any annual meeting just last May. Not last name, but just in May, a few months ago, a resolution passed overwhelmingly saying exactly that every state should have at least one technician voice really encouraging.
00:17:04:14 - 00:17:27:06
And kind of just circling back to the survey data I was talking about, you know, technicians are saying we want this to be a career, right? If I'm an employer or, you know, a pharmacist at, you know, any type of pharmacy, this is a big red flashing light, you know, asking me to invest in my pharmacy technicians right beside a technician who isn't certified.
00:17:27:06 - 00:17:49:07
I'm going to go to them. I'm going to encourage them and maybe even fund it. Right. Because it's not particularly expensive. And then finally, kind of our data indicated that the majority of techs, they saw the job because they wanted to help patients. Right. Even when they stumbled into the role by accident, which does happen. Right. They stayed because they want to help patients.
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00:17:50:15 - 00:18:17:03
Excellent job, Bill. I'm going to have one quick follow up question here for you before we get on to our our last question for the conversation. But are there any other areas that are that you're seeing as perhaps the new frontier or new opportunities for pharmacy technicians? Obviously, a lot more expansion around immunization services, but I guess what's the next big thing that maybe folks haven't heard as a topic but they should start to become familiar with pretty soon?
00:18:17:05 - 00:18:50:02
Maybe? You know, just off the top of my head here, pharmacy operations. Right. Again, I would you know, if I were a technician, I'm already doing a lot of those things. And it's not formal, though, right? I'm maybe I'm a jack of all trades in my pharmacy, but there are some even a large chain that has started to recognize that this is a great thing for technicians to do and be the pharmacy operations manager, because, again, you're freeing up the pharmacies time to to, you know, practice at the top of their license.
00:18:50:04 - 00:19:14:16
So I'm glad you asked that. We are on a periodic basis. We do what's called a job task analysis survey. And I know at peak U.S. life data, you probably like data as much as I do. Right. We're very, you know, data focused at PDB with this basically is a very comprehensive survey asking technicians what they do on a daily basis and then how often they do it.
00:19:14:19 - 00:19:37:00
Right. And finally, how important is that task toward patient safety? So if you're filling this out for us, it usually takes at least an hour. And we got 40,000 responses the last time we did it in 2016. And that essentially shapes the credential. Right. And it's time for one of those. Again, we learn a lot every time we do it.
00:19:37:02 - 00:19:56:01
So when you talk about a new frontier, you know, maybe we find something in there that we didn't know about before. You know, we've we put that we put out over ten times ten or 11 new credentials, you know, across the last five years. So, yeah, we're not quite sure what's next. I suspect we're going to find out, though.
00:19:56:03 - 00:20:19:21
Excellent. Well, Bill, our final question for this topic for today, and it's an important question we always focus on here at the show, it's improving patient health outcomes. So we've we've covered, you know, how and why pharmacy technicians are more actively involved with patient care. But can you help us describe how we can measure and quantify how pharmacy technicians are actively having an impact on patient care?
00:20:19:23 - 00:20:48:23
Yeah. At PTCB We talk about this is kind of the Holy Grail, right? Especially when you talk quantitative, you know, health measures involving technicians. But I'll start with qualitative. There is a fair amount of data from pharmacists, technicians and employers showing that a technician taking the time to earn a voluntary credential like a CBC, DHT, and then showing the dedication to maintain that credential over time, they're viewed as more committed and professional member of the pharmacy team.
00:20:49:00 - 00:21:15:11
And there's a number of studies out there showing that. Again, if I were an employer, this would not surprise me. What it should do now is give me an opportunity to step back and recognize the potential and attacks on my team. Right. I should be investing in those technicians with compensation, training and opportunities to advance, you know, every pharmacy employer I've spoken to over the last 18 months has mentioned a shortage of technicians.
