Pharmacist Kelley Carlstrom, PharmD, BCOP, talks about becoming an oncology coach for other pharmacists.
Speech to text:
Mike Koelzer, Host: [00:00:00] Kelly for those who haven't come across you online, introduce yourself and tell our listeners what we're talking about
Kelley D. Carlstrom, PharmD: today. My name is Kelly Carlstrom. I am an oncology pharmacist by background. So today we're going to be talking about oncology pharmacy and why I think it's the best specialty for pharmacists.
Mike Koelzer, Host: You know what? I'm so glad I didn't see it on your website. All right. Every time you go on, to someone who's in a certain field like cancer or something, they're always like, well, let me tell you my horror story. It kind of loses its effect because everybody's touched by cancer. Someone's reading it. And they're like, Well here's another boring cancer story, or they're going to try to one up you into their cancer story.
So Kelley on behalf of. all the Consumers and people browsing the internet. Thanks for not telling us a cancer story, because I know it hits
Kelley D. Carlstrom, PharmD: It hits everybody. That's one of the challenges in oncology and why there's so much opportunity for pharmacists because it is so widespread.
Mike Koelzer, Host: [00:01:00] When you say opportunity, pharmacists are kind of already supposed to know a lot of this stuff.
What do they do when they know more about cancer?
Kelley D. Carlstrom, PharmD: The opportunities. I mean, in oncology pharmacy, our job opportunities and professional development career opportunities, there are a ton of jobs in oncology. Right now. We are losing a lot of our experienced oncology pharmacists out of direct patient care.
Mike Koelzer, Host: Oh, so there is an oncology pharmacist, cause I'm picturing a pharmacist, just knowing more about oncology. It's like, well, study it on your own, but this is actually a pharmacist. That part of their title is like oncology
Kelley D. Carlstrom, PharmD: pharmacists. Yes. There are a lot of different types of oncology pharmacists. I didn't
Mike Koelzer, Host: know that.
Is that something that's in there like the title?
Kelley D. Carlstrom, PharmD: Yeah. If you search on LinkedIn, do a search for oncology pharmacist, you'll get a lot of different types of titles. So oncology pharmacists can work in the inpatient setting in the hospital setting. They can work in the ambulatory [00:02:00] setting. See patients see patients in the outpatient clinic.
They can work at specialty pharmacies. They can work for insurance. Okay. They can work in informatics. They can work on the technology side. Like my day job. There is a lot of different kind of carve-outs where knowledge about oncology, knowledge about not just oncology, pharmacy, but knowledge about the cancer patient journey goes so far, but
Mike Koelzer, Host: right there, the knowledge of it is different.
Knowing it than actually saying I'm actually a cancer pharmacist, oncology pharmacist, and that's their.
Kelley D. Carlstrom, PharmD: Yes. So let me tell you an example of what that would be. So if you knew somebody who had cancer and they were getting treated. They go into the cancer center, say this is, uh, an ambulatory treatment that we're giving the doctor orders, the treatment, hopefully the day before or earlier than that treatment day.
But sometimes it's the day of [00:03:00] those orders. Similar to other hospital or ambulatory clinic orders get sent to the pharmacy. These get sent to the specific cancer center infusion pharmacy. Where pharmacists and technicians are, they're compounding those drugs every day. So the process is usually there's a two check pharmacist verification.
So one pharmacist does an initial check. They will look at things like what is the patient's disease? Is this treatment regimen or these drugs appropriate for that disease? Is the dosing correct? Should we do dose adjustment for renal hepatic issues? Similarly, you know, all the things pharmacists look at like we do with other drugs, we also will look at pre-medications and drugs like nausea, vomiting, or do we have the appropriate prophylaxis in there?
And the pharmacist does one check and then there's a second check as well. They have to make sure that they're getting it in the right bag of fluid. Is it supposed to be NS or then it gets [00:04:00] to the technician usually to compound it. Then there's a product verification. That's one example of pharmacists that are called oncology pharmacists, that touch the patient with cancer.
And there are, like I said, there's a lot of different roles, especially in the hospital where we're, the ordering process is a little bit different than ambulatory, but those pharmacists are critical, critical. They are the ones looking at is this dose correct? That the doctor just signed before the nurse receives the.
Mike Koelzer, Host: In a big hospital that maybe has a lot of cancer stuff. There might be two pharmacists that run into each other. And one of them says, oh, I'm Sally, the ex cancer pharmacist. And someone says, I'm Bob. The reason for the cancer pharmacist. I can see them doing different things in their job, but they actually narrow down their specialties too.
And what might that X and Y be in front of the cancer pharmacist?
Kelley D. Carlstrom, PharmD: They would call themselves either an oncology pharmacist. They might [00:05:00] say they're an infusion pharmacist if they're working in the infusion center. Um, and that crosses over with some non-oncology things. So there's, you know, rheumatology clinics and where they give other infusions.
There's the specialists that would call themselves the clinical oncology pharmacy specialist
Mike Koelzer, Host: versus someone who's actually dispensing.
Kelley D. Carlstrom, PharmD: And the infusion center and then specialty pharmacists might still be called oncology specialty pharmacists. If you're, if you're dealing with oncology, I am an advocate for putting oncology in your title because it's such a hyper specialized knowledge and that communicates to everybody.
Oh, there's an, there's a, there's a knowledge here. There's interaction. There's experience dealing with some parts of cancer.
Mike Koelzer, Host: What value do you give as a real reason, like job security or getting a better job you want? I mean, what's the real reason why somebody would want to come to you? [00:06:00] I
Kelley D. Carlstrom, PharmD: would say too.
There's two reasons. One definitely job security in, in the world we live in right now with pharmacy, we have. We've got a lot of disruption going on in oncology, in my opinion the safest specialty cancer is not going anywhere. It's actually getting bigger. We have more and more cancer survivors. We have a lot of complicated drugs and the new drugs that come out are incredibly difficult to not only give, but monitor lots of unusual texts.
But the other piece, really? Maybe it's a little too woo for you, Mike. But I think at the end of the day,
Mike Koelzer, Host: in my early podcast, I don't even know what the hell. Woo man. I 'm one of my podcast guests. I'm like, what'd you say that had woo I'm like, I didn't know what that is. All right. So at least I know what wood is.
Now hit me with what it's
Kelley D. Carlstrom, PharmD: about. I think it's about especially right now where everybody wants a job that is meaningful. What oncology pharmacy does is you get to help a patient through the most difficult time they [00:07:00] will face in their life. There is nothing more rewarding than that. And I get a lot of people that ask me, well, isn't it so sad to work in oncology, it would be so depressing and sure.
