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Providing the right Rx for a new facility

On his first day as dean of the pharmacy school at Palm Beach Atlantic University in Florida, Scott Swigart remembers staring down at a blank sheet of paper, unable to decide what to do next.

It was not his first post at a new pharmacy school. He had spent nine years as an assistant dean at Nova Southeastern University in Fort Lauderdale, but this was the first time he had held the top spot. Swigart was used to following directives, helping push a school toward someone else’s goals, but now it was his job to set the goals. He was starting from scratch.

By the time Swigart, 53, was picked to lead St. John Fisher’s new Wegmans School of Pharmacy in 2005, he had the school-building part down.

"The beauty of what I get to do is that I never have to hear, ‘This is the way we’ve always done things,’" Swigart says. "It’s also a lot of work. When you start from a blank piece of paper, you have to build structure, admissions, your student processes and academic and professional organizations, and then … a faculty and a curriculum.

"It’s a lot of work, but you get to be creative, and that’s the joy of the job."

The pharmacy school today has 267 students and 28 faculty, with two more expected to be hired this year. In May it will graduate its first class of doctor of pharmacy students, and applications to the school are growing each year.

Coming to Fisher
When Swigart interviewed for the job at St. John Fisher, he was also looking into two other pharmacy schools. At the start of the process, he had St. John Fisher pegged third.

Its stock rose as he began to see the strengths of the college and the Rochester area. The school was similar in size to Palm Beach Atlantic, and the six-county area surrounding Rochester has a population base of more than 1 million people.

Locally, pharmacists embraced the idea of a school of pharmacy. But what sealed the deal for Swigart was the college’s student-centered commitment, which had been a benchmark of how he built Palm Beach Atlantic’s program.

"Fisher slowly rose to the top of my list when I interviewed and looked at the other programs," Swigart says. "One of the most important things that brought me here was the Fisher model. I just absolutely love the student-focused approach. I believe that has to be Fisher’s ethos."

It helped that Swigart’s natural homing device was pulling him out of Florida and to something at least more familiar to his Midwestern roots. His 15-year-old son, Aaron, who was born and raised in Florida, helped lead the charge. When they finally settled in Victor, Aaron relished the winter weather, skiing nearly once a week.

Swigart admits there are some challenges in building a professional program in a liberal arts college. Structures usually are set up differently, he says, and faculty contracts in the pharmacy school are 12 months, as opposed to nine months in traditional liberal arts colleges. But despite the superficial differences, the pharmacy school fits well within St. John Fisher’s mission, he says.

"We bring a slightly different view, but we also want to build in that same kind of environment that’s student-centered and where teaching and academics are the priority," Swigart says.

As with Palm Beach Atlantic, there were two main challenges in building St. John Fisher’s pharmacy school. The first was the ability to hire faculty, and because two-thirds of the school’s professors are licensed pharmacists, Swigart had to compete with pharmacies and hospitals. With a national shortage of pharmacists also came a shortage of prospective faculty members.

Swigart entered St. John Fisher assuming it would be an even bigger challenge attracting pharmacists to the cold New York winters than it was to Florida but found the opposite to be true.

He learned that many pharmacists had a propensity to take jobs and start their careers close to the schools from which they had graduated. This was a boon for Western New York, because of numerous schools both upstate and downstate.

"Florida, especially south Florida, is so far from everything," says Swigart. "Outside the University of Florida, Georgia was the next-closest place (that graduated pharmacy students). Here in the Northeast we have a group of schools within our region, a number in New York City but also Philadelphia, Buffalo and Albany. That’s been one of our strong suits."

Being the one who fills the blank page with plans, Swigart was able to seek out faculty members who fit in with the mission. He looked for those who embraced the school’s student-first approach and also could contribute to the field through their scholarship.

"We truly believe that for our faculty, their development as educators and scientists is centered around their ability to discover new knowledge through scholarship," Swigart says.

Warren Richards, the associate dean of the pharmacy school and also a former colleague of Swigart’s at Palm Beach Atlantic, says Swigart’s excitement about the profession seems to rub off on professors. Richards says Swigart is flexible in his approach to academia, seeking partnerships with other schools within St. John Fisher, including ongoing discussions with the Bittner School of Business to create post-graduation opportunities for pharmacy students.

"You kind of pick up his enthusiasm," Richards said. "He’s infectious, which is very good for the faculty."

The other challenge facing the pharmacy school is also its biggest limiting factor. One-third of students’ time is spent in clinical settings, learning to dispense medication and work with patients. Because the students need one-on-one supervision, there are only enough placements to support classes of 75 students.

The economic crunch on the organizations that run the pharmacies-from hospitals to supermarkets-means it is even more difficult to find pharmacists who have time to train students, Swigart says.

"The pharmacists are busier, they are taking on more responsibilities, and then to add to it the student is another responsibility," Swigart says.

The local pharmacy community, busy as it may be, has embraced the school and the students who work in clinical settings, says Daniel Rimmer, manager of staffing and training for Wegmans Food Markets Inc. pharmacies. Rimmer works with Swigart to craft the clinical program and find assignments for students. He says the passion and excitement Swigart has for the program show through the students.

"The kids are coming in energized about pharmacy and are doing great work in the stores," Rimmer says. "Scott is so happy to be doing what he’s doing, and that attitude comes across from the top down."

