RxRewired – Ep 01: Pharmacist Lawmaker Says We Are Our Own Worst Enemy | Gallop Franklin II

Episode Transcript

Madeline Camejo
You've seen healthcare, I would say, from both sides, patient care because you are a pharmacist and policy making side. You know, what is the truth about health care policies that pharmacists don't always want to hear?

Gallop Franklin II 
No, great great question.

Madeline Camejo
Welcome to RxRewired: Inside What's Next, a podcast by Florida Society of Health System Pharmacists, where we explore the people, ideas, and decisions shaping the future of healthcare. I'm your host, Madeline Camejo, president of Florida Society of Health System Pharmacy.

Jeremy Espeut
And I'm your co-host, Jeremy Espeut. Today we're excited to welcome Representative Gallop Franklin II. Representative Franklin is a pharmacist, educator, and member of the Florida House of Representatives. Since being elected in 2022, he has championed efforts to expand access to care, improve affordability, strengthen higher education, and advance policies that impact the health and well-being of Floridians. Representative Franklin, welcome to RxRewired.

Gallop Franklin II 
Pleasure to be here. Thanks so much for the invitation.

Madeline Camejo
We're so excited.

Jeremy Espeut
My first question to you, Gallop, is Gallop okay? Yeah, yeah. My first question to you. What first inspired you to get involved in politics?

Gallop Franklin II 
Great, great question. So as a kid, you know, y you grow up just kind of wondering what's your purpose in this world. And and for me, I figured out kinda early just to help other people. And so what's interesting is the same reasons of why I went to healthcare. You know, as a kid I was wondering how could I help others? And that was decent in math and science. It takes that, right? To do well in healthcare. So that's why I went to healthcare. You know, I thought we're gonna go make an impact in this world. And, you know, growing up back in college, it's a funny story. I had a pickup truck and I used to help just students move all the time from apartment to apartment or dorm to apartment. And to be fully honest, I think that's why one student body president.

Jeremy Espeut
Always been a servant leader.

Gallop Franklin II
Yeah. And so just just that knack of of wanting to be helpful. And really I I say this to a lot of young people all the time is we're always trying to like, you know, look for what our purpose might be. And I say, like, hey, you know, I'm religious person and and in my opinion, you know, God put us on this earth to help other people.

And so really that's our purpose, but it might look different along our lives. So I've done it as a healthcare provider. And that's also what and why answered the call to to serve in the state legislature man for office and now doing it in a different capacity.

And a lot of times people in the house are normally accountants or mostly attorneys.

Madeline Camejo
Attorneys, yeah.

Gallop Franklin II
And what people think, they think, well you're dealing with laws and policies. So you need to be an attorney, but we're dealing with laws and policies that impact professions.

And so just think about it for a second. Do you want to architect drawing legislation for the brain surgeon? You know, do you want the brain surgeon drawing legislation for the accountant? Do you want the accountant drawing legislation of policy for the pharmacist?

And so it's important that we get engaged and and that's what we did.

Madeline Camejo
That's great. You've seen healthcare, I would say, from both sides, patient care, because you are a pharmacist. And policy making side. You know, what is the truth about healthcare policies that pharmacists don't always want to hear?

Gallop Franklin II 
No, great, great question. I mean, for sure, we're very, very highly regulated as a profession. As you know, there's so many laws and regulations that really constrict what we can do. And so to your point, it does restrict and limit to what our abilities are.

You know, we go to school and and as you guys know, obviously in the classroom, we're basically learning how to treat patients. You know, back in the day, let's say back in the day, we're saying way back in the early nineteen hundreds, as you know, the physician always diagnosed the disease state.

And then the patient came to the pharmacist and said, "Hey, the doctor said I had this, and now what should you give me?" Now back then we might give wet some whiskey and cocaine.

And and so the reality was pharmacists were actually the ones who were treating the patients back then. So it was less limitations. And as regulation and law started to form, pharmacists started kind of being put more in a box and and less directly treated. And of course we have collaborative practice agreements and we're very clinical in the hospital settings, but overall, you know, the majority of pharmacists are behind the counter at a CVS or independent or Publics or Sam's. And in that space, a little more restricting.

So I say one thing a lot of pharmacists probably don't like to hear is what they can't do, even though they were trained to do something.

Madeline Camejo
And I say between health care and government, which side I sometimes feel more disconnected from reality?

Gallop Franklin II
Great, great question. So there's a huge disconnect just with what's happening on the front lines typically.