Patients die of cancer. There's, there's, there's a lot of challenging pieces to taking care of cancer patients as there is in any specialty, I think, um, particularly in the acute care setting, but. Even with that, you still have the ability to, to make an impact, to have moved the needle a tiny bit and how the patient feels or how the patient thinks.
We get to be present to bear witness to somebody going through the most difficult time in their life. I don't see why you would want to work anywhere else.
Mike Koelzer, Host: I can see like, learning all this stuff, but. Not knowing what direction to go. Is that something you talk to people about after you you're training them in the oncology
Kelley D. Carlstrom, PharmD: stuff?
So the pharmacists that work with me right now are mostly already [00:08:00] working in oncology. They are in a role for a variety of reasons. A lot of them have been at an institution and there was an open. And what often happens, especially at smaller centers, nobody raises their hand to work in oncology because it's scary.
So I just heard from somebody last week that said there was an opening and I raised my hand and here I am, you gave them that
Mike Koelzer, Host: confidence.
Kelley D. Carlstrom, PharmD: Maybe they saw my post on LinkedIn and got confident that they could do it.
Mike Koelzer, Host: They hit them in working with you already. Kind of raise their hand and then they knew that you were
Kelley D. Carlstrom, PharmD: out there.
Yes. Or they've been working on cology for a couple of years and they want to pass the beat cop exam and they need some kind of more structured learning to get there. But the majority of my clients are people who've been, who are newer to a position within the first year or two, and have realized that the training at their institution is very operational focused, how to approve orders, how we do things at this organization.
And it's less. So how do we treat breast cancer? Wa, when do we [00:09:00] use this drug versus this drug? So they need more of that, that clinical knowledge to have a better confidence around answering questions. You know, a lot of them will get questions from nurses or doctors or mid-level providers, and they want to feel confident, um, being able to answer those
Mike Koelzer, Host: It's changing so often that the old time thought of doctors sending stuff down to pharmacists is no longer there, it's lateral.
If. Looking up to the pharmacist who truly would have a need for knowledge of this medicine.
Kelley D. Carlstrom, PharmD: Definitely. I think in several diseases where there are multiple drugs that could be used at the same level, that question is, you know, how, which one do we pick? Well, based on the patient's comorbidities may be based on their organ function, based on pill burden, you know, maybe they are really going to struggle with.
Multiple pills per day. And there's one that has a fewer pill burden. All of those different things to weigh in pharmacists really have a role in the toxicity piece. So if a new, [00:10:00] if a new drug comes out and it causes hyperintense. And your patient already has hypertension. The big challenge there is that oncologists are not primary care providers.
They don't want to manage a patient's high blood pressure, but in my mind, you know, they may have come in with high blood pressure, but we made it worse. Our treatment made it worse and their primary care doctor probably doesn't know it's worsening because of this chemotherapy drug they're on. So I actually did a lot of, of, um, maintenance like that when I worked in bone marrow transplant.
And I'm in my previous clinical role because after bone marrow transplant, these patients get hypertension, hypertension, dyslipidemia, they get osteoporosis. So we're, we're managing these things that their primary care provider, uh, typically manages. Um, but the pharmacist has a great role in that because the oncologist is like, oh, I haven't managed osteoporosis really in a while.
Um, so the pharmacist can take a role in that.
Mike Koelzer, Host: Would you ever have a situation where you have a primary care doctor? Looking for [00:11:00] oncology advice or does that always go to an oncologist specialist and not get treated by a primary care provider? I think
Kelley D. Carlstrom, PharmD: it would go back to the specialist in my, in my experience, primary care doctors don't want.
Mess with those treatments. They may have questions. You know, if a patient comes back to them, they're not super familiar with this new drug, the patient is on. Maybe they'll ask their local pharmacist about it. Um, or there may be a drug interaction that comes up because of course every new drug approved goes through three or four.
I don't know why drug companies can't figure that out. Um, so there's always drug interactions to consider. So there might be questions for that, but the PCP won't be managing the oncology there.
Mike Koelzer, Host: What are the financial implications behind this B cop thing I hear you say. And I asked financially, just because of the nature of our podcast, I know they get more specialized.
Then what does that stand for? Become board
Kelley D. Carlstrom, PharmD: certified oncology pharmacist.
Mike Koelzer, Host: That's where I can pull out a [00:12:00] certified oncology pharmacy. The financial implications behind that is like putting any letters behind your name again, job security. Would that be one of the reasons for opening up doors because you have that and do pharmacists put that in their alphabet soup behind their name?
Kelley D. Carlstrom, PharmD: definitely in your alphabet soup. The beat cop exam is very hard. The pass rate actually went down last time. I think it's, I think it was just below six. I think it was like 59%. So if you pass BEACOPP, you should put it in your alphabet soup, for sure. So there's actually a lot of conversation about board certification.
Uh, I've seen some interesting posts on LinkedIn about it and whether board certification is worth it. I am an advocate for BEACOPP personally. And the reason may surprise people because I, I first got it. When I was in clinical practice. After my residency training, I took it like everybody else does after PGY two, it was kind of expected.
Um, my employer, I think, paid for study materials, but didn't pay for [00:13:00] the exam. Didn't pay for upkeep per se.
Mike Koelzer, Host: How much is that to take it into
Kelley D. Carlstrom, PharmD: study? Take it, I think it's like 600 to take the exam. I think, um, I, yeah, I think it was 600. I recertified my exam last year. So I'm one of the few people that REApps by taking the exam again, instead of by doing CE.
There's there's only a small handful of us that do this
Mike Koelzer, Host: on purpose. Some of the doctors have to do that. Like every five years they got to retake the damn test. I had an
Kelley D. Carlstrom, PharmD: old boss who told, who recommended it. He said, don't worry about the CE, just take the exam. And it sounds great for the first six years.
And then you get to year seven. You're like, why did I do this? And I actually recertified right after the pandemic started. So I had that on top of it.
Mike Koelzer, Host: C E for that anyways, or? Well,
Kelley D. Carlstrom, PharmD: if you, if you're going to recertify by the CE route, you [00:14:00] have to get a hundred hours of CE over that seven years in cancer in the very specific be cop
Mike Koelzer, Host: CE.
And can you use that for your general pharmacy? Yes.
Kelley D. Carlstrom, PharmD: B CUPSI is very difficult. There's only two providers that provide it and they're difficult exams. You have to pay. And it's really very expensive. I wrote a blog post about it. I think it was about maybe 5,000 over the course of seven years to upkeep.