The clinical experiences are rigorous. Students start out learning the basics of dispensing. This takes place in a variety of settings so they can learn how the skills and tasks required for Wegmans might differ from a nursing home’s, for example.

From there they progress to more patient-focused responsibilities, finding the right medicine for the right disease for the right patient. This becomes a special challenge when they work with patients taking multiple medicines, Swigart says.

"The pharmacist is the front-line person who works with those patients who could be on five, six, eight or 10 chronic medications," he says. "It’s full-time work for the patient to take those medications, but there are interactions and side effects, so many things that can affect the success of the medication."

Student-focused
As an undergraduate student at Wayne State College in Nebraska, Swigart had no real idea of what to do after he graduated. Actually, as a senior all he really knew was that he did not want to leave.

"I remember at the beginning of my senior year I was sitting down with my chemistry professor, who was my adviser, and he asked what was I going to do next year," Swigart says. "I said, ‘Oh, you mean I have to leave?’"

The discussion with the professor helped Swigart look into graduate programs where his chemistry major could be put to good use. After examining options such as medical school and physics graduate school, pharmacy school rose to the top of the list. He saw it as the perfect way to meld his education and desire to help people.

Swigart never strayed far from the classroom. After graduating from the University of Nebraska College of Pharmacy, he did a post-doctoral residency specializing in pediatrics at the University of Nebraska Medical Center. He took a faculty position at the University of Nebraska, then became head of the department of pharmacy practice at Ferris State University’s College of Pharmacy in Big Rapids, Mich., before leaving for Nova Southeastern University.

In all, the 53-year-old has spent more than 30 years in academic pharmacy, including the last 10 years as a dean. Throughout his career, both academic and professional, Swigart seemed to be drawn to the same kind of setting-the 3,500-student liberal arts school with the focus on students.

The entire curriculum at the Wegmans School of Pharmacy is challenging for students, who must have a minimum of 64 specific credit hours to be admitted, Swigart says. More than half who enter the first year of the professional program already have a baccalaureate degree.

The student population, slightly older than typical undergraduates, makes for an interesting mix, Swigart says. Though the average age for students is 24 to 25, there are also students in their 30s and 40s, those who may have started in different careers or as pharmacy technicians looking to move up.

The groups might have little in common but for the school-required dress code-no pants with rivets, no hats, hair neatly trimmed-that is borrowed from professional pharmacy settings.

"We do a lot of small-group activities, and it’s fun to watch-the young and energetic mixing with the more mature, who bring this sense of the real world to the settings," Swigart says.

The student focus extends beyond the classroom to the work in clinical settings. Rimmer, who coordinates with other pharmacy schools in the region to shape clinical programs, says the level of cooperation between the Wegmans School of Pharmacy and the local professional community is unprecedented.

"So often schools live in a bubble, trying to create this test-tube environment for students," Rimmer says. "One of the good things of the Wegmans School of Pharmacy is Scott’s desire to talk to professionals who are out there and make sure we’re preparing students to be successful."

Future for the pharmacy school
Pharmacy is on the doorstep of a golden age, Swigart says. The first group of baby boomers will be turning 65 soon, and for a 20-year stretch they ensure a sizable population of pharmacy patients who have shared a lifelong devotion to health and living well.

The number of chronic medications for patients older than 65 is nearly double that for younger patients, and Swigart says that is likely to go up as medicine continues to improve. One of the fastest-growing populations in terms of percentage growth is the over-80 group, which he says has an even higher level of medication needs.

"This group will help keep pharmacy going on and on," Swigart says. "At the same time, drug therapy is getting so good that we can manage many chronic illnesses so well."

The population growth coincides with the growing study of pharmacogenomics, the ability to tailor medication to a patient’s individual genetic makeup. Swigart explains that science is helping to create more drugs than ever before, but with this ability comes added responsibility for the pharmacist.

"There are more interactions and the drugs are more potent so have more side effects," Swigart says. "That’s one reason why the role of pharmacy is changing from dispensing to being a manager of drug therapy."

A national shortage of pharmacists has made a seat in a pharmacy school a coveted commodity among students, and St. John Fisher has seen the benefits. Swigart says even without the school’s efforts to promote itself, there would be more than enough applications for enrollment to sustain the school.

Still, Swigart does not see the school expanding beyond the 300 students it is set to reach within the next year or two. There just are not sufficient clinical settings to accommodate any more, he says.

Swigart is happy watching the school mature, if not grow.

"It’s an enjoyable process, but you start looking at different things like where we’re going with our research efforts and how faculty integrate students into those efforts," Swigart says. "In the first few years we were so focused on starting courses and tweaking this and that, but now we’re starting to put our efforts into research, possibly graduate programs in clinical sciences and post-doctoral residencies and fellowships. It’s really an exciting time."

Scott Swigart
Position: Dean, Wegmans School of Pharmacy, St. John Fisher College
Age: 53
Education: B.S. in chemistry, Wayne State College, 1979; Pharm.D., University of Nebraska Medical Center College of Pharmacy, 1983
Family: Wife, Cynthia; daughter, Kim; son, Aaron
Residence: Victor
Activities: Golf, winter sports
Quote: "The beauty of what I get to do is that I never have to hear, ‘This is the way we’ve always done things.’"

10/23/09 (c) 2009 Rochester Business Journal. To obtain permission to reprint this article, call 585-546-8303.

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