Obviously government's a bigger, if not the biggest, organization industry in the world. And so the bigger you are, the less nimble you are. Obviously, the less you can pivot to address issues and challenges. And we have a huge ship to start turning that bad boy, it's difficult, right? And so naturally I would say government's the most out of touch just because of those components.

But the healthcare, you know, behemoth that we've seen to come into fruition, the system that we have is so complicated and and so many so much fragmentation that also, I mean, the healthcare industry is not well connected either.

And and they do run off of different incentives. You know, the healthcare industry, as you know, is typically fully privatized. I'm a capitalist, so I'm not saying anything wrong with that. Yeah. But a lot of times though incentives just aren't always in the right place. You know, you gotta make sure you're returning value to the shareholder, which is important.

But the way that government structures our payment systems aren't structured in a way to incentivize healthcare companies, of course, and and healthcare players to truly be focused on what's best, which are just outcomes.

Madeline Camejo
Well pharmacists are usually ranked the most trusted profession in America. And being said, that being said, why do pharmacy bills continue to die in legislation?

Gallop Franklin II
And so once again, there's that gap between typically what communities are needing from an access perspective of healthcare and then also what it takes to make change for those things to happen.

And so for example, you know, from a pharmacy perspective, we don't do the best job advocating. Most of our, as you know, folks who are working in pharmacies don't really understand or maybe value the impact that they can have on legislation and things that are happening in this world.

And so what really what it is is it's called apathy, like being apathetic and just not being engaged in the process and not really understanding how your advocacy can truly change your outcomes.

And now we live in what we call what I call anyway the microwave or you know, the microwave. And so with that you want everything now, instant gratification. And things take sometimes 10-15 years of a slow grind to make things happen. Like we didn't just wake up and become pharmacist. Like imagine the hours and the hours...

Jeremy Espeut
Organic chemistry one and two, general chemistry, biochemistry.

Gallop Franklin II
The exam. Wake up, boom, I'm here. But then we want to have the same kind of attitude towards other things. Boom, we're just getting it done.

So there's a lot of organizations out there that are much better at advocacy, being impact and being engaging at the Capitol than us. I mean, tons of them.

I mean, we're really as as pharmacists, we're on the bottom of the toe from an advocacy perspective. Now, obviously we have good advocates for us and so because of that, we don't get too far left behind, but we we just aren't that engaged.

Madeline Camejo
So do you think, one more question. Do you think that, I think sometimes being president for FSHP, I feel like in our profession we we have so many different aspects of what a pharmacist can do, right? So you have your retail, your community, you have your pharmacists who work in clinics, you have your pharmacists who work in you know, the hospitals, and in the pharmaceutical industry. I mean I think this profession gives you an opportunity to do many things in healthcare.

But I also think that because of that, I feel like we we're disconnected and we don't have one voice. So I think when, you know, like FPA or the the retail community has a legislation that's important and we have one, it kind of competes. And what do you think we could do better so that we have more of a one united voice because it doesn't matter to me if a retail person wants to create a clinical service inside the retail pharmacy that they could come see the pharmacist and be able to do those things, it benefits everyone in the profession.

So any, what I would say, any recommendations or advice that you could give us that we could do better.

Gallop Franklin II 
And and and to your point, pharmacy is fragmented, unlike maybe realtors, right? Real estate agents are typically all in that same bucket. But I will say there's people like the nurses or the physicians that are fragmented.

I mean, think about all the different types of nurses. You have nurse anesthesist that help put people to sleep, and then you have, you know, LPNs that are just assisting with moving patients around. Physicians, you have brain surgeons, primary care, cardiologists, they work in industry. Some of them are CEOs of industry companies, right?

And so there's there's fragmentation other places too. We just don't collaborate well enough. We don't have the communication lines open and looking at how do we collaborate. Like how often, for example, do the Florida associations from industry, FSHP, FPA, how often do they meet together? And and not like collectively as like all three thousand members. Yeah. But just like leadership. And kind of talking through how do we start organizing as an organization.

And so for example, you don't have to come together maybe on the issues as much as building political and community capital, expanding membership, expanding membership engagement, expand like organizing block by block.

So for example, we all should be out knocking on doors at retail independent hospital pharmacies and clinics and asking them to get involved and engage, asking them to donate the campaigns, asking them to show up to events, asking them for their opinion on how and what we should be doing. So those things aren't happening. So I call it like old school organizing.

Just like we organized years ago for different issues all the time, we have to start organizing and making sure we build an infrastructure that builds community and political capital. And at that point, then you can kind of squash out what issues most important and how you do that. But what happens is people know the pharmacists are in charge. So like we we gotta see what they're talking about. And obviously not in charge, but you know what I mean? Like they they've got a little bit of sway. So we gotta find out what they're talking about, what works best for them.