Mike Koelzer, Host: Oh, I've heard that conversation about different things, about the unwritten expense of these testing
Kelley D. Carlstrom, PharmD: things. Yes. But if you recertify by exam, you just pay that $600 fee in year seven. And you're good. You don't have to do a hundred hours. Nope, that's what I did last time. So I'm a big advocate for people doing it.
The reason people don't like to do it is because it's a hard exam and they're worried about not passing and it is a hard exam, but I'll tell you that experience weighs in your favor. So I was nervous about taking it. I took it right after COVID. I took it with a mask and gloves on [00:15:00] trying to type on a standardized exam with gloves on was a hot mess.
It's fine. So I'm an advocate for that.
Mike Koelzer, Host: If you want the CE route, it's tough. CE compared to general pharmacy CE.
Kelley D. Carlstrom, PharmD: Yes, it is very difficult. More difficult questions. Yeah. Well, and the, the BEACOPP providers, like the, even the level I've done some work on the CE side of our profession before from the ACPE perspective and ACPE, you know, as you probably know, has all these rules, you have to follow BEACOPP CE on top of that is even more cumbersome.
Um, there, I mean, Done the CE myself. How would you know? But I've heard, I have heard lots of pharmacists talking about it, but you already took your test.
Mike Koelzer, Host: I already took the test a couple of years ago.
Kelley D. Carlstrom, PharmD: I've taken the test twice now once in 2012 and then 2020 maybe 2013 is when I took the first one. Yeah.
Mike Koelzer, Host: What'd
You graduated pharmacy when you were 15?
Kelley D. Carlstrom, PharmD: I graduated in 2010. [00:16:00] I went to pharmacy school a little later than most
Mike Koelzer, Host: it's every seven years you take the test. You don't look past 29.
Kelley D. Carlstrom, PharmD: I appreciate that. Mike
Mike Koelzer, Host: Kelly, Kelley you've got this business based around pharmacy cancer. I keep calling it cancer. Is that derogatory?
Kelley D. Carlstrom, PharmD: No.
Mike Koelzer, Host: Is it kind of like me calling like a, like a garbage collector versus a sanitation, something or other, or can I call it cancer?
Kelley D. Carlstrom, PharmD: You can
call it cancer or oncology
Mike Koelzer, Host: either one.
You do a business around this. I'm thinking the business has something to do with, we talked about learning about it, but I'm thinking it's something to do with BCOP too, because that sounds like a hole to fill
Kelley D. Carlstrom, PharmD: My business helps pharmacists learn oncology, whether they want to learn oncology for their day to day work, to get better in their day-to-day work, or they want to learn and study to take the BCOP [00:17:00] exam either way. Both of those types of pharmacists will get value from my programs.
Mike Koelzer, Host: Do you like pharmacists?
Because you seem, what's the word I'm looking for? What do people call you?
Kelley D. Carlstrom, PharmD: Why do people
Mike Koelzer, Host: Call me? You look at people, see you online. I know the word I want to use, but I don't want that to be derogatory. What do people call you when they see you, Kelly? Now, what do they call your
Kelley D. Carlstrom, PharmD: personality? Oh, um, a lot of people think I'm extroverted.
Mike Koelzer, Host: I was going to say that what's another one.
Kelley D. Carlstrom, PharmD: Um, um, I've gotten bubbly before, right? I didn't want
Mike Koelzer, Host: to say it because I'm not sure if I can say that and it's not real professional, you know, but it kind of a bubbly, extroversion
Kelley D. Carlstrom, PharmD: an optimist I get. Yes, for sure.
Mike Koelzer, Host: Pharmacists are kind of like the opposite of, I mean, in general, they're kind of the opposite of that.
How do you jive with [00:18:00] that? That would drive me crazy sometimes to work with that. I mean, I own an independent pharmacy and typically there's one pharmacist. There it's either, either I'm there or somebody else I'm not dealing with pharmacists, a iLab, but. That would seem to track me down a lot. Does it drag you down?
Kelley D. Carlstrom, PharmD: But I think maybe because pharmacists self-select the ones that come into my program, right? These are pharmacists that are interested in leveling up their professional development.
Mike Koelzer, Host: It doesn't change my question, Kelly, just because they're interested in that. Does it make them, what are the three things you said you were bubbly?
Extroverted? What was the next one? Optimistic. Bubbly. Extroverted optimistic. You said, yeah. They want to learn a lot about cancer. You couldn't even come up with something.
Kelley D. Carlstrom, PharmD: Well, Mike, I don't know every pharmacist in our profession, there's 300,000 plus of us.
Mike Koelzer, Host: I know what an average, the ones that come [00:19:00] to you, they're kind of the app.
We, I mean, I'm putting myself in that position because I'm not an optimist. I mean, there's a lot of things I'm on the, I'm an extroverted. I don't think I'm bubbly. So I'm like none of you, but I'm also not intelligent. I can't put myself into the category of the people that are just like eyes to the book, but isn't it kind of a drag dealing with
Kelley D. Carlstrom, PharmD: pharmacists?
No, it's not dry, I think people make assumptions about what they perceive extroverted people to be like. And I actually don't consider myself an extrovert. I consider myself an ambivert, which is in the. Of extrovert and
Mike Koelzer, Host: introvert. You cannot judge an extrovert and introvert by really how they act in public.
It really, where do they get their fuel and life from? So if you're an introvert, you could be a bubbly introvert, but you get your replenishment from. Being alone or reading a book at night or something like that. But then you come to life bubbly in front of people. That doesn't mean you're an [00:20:00] extrovert, you're really an introvert, but you're an ambivert.
Kelley D. Carlstrom, PharmD: Yeah. So I get energy from being around people, for sure. Especially now that conferences are becoming a thing again, that definitely lights me up when I'm in a room of other people that we're having interesting conversation with, but it also drains me and I need to have quiet time after that. To kind of regroup and re-energize and do it again the next day.
Mike Koelzer, Host: You try too hard.
Kelley D. Carlstrom, PharmD: I hope not. I don't think so because your brain is constantly trying to put together connections. Right. You're meeting people. You're trying to remember names. You're trying to think what the conversation tie-ins are. That's the whole great thing about networking.
Mike Koelzer, Host: It's not that you're trying to be somebody you're not, you're actually being more of who you are by making all those connections.
Kelley D. Carlstrom, PharmD: Yeah. You know, that's really interesting. I was thinking about this the other day, about how the more time you get in your professional journey, the [00:21:00] more easy it is to be yourself in environments like that, where you're not always trying to kind of put on your interview face. You know what I have realized, especially over the past couple of years, of starting a business is.
