Lucinda Maine tells the story of her career as if it happened through a series of serendipitous accidents, unexpected opportunities and surprises of support. As she tells it, doors opened for her and she simply walked through them. Serving as AACP’s executive vice president and CEO for 20 years, Maine has been a visionary, strategic leader. She was awarded the Remington Honor Medal in 2019 (on its 100th anniversary), the highest honor in pharmacy, recognizing her nearly five decade-long commitment to her vision to elevate pharmacy education and provide better patient care.
In this two-part series, Maine reflects on her career and looks forward to what comes next. It’s clear to see her success may stem from the steadfast stance by which she lives: The beginning is always now.
What led you to a career in pharmacy?
It was a bit of an accident. I left the first grade and looked at my first-grade teacher, Ms. O’Brien, and said, ‘I am going to be just like you when I grow up.’ And forever I was going to be an elementary school teacher. Then in middle school I had my first taste of biology. I loved it. By the time I graduated from high school and knew I was going to Auburn, I was toying with a health profession. The one that stuck out for me because it had such cool biology classes was laboratory technology, so I declared that as my major. Just before I went to freshman orientation, my stepdad, who built submarines for a living, looked at me and said, ‘Have you ever thought about pharmacy?’ And I said, ‘Nope. Not once.’ He said, ‘Well, you should go talk to our pharmacist, Charles Dart.’ I went to see him. He was probably somewhere between six and 10 years older than me. He was an Auburn grad, working in a small chain but he ran it like an independent, and he loved every minute of what he did. He said, ‘Pharmacy is fantastic. You would love it. And besides, you go to school for five years, you get out and you make $20,000’—this was 1974. And then he read me the classic line, ‘You know, it’s a great career for women because if you want to have a family, it’s flexible.’ So, I got in the car with my mom, we went up to freshman orientation, I changed my major to pre-pharmacy and honestly, never looked back.
He was so right. And it’s funny, Auburn profiled me in their pharmacy alumni magazine in 2016 or 2017 and he wrote me this letter. We had not been in contact, but he had hired me to work behind the counter with him after my freshman year and I learned so much. I saw his humanity for the people who were his beloved patients. Because of where we lived in Mobile, Alabama, a lot of them were Medicaid patients, and there was one episode of care that I’ll never forget. At that time you didn’t have a computer, you did your third party on a triplicate form that had all the information and the patient signed the form, and somehow he signaled to me as I was checking this person out that she was going to sign her name with an ‘X’ because she didn’t know how to write her name. That could have been so embarrassing, but he got me that information so that I treated her with the same level of kindness that he extended to everyone. So, he saw my name on the bottom left side of the cover of the alumni magazine. In it, I told the story of how I had come to pharmacy. He wrote me a letter and said, ‘I never knew I had that impact on you and I’m just so amazed by the things that you have done.’ It was really emotional. At 70-something he still does relief work a couple times a week and he still loves the pharmacy profession as much as he did in 1974, when he convinced me to come to pharmacy school.
How does it feel to be on the opposite end, to have someone tell you that you were the person who inspired them to pursue pharmacy?
When I was at Auburn, it was older students who convinced me to go to the student APhA meeting in New York City in 1977. I’m a volunteer, I get involved, so I said, ‘OK. I’ll come.’ Then they said, ‘And furthermore, Lucinda, you have to interview with the president elect and find yourself a national committee appointment.’ So, I met Dennis Kimmel, who was the president elect. He was a student at Ferris State. I interviewed with him and was told to come back by the office later because the committee assignments would be posted. So, I went out to dinner and got back to the hotel and went down to the office. Dennis was still there but the assignments weren’t posted. I ended up taking his hand-scratched notes and helped him get those committee assignments posted. I was on membership committee, I think. We were talking and I told him a little bit more about myself, he told me a little bit about himself, and he said, ‘Have you ever thought about running for national office?’ Now here I was, a first-year pharmacy student and I’m at my first meeting and this guy’s asking me if I’m going to run for national office, so I said, ‘No, there’s no way.’ But I use that to tell you, the people I think I have inspired the most are people who, when I go to my next APhA meeting—and I’ve never missed one, except the ones that didn’t happen in ’20 and ’21—are the people who will come up to me and say, Lucinda, I know you don’t remember me, but when you were student president of APhA I met you and you just stimulated me to do this or that. I still love going to white coat ceremonies and commencements and sometimes I get to address a class. I was at Belmont not long ago for their white coat and this young lady came up to me to say, ‘How did you get involved and what did you do,’ and I made myself a note, I am going to write to her today and ask if she’s going to the APhA meeting. That’s the paying it forward part.
How has the profession changed since you first became a pharmacist?
