Darshan
Hey everyone, welcome to the DarshanTalks podcast. I'm your host Darshan Kulkarni. It's my mission to help you test the products you depend on. As you can see, I'm in a new location. I'm actually at someone's house. So I apologize that this looks different. But I have to imagine it's a little bit of an upgrade. As you know, I'm an attorney. I'm a pharmacist and I advise companies with FDA regulated products. If you think about drugs, wonder about devices, consider cannabis or obsessive pharmacy. This is a live stream for you. I have to say I'm an attorney. But this is not legal advice. Both my guests and I are both pharmacists. It's not clinical advice. I do these live streams because this is my love letter to the life sciences. And because it's a lot of fun, because I find myself learning something new each time. So it'd be nice to know someone listening. If you like what you hear, please like, leave a comment, please subscribe. And if people hear. Here's something that other people like to hear, please share. We'd also love for you to actually ask questions while we're talking. So if you if you want to find me, please reach out to me on twitter at Darshan tops, or just go to our website DarshanTalks calm. Our guest today. I'm actually really, really excited about our guest today. And I hope I've done justice in in marketing, who I think is is someone that that I can't believe I'm actually talking to. She is the president of the American Pharmacists Association and growing up, and I'm sure she did this as well. But in pharmacy school, we heard so much about HGH. And we we sort of were always impressed by it. So to actually talk to the President. I mean, I'm really, really excited. So if you are in health in the life sciences, if you're a pharmacist, you probably care about today's discussion, because this, these are the issues that we care about as pharmacists, so this should be a lot of fun. Our guest today, like I said, is the President of the American Pharmacists Association. She is on the current board of directors for the National Center for farmworker health, she had several other things that I pulled out because she is in the middle of changing roles. And she is, in her words, looking to also to continually change the scope and to have a bigger impact. So I'm really excited to discover more about what that looks like. So, ladies and gentlemen, our guest today, Dr. Sandra Leal, Hawaii Sandra,
Sandra
I'm doing well thank you for the invitation to join you this morning or afternoon wherever you're at. It's it's Yeah, it's been a wonderful week. Your whole career I have when you mentioned earlier body PHA? Yeah, it's interesting, because it's one of the things that I never thought I would do in my career is to be president of a PHA. So it's definitely a very incredible experience that I'm having this year doing that, especially during this pandemic, which you know, pharmacists are playing a significant role in, in overcoming this pandemic. So I'm happy to be here representing that.
Darshan
We already have people jumping in we have Dr. Sir, our to going love a PHA. So this is going to be awesome. So so thank you for joining us. So let's ask the basic question, Sandra, how did you even get involved with a PhD? How does someone who's who's a student today, going, I want to make a difference? That's why I went to school. That's why I became a pharmacist. How do I become a leader like Sandra?
Sandra
Yeah, well, I think that, you know, everybody should stay engaged after the graduate definitely during their student years with a professional organization, and I love a PHA because it does represent all pharmacy. And so to me, that's the umbrella organization for everything pharmacy, it's at, you know, it's in the mall and the US Capitol. And so there's a proximity to policymakers and they really try to influence positive changes for pharmacy and pharmacists. So can't encourage that anymore. The way I became involved was a little bit less traditional, but there's the the the traditional paths are becoming a student member joining the student organization and there's a lot of incredible activity happening in student chapters. So generation Rx, for example, there's screenings for different disease states conditions where the students get engaged and actively participate and show the public you know, what pharmacists can do. And so it's, it's really building that, that portfolio early on in your career, there's a new practitioner group, so after you finish pharmacy school that you can continue tracking in with and then there's the obviously when you're practicing as a pharmacist, joining a PHA to continue your your involvement. There's a lot of positive things about being a member. See that's available like this year, for example, I've been hosting a webinar every essentially every two weeks, talking about COVID related information, late breaking news, anything related to new guidelines, any resource clinical pearls that would be very important for pharmacists to have immediate availability and access to that. And so like, for example, this Thursday, I'll be holding one where it talks about vaccine confidence hesitancy and actually in the Hispanic population with the National Center for farmworker health. But there's different section interest groups, I just want to quickly mention this where you can get involved. And so section interest groups allow an opportunity for pharmacists to join because there is some sort of connection with other pharmacists. It could be public health, it could be care for the underserved, it could be accountable care organizations, and then through that there's leadership opportunities to be like the section lead. hold an office where you can then move up and then hopefully, at some point, join the board and then run for president like what happened.