It's so much easier to be you just to show up like you are, uh, imperfections and all are interesting nuggets and all, and, you know, go through life that way, because life is too short. As we all know too short to, to mess around with trying to pretend to be somebody else. One thing
Mike Koelzer, Host: I would have done earlier in my life career is to be.
More honest. I don't mean lying. I don't lie, but I mean, just being more honest about what something means to you kind of gives your opinion, your, your true opinion more often and letting the chips kind of fall, because you can get into a heap load of trouble in a hurry with your identity when you're trying to.
Please different people. And [00:22:00] pretty soon you have all these splits going on and stuff. It's just easier just to be
Kelley D. Carlstrom, PharmD: yourself. Yeah. And you don't know where the future will take you. Anyhow. I mean, if I had looked back on how I ended up where I am today, I never would have been able to plan that out. Even if I was intentionally trying to, you know, put on a face or try to get to where I am.
I mean, it's just, that's the nature of life and that's what's so fascinating about it. I'll stop with the
Mike Koelzer, Host: optimism. Kelly. When was that time that you decided to switch that into saying that you're intrigued with this to saying that you were going to make some money from this world of oncology?
Kelley D. Carlstrom, PharmD: So this started very slowly for me.
I, you know, as you know, we don't get taught business particularly on online business in pharmacy school. I think we had a business elective in my school, but I didn't take it because it was focused on independent pharmacies, so much
Mike Koelzer, Host: business, even outside of independent pharmacies that could be touched on, but [00:23:00] it's not properly.
Kelley D. Carlstrom, PharmD: Right. So I didn't have any clue what this was. I just kept getting questions. I kept getting connections through LinkedIn. I've been active on LinkedIn for years and I kept getting pharmacists asking me literally the same question. I'm new in oncology. Can you send me a video where that'll help me learn it?
I would say there's about a thousand
Mike Koelzer, Host: videos. They didn't want you to record a personal one for them. They wanted a link. Sent to them that you
Kelley D. Carlstrom, PharmD: knew of. Right. They were connecting with me. They knew I was experienced in oncology. They just wanted me to share some resources. So I did that for a while.
One-off messages would send them a bunch of hyperlinks and, but I just kept getting the same question. So that made me think, Hmm. Okay. Something is missing here because people keep asking me the same question. It
Mike Koelzer, Host: wasn't the same person asking you. No. I'm dealing with independent pharmacy customers. You know, we might get the question all the time and we literally mean all the time from the same [00:24:00] person.
These were different people asking the same question. Yes. Different pharmacists. So they would ask the same thing and you say, There's a hole there that needs to be filled.
Kelley D. Carlstrom, PharmD: Yeah. And I actually got a call with several people to really understand what it is that they needed because I, even though I had worked, I worked at a large academic center and then I worked at a small community center.
So I had some knowledge of that small community center where a lot of these people were asking me questions from, but I didn't have an appreciation for exactly what they thought they needed. So I got on a lot of phone calls and heard from them. And what, what resulted from that was my initial, um, uh, basics course.
I created an online course, a little under three hours of video content, with me presenting on video the basics of cancer, a kind of refresher on the cell cycle. What is staging, what's performance status, how to verify a chemotherapy order. So really walking through the logistics [00:25:00] of what you would need, what steps to take.
And I put that out there for. To see if anyone would buy. And people
Mike Koelzer, Host: did really that's
Kelley D. Carlstrom, PharmD: cool. It was very cool. And then people got back to me and said, Hey, this was great. I need more, I need to learn all the diseases,
Mike Koelzer, Host: those early sales. Where did those come from? You had to have a base somewhere. Was your base a website that you had.
Kelley D. Carlstrom, PharmD: I had a website that I built myself. So it was pretty interesting. And the initial, the initial kind of several months of that was a fascinating rabbit hole learning journey for me about how to do an email list, how to make money. I didn't know how to take money from people. You're not going to send me a check in the mail.
I got to figure out what Stripe was, how to hook that up to my website. How to get people to know about my course. So that was a fascinating learning journey. And one of the reasons I am so interested in all the different business models that are out there, both in [00:26:00] pharmacy and outside, is because there's a lot of different ways you can sell products.
And I just went down one way. So I was listening
Mike Koelzer, Host: to a podcast the other day, and they were talking about how there's a few different levels of. Learning about stuff. And because he has some kind of a course, I forget what it was, not pharmacy, but one of the values of courses and uh, his teaching was that there's a ton of information out there, but.
People do in courses give them orders and give them kind of a purpose and people really want to pay for that application. I forget the words. I think it was an application. So there's a lot of information out there. There's the. Application, which is a course, I suppose the next level would be getting into like, you know, even a one-on-one thing, like specific for that person, this hodgepodge of information they've seen come at [00:27:00] them.
They're willing to pay for that straight narrow. And the trust that comes from that they're spending time on the right stuff. I guess
Kelley D. Carlstrom, PharmD: that word is curation. And you've exactly described my business model. So there is a ton of information in oncology out there for free online. Anybody can learn oncology.
All their learning has been democratized over the past couple decades. Right. We used to have to go to the library. We used to use encyclopedias. Now everything is at your fingertips. That is also the problem with oncology because it's so thick. There's so much nuance. So. My program curates that I go out and find all of the great information and I weave it into a story.
So you don't just get the breast cancer guidelines you get. This guideline was first approved in this year, and then it got updated the following [00:28:00] year because these two studies came out. Then it got updated again. I learned really well by understanding the story of how we got to now. So that's, that's what you don't get when you're searching on Google breast cancer.
Mike Koelzer, Host: You see, did they need anything else? For example, they might have thought they were looking for something, but you could tell they were really looking for something else. Was there anything missing that they didn't even know they were missing? I
Kelley D. Carlstrom, PharmD: I think people have the assumption that if they just read enough or they just get through X training material, that it will click and they'll understand it.
And they will be confident in making a recommendation to a doctor. But oncology is more challenging than that because it's so complicated. Maybe 20 years ago when we had a lot fewer drugs, it was a little easier to wrap your head around. We didn't know all the things we know right now about cancer and the genetic components.
I did a, um, a LinkedIn poll probably a couple months ago about, I asked people, [00:29:00] how long did it take you to feel comfortable? In oncology pharmacy. And I had options of like less than a year, one to three years, and then a couple other ones. And I got a couple people that responded less than one year. So immediately I threw them out.
