Rick Oehler is quick to thank the people who intervened after he was found unconscious in his apartment in August 2024: The neighbor who called 911, the nurses who watched over him in the hospital for four days, the interdisciplinary care team now treating him for diabetes.

But according to Rick, it’s his pharmacist, Dr. Brandi Bowers, who has truly helped him put in the hard work to manage his health.

On that fateful day, Rick’s blood glucose A1C registered 17.8%, more than three times the normal level. The cause: undiagnosed type 2 diabetes. “I should not be here. But I guess God wants me around for a little longer,” the 64-year-old recalls.

Once Rick’s condition stabilized, he needed comprehensive outpatient care. However, the retired semi-truck driver says he found himself in a Catch-22 when it came to accessing that care. His income is too low to afford private insurance, yet too high to receive Medicaid. He’s too young for Medicare and doesn’t qualify for full VA benefits from his early years in the Air Force.

But according to Rick, it’s his pharmacist, Dr. Brandi Bowers, who has truly helped him put in the hard work to manage his health.”

A nurse referred Rick to the MSU Care Clinic in Springfield, Mo., a partnership between Missouri State University and Mercy Hospital that treats Medicaid recipients and uninsured people with very low incomes, at no cost to the patient. That’s where he met Brandi, a Clinical Associate Professor with the UMKC School of Pharmacy satellite campus at MSU. In her role, she also serves as MSU Care’s clinical pharmacist.

Brandi developed a personalized plan to help Rick get back on his feet, in collaboration with the clinic’s registered dietitian, physician assistant, and other care providers. She started, as she always does, with an in-depth intake visit.

“I usually tell people this visit is for me to get to know you, because I can’t make medication decisions without understanding the day-to-day life you’re living. I specifically work in a clinic that sees patients who face a lot of social barriers. I can’t go in blind and use cookie-cutter recommendations. That’s not the role of the pharmacist in any way,” Brandi explains.

Rick knew how serious his situation was, as his wife died from a diabetes-related heart attack in 2013. Still, Brandi started with the basics, explaining the physiology of diabetes, the meaning of the A1C and other numbers, and how different medications work in the body. Step by step, she imparted the knowledge and tools Rick needed to understand what was going on with his disease and make incremental changes to improve his health.

It’s important to meet people where they are, Brandi emphasizes — especially with a chronic, largely self-managed condition like Rick’s.

“When you get diagnosed with diabetes, you either get so much information in a space where you can’t absorb it, or you get no information. Almost without fail, patients identify with one of those two buckets. A lot of times people are told to do better and they don’t even know why it matters.” For his part, Rick appreciates Brandi’s direct communication style. “I’m not one to take pills unless I know what it’s going to do or what it’s for. Growing up in the country, we didn’t go see the doctor unless there was blood squirting. If you got sick, Grandma would come up with a cure. If you weren’t feeling good, we were told to get over it,” he shares with a laugh. “Well, Brandi has put my mind at ease on a lot of it. She didn’t sugarcoat anything. I told her to give it to me straight, and that’s what she’s done since day one.” 

Rick’s overall treatment plan includes insulin and multiple other medications to manage his diabetes, high blood pressure, and high cholesterol. The clinic also helps coordinate Rick’s care among other specialists such as urology, orthopedics, and optometry, with Brandi keeping a bird’s-eye view of all his medications. “The medication list is the central hub where everything has to come together. You have to be able to see all the care that person is receiving…. [A team-based approach] elevates care for the patient,” she says.

With coaching from Brandi and MSU Care dietitian Jaime Gnau, Rick also gradually overhauled his lifestyle. After 40 years spent on the road, he worked on being more physically active throughout the day. Rick takes his new bike out for a spin at least three days a week — sometimes as early as 6 a.m. to beat the Missouri summer heat.

Rick’s adult children helped him clear out his refrigerator and cabinets for healthier choices that would help keep his blood glucose in check. He likes to add vegetables such as onion, bell pepper, and spinach to his morning scrambled eggs. And he’s learning to make healthier dinners in the air fryer, instead of turning to the usual fast food.

In the beginning, Rick visited MSU Care once a week. A year later, his appointments are down to once every one to three months, depending on the provider. This pattern is one of the things Brandi loves most about being an ambulatory care pharmacist: “I meet you and it’s a years-long conversation. When you walk through those hard moments, I have that relationship with you to walk through it with you.”

And it’s working. Today, Rick’s blood glucose is routinely in the target range, and he has dropped 50 pounds from his 5-foot-8 frame. Next up, Brandi encourages him to give up smoking.

When the holidays rolled around, she even arranged for Rick, his son, and his daughter-in-law to receive a full Thanksgiving dinner from her church, complete with ingredients to make a chocolate pie. “She just renewed my faith in people,” Rick says.

Witnessing such progress is satisfying for any healthcare professional, but Brandi gives credit where it’s due.

They can make a difference in your life — and not just keeping you alive, but the quality of your life.”

“I try really hard to help patients see that my role is not to do the work. My role is to equip you. Rick showed up ready to do the work. [I tell him] I helped you work through what your goals were and how to match up the choices you’re making to those goals. You’re the person who gets up and gets on the bike every morning. At the end of the day, you bought the different foods and cooked instead of grabbing the thing you wanted to eat,” Brandi says.

Rick looks forward to a long retirement and meeting his two great-grandchildren who are on the way. “Thanks to the MSU Care Clinic, I believe that’s going to be possible now. I owe them the world,” he says. “I’m here because of a pharmacist who cares enough to actually listen to patients. They can make a difference in your life — and not just keeping you alive, but the quality of your life.”

Meeting patients where they are, forming long-term relationships, giving them the tools to take charge of their health: For people like Rick, that’s what it means to be your pharmacist.