Darshan
So that's an interesting step. But you said run for president so so people voted for you, this was not a you're assigned, or you're sort of mixed up in line right there that?
Sandra
No, it's really interesting. It's essentially you join the board, you know of Trustees where you can actually be nominated to be president or you can self nominate to be president and then usually it's because of your relationship with organization being in the section interest groups, people knowing you through that professional organization, that then they vote for you because you represent them or you want them to represent you know, your your priority. So it was being selected to be slated as a candidate. And then I was a it was a vote, I was running a guest a different person. And then I was elected. But you know, a lot of the people that end up getting slated it is because they have been part of the organization for a while they've been part of groups, they've been participating people, you know, essentially know you and your impact, or whatever you're doing to advance the profession.
Darshan
So so we have to ask the obvious question, then you said, people vote because they agree with your priorities, what priorities that you have.
Sandra
For me, it's always been very much about caring for the medically underserved, I worked in a federally qualified health center for 14 years. So a lot of my work was around building practices that help patients who were experiencing health disparities. I also had a what I considered a niche in my practice trying to build a sustainable service model. So a lot of my platform was around pharmacists, providers, that is to recognize the pharmacist is eligible providers under Medicare Part B. And that's always been something that I push for, because it's always been a barrier to be able to do the work that I want to do not not that that stopped me from doing it. But it's obviously a barrier to being able to do it in a way that's easier, because that's what we've been trained to do. And fortunately, there's blocks that prevent us from doing it to the level that we need to. So So that was an area of interest. And then I personally had a practice in managing people with diabetes. And so the whole area of diabetes management, making sure people had excellent care in that and having the pharmacist be part of the care team for that was another area of interest and impact that I've had. So my platform this year for this current position has been to be the voice. And so that really means a lot of things. That means representing pharmacist, it's having a platform that, you know, advocates for us and our role in care. And then it's also the voice of people that are struggling and that are experiencing health disparities, social determinants of health that really put them at a disadvantage, and that put people in marginalized positions when we should really be advocating for people to have better health outcomes. And I know pharmacists play a big rule. And that being the case, you know, if they actually have pharmacists on the team,
Darshan
there's so many things to break out parents sounds like such an interesting thing. But but I'm gonna ask a couple of things that may not be the most popular, but I've always wondered about this since since I was a pharmacist, the big thing literally since I have been involved in first of all we have john is pointing this out. your priorities related to advocacy and awareness of health disparities, provided status and pharmacists involvement are all admirable thank you for what you do. So I actually have to agree with her with her that thank you for what you do. But I am going to question the idea of the provider status because that's been something we've been talking about literally since before I was in pharmacy school many years ago. And my question to you is, what do you think will change if we get provider status? Because it's been that battle for so long? Yes, we get reimbursed. But all I've heard ever has been Medicare and Medicaid, barely pay for anything. Doctors really don't like Medicare and Medicaid for payments and reimbursement. So there's more to the story. What do you think will change once we get it
Sandra
so well changes our ability to participate in programs and actually get credit for what we do. A lot of times we're contributing, we're doing the work, we're doing a lot of things to contribute and then we are not recognized, you know, for our services. So for example, everybody talked about How the Affordable Care Act or every you know affordable value based programs are going to change for pharmacists and make it easier. I do agree it's made it easier what is currently still the issue is that even for the value based programs, they still go back to the Social Security definition, and have pharmacists listed there as to whether or not they get some of the the the credit for some programs. So for example, one of the areas was meaningful use, you know, implementation of EHR documentation, all these things. Pharmacists were not listed, listed as one of the meaningful use providers, even though we contribute to Meaningful Use, we contribute to these things. So even in the value based picture, we still are not part of the definition to do that. Now I get it, people don't like Medicare, Medicaid, it doesn't pay whatever. But that's unfortunate that is, or fortunately, that is the standard, right? As much as you don't like it, it doesn't mean you you will walk away from it unless you're going to go and do a concierge practice. But then you're going to miss so many people and you're not going to impact the population as a whole, you're doing a boutique type of practice. Medicare sets, the standard Medicaid is the state standard, and then commercials and then it self insured employers, a lot of them follow that standard. And that's part of what we want to be we want to just be eligible providers, we're not asking for anything more, anything less, we want parody, or recognition. And until we get parody, it still creates barriers for us to be successfully part of what I considered what should be a standard of care. I've received Best Practices award for you know, the work that I do when I'm part of the team, I shouldn't be a best practice, it should be a standard practice. And it should be a standard of care for patients to actually have access to pharmacists in a meaningful way. Which means that they get to sit down with them, they get to review their meds, they get to identify problems and get problem resolution, because we know that does contribute to better health outcomes. And that should be what happens. And unfortunately, right now, that is not the case, it is a best practice is unique. It's all these, you know, lucky for you if you get to have that luxury. And
Darshan
so what I hear you saying and please correct me if I'm wrong with what I hear you saying is the fact is that right now, pharmacists aren't in every place that they could be. And what I hear you saying is that the provider status, will will cause pharmacists to be in more places. And that is where we can show the impact and we can show the value that pharmacists bring to the table.