I'm like, okay, come back to me. I'm going to ask you this in six months again, because I think that initial freshness of being an oncologist, you're like, oh yeah, I just need to get through all this material and it'll click and I'll be good. And then kind of a year and you're like, man, I still don't feel like I know how much
Mike Koelzer, Host: they don't know
Kelley D. Carlstrom, PharmD: what they don't know.
They don't know what they don't know. And what's interesting is I, as the pole creator, I can see who answered what, and the people that picked, you know, the highest thing, which I think was four plus years or five plus. They are super smart pharmacists and they recognize, man, it took me years to kind of build up this knowledge, build up these experiences, build up my network of people that I'm around, [00:30:00] that can help filter in information.
This is a career path. Like you're not learning oncology to get a job for this year. And then you're going to go pivot and work in, you know, some other disease. Oncology is. You're going to learn it and you're going to continue learning it for the rest of your career, but it will support you in the rest of your career because there are so many opportunities, like I mentioned in oncology, pharmacy positions are only growing, not shrinking.
Mike Koelzer, Host: You talk about people kind of chasing you down after they've experienced or maybe been offered a spot. Is it too big of a jump for someone to come in? Who let's say lost their job? With a CVS closing or something like that, is it too big of a stretch for someone to come in and think that learning it behind the scenes and maybe even getting the beat cop is going to get them into this whole new, you know, quote like profession.
I mean, it's so different from what they've been used to. Is that too big of a leap [00:31:00] for a, let's say a mid 40 year old guy. It
Kelley D. Carlstrom, PharmD: is. I will, I will not sugarcoat. It's challenging to come from brand new, no oncology experience into oncology for a couple reasons. One is that when you are looking for a job in oncology, the employer needs you to do the job one day.
Yes, they'll give you some training materials. They'll kind of teach you the EMR, the system there, but you're going to start getting orders for chemotherapy, and you're going to need to know what to do with them to make sure that you're giving patients, um, that you're appropriately, you know, keeping safety and efficacy in that.
But with that said, I believe that any pharmacist can learn oncology if they have the right support to do it and the right motivation. Cause again, this is not an overnight thing. This is a long-term commitment to learn oncology.
Mike Koelzer, Host: What trait do you see in a pharmacist that even if they have all this information, they may [00:32:00] not be good.
And we'll say it in oncology, but even in moving up the ladder of let's say business, what trait of a person. Do you think they hold them back?
Kelley D. Carlstrom, PharmD: I think it has to do with expectations. How do you see this trajectory going in your career? Pharmacists, myself included. We don't like to feel that we don't know what we're doing.
We don't like to feel uncomfortable and you're going to feel uncomfortable in oncology for a while. There's too much information. Nobody knows everything. Even the smartest oncology pharmacists out there, they'll tell you, oh, I'm an expert in AML or acute leukemias, but I don't know anything about breast cancer.
So having on unrealistic expectations of what you can achieve in a certain timeframe, how does that hold
Mike Koelzer, Host: them back? It brings them down.
Kelley D. Carlstrom, PharmD: It gets people frustrated that they haven't. Learn fast enough that they think [00:33:00] it's, they think that they're not smart enough to learn it. Like, oh, I didn't grasp this.
Right. Yeah. I'm definitely not the smartest oncology pharmacist. Like I think it's important that you're in an
Mike Koelzer, Host: arm that
Kelley D. Carlstrom, PharmD: it's important that you're in the room with smart people. When you surround yourself with other people, whether that's conferences, whether that's the team that you work with, you learn a little bit through osmosis, honestly, you know, that's not exactly how we learn, but when you're surrounding yourself with other people, Are on the same path as you, that could answer a question or we'll give you a different perspective.
This is so true in life. In general, not just oncology. I have found this in groups that I'm a part of, you know, somebody could just say something a different way and it clicks that day and it kind of puts pieces together. And that propels you to say, oh, okay, maybe I'm just missing this piece. And this other thing, that's not clear to me.
So, so being open to. The [00:34:00] journey. I say a lot. Oncology has a journey where we're running a never ending marathon here. You're not in a sprint.
Mike Koelzer, Host: Has this been the first time with your going to associate things that you've been known as Kelly C pharm D in other words, where you are an obscure closet, extroverted pharmacist before COVID and now all of a sudden here comes cancer.
Kelly. Walking through the halls of the pharmacy conventions. Okay. I'm
Kelley D. Carlstrom, PharmD: not going to put cancer Kelly on my business cards, Mike.
Mike Koelzer, Host: All right, Kelly. Here's some advice you could put on there as that, but don't do the whole cancer with a K thing. If anything, switch your first name to a C. I'm not sure if there's Kelly's with a C, but don't do the whole cancer K thing.
Then you're going to get into the whole hair cut [00:35:00] thing. You know, hair today is gone tomorrow. And every time you go to a damn barbershop, y'all got some cute name like that, but we don't need cancer with a K don't do
Kelley D. Carlstrom, PharmD: it. No, we don't.
Mike Koelzer, Host: All right. But. Since you've had cancer. Kelly, is this the first time you've been in front of people at this last convention?
Kelley D. Carlstrom, PharmD: pretty active on LinkedIn for years before? COVID no, but in person,
Mike Koelzer, Host: um, or have you not been, have you been to a convention yet? So
Kelley D. Carlstrom, PharmD: we, oh, let me think. What did you go to APHL or anything or? I did not go to APJ. I went to, uh, an oncology specific one last week and there's one coming up. How was it in person?
Mike Koelzer, Host: Fantastic. Did people get it?
Kelley D. Carlstrom, PharmD: Uh, I did get a couple selfies. Yes. So interesting. I sat down at a session and the lady next to me, about 20 minutes in, leans over and says, are you Kelly Carlstrom? And I said, yes. And she said, I know you're from LinkedIn. Isn't that fun? And it was pretty fun.
Mike Koelzer, Host: My wife and I, when I would try to get on local [00:36:00] TV, this is years ago, you know, when I was trying to promote my local pharmacy, we went through our online at the grocery store and some person looked up at me and said, I think I know you from somewhere.
And I said, well, I'm on TV a little bit. And anyways, I had actually just seen the guy the day before, when I went in and bought a six pack.
But why not use it as a time to promote myself in front of my wife? You're a famous mic. Yes. Yes. But that's kind of cool. Isn't it?
Kelley D. Carlstrom, PharmD: Cool. Let's knit. It is very cool. I love connecting with people on LinkedIn and.
Mike Koelzer, Host: It's cool to be recognized. You weren't recognized because they said, Hey, I came across you on LinkedIn.
You were Kelly. See from LinkedIn. You see what I'm saying? Yes.