One of the things that most people don’t know about pharmacy, and I was absolutely shocked and appalled when I learned it myself, is that the code of ethics from the ’20s to the late ’60s had a provision that a pharmacist shall never divulge the information about a prescription a physician has written. Pharmacists in classes before mine were taught how to deflect a person’s question. When they asked, ‘What is this drug?’ the answer was, ‘It’s best for you to ask your physician.’ The state practice law at the time said you should not put the name of the drug on the label and you should not tell a patient what it is. And for the longest time, I really didn’t understand that, but drugs weren’t very powerful back then. The ones that we have today are just so much more important. When I was in school we didn’t know about HIV/AIDS, it wasn’t an issue yet, and then it became a sure death sentence because there was nothing to treat it or prevent it, other than abstinence. Now it is not only preventable thanks to drug therapy but it’s also almost curable. I often put that into a presentation to students, and I say the rapid changes in science are even going to make that miracle pale in comparison. So, the role of the pharmacist has changed, not as far as I want it to, we’ll come back to that, but the whole armamentarium of health maintenance and disease management and prevention and cure has been transformed in my professional lifetime. It’s really astonishing.
What led you to academia and then to pharmacy associations?
Every summer of my pharmacy school tenure I did a different job, so I worked for Charles Dart the first summer in basically an independent pharmacy and I loved it. The next summer I worked in a shipyard chemistry lab, where my stepdad got me a really well-paying job, but I hated it. That answered that; I knew I was not going to be working in a laboratory. I went back to Mobile after I finished my first year in pharmacy school and I got a job in one of the hospitals. Then the summer after my second year in pharmacy school, right after I went to the APhA meeting in 1978 in Montreal and ran for president elect and won, I applied for an internship and went to Upjohn in Kalamazoo, Michigan, and I began to get really confused about what I was going to do. I knew that my bachelor’s degree was not going to be enough, and so I thought about a Pharm.D., after that summer in the industry I thought about an MBA. I knew that I was not going to get a Ph.D., because I didn’t care for research as an enterprise, and so I tell people I accidentally got a Ph.D.
I worked my last summer as a COSTEP, which is a government internship program, and the head of the pharmacy program for the Indian Health Service always held this position available to the APhA student president so they could come to the Washington area for the summer and be more in touch with the staff and make sure that everything was ready for the fall. By the time I was done, I was still confused about what I wanted to do. I mentioned that to two people I was serving with on the APhA task force on women in pharmacy, they were Ph.D.s in pharmacy administration, they looked at each other and said, ‘This is a Pharm Ad grad student if I’ve ever seen one.’
I started graduate school at the University of Minnesota in January 1981. Albert Wertheimer, who was the director of the graduate program for the social and administrative pharmacy program, promised me that he would not try to convince me to stay for a Ph.D. I just wanted to get a master’s degree, and there were some other things about Minnesota that I really wanted to learn more about, like long-term care. I really cared about drug use in the elderly population, nursing home practice intrigued me and there were some really good long-term care pharmacists based in the Twin Cities. Albert had gotten a grant from the Kellogg Foundation to implement a part of a report that AACP was responsible for developing called Pharmacists for the Future. In that report they talked about how the future work of pharmacists was going to be knowledge work, and they recommended that the profession needed a small cadre of pharmaceutical clinical scientists. Albert took that idea and turned it into a grant from the Kellogg Foundation to develop this concept of a pharmaceutical clinical scientist who was ‘as comfortable in the laboratory as at the bedside,’ and the grant supported the development of 15 of these graduate students, each with a stipend of $10,000 a year. Albert had enrolled the first five in Fall1980. When I came in they were in their second semester and I was in a lot of courses with them. At the end of that semester, he broke his promise. He said, ‘Not only do you need to stay, you need to apply to be one of next 10 Kellogg fellows, because you will be a fabulous pharmaceutical clinical scientist with a passion for drug use and the elderly.’ So, I applied, I stayed and I studied drug use and the elderly. Larry Weaver, the dean and my clinical advisor in the program, Paul Batalden, and the dean, who happened to be a pediatrician, created my first position and I stayed on the Minnesota faculty for two years. I worked in a multi-specialty group practice, which was so hard because ambulatory care pharmacy really just didn’t exist then, but I did enough of the seed work that the practice flourishes yet today. That’s the only part of my career I wish I could go back and do a redo, because what struck me after time, was that four hours away in Iowa two very pioneering pharmacy leaders, Dennis Helling and Barry Carter, were delivering those services in a family medicine practice. If I had known I would have taken a trip down there and learned how they organized their practice, how they sold it to the physicians, and what this patient care model looked like.