00:21:15:13 - 00:21:45:13
So why not invest in the technicians already working at your pharmacy? Retention is so much easier and less expensive than recruitment, right? Especially in the job environment we're in now. And then turning to quantitative, there are some great data sets out there as well. I'll give you an example of a health system that trained a group of technicians to perform medication histories as part of the med rack process.
00:21:45:15 - 00:22:10:21
The number of comprehensive histories taken doubled in this particular health system from 49% to 98%. So essentially, they were getting partial med histories. They trained some technicians, they put them on the job and it went up to 98%. And then they estimated an annual net savings of $1.6 million for that particular health systems. And obviously, we can't forget the patients.
00:22:10:23 - 00:22:41:01
The average number of discrepancies that they located during those medication histories was six for each patient. And then they estimated a cost savings of $200 also for each of those patients. So, yeah, just trying to come full circle here. The expansion of technician, scope of practice and operational responsibilities should also start to yield mountains of data. Right. Tens of millions of vaccinations and a lot of researchers.
00:22:41:05 - 00:22:50:04
I think we're going to see a lot more datasets with rich data that we're going to learning more about this over the next 510 years.
00:22:50:06 - 00:23:16:03
So, Bill, there's a quick follow up question I have before we wrap up as it relates to this topic. And, you know, PTCB, you talked about how PTCB has been supporting these efforts, looking into research and information and data. And yes, we are big fans of data on the show, but how is PTCB looking into the future and remaining on the forefront as and addressing issues for the pharmacy technicians, for the pharmacy community and of course the patients that we serve?
00:23:16:05 - 00:23:46:16
Yeah, I guess I'll start with how I mean, almost everything we do involves listening to the voices of the professional right technicians, pharmacists, educators, employers. You know, like I mentioned before, we are very, very data focused. So efforts like the Workforce survey we talked about will be repeated periodically, as will the job task analysis, of course. We have informal conversations with regulators and employers and the smallest and the largest pharmacies right.
00:23:46:18 - 00:24:18:16
We completed just recently a DEI Diversity Equity inclusion focused survey with an eye toward kind of setting a baseline because this was new for us as to what pharmacy technicians are experiencing on the job. We're still analyzing the data, but the questions focused on whether they feel they are getting the training they need to serve, you know, a diverse population with social determinants of health affecting everybody in different ways because they're the first and the last person the patient speaks with.
00:24:18:17 - 00:24:47:11
Right. And it also concentrated on how their employers approach these issues, because obviously that's going to affect their own kind of wellbeing on the job. So PCV also recently welcomed the Pharmacy Technician Educators Council into our organization. P-TECH is a membership organization for all the dedicated people educating and training techs all over the country. Tech educators already know that the potential of the technicians they're teaching.
00:24:47:13 - 00:25:07:20
We're working to find as many as we can to provide them resources and networking opportunities and a national conference in 2024. And you can learn more at detect that org. The conference had to take a break for a few years, but we're excited to bring it back in 2024. So ending with the why? It's because of patient safety.
00:25:07:22 - 00:25:32:03
It's in our mission. I believe it's in PQS's mission as well. Health care is a vast ecosystem of people, processes and software. We're just trying to play our part to ensure that technicians filling about 5 billion prescriptions each year not only have the knowledge and skills needed to keep patients safe, but they're also getting the recognition that we think they earned a long time ago.
00:25:32:05 - 00:25:50:06
Excellent. Well, Bill, thank you for that for the rundown as we cover these items and a lot of information that's coming from PTB. A lot of updates coming from our pharmacy technician community and a lot more. That really is benefiting patients. I mean, you already talked about this, the expansion and opportunities as it relates to the pharmacy technician.
00:25:50:08 - 00:26:20:14
One really lets them utilize their job as a career pathway, which is a great thing. It allows a properly trained pharmacy technician to really further support the pharmacist and the pharmacy team, which then also allows the pharmacy team to be more clinical and be providing really the clinical services, the clinical knowledge to the patient care. So you already referenced some of the numbers and the ways that this impacted the pharmacy, the pharmacist on the team, which is also fantastic.