Sandra
Absolutely. I have literally sat across the table from many chief financial officers from chief medical officers. And number one thing they get told us, well, pharmacists can't build, we're not eligible providers we're not. And so immediately that already puts a barrier for whether or not I can hire more FTS. Or say, well, we can do this with a nurse practitioner or a PA I'm like, but they don't bring the expertise of a pharmacist not to minimize their contributions. But because we have that entry block immediately that changes a conversation. So now I have to like work uphill to try to get them to see it show pilots demonstration. I'm like, oh my gosh. But that is the number one thing that comes back to us it comes back to us from from finance, it comes back to us from you know, audits and what we can and can't bill when you're trying to speak to your team, you know, the the block of not having that recognition immediately creates a barrier for more access to care.
Darshan
But what I'd like to explore a little bit more is this idea that we often compare ourselves to NPS and we compare ourselves to Aryans, which is fine. I mean, they're great professionals and PhDs and stuff like that. But what I keep reading and I'll admit, I'm reading this off of Reddit forum, so maybe this is not the most, this is not the best source of information. But MPs and MDs have a little bit of a TIFF going on in terms of our NPS encroaching on what is traditionally physician territory. If we position ourselves as another provider, are we now in another seat of P days NPS, etc. And we're now doing the same thing creating adversarial relationship with with physicians, what do you think that that's not what we'd be doing?
Sandra
So I think there's different approaches to that. A lot of times when we talk about what our role is, we do want to work in collaborative models, right? We're not necessarily trying to be independent prescribers. Not to say that that's not happening. I'm just saying that our position has been to be in collaboration with a team and work with a team together to decrease fragmented care. That is a problem right now we have so many people seeing different providers, different systems, you've got, you know, different access points. And there isn't a good way to maintain continuity with that communication. So when we speak about it, that's how we like to approach it as a collaborative model where we are discussing as a team, the best approach for the patient, and that does include other other ancillary groups that help support that. It's the concept of like a patient centered medical home, right? It's using promo code as a solution to go out into the community and reach people. We can't be everything for everybody. People don't always walk into the four walls of the pharmacy or the clinic, how do we then bridge into the community and do public health efforts to do that. So in my mind, when I think about how our role is, enhancing that team based approach and looking at those aspects that reach out into the community to reach people, then you can actually have a dialogue about how we can work together and not be in a turf issue around who's going to get what, in my mind, that's still there's not enough providers of any kind, we have people that have deficits, rural communities that don't have providers, they can argue that all day long, I'm not on that. But I do feel like there's there is opportunity for us to all work together to figure out better ways to provide care. And I just think of the one condition I've always focused on is a huge, you know, entry point, diabetes, 88 million people with pre diabetes 88,000,001, in 330 million people with type one or type two diabetes. We don't even have enough providers for that one condition. We don't have enough endocrinologist, we don't have enough of anybody. And so to argue about, you know, who's going to take what I'm like, gosh, I need like 10 times a force right now to even just manage one, one condition, let alone the behavioral health issues that are coming on and all these other issues that are going to hit us really hard during now during the pandemic, and then post pandemic.
Darshan
And do you think we as pharmacists have been trained to handle that? Or do you think we'll need to supplement the education we already have to be able to meet this additional need as we start, hopefully becoming providers as you're, as you're asking for?
Sandra
I mean, I think there's definitely a pharmacist can do a lot, right. Like I definitely want to say the curriculums of pharmacy school have changed, asked us we're doing more clinical based care. Do we have to get more training? I think we do. physicians have to get more training in certain specialty areas, you have to get board certifications. Pharmacists have to do that, too. I became a certified diabetes educator, because I was really involved with with diabetes. So that was something I went out and saw if you look at people right now with vaccinations are going out and getting vaccination certificates MTM. And so I you know, I think that's happening and pharmacists know what they need once you start dealing with practices. And guess what you can change to right? If you go and get what's your tip area, and then you go into another practice, you're probably going to try to get more training in a new area of practice. So it's really important to continue learning. That's something we all have to do to be effective people, effective providers. And so yeah, there's going to be some additional but it's basically going to be dictated by where you have a passion of where you practice, you know, the populations that you serve. And I think that's a good thing.