Kelley D. Carlstrom, PharmD: But it is hard to, I mean, I do post a lot on LinkedIn too, so people may think. Always go to my website [00:37:00] or know exactly what my business is. So I'm out
Mike Koelzer, Host: there. She recognized you because you had packaged yourself. What'd you call it? Not just packaging.
What'd you call that application? What was the word we used curation? Yes. She recognized you because you not only had your own business. Not only did you curate this, but you curated. This is like a mythological larger than life. Pharmacist's kind of thing. How else can I put it? You're famous.
Kelley D. Carlstrom, PharmD: Yes. And a lot of people are not posting regularly on LinkedIn.
So those of us that do, I get a lot of traction from that because my face is out there a lot.
Mike Koelzer, Host: Why aren't people posting? Where do you think LinkedIn is now with pharmacists? Is it young? Is. Middle-age as far as pharmacists adopting it, where's that all going?
Kelley D. Carlstrom, PharmD: It gets a hodgepodge. I've seen older pharmacists.
I've seen younger pharmacists there, but I see plenty of people that aren't there [00:38:00] yet. That's what I'm getting at. And let me tell you, I get multiple job opportunities through LinkedIn, the job I'm in now, my day job I've got through LinkedIn. They created a job for me because of my presence on LinkedIn.
So I think there's a lot of opportunity to get, see. And to be seen and to see others when you're on LinkedIn, but we're afraid. I think, and I was initially too, of how much we should say, what should we put out there? What should we talk about? And that goes to that, that piece, about being comfortable in your experience, kind of sinking into what you know, and what you should talk to.
When I first created my business, I was super nervous about being out there kind of more in the public eye. And I had to figure that out. I had to get over it and recognize that my experience is valuable to some people, it's not valuable to everybody. So those people that don't find value in. Won't pay [00:39:00] attention to me, but the ones that do will send me a nice message sometimes that says, Hey, I really appreciate you posting that.
Or they'll lurk on LinkedIn for a year plus, and then send me a message that says I've been following you for a year. And I just thought, I'd say I'd send a message and say, hello. I do get quite a few of those online
Mike Koelzer, Host: selfie
Kelley D. Carlstrom, PharmD: or people at these conferences. You know, when people interact with me on LinkedIn, I start to recognize their name through the notification tab.
And if they don't like or comment on any of my posts, I don't know who they are. They're lurking
Mike Koelzer, Host: there. Lurking.
Kelley D. Carlstrom, PharmD: Yeah. So one great takeaway for pharmacists listening to this, even if you're not posting content yet on LinkedIn and you should in the future, at least what you should be doing is interacting with other people's posts.
So your name comes up in Mike and mine notification channel. We start to recognize your name. What are we afraid
Mike Koelzer, Host: of?
Kelley D. Carlstrom, PharmD: Image looking [00:40:00] badly saying the wrong thing. We're very risk averse in our profession.
Mike Koelzer, Host: They're not afraid of saying something stupid. That's going to hurt them financially or hurt them in their job search.
You're talking more of an identity issue of saying something that just makes them look bad from the inside
Kelley D. Carlstrom, PharmD: out. Maybe they're concerned about saying something that could impact their job or their potential future job, because LinkedIn is a professional platform, but. I'll tell you, I think it's the opposite.
The more you're out there, kind of sharing your ideas and your perspective on things. The more you're going to get noticed, because very few of LinkedIn users, LinkedIn has hundreds of millions of users. Very few of them post regularly. So you doing that already puts you above so many other people.
Mike Koelzer, Host: Social media in general, every company goes through their timing where you have a lot of early influences. And there's not enough content on there. [00:41:00] Early Facebook posts would get hundreds and hundreds of likes because there was not enough content, too many lurkers out there. Then it goes through a switch at some point where there's more people start to post.
And then pretty soon that kind of flip-flops and you have a lot of people posting, but maybe some of the people that. We're getting a lot of the attention now and have already gone into something else. So it's kind of Peters out on LinkedIn, you got a big audience with not a lot of pollsters yet, so there's still a lot of attention there.
Pretty soon people will start getting comfortable and you'll have more content. And maybe not as many people watching. I question though, where is the next. LinkedIn and social, I mean, you know, it's Facebook and then Instagram and then Snapchat and then tic TAC, it's going to be on something else pretty soon.
As soon as some of us old farts start going on to take TOK, it's going to go to something else. What do you think the next LinkedIn is going to be?
Kelley D. Carlstrom, PharmD: I think [00:42:00] LinkedIn is going to be around for a while. Because it's so different from the other platforms. They have longer form co I mean, I can't put my posts on Twitter.
I hardly ever tweet because. You got
Mike Koelzer, Host: concise? I don't know. The once I start posting my cat pictures,
Kelley D. Carlstrom, PharmD: there's not a lot of cat pictures on LinkedIn, but I'll tell you a tip that most people don't realize is, you know, I get a lot of people that ask me, well, LinkedIn's boring. Like I don't want to hang out there because there's not a lot going on.
And it's to your point that in their feed on their homepage, they're not seeing stuff that's engaging to them. And the reason they're not seeing that stuff is because their network has a hundred people in it. And they're only seeing. Those hundred people and they probably connected with their local dry cleaner, or their mother.
And you need to connect with people that are doing things that you're interested in. So if you're interested in oncology pharmacy, please connect with. If you're interested in the business of pharmacy connect with Mike, and then you'll start seeing our posts in your feed. And that then you'll, you'll see [00:43:00] people that comment on mine, or like my posts.
You can go connect with them. See what they're saying? You start building out that network so you can see reality. I mean, my feed is amazing. I have so much. Awesome stuff I want to read. I don't have enough hours in the day.
Mike Koelzer, Host: Kelly. I'm not a social media. Purists will say certain things should be on there, but LinkedIn.
And more power to them, but it's going to start turning into and they wanted that. They want it to be more social, you know? So they want you to start posting more personal lists. That's still business, but it's going to start coming with the cat pictures, you know, and pictures of people, you know, 12 year old daughters winning cheer camp or something like this.
And it always starts with an apology. It's like, I know I'm not supposed to put this on LinkedIn, but this is a real special thing, you know, and it's going to start creeping in. So eventually. There's going to be somebody that out businesses. LinkedIn. I don't know where it's going to come from. It will come.
Just say, people didn't think Facebook was going to go away or whatever, but it [00:44:00] will come.
Kelley D. Carlstrom, PharmD: Uh, what matters is relationships? And so LinkedIn will, will tell you that I'm sure I'm not. You know, in the know with LinkedIn's kind of future plans, but they want you to develop actual relationships and not just kind of have Twitter followers or Instagram followers.