00:26:20:14 - 00:26:40:07
And the biggest thing here, which we also covered, is that this does benefit patients, right? Some of the extended check opportunities for technicians shows that there is a great opportunity there to provide aid to continue providing safe and effective health care for those patients. And so we've got more work to go to expand the role for pharmacy technicians.
00:26:40:07 - 00:26:58:24
But we're on a great pathway. Now, Bill, this is the part of the show where we get to a few final questions for you that are not really going to be related at all to my primary topic. These are rapid fire questions that are to get, you know, you a little bit. They may not pertain to health care or pharmacy technicians, but if it comes up, so be it.
00:26:59:01 - 00:27:02:08
Bill. Are you ready for our rapid fire questions?
00:27:02:10 - 00:27:03:19
00:27:03:21 - 00:27:07:09
First question. Are you a morning person or a night owl?
00:27:07:11 - 00:27:16:02
I think I'm a night owl who wishes they were a morning person. As I get older, the late nights you just get an artist.
00:27:16:04 - 00:27:30:17
I think that I am in total agreement with you on the points that you've stated. And that's probably how I feel about these things as well. Next question. Do you prefer to read the book or watch the movie? And depending on your answer, do you have any particular examples?
00:27:30:19 - 00:27:49:21
Yeah, I'd say definitely read the book. Maybe a good recent example for me is the Song of Ice and Fire series, which is, you know, Game of Thrones once it hit TV, but there are always exceptions. Right. If I went back 20 years, I would say that the HBO version of Band of Brothers was superior to the book, Right?
00:27:51:00 - 00:27:58:16
What's good call out. Yeah, Good, good call out on that one. Next question What is your recommendation for living a healthy life?
00:27:58:18 - 00:28:20:06
Go and keep moving. You know, whatever that mean might mean for you, right? It could mean physically. It could mean metaphorically. I'm really talking physically, you know, be it walking or pickleball or running a marathon. Right. But kind of just not forgetting mental health, I would say we just all want to see connection in the ways that are important to us.
00:28:20:06 - 00:28:30:23
Right. Family, friends, professional. You know, my colleagues at PTCB. And those I've met in this job, you know, all the pharmacists and technicians, they keep me energized for sure.
00:28:31:00 - 00:28:41:02
Excellent. And then, Bill, final question here for this segment. What is one goal you are working towards? It could be personal, could be professional. Your your choice, your call on this.
00:28:41:04 - 00:29:00:03
Yeah, I'll go personal. You know, I used to compete in a lot of, like, endurance races, marathons and triathlons and things like that. And my body is in an age of catching up to me. So I'd like to get back to doing more of that again. My kids are getting older, and I'd like to at least run a half marathon, you know, this year and next year.
00:29:00:05 - 00:29:16:14
Excellent. Well, best wishes there. I've got faith that you'll be able to to hit that mark. And we'll we'll check in with you on the future to see how you're doing on that part. I also want to thank you for joining today's episode of The Quality Corner Show. And before we close, there may be listeners that have questions for you or have questions for SCB in general.
00:29:16:14 - 00:29:26:21
So where can they contact you and where can they find more information about PTCB its efforts and opportunities to perhaps be involved with PCB?
00:29:26:23 - 00:29:43:10
Yeah, I'm happy. Happily. Take emails from folks. It's email@example.com and obviously the website is the same. So yeah. Come visit us, please.
00:29:43:12 - 00:30:04:12
Excellent. Bill again, I thank you for your time today. Thank you for your information. Thank you. You personally, but also TCB in the ways that it is supporting pharmacy technicians, the pharmacy profession and the patients that we serve. But with that, folks, we have wrapped up today's episode. So we thank you for joining us. We hope you listen to our next episode of The Quality Corner Show.
00:30:04:14 - 00:30:08:20
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00:30:08:22 - 00:30:30:10
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00:30:30:12 - 00:30:52:17
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