Darshan
And that raises the next question. I know it's something that's near and dear to your heart. So I want to talk about this a little bit more. You are a current board member for the National Center for former farm worker health. What I'd love to talk to you about is you're talking about this need of pharmacists to be able to help and we have the ability to do that. Can you talk a little bit about how if pharmacists are part of the of the program at the National Center for farm worker health, what do we do, and how can we do better and not just that group but other groups?
Sandra
Yeah, so you know, interestingly enough, I was a first pharmacist, board member for the National Center for farmworker health, I was president of the National Center for farmworker health. And just recently I I nominated another pharmacist to join the National Center for farmworker health. It's actually a diverse group of board members, a lot of them happened to be leadership roles, CEOs, you know, CFOs of organizations. And so it has been great to go into an organization that didn't have exposure to what pharmacists can do and come and actually really show which is showcase what we could do when really talk about the value pharmacists bring to the migrant. fpH sees that sort of migrant populations. And so for me, I always recommend to pharmacists join groups that don't have pharmacists, so that you can really share your impact your experience, and so that they understand the role of pharmacists and not have just that one perception of what we do but really see what else we can do. So as much as I learned about, you know, the farm worker issues they learned about what pharmacists do and what pharmacists can do to enhance the care of farm worker populations. And so right now, a lot of the, the health centers I've worked with, I've done, you know, essentially I've gotten into the centers I visited, we've talked about programs that could actually start Clinical Pharmacy services start 340 v programs, start things that could actually help impact the populations being served by that group. There's another group I was the first pharmacist on it was the Association of clinicians for the underserved. Again, the first pharmacist, the first pharmacist president, and again talked to multiple groups of clinicians that hadn't necessarily work with pharmacists to showcase what we could do. So those are the impact opportunities we can have where we don't just have to pharmacists, right but others to show what we can do.
Darshan
I love the idea I've never even thought of that I always thought you want to walk in with the only value what's your doing and what you're talking about is a completely different approach. And I appreciate that which is for them to value what you're doing, you sometimes show them what you can do. And that sometimes means breaking those barriers, that sometimes means being the first person out there saying, look, I think I can help. And here's how I can help. So you in the, in the current formation or current, you're obviously you've, you've been, you've led the board of directors for the National Center for market health. Is there a pharmacist? Now I know, there's, you introduce another board member is a pharmacist. Is there a pharmacist now who's actually serving operationally and and assisting with that group and and what do they do right now?
Sandra
So the the way, the National Center for farmworker health works is that they, they basically help refugees across the United States who serve farmworkers, essentially. So there's migrant streams. So what's happening is they do a lot of technical assistance for different things. So for example, they help people who are in migrant clinic start, for example, MTM programs. And so a lot of times, they'll ask me to come and do a C, E, or they'll connect me or make a recommendation to connect to another pharmacist and an FPT that's doing this work. So it helps see that program and start a new opportunity. So what it's done is, it's actually helped propel you know, the role of pharmacists within these migrant clinics to see what value pharmacists can bring to the table. And then we've done a lot of unique programs like partner pharmacist with Brahma Thoris, Ray promotoras, are community health workers that go into patients homes and reach them. And we've partnered through models where we at the pharmacist connect with the promoters, maybe we can't be out at a person's home, but we can sure connect and then address issues related to the patient that the pharmacist can help with, and then through that model, help expand the type of services that we do. So it's really an incredible organization. And their goal is really to improve resources and access that improve the care for farmworkers, the people that literally pick our fruits and vegetables so that they can, you know, feed us every day.
Darshan
I mean, it sounds like a mind blowing rotation if I was a pharmacy student to be able to do something like that, and to actually make an impact. Has there been any discussion about pharmacy schools having a rotation like that?
