The Member Spotlight section of the APhA Health System Strategy Council’s newsletter, The Front Line, is meant to highlight an APhA member’s career journey. These “movers and shakers” within the profession share with us career steps, vision, and important decisions that you won’t find in any company bio. We hope you enjoy learning a little more about our profession’s leaders!
I walked into the APhA reception for past leaders at the 2022 annual meeting, and with a quick scan of the room, two things were clear. The friend I was there to meet had not yet arrived, and I knew no one else in the room. I was earlier than I’d hoped, and there were fewer than ten others present watching the slideshow rotating through pics of each year’s APhA-ASP national leaders for multiple decades. Raised in the South, I know the social rule that if you’re standing within earshot of someone speaking, you can join the conversation. Tom Worrall does too. He was naming off someone he knew from almost every slide, and he soon began asking me if I knew them too. This transitioned to him introducing himself and his wife, Cathy, but it didn’t click that we already knew each other until it was my turn. After my name and background, Tom responded with an "Oh yeah!" and immediately shared kind words about my contributions to our monthly HSSC Committee calls. Without hesitation, he shared specific examples of my input that he appreciated and that left me both edified and grateful. That night was my first encounter with the remarkable memory and generosity of Tom Worrall.
A month later, our committee was deciding which member to feature first for our newsletter, and Tom was the obvious choice. The pharmacy team at the Ralph H. Johnson VA Health Care System in Charleston, SC was recently awarded the Association of the U.S. Army (AUSA) Outstanding Service Award, and it became clear to me that Tom’s contribution is an important part of why. It’s been my honor and privilege to learn about the life and pharmacy career of Tom in this process. The clear themes, like sage advice, practicing the pivot, and leaving a legacy, are interwoven throughout his story. A remarkable historian and an excellent storyteller, Tom started at what he considers the beginning of his pharmacy journey.
When Tom was in 7th grade, he lived near the Jersey Shore with his family following his dad’s departure from military service. While most visited the shore only for summer vacation, many others retired there. Such was the case with Tom’s 7th grade science teacher. He retired from pharmacy and wanted to give back, so he started teaching at the local school and introduced Tom to pharmacy as a profession. During this season, Tom was also considering medicine, but due to growing pressures from insurance companies, the two local doctors (a male and female practitioner) he was getting advice from portrayed a bleak picture of the future for physicians. Between the science teacher and the local doctor couple, the retired pharmacist won, and in 7th grade, Tom decided on his career.
In case there was any remaining doubt, Tom ended up with a high school chemistry teacher with a PhD in Chemistry who had recently retired as a Professor Emeritus from Temple University. The teacher was so lauded by the Board of Education that they built an entire new chemistry lab for him. What was his profession prior to his success in academia? If you said "pharmacy," you guessed it. Tom relished the opportunity to learn from a master about chemistry and the profession of pharmacy. He was so sure of his next step, he applied to Rutgers University College of Pharmacy during high school because it was highly ranked and he had heavily researched it, of course. He found out on Christmas Eve of 1986 that he was accepted.
In the fall of 1987, Tom began his pharmacy school program at Rutgers. During his time there, the school introduced a PharmD program and made it available for the Bachelor students to "track into" if they chose. Tom had built relationships with his professors and sought their advice on what he should do. All his mentors had received their Bachelor’s in Pharmacy, completed a residency, and gone back for a post-bachelor’s PharmD. They were unanimous in support of this path and felt he would gain more from the PharmD program by completing residency training first. So that is what Tom did.
He had narrowed his residency choices to four programs: New England Medical Center in Boston, Mount Sinai in Manhattan, Johns Hopkins in Baltimore, and Moses Cone in Greensboro, North Carolina. His top choice of New England MC was based on the residency program director at the time, William (Bill) Gouveia, being a Harvey AK Whitney award winner. Tom was intent on being Bill Gouveia’s resident. He was crushed when he was matched with Mount Sinai instead. There, his program director and mentor was Bernard Mehl. He floored Tom when, at a pharmacy meeting, Dr. Mehl introduced Tom to heroes of his in the profession, editors of DiPiro’s Therapeutics chapters who were longtime friends. Two years after Dr. Gouveia’s award, Dr. Bernard Mehl was named ASHP’s Harvey AK Whitney Award winner. Tom told me this story because he shares it often with his students and residents in training. He seeks to encourage folks who are not getting to walk the path they planned for. This and other examples ground Tom’s belief that everything happens for a reason, and pivoting will offer blessings if you look for them.
The next fork in the road for Tom came after his residency when his wife Cathy completed her critical care specialty residency from University of Tennessee. Since critical care roles were harder to find, Tom followed Cathy to Mayo Clinic, where he landed a role as the inpatient family medicine clinical specialist, rounding with the family medicine team. The set up was that two groups of local physician groups, totaling over 30 at the time, would all be admitted to Tom’s hospital. Due to the doctors’ rotation schedules, Tom and two other pharmacists quickly became the primary care providers, seeing the same patients on a consistent basis. As they dove into the care for the frequent fliers, the pharmacists’ interventions were resulting in reduced readmissions and overall better outcomes for patients with chronic diseases such as heart failure, diabetes, and COPD, to name a few. The attending quickly realized the value and requested to have a pharmacist added to their outpatient clinic in 1997. He and Tom began that service one day each week in addition to their inpatient duties.
