How Empathy At Scale Drives Bottom Line Results & Patient Outcomes

It doesn’t take an industry expert to understand there’s something wrong with healthcare and pharmacy benefits today. Most of us have an anecdote of how the healthcare system has failed or confused us in some way. To fix it, we need people, and companies, who understand how to lead through the complexity with empathy.

Drivers for this change can come from some of the most unexpected places. When I made the pivot into the pharmacy space several years ago, I felt unsure that my skills from the hospitality industry could translate. After a grueling round of interviews, a speciality pharmacy organization offered me a chance to lead operations—and I was candid about my reservations. The response was surprising: “Joy, I need someone who can run the business, and I will teach you the pharmacy part.”

Through that experience, I was able to apply my passion to serve people to their healthcare experiences and make a profound impact. I also learned  that the key to fixing it doesn’t rely on supporting the same broken systems and procedures. We need forward thinking, empathetic people to lead the charge for a more sustainable healthcare future.

Legacy Pharmacy: Bad for Patients and Business

My first few years in pharmacy were categorized by a whirlwind of disruption. Nine months after I joined the specialty pharmacy, it was purchased by a distribution company, then sold to a larger distribution conglomerate, and then eventually spun off to a national pharmacy company. Though I “survived” each of these transitions and was kept on for my success in running the business, I knew that my values and priorities were not aligned with the new company’s ethos.

Working on the pharmacy side, I saw how detrimental the day-to-day mechanics of our broken healthcare system are up close. I dealt first-hand with the predatory practices of legacy healthcare players—especially the legacy pharmacy benefit managers (PBMs).

• Low Reimbursement & Financial Pressure: Legacy PBMs, leveraging their hold on the market, would dictate reimbursement rates that often fell below the cost of the drug itself, not accounting for labor or overhead. Independent pharmacies were losing money hand over first on every script dispensed. 

• Vertical Integration Manipulation: I witnessed instances where legacy PBMs, who owned their own pharmacies, would actively steer patients away from independent pharmacies to their own pharmacy assets—a practice that drove revenue for them and directly undermined patient choice and fair competition (which in turn, drove costs for patients and their employers). 

• Prioritizing Rebates Over Patient Cost: I was forced to dispense the brand-name version of drugs when generics became available, not because of medical necessity, but because the legacy PBM was receiving a rebate on the brand. This led patients to pay higher out-of-pocket costs when a cheaper, equally effective option was on the market.

Personally, I had an experience with the healthcare system that hit incredibly close to home. When my daughter suffered a severe concussion while playing competitive soccer, her recovery was extremely arduous and frustrating. Even with my industry knowledge and connections, navigating the complex healthcare maze was nearly impossible. We ended up seeking out and paying cash for alternative, non-covered treatment because the system failed to connect the dots. I realized that if someone in the industry struggled to use the system, we couldn’t possibly expect patients—often at the most vulnerable point in their lives—to self-serve.

Changing My Perspective on PBMs

My time in specialty pharmacy space fundamentally shaped my perspective on PBMs—and not in a positive light. I spent years on the receiving end of what the industry called the PBM "dark side," constantly battling aggressively low reimbursement, the strong-arm tactics of vertical integration, and what I saw as an unethical practice of forcing patients onto costly brand-name drugs for rebate capture. 

I swore I’d never work for a PBM. That stance was challenged, however, after a patient escalation led to an interaction with Jake Frenz, SmithRx’s CEO. Unlike the legacy PBMs, SmithRx’s commitment to a transparent, non-integrated model was compelling. Convinced that this company was serious about creating a PBM that actually served clients and members first, I shifted my perspective from adversary to advocate, realizing I could leverage my deep operational and service background to help build the ethical, patient-centric PBM the industry desperately needed.

I was excited to be able to leverage my experience with contentious, high-stakes roles and leading with empathy to SmithRx. I’ve been able to build a team that treats every member that calls in like they’re family—and reshape the patient’s experience with their PBM for the better.

Empathy Doesn’t Limit Business, It Boosts It

The common narrative is that “doing good” comes at the expense of making money. That narrative is certainly leveraged by many players in the industry to cut corners and short-change businesses and patients. My experience proves the inverse: exceptional service and ethical business practices have an undeniable return on investment. This positive ROI is not just in goodwill, but in patient loyalty, adherence, and ultimately, better health outcomes that can mean fewer plan expenses in the long-term. 

Empathy is baked into our processes at SmithRx. It manifests itself in an integral focus on the member experience: we optimize for the shortest wait times, lowest member effort, and 5-star service. Our team is trained to always put themselves in the member’s shoes, which means we have an entire organization that is aligned on delivering truly empathetic service.

Putting empathy at the heart of what we do at SmithRx has led to amazing results for clients and members alike. To think of one example, a member contacted us on behalf of her husband who was undergoing cancer treatment and unexpectedly needed a blood thinner, which carried an out-of-pocket cost of $500. His wife called our Member Services team in tears, unable to afford the critical medication.

Our agent, listening actively and empathetically, immediately identified that the patient was eligible for a copay card. The agent enrolled the patient, called the pharmacy, and by the time the wife hung up on the phone, her out-of-pocket cost for the life-saving medication was $0. 

This wasn’t just a feel-good moment. It was a business outcome.

• Patient Adherence: The patient received the critical drug they needed right away, ensuring adherence to the new treatment plan.

• Improved Health Outcomes: The medication helped manage a clotting issue, preventing a potentially disastrous health event. 

• Plan Value: The member and plan sponsor saw the direct, immediate value of the program.

When you can turn a moment of distress into a tears-of-joy experience, you aren’t just providing service—you are actively participating in a patient’s journey to getting healthy. 

I joined SmithRx because I was so thrilled to know that there are PBMs out there who don’t believe in being vertically integrated or playing the rebate margin game to be successful. By maintaining an unconflicted, transparent model, we’re disrupting the pharmacy benefits space. I’m proud to say that we’re committed to being ethical, fiscally responsible, and—most importantly—deeply empathetic to the clients and members we serve.

I’ll be regularly bringing my perspective to the SmithRx blog, so stay tuned for more on the blog home page. If you have any questions about my role, my team, or what makes the way we execute service at Smith so different, please connect with me on LinkedIn and reach out.