Sandra
There's been Yeah, so here I met in Tucson, the University of Arizona has a rural health type of experience where they do put students in different cities and rural communities, they can participate in programs like these that are like quality improvement programs. I grew up in Nogales, which is on the border, and there's a lot of border health issues around health disparities. So students have done work and research down in the border area. So tremendous opportunities, I think when you do something like that, you then start really seeing the possibilities of what you can do when you get out and practice. And so for me, I'm always like, Oh, my gosh, I don't have enough time to like, do the really cool things that I want to do. Because there's a lot of things sometimes there's not what do i do i go into pharmacy, I work in, you know, this type of setting. That's it, like oh, my gosh, no, you really find and maybe it starts with volunteer, right, like volunteering extra time. But then it could start building a practice or building, you know, some type of model that then becomes your future position. And that's what I always when I mentor students and student residents, I always talk about, you know, this is a gap. What does that gap allow you to then create to fill that gap? Is it a new role? Is it a new opportunities, a new program? Is it a new research, you know, impact opportunity. And then from that you can start building what you want your your practice to be your passion to be, and then it makes your career selection, something that you really love, because I always hate it when people tell me they're they're frustrated that they wish it would have picked something else. I'm like, Oh my gosh, for me, I would do it all over again. 100 times over the thing. It's been a wonderful career. And I just I'm like I hopefully I'm not even halfway through my prep, hoping to do more. So I love what I do.
Darshan
Oh, it's Yeah, I can tell you love what you do. And I'm but but I think the reason you love what you do is because you didn't choose the obvious answers. You try to look for the unusual. I think that that almost always is a recipe for success. So let me one of the things I asked you was how do people react to pharmacists being being on there and one of the things you mentioned was they seem to react positively, they learned something new. One of the questions I didn't ask was how do pharmacists react to being in that in a new role, where they're now actually hands on helping people who are literally picking a fruit feeding you every single day? Do they kind of go this too hard? Or do they tend to go Oh, this is very different from what I expected. You talk a little bit about that.
Sandra
Yeah, I mean, I think that I think they I think they like it, you know To be exposed to something different to show the impact, and then when you're working with people that really appreciate what you do, it's just super rewarding, right? Like that's just so rewarding in itself. And I'm one that doesn't like routine in my day, I really like to do different things I like to teach, I like to travel, I like to, you know, do programs, I've published quite a bit in my practice to share experiences. So I really like variety in my day, I kind of get bored doing the same thing over and over. So I think when people see what you can build, you know what kind of other experiences you can have they they start to see opportunities that they never even imagined. And that's a really positive thing. I ended up getting my degree in Public Health, mostly because I was starting to do more population health programs, looking at policy and legislation for advocacy. And really, it's led down the path of some of this board work and this volunteerism, I have a number of people I mentor, and the first thing I tell him is get out there, do something different, right? Go out there sit on a board, or even an HOA board just to get the experience of like running a meeting, Robert's Rules of orders, those kinds of things. Because you're gonna start to see that that opens up opportunities. And when you have opportunities, then maybe you're frustrated at your work for a little bit. But these external things could really validate why you do your work. And then you can start being an expert and sharing with others what you do. And so it then validates what you do. And so it sort of starts building on itself, the momentum and creating those new opportunities that you won't find if you you know, if you just go home frustrated and think, Oh, I hate my job Well, look, create a different scenario, different situation doesn't mean that you necessarily have to walk away but that you create other external opportunities that validate what you're doing, and that reinforce you know why you went into this particular profession.
Darshan
It's funny to say that because I've talked to so many people just like you do about her saying pharmacists, pharmacies, overcrowded, there are too many pharmacists out there, salaries are going down. And I've everyone I speak to who says that they're only thinking of the traditional jobs, as the job satisfaction is down, but you're looking at traditional jobs, let's let's be honest, being a pharmacist is a blessing because we get to, it is a highly paid job, that quite honestly, we get rewarded when people look at us and and, and people trust us. And that shows up as you know, in many different forms. But, but if you're doing the same thing over and over and over again, you're going to get burnt out. And and what you're talking about is Here are ways you can use your knowledge, use your skills, and be and do something different. So thank you. Thank you. Thank you so much for coming on, explaining that I have 100 more discussions I can have with you. Like literally, I want to get into health disparities. I want to talk to you about social determinants of health. I really wanted to get into this idea of you mentioned 340 b program, what your thoughts are, you hinted at this idea of getting to new areas, and I was going to talk to you about digital pharmacy. And I want to talk to you about cannabis pharmacists. And what that means there like literally so many things we could discuss. I would love to have you back. Would that be okay with you?
Sandra
Absolutely. We will not have an end of topics because there's so many things that I love and care about and things that I know we can impact?
Darshan
Absolutely. As you know, I'm gonna ask you four questions. The first question, based on what we discussed, what would you like to ask the audience?