At the same time that Tom was innovating in early ambulatory pharmacy roles, he had also begun his post-bachelor PharmD program at the University of Minnesota. He was driving up on the weekends to complete that coursework. Of the choices Cathy had for a critical care job, part of the reason they chose Mayo Clinic was so that Tom could complete his PharmD program there. One of Cathy’s options had been the VA in Charleston (and they had a job for Tom too), but at the time, the VA position was frozen, so it was Minnesota or Denver for Tom and Cathy. That piece becomes relevant later on...
Two years into his PharmD program, commuting up to the university every weekend, working and maintaining a 4.0, the college of pharmacy lost their dean. The result was that the University of Minnesota abruptly cut their post-baccalaureate PharmD program except for the full-time portion. Full stop. No alternative, just a dead end. The need to pivot had come again.
Cathy and Tom began looking, and the Medical University of South Carolina (MUSC) came calling. They eventually coaxed both Tom and Cathy into positions, and Tom stayed there for two years before moving over to the VA in Charleston, back into ambulatory care. I should clarify that he took a day job at the VA in ambulatory care and continued to staff at MUSC three days a week from 5 p.m. until midnight to save money for their kids’ college funds. By this time, they had a daughter and twin boys at home. One detail I should add here: While working two jobs, Tom was also driving to Jacksonville, Florida, on the weekends to restart and complete his PharmD degree. The program was three years, year-round, with both Tom and Cathy working, and a 2-year-old and twin infants at home. Tom English, APhA Senior Director of Member Relations and Communications, actually wrote an article featuring Tom and Cathy during that busy season, showcasing "a day in the life" of Tom as a student and them both as full-time working parents on top of that.
After his PharmD was completed, Tom moved his focus to his work at the VA. The Charleston VA is where Tom found his niche, and he’s been there for the last 23 years. Early on, he would fill additional shifts on the inpatient side because, according to Tom, "Once you have it, you don’t lose it, you know?" As a former hospital pharmacist myself, I can assure you that has not been my experience. As I was talking with Tom’s pharmacy chief, Dr. Sharon Castle, she described Tom the way Tom described one of his former heroes at Mount Sinai: he remembers everything; everyone goes to him when they need a problem solved; he stays up to date on all the guidelines and new clinical data. Tom is still emailing the latest hot topics to his teammates at the VA and to an email list of former residents and students that have trained with him. His example of staying up to date on literature and his legacy of clinical contributions continues to leave a broadening wake.
The other two legacies of Tom’s are those of compassion and service. It was clear when listening to him and Dr. Castle that Tom clearly cares about each of his patients as if they were his own family members. She said it best that Tom has "the heart of a clinician you would want caring for you or your father." One of the reasons the VA and serving veterans are such a good fit for Tom is that Tom’s family is steeped in military service. In short order, Tom listed at least 10 family members who had served or were serving in our armed forces. He told stories of which uncle had stormed Normandy and which fought in the Battle of the Bulge. His father-in-law was a World War II Pacific Theater veteran. Veterans as patients deeply matter to Tom and his team. He shared how he coaches all his students and residents to be grateful for the opportunity to serve veterans. To Tom, they are "the 7% of the population who have served, and very few people are willing to stand up and give up, including their lives." The respect and admiration for his patient population is evident, and Tom ensures each of his learners see this perspective to pursue the level of service he feels his patients deserve.
Tom’s desire to pursue excellence in his care of patients and his training of learners also extends to his investment in the advancement of the profession. The list of committees and leadership roles Tom has held in pharmacy associations is long. With his remarkable memory, he’s a walking historian, detailing which pharmacy leaders were working on which burning issues and what each of the organizations’ actions were on them at any given time over the last 30 years or more. With all that Tom invests in his patients, his team, and his students and residents, I wanted to know his "why" for continuing strong pharmacy organizational involvement throughout his career. His answer was to leave a legacy of service. He detailed quickly how advocacy and advancement are the right ways to help our profession serve patients better and invest in the next generation of pharmacists’ ability to continue the same. Tom never mentioned any awards; he did not go through every committee he’s served on, and I’m sure there have been many of both. Whether it’s for his patients, his learners, or his work in pharmacy organizations, Tom’s genuine care for all his patients, his desire to advance his profession, and his expectations of nothing in return are evident.
Throughout my interview, a theme I heard ringing clear was Tom’s admiration for heroes of our profession and the ripples from their contributions, but I couldn’t help but feel the same about Tom. His impact is clear and will continue to ripple through generations of pharmacy.
About the Author
Lauren Bristow, PharmD
Director of Pharmacy, Southwest Washington
Providence