So I think that they, that's why they like the longer form content, whether it's the new newsletters that are out or the articles they favor video, because video helps make those connections. So having, having, like making comments on people's posts are really important. And that's why I enjoy having longer form posts, because I want to help get my thought process out there instead of just kind of a one-liner
Mike Koelzer, Host: the whole world of longer form content, whether it being LinkedIn or blog posts or podcasts or something it's like through the years.
When I used to try to get noticed locally, instead of [00:45:00] just because of my beer purchases the night before, when I really tried to get noticed for the business, you had to pick one side or the other, you know, you got like 15 seconds to make a comment on the news. It had to be positive or it had to be negative.
It was basically Twitter back then. But that's not how life is, you know, it's this longer form. It's getting to know issues from the front and back and just longer stuff. And LinkedIn does a good job of that. You yourself on LinkedIn, you may have done longer posts. Have you done it? Articles or newsletters.
There's now a new subscription thing to it. What have you personally done for your business on LinkedIn?
Kelley D. Carlstrom, PharmD: I have not done the LinkedIn newsletter yet. I do have an email newsletter that I email
Mike Koelzer, Host: out to. You should put it on there then, because I saw it like a month or so ago. I was there looking around.
It's probably before this, but I just came across it. People can sign up for your newsletter on it, not just signing up for you as a follower, but for the actual news.
Kelley D. Carlstrom, PharmD: So I haven't done that yet. I have written some articles in the past on LinkedIn, but, [00:46:00] um, most of my articles live on my website and there's a couple of reasons for that.
One has to do with SEO and having my website show up in Google search. So I have a couple blog posts that I've written that are particularly helpful when people are searching for learn oncology
Mike Koelzer, Host: where you're not going to suffer from putting that on LinkedIn.
Kelley D. Carlstrom, PharmD: No, I could, I could do it in addition to, and I think I have one.
That is cross posted, but not all of them. Blog
Mike Koelzer, Host: posts and podcasts for that matter. It's kind of a black box. It's like you go there, people comment in podcasts, you can't even comment. So social is so important for that. So yeah, you got to bring those articles into there and you got to believe that I know there's SEO with your articles online, but you got to believe.
SEO poking around inside of the articles on LinkedIn to
Kelley D. Carlstrom, PharmD: link your LinkedIn profile. Definitely. SCO with it. If you [00:47:00] Google my name, my LinkedIn profile will be one of the first things that show up. So that alone is a good reason. If you're not on LinkedIn, create a profile because if you're applying for a job or doing anything professionally, somebody's going to Google you and you want, whatever is out there, you want your LinkedIn posts or profile to be front and center.
Mike Koelzer, Host: I was just listening to podcasts this morning. It was Tim Ferriss talking about podcasting. Who he was conversing with, but he was saying one of the ways that he gets a hold of top Hollywood people for his podcast. And I know our listeners aren't trying to go to Hollywood podcasts, but they might be trying to get the attention of maybe an administrator at a hospital or an insurance company or something like that.
But he says his method is to follow people on Twitter for at least a few days. Comment for a few days, hit them up probably 10 times in a few days, they don't know they're being hit up, but just the little light here and this and that. [00:48:00] But as soon as they follow you, which they normally do once they do that, then you can come in through the back door with a DM through their Twitter, which you can't do unless they follow you.
Instagram was just asking for trouble. I think they allowed their Instagram DMS for, I think they still do without you having to have any connection with them, that just asking for. Too much onto people, I
Kelley D. Carlstrom, PharmD: guess. So that's an interesting take from him. I would disagree for a couple reasons. One is I get a lot of those messages on LinkedIn when somebody connects with me and I accept, and I immediately get a sales message that even, even if you interact with my stuff for a week, and then I get a sales message.
So, uh, there's a really good book that came out a couple of months ago by Dorie Clark called the long game. I would definitely recommend it. It's a good professional development book. And there, she makes the recommendation that when you network and make a connection with someone [00:49:00] that you do not make an ask for a year, a year, sounds like a long time and it is, but the point is.
You want to build a relationship with somebody before you ask for anything, because you're much more likely to get somewhere. Those people that Tim Ferris is messaging may be getting back to him because he's Tim Ferris. But if that was, you know, um, Sally Jane pharmacists, trying to make a connection to a director of pharmacy or somewhere that she really wants to work, I think that can leave a bad taste in people's mouth.
Asking for something before you have built any rapport or build a relationship,
Mike Koelzer, Host: As I think more about it, he was talking more about how to possibly break through to an elite person when they've. Staff trying to keep people away from ya.
Kelley D. Carlstrom, PharmD: So Mike it's like a pharmacist trying to reach out to you.
Mike Koelzer, Host: I'm an easy sell.
I'm an [00:50:00] easy sell. You came on the show, but I, you know what, I think it was a year though, before you came on here. So maybe I asked you two soon to be on. I think I asked you at hello, you were playing hard to get, you're playing podcasts hard to get for a year.
Kelley D. Carlstrom, PharmD: Well, I had a lot going on when you first reached out to
Mike Koelzer, Host: me, but I don't consider my podcast.
Ask. I mean, it's kind of a mutual thing for people. Yeah.
Kelley D. Carlstrom, PharmD: This is a casual conversation, but I think the, the, the underlying rule here that I have learned over the past couple of years and how my professional journey has moved is you have to provide value. And wherever that lives. So if you're, if you really want to make a connection on LinkedIn to somebody, bring them something of value.
Now you may not know exactly what that is, but maybe it's okay. You've got, you know, like you're connecting with me and you know that I love talking about oncology pharmacy and you came across another post [00:51:00] that talks about oncology and you tag me in that post, like, oh, that was. You're paying attention to what I'm interested in and that shows whatever value you can bring, whether it's sharing a blog post or sharing.
Oh, I saw this interesting article that I think aligns with what you talk about on LinkedIn. Those all go a long way.
Mike Koelzer, Host: Using me as an example, if I may have the importance of not asking, I've had 150 episodes and three years of giving. Giving giving. And one of my followers, I guess, today, she said, I dunno what your end game is, but thanks for what you're doing.
And I said, it's a secret. And the secret is, I don't know what it is. So I don't know myself. It's a secret to me, but I know to mark what you're saying, it's the importance of giving in. You're building up a giving bank account who knows when you'll need it. Absolutely.
Kelley D. Carlstrom, PharmD: And maybe there's not any end game at the end of that, because you can just give value to [00:52:00] give value.