Sandra
You know, what they find interesting what they want to learn more about, I think, to me, that's really critical just to get a pulse of what people are thinking. And then that really informs my own thoughts about what am I doing, especially in this role as president? Am I doing the right things? Is the organization able to respond to what what people need, you know, what pharmacists need out in that field? And that's really important to me.
Darshan
So I kind of make a first effort to answer the question. So my answer, and this is something that's always been important to me. But I've always thought because I'll admit to a man with a hammer, everything looks like a nail. So I went into industry, and my my thought process was always that a PHA and a pH and ashp. And all the other organizations are always always focused on the needs of pharmacists going into Clinical Pharmacy, which absolutely there's a there's a value to there's a need for, but it felt like industry was a redheaded stepchild. And I would love to have more of a discussion about what that looks like and maybe some some working together to take that to the next step because there's so many opportunities that we can talk about there. Whoops, sorry about that. The the the second question I have for you is over the last month, what is something you've learned that you think the audience would love to hear like something interesting?
Sandra
Wow. Well, I mean, I've been super involved with COVID right now, right? COVID, Maxine's or masks, mandates, vaccine mandates, just really been very engrossed in that and interestingly enough here in Arizona, too. has already started the school year. And so while we're learning a lot, what's interesting is just a number of outbreaks and just comparing those schools that have had mass mandates those that haven't what the impact is on quarantine all of these issues. My own daughter who think goodness is vaccinated already has been exposed to three individuals already with COVID in the last week and a half since she started school, which is really concerning. Because, you know, obviously we don't have all kids vaccinated yet. So I just I mean, I'm really encouraging pharmacists to advocate for more conservative like, you know, taking care of, of the population, and really just being a strong advocate for making sure people get the right care. We're talking about all I was reading this morning about information and the like, number of prescriptions about monoclonal antibodies, I'm like, Oh, my gosh, I get that those are options are good to have, Oh, wow. If we vaccinated, right, if we vaccinated, we got people that hump that would really hopefully offset like use of some of these things that we don't even especially in Vermont, and the safety and all these things that really impact care. So I'm a big advocate for vaccination, huge public health advocate, I've done CDC videos for you, I was a flu fighter for them for a video series. And I just recently did a couple of videos in English and Spanish to try to encourage people to reduce their vaccine hesitancy improve the confidence around it. And I even participated in one of the clinical trials for the vaccine. So I got vaccinated last year, to try to get more comfort and trust in trying to build you know, people people's understanding, and hopefully get them to go through that hump and get vaccinated. So that's a big priority for me, and I'm going to continue to dedicate time and effort until we get beyond this pandemic.
Darshan
Awesome. And let me ask you, the last question I was gonna ask. And by the way, well, one of the questions I do ask is, how can people reach you, and that is s Li, l r x on Twitter. What else is that?
Sandra
LinkedIn, Facebook, and Instagram. So they're all sort of connected. But LinkedIn, for everything professional, I put a lot of articles around pharmacy impact, that kind of stuff on LinkedIn. And then I have a Twitter, you know, feed that I actually follow again, same kind of thing. My personal ones are more than Facebook and Instagram.
Darshan
Very, very cool. And last question, what is something you did in the last week that made you happy?
Sandra
Well, you know, I sent off my daughter to high school, and she drove by herself for the first time, that made me happy, because when she's getting more independent, and then obviously it opens up all sorts of time. And now that she's driving by herself, but I kid you not, I was very nervous. And I keep asking her to text me when she gets to where she's at. And so that's one of the things that that's been quite interesting and stressful this week, and I've been enjoying the joy of independence.
Darshan
That's a really interesting joy. I have to ask, mostly because I had flashbacks with my mom asking me to do to call it when I read somewhere. Does your did your daughter actually test text because I never called
Sandra
it she did she? So she's so funny because we have this this app called 360. And literally tells me what she writes. So she doesn't even have to text me. But I was still testing her to see if she would and she did and she she's been very good about it. So I told her you know, we don't have to keep doing this forever. But just a couple more. today. It was raining in Arizona. So today was her first time driving by herself and rain. So this was particularly a special day for her to let go she got there safely. Like, here's how you use the windshield wipers like we don't even use them here that much in Arizona. Give her the rundown before she left. That's
Darshan
awesome. So again, thank you so much for coming on. We'd love to have you on again. And we have so much more to discuss.
Sandra
It sounds great. Thank you. Thank you.
Sandra
This is the DarshanTalks podcast, regulatory guy, irregular podcast with hosts Dr. Shaun Kulkarni. You can find the show on twitter at DarshanTalks or the show's website at DarshanTalks.com