And so until we start organizing ourselves better, until we start actually being committed to having captains of neighborhoods and captains of cities and and vice presidents of regions that help organize and get people organized in a way. And then also getting creative.

I like this this past weekend, I was at an association meeting up in Palm Beach. I was up there for two days. And somehow they put within their membership dues like parts of what goes to their PCs. I'm not sure how that works and how it how they do it, but a part of their annual membership dues go towards the PCs, right? They're political committees, but they donate to campaigns.

And so they do a really they're actually probably one of the most influential, I call we're all interest groups. Yeah. But one of the most influential associations, industry associations in the state of Florida. And so we just have to start looking at what's working for other people, how do we kind of capitalize on that? And then obviously our situation is different because of the the for profession we're in, and how do we make sure this apathy's not creeping up and how do we keep people engaged.

Madeline Camejo
Those are great those are great advice.

Jeremy Espeut
Artificial intelligence is rapidly changing healthcare. What are legislators doing to ensure healthcare policy can keep up with the rapid changes?

Gallop Franklin II
That's a tough one. As you know, Europe has already come out with some guidelines around ensuring that AI doesn't have certain biases and and obviously there's a lot of auditing that happens to make sure they're safe and there's a little bit of oversight. The United States haven't done much of that at all. I know at the state of Florida at the legislative level, we haven't done anything on it, but I know the current executive branch is interested in doing some things.

See, it historically when you go back and look at the dot com bust and and we went and started, you know, we went online what nineteen ninety six or ninety nine, whenever it was, right? In the late nineties, everyone was terrified of everything being online and the internet. Like, man, what's this dailtone? What's going on? Someone listening to you.

But United States was really apprehensive about regulating the internet. And the reason why from a government perspective you become a little apprehensive is just because you slow down innovation. So whenever you add regulations to things, then you might not have the Facebooks of the world, or you might not have the AOLs of the world. You might not have, you know, SharePoint and all those things we have today.

So the reason why I know it's more challenging to regulate, you know, artificial intelligence at the place that most people probably feel most comfortable is because you slow down innovation. And so then now you've got China and other countries who companies are being incubated and just really taken off in comparison to America.

So it can put you at like a global disadvantage if your technology is not there. But there are real concerns, right? Privacy is the hugest concern. And in my opinion, I think that's a place where you can start looking at to ensure that you're not being surveillanced without your permission.

I mean, right now, I think when they look at the cars, I was reading the article and when I look at all the cameras on cars and stuff now, I think there's like seven hundred and fifty billion dollars a year of data being sold through all those cameras and things. So like they can know if I came to your workplace, they'll know Gallop was there at this time. Those kind of things.

Now obviously they d didact it and they don't show it was me, but they can sell that data. So now if someone's trying to find out what I like, you know, they know I've been to Starbucks twice this week, you know, based on where my car was or where my phone was.

And so there's big business in that, obviously from a marketing perspective, but making sure not being surveillance without your permission. So looking into ways that people are protected.

And that AI is is not to your point, you know, bad information in, bad information out. So how do you kind of make sure there's good information going into these models?

And then also there's the biggest question around job loss. Yeah. You know, people always think about, well, wow, AI is gonna take all the jobs. And and there are some predictions. There's some predictions. This is about two years ago, where we're predicted to lose about eighty eight million jobs as a country, but then create, I think, around ninety four or ninety six million. So you're still like a net plus 8 million jobs from the creation of AI.

And in my opinion, until we have abundance, AI is not going to take away jobs overall. So even healthcare, when you think about healthcare, imagine all the patients who go without care. Tons of them. We have a huge gap in access to care. And it's also super expensive. But if I could see 1,000 patients in 10 minutes using AI as a tool, then we might no longer have this healthcare access gap.

Yeah. And so until we meet the demands of what's out there, then I have a concern about job loss. But until then we have so much ground to carry up to to carry that it's it's almost impossible in this moment for folks to go without jobs, right?

Now now if we get to the point where I can see three hundred and fifty million patients in one day, that's the whole country. We've got real job loss. And I think that's when you might see government kind of step in and make sure there's human oversight in in some way.

Or I mean the the bigger question is you hear this a lot, universal basic income, right? Because at that point, how do you how do you work? And and so we we're a while from that. In our lifetime, we might see it, but you never you never know.

Jeremy Espeut
And do you think because of this pharmacists are defending task versus value?

Gallop Franklin II
That's good point. Because sometimes as pharmacists we do defend tasks.

