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Student Profile: Dave Smith

When Dave Smith entered the UCSF School of Pharmacy in 2004, little did he know that Medicare Part D would launch his role as a student leader who would teach others how to guide patients through this confusing and complex prescription drug benefit.

When it made its debut in January 2006, Part D offered scores of plans to the Medicare-eligible. But for many patients, an even more daunting task was planning for the "doughnut hole" in drug coverage--the point where Medicare stops paying for prescription drug coverage until federal assistance kicks in again. In the hole, the patient is responsible for all prescription drug costs.

As they learned more about Part D, Dave and two of his classmates, Tony Chung and Troy Drysdale, realized something needed to be done to help seniors understand the changes they would soon be facing.

"Toward the end of our first year, we realized we wanted to do something significant for patients," Dave says. "You could see it was a great, looming issue on campus. We realized it's important to give (patients) information. That's the best way to help them help themselves."

Together with UCSF School of Pharmacy faculty members and Marilyn Stebbins, PharmD and Tim Cutler, PharmD, who were quickly becoming Part D experts themselves, the student trio mobilized their classmates and initiated a Part D squad of student pharmacists to help seniors get the most out of the benefit.

"It was a wild and wonderful time," comments Cutler. "The students demonstrated in no uncertain ways that they were getting involved, that they were leading this change. It was our joy as teachers to give them the information and the advice they needed to succeed. Dave and friends eventually then worked with our faculty colleague Helene Lipton and began teaching Part D to nursing and medical school students."

According to Cutler, these early events sparked the eventual formation in lat 2006 of Partners in D, the partnership among 7 California pharmacy schools to help seniors, especially underserved seniors, benefit from Part D.

"Working on Part D was probably was the most significant thing I did while in pharmacy School," says Dave who graduated with a Doctor of Pharmacy in 2008. "It made a personal impact, for me, on what it means to be a patient advocate and how advocacy can carry over into many different settings. We didn't see it as an opportunity for us as much as a way pharmacy students could help others.

"We would tell our classmates not to be afraid to ask the seniors about their medications, their incomes, whatever they needed to know to help while being sensitive."

Dave, who grew up in Palo Alto, California, has a cautious thoughtfulness. His wife is a pharmacist, and he is a young father. He majored in molecular biology and political science as an undergraduate at the University of Washington, and then worked in the biotechnology industry for several years before deciding to attend pharmacy school at UCSF. "I didn't feel that what I was doing (in biotechnology) was directly helping people," he says. "The choice of what to do next wasn't difficult. Early on, I saw the impact that pharmacists could make."

Today Dave is still using lessons learned from his Medicare Part D experiences as he completes his pharmacy practice residency at the San Francisco Veterans Affairs (VA) Medical Center. The stark differences in medication insurance coverage between the patients at the VA and those with Part D constantly remind him of how much farther Part D can go in order to maximize affordable drug coverage in vulnerable populations. "I have continued to give small lectures to medical residents on Part D and helped my family and friends navigate the maze of Part D." Dave looks forward to taking the experience gained through Partners in D into the realm of clinical pharmacy and managed care once he completes his residency in July 2009.