Mike Koelzer, Host: I'll find a way to get something out of it. I just want to look good in front of my wife.
Kelley D. Carlstrom, PharmD: We're in it for the long game, especially in oncology pharmacy. It is a long game.
Mike Koelzer, Host: What's going to be cool for you in like 10 years. So you're 29 now I'm
Kelley D. Carlstrom, PharmD: 29
Mike Koelzer, Host: and 39, 10 years from now. What are you going to be doing?
Is this business bug inside of you? That pharmacy can kiss it. Where are you in 10 years with this business? Kelly sees a phenomenon.
Kelley D. Carlstrom, PharmD: The business bug has definitely bit me. I love it. All of the puzzle pieces that our business, you know, that has been very eye opening to me. It's an interesting journey to try to piece together and fit together all the different pieces to run an actual business, to make, to run a profitable business.
So that's definitely not going away what exactly my [00:53:00] programs and my offers will look like in 10 years. I'm not really sure. But I do love, I mean, they're definitely pharmacy related. They're definitely an oncology pharmacy. This is my wheelhouse that I will be sticking with, but I also love the ability to have my hands in the kind of proverbial pie that's out there with oncology pharmacy, you know, whether that is doing consulting to kind of.
New companies get a project off the ground, whether it is, um, you know, working with schools or individual departments on a short term project based, I have found in the past couple of years that I, when I, I did some consulting for a couple of years and I re I recognized at that time that I really love project based.
Right. There's something that has a start and an end, and you're kind of figuring it out in the middle. You're putting that puzzle together. And then at the end you kind of find the next project. So I think that's something good to think about when you're, when you're in your professional journeys. Like what, [00:54:00] what lights you up, what motivates you?
What is interesting to you? And that vernacular wasn't in my brain before, but now that I know that that helps me think into the future of, oh, I could do short term consulting projects too. Uh, company and organization, get a project off the ground and then move on to something else. And you kind of get the best of both worlds in my mind.
Cause you get to see a lot of cool stuff.
Mike Koelzer, Host: The whole school system for better, for worse, it was project-based exams. It was quarters, semesters, you know, seasons. It was kind of marking that and now people it's just like, all right, you're 25 have fun for the next 40 years. See how on the other side?
Kelley D. Carlstrom, PharmD: Yeah.
There's something to projects. There is something to projects. Yeah. And it gives you that ability to feel accomplished. Like I did a thing, I pulled this thing over the finish line.
Mike Koelzer, Host: Let's say that somebody said that for whatever reason, you couldn't be in pharmacy [00:55:00] for whatever reason, where could you find that love in the business sector?
If it wasn't a pharmacy?
Kelley D. Carlstrom, PharmD: I think the. The connecting trail of what I really find enjoyment in. And the work that I do is helping people realize potential, helping them kind of overcome that negative self-talk we all have in our head, like I'm not smart enough to do this or learn this. Somebody else could do this much better than me.
You know, getting through that so that that's a human condition. Right? I feel like I could do that at my local orange theory and help people kind of move past whatever barriers they have. What's orange theory? It's an exercise business where you go and you just show up and they tell you what to do.
It's a chain. You run this. No, no, no. I just go to it. I go to exercise there or I'm sorry. It's great. Either. There's a treadmill, a row. Uh, wait [00:56:00] floor and you just show up and they tell you exactly what exercises to do.
Mike Koelzer, Host: Oh, it's kind of like exercise of the day, like CrossFit. It's kind of like CrossFit,
Kelley D. Carlstrom, PharmD: I think.
So. I think they yell a lot more at CrossFit, but I haven't been, so I'm not a hundred percent sure. Wait
Mike Koelzer, Host: a minute. Now that explains it. I was online last night. And the guy said something like this is my orange crush or my orange drink is that this orange thing?
Kelley D. Carlstrom, PharmD: I don't think so. They call it the orange theory.
It has to do with your heart rates, like when you're in the orange zone of your heart rate, that's when you like have the best benefit,
Mike Koelzer, Host: because I don't want to ask too much about the orange. Number eight is enough. You're not old enough for that. Eight is enough. Remember that, but the van pattens or whatever
Kelley D. Carlstrom, PharmD: their name is now you can tell I'm not 29.
Mike Koelzer, Host: Wow. There just reruns Elizabeth was on. And she was a long brunette. She was like 16. And [00:57:00] she went on this thing called the pill. And I asked my family, "Are you sitting around?" I'm like what pill? And they were like the pill. I'm like, I didn't know if there's, I don't know if there's a pill, as far as I know my dad and his pharmacy had shelves and shelves of different pills and I never got it.
Anyways, when the orange crush thing was on there, I didn't want to ask too much about it because I thought maybe it's some, you know, pill kind of thing. Not a medicine, but in that genre of me, you know, and I thought I'm not going to ask anybody. I could have gone in line, but then it wasn't that important to me.
But I think it has to do with your orange. What is it called? Orange.
Kelley D. Carlstrom, PharmD: Why orange theory? I'm not sure about this orange crush thing. You're going to have to school me on that. When you look it up,
Mike Koelzer, Host: I'm not going to look it up.
This business is called orange theory.
Kelley D. Carlstrom, PharmD: Yes, it actually, it's funny because it, I, this came to me six months ago or so. I see a lot of analogies with orange theory in my [00:58:00] business because orange theory, like I don't have. Kind of sort through the internet of oncology information. I don't have to sort through all the fitness exercises.
How much should I do on the treadmill? What weight lifting should I do? I just show up to people that are experts. I walk in the door, I come prepared to bring sneakers and water and I'm like ready to do the work, but they instruct me. They tell me where to go. And they put me on the rower, but I still need to strap in my feet and start to row.
I got to do the thing. And so I see a lot of analogies like that to my program. It's hard work. You have to sweat a lot in orange theory, but you're getting that curation, the fitness experts are there to curate the exercises for you. So you can take that piece out and just focus on the word.
Mike Koelzer, Host: Hey, if I see you in person, I'm going to get a selfie with you.
Is it a selfie with two people?
Kelley D. Carlstrom, PharmD: Yeah. Cause we're taking it ourselves. I think [00:59:00] you can take a selfie with multiple people.
Mike Koelzer, Host: I better learn that before I ever go to someplace and somebody says, you know, talk about a selfie or something. I would just like to hand on my phone and say, yeah, take a picture of yourself.
Kelley D. Carlstrom, PharmD: I would love to take a selfie with you, Mike
Mike Koelzer, Host: Kelly. Thanks again. We'll talk soon. All right. Thanks. Bye.