When it comes to legislature, I remember there was an idea of allowing pharmacy technicians to do a little bit more in the pharmacy. Yeah. And some pharmacists or a lot of pharmacists were pushing back on that. Yeah. And to your point, kind of defending a task and saying, like, hey, we need to still hold on to this or we might be obsolete in a way at some point in time.

And so you're you're right. I think people naturally are and it's the same reason why the physicians get scared when the pharmacists want to do some type of prescribing or infusions or injections. It's just because you're thinking self preservation.

Jeremy Espeut
it's a knee jerk reaction. It's like, well, I want to preserve my job, my livelihood. Let's maybe pump the brakes a little bit.

Gallop Franklin II 
And we call that protectionism. Like you're just trying to protect, you know, where you are in your space, which is natural because you're thinking, well, I might not be able to provide for my family. Can I not do this? And so I I do believe that's a part of of of defending those tasks.

Madeline Camejo
So what is the one thing pharmacists should stop doing tomorrow and the one thing we should start doing today to create a a f a stronger future for our profession?

Gallop Franklin II
Stop doing tomorrow is I would say... have to be a little less self centered based on current circumstances. So what happens is, you know, pharmacy job's a pretty decent job. It's decent pay, you can provide for your family, and so you can goto work, right? Work the shift, go home and live your life. And in that in that moment, you're in this bubble and when you're in this bubble, you're like, okay, I can do this for twenty or thirty years and then retire.

But there's there's pharmacists coming after you. And and the challenge is there was pharmacists before you that got the profession to where it is today. And so now the question is what are we doing to ensure that the profession is still even here, first of all. And then two, is advanced in a way where it's something that can be impactful and meaningful for those who of course are the pharmacists themselves and of course the patients who are receiving the services from pharmacists?

So I think, you know, the the biggest apathy challenge we have is just that convenience, you're comfortable, you make decent money, and you're just you're just thinking whatever happens in government, it's just going to happen. I can't influence anything, it's too big of a ship to turn. So I'll say like stop being so apathetic and disengaged.

Start being more engaging, right? Actually being understanding what's happening, seeing where you can try to make a difference and and not just of course in policy, but also in your communities.

And so that's the biggest gap I see for pharmacists is we get to our little bubbles. And then we get so focused on which is important, family, raising kids and providing for your family, but also just thinking through how can I play a role in the part.

And it's not fully everyone's fault. You know, oftentimes someone has to call you and you have to answer that call. And so there's people willing, I'm sure, to do a whole lot of stuff and looking to be leaders in our communities who they haven't even received that call.

So that's why I say it's up to the organizations to kind of come up with an infrastructure strategy to actually build out an organization that's focused on community and pharmacist empowerment and engagement that gets them involved and engaged beyond just let's sit in a room and talk about what we're gonna kind of push. How are we organizing ourselves? Like how are we growing membership?

And then membership beyond, you know, for some people, they might not be interested in going to CEs for the summer or they might not, they might have their own line CEs with their hospital already. And so maybe CEs isn't the push for everyone, right? Maybe they don't see the value in paying the 300 bucks a year for a membership because they just feel like, well, I don't need the CE. I don't, I don't know. And so how do we just kind of expand? Okay, what are people looking for?

How do we get them engaged? Maybe they can there can be memberships where all their dollars goes to the back. Maybe that's it. And they feel like that's going towards something that they believe they want to be a part of. I I don't know the answer to the question, but we have to figure out those answers during surveys, having conversations and seeing how to get people and people are looking to be leaders of their communities too.

And so it can be more than just getting political capital, community capital. Like what youth organizations are we volunteering with? How are we going to schools and encouraging people to get into healthcare, are we doing any kind of math and science tutoring?

Like I mean like really building out an infrastructure where, you know, when you do that in every community, now statewide, you have tentacles in all those communities that can translate into elections, can translate into phone calls to the to your congressperson, can translate translate into, you know, sitting in people's offices back in the home district, like a state rep or state center, a congressperson, US senator, when there's legislation coming before them to impact their decision.

Madeline Camejo
I love that. It was a great answer.

So, Gallop, thank you so much for joining us. I loved hearing your perspective. I think you were spot on on so many parts of it. And thank you for really coming and joining and being with us today.

Gallop Franklin II
Thanks for the invite. I appreciate you guys having me on and be back any time we need me.

Jeremy Espeut
Thank you very much. If you enjoyed today's episode, be sure to subscribe, follow and share with your colleagues and networks.

Madeline Camejo
And remember, the future of healthcare depends on who controls the change. Just as Gallop said, let's get involved. And we'll see you next time on RxRewired.