Distinguished Service Award Corner: Brian Tuttle

By: Chris Doody

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This column features another of the many great hospital pharmacists of the last 40 years, Brian Tuttle. Brian grew up in Pugwash Junction, Nova Scotia, and graduated with a BSc in pharmacy from Dalhousie University in 1968. He continued his education with a residency at the Toronto General Hospital in 1969 and obtained his MScPhm from the University of Toronto in 1971. He returned to Halifax as an Assistant Professor at Dalhousie’s College of Pharmacy. In 1972, he received a cross appointment to Camp Hill Hospital as Teaching Fellow. In 1975, he joined the staff of Camp Hill Hospital as Supervisor, Drug Information Services and, in 1981, he was appointed Assistant Director of the Department. Later in 1985, he was appointed Director of Drug Information Services, Pharmacy Department for the new Camp Hill Medical Centre. With the formation of the Queen Elizabeth II Health Sciences Centre in 1996, he became Manager of Drug Information Services. Finally, with the incorporation of the Capital District Health Authority in 2001, he was appointed Director, Pharmacy.

He officially retired in 2007, but he has remained active in pharmacy affairs, most notably with the Nova Scotia Branch, the College of Pharmacy, and PEBC.

As one might expect of a DSA recipient, he was very involved in association work. It began with various publications on drugs and therapeutics. For ten years from 1981−1991, he was Coordinator of the pharmacy residency program at Camp Hill. In 1993, he became Manager of a Drug Evaluation Unit for the Queen Elizabeth II Health Sciences Centre and the Nova Scotia Department of Health, followed in 1994 as Manager of Health Canada’s Adverse Drug Reaction Regional Centre for Atlantic Canada. In 2001, he was appointed Program Director for the Hospital Pharmacy Residency Program, Capital Health in Halifax. Among many committee appointments, in 1993 he was Chair of a steering committee on inpatient use of medical marijuana and, from 2004−2007, Chair of the Medication Systems Committee at Queen Elizabeth II Health Sciences Centre. Throughout the 1970s to the 1990s, he gave innumerable presentations and lectures at Dalhousie University and affiliated hospitals.

With regard to pharmacy organizations, he became President of the Nova Scotia Branch of CSHP in 1976. He was chair of CSHP’s Drug Information Committee (1976−1979). He was CSHP’s President from 1980−1981. During this time, he was involved with numerous committees and task forces. From 2002−2004, he was President of the Nova Scotia Association of Hospital Pharmacy Managers. Brian has published several papers in the field of drug information services, as well as on new drugs and therapeutics of all kinds, on pain management in particular, over the years.

Brian’s award history began in 1978 with the Meritorious Service Award and the Bowl of Hygeia in 1991, both from the Nova Scotia Pharmaceutical Society. He became a CSHP Fellow in 2004 and in 2011, an award was named after him for pharmacy residents at Dalhousie and affiliated hospitals. CSHP awarded him Honorary Life membership in 2013. In 2014, the Nova Scotia Branch created the Brian Tuttle Excellence in Hospital Pharmacy Award.

Brian is known as a quiet-spoken, approachable gentleman who is popular within the pharmacy profession.

Interviewer (WM): Brian, in reading over your CV, I began to wonder how you managed to be so involved in so many pharmacy activities and organizations. How did you manage all of these?

BT: I attribute early correspondence with Dr. Gordon Duff to my fascination over what might lie ahead in program development both in pharmacy education and clinical practice. In 1969, he was in San Francisco on sabbatical from the Dalhousie University College of Pharmacy and I was a pharmacy resident at the Toronto General Hospital. Later, I was privileged to work for pharmacy directors (Betty Anne O’Toole and Bonnie Salsman) who, because they had great vision, provided extra elbow room that enabled me to pursue challenging opportunities in the pharmacy/medical fields. This showed real leadership on their part and, while I probably didn’t realize it at the time, their support required them to be quite tolerant. In the early days (1970s), I was welcomed into the local pharmacy directors group by very motivated individuals who were keen on exploring new directions in their pharmacy programs (e.g., pharmacy residency training, drug information services, and clinical practice). This evolved into career-long collaborations and program development with a number of very talented individuals in the fields of pharmacy, medicine, and government. This was certainly a busy time; however, I believe when a particular venture is exciting and holds promise, you tend to find the time to make things happen. I admit to editing many manuscripts during my 1-hour bus commute into Halifax.

WM: Throughout your career in Nova Scotia pharmacy, what were some of your greatest professional challenges?

BT: By the late 1980s, it was evident to some of us that we were not effectively evaluating new, high cost drugs before they were considered by the Pharmacy and Therapeutics Committee. It was my responsibility to prepare these drug evaluations, so I was well aware of both my personal skill set and shortcomings and the fact that we really needed to do something about the drug evaluations process. While the principles of pharmacoeconomic analysis were known to a few advanced trained practitioners, it was a unique skill set that had not been transferred into general practice. It became very apparent that, in our tertiary care teaching centre, we needed to create a position solely responsible for developing critical, evidenced-based evaluations of new, high cost drugs. We made the case to our Department of Health, illustrating the patient care and financial benefits to both our region and province. This was successful and one FTE was added to the Drug Information Centre dedicated for this purpose. By 1993, the Drug Evaluation Unit compliment had grown to 2.5 FTE pharmacists, as services were extended to other institutions and as it became a major resource for the Nova Scotia Department of Health and its Seniors Pharmacare program. I faced what was certainly the major challenge of my career when I assumed the role of Director of Pharmacy in 2001 as the Capital District Health Authority was formally taking shape. Very strong management teams in all sectors backed by talented and versatile clinical and technical practitioners, which made my tenure very exciting and fulfilling.

WM: Why do you think you were awarded the Distinguished Service Award?

BT: I may have been able to provide opportunities in pharmacy practice that satisfied some of the core aspirations of pharmacists and pharmacy residents in the region. Perhaps I assisted budding authors in honing their writing skills, or perhaps, in some way, I helped pharmacists and pharmacy technicians realize their own leadership potential.

WM: I appreciate that you are now retired, but what do you perceive as the major challenge(s) for today’s hospital pharmacist?

BT: There is mounting pressure from Ottawa on the provinces to show more accountability in health spending and, as Health Transfers become less predictable, pharmacy services will not be left out of cost benefit analyses that are to come. Institutional pharmacy has streamed into many varied and highly specialized fields of practice. It will be important for individual pharmacists to recognize who these specialized practitioners are, where they practice, and how to complement their unique skill sets (i.e., learn from them and support their practice).

WM: Are there any lessons you learned that you would like to pass along to today’s practitioners?

BT: It is unfortunate, but it may not be until retirement when you really understand what a great privilege it is to practice pharmacy in an institutional setting. I have learned to place high value on the experience of those who have done it or something like it before. I have also learned to appreciate that what at first seems to be a boundary may in fact be movable.

Brian has retired and remains in good health in Dartmouth.