Where Pharmacy Meets Health featuring Claudia Cometa
Claudia is a clinical pharmacist by training and patient advocate by passion. After over a decade of working inside the healthcare system, she faced her father's cancer diagnosis and later passing. This experience provided her with a deeper understanding of how difficult it is to navigate our modern healthcare system. She decided to do for others what she did for her father and founded Peace Advocacy Group in 2017.
Claudia’s approach to advocacy is in line with her philosophy: “Health is a state of body. Wellness is a state of being.” But, Claudia’s life passion and mission is for every individual who crosses her path to leave with a heightened state of wellness.
We had a lot to talk about with Claudia including her career, her vision, her podcast, and her upcoming book! Enjoy this jam-packed interview with Claudia Cometa, PharmD.
Transcript
Host
Today on the patient advocacy now podcasts were joined by Claudia cometa. Claudia is a clinical pharmacist by training and patient advocate by passion after over a decade of working inside the healthcare system. She faced her father's cancer diagnosis and later passing this experience provided her with a deeper understanding of how difficult it is to navigate our modern healthcare system. She decided to do for others what she did for her father and founded peace advocacy group.
in 2017. Claudia, thank you so much for being with us. How are you today?
Claudia Cometa
Fantastic and thrilled and honored to be here with you.
Host
Well, we are honored to have you. I think your story is so indicative of so many advocates in the field where you have a friend or a family, usually a family member who falls ill and you have to kind of step up and be the advocate. Um, and, and then you realize there are other people who need this service. What made you decide to kind of, you know, cause a lot of people do go and
help their family, but it never occurs to them to kind of continue that work. Why did you decide to kind of do that yourself?
Claudia Cometa
Yeah, you know, all of what you just said. I when I chose pharmacy as a career prior to advocacy, it was very analytical and methodical, like, you know what, I I'm good at chemistry and it very checkboxy and I need something that will help.
allow me to help people while also having a flexible career. And so I checked all the boxes. This switch to patient advocacy was very much the opposite. It was very much just an inner knowing that I have to do what I did for my dad, for other people. At that time, I didn't even have the verbiage of patient advocate. I knew...
what the work was that we did, but I didn't know that this was a field and that others were doing it. I just knew that it was a gap that needed to be filled and there wasn't even a decision. It wasn't analytical. It wasn't even in my head. It was just like, I have to do this and I'm gonna just figure it out. So as I was helping my dad and really in the weeds of his medical care and real time looking at his labs and making decisions and talking to the medical team.
Host
Thanks, everyone.
Claudia Cometa
I'm looking around the ICU bay and the other patients who are around him thinking, what are these people doing? Who's helping them? You know, there's nobody in their room. Is it just they just receive the care that they receive and nobody knows what's happening on the back end? Because I can tell you there's a lot of errors that happen on the back end and not out of mal intention out of the team. But the reality is, it's everybody's overburdened and overworked and humans make errors. So I just was shocked.
Host
No.
Host
Keep it coming. Thank you.
Claudia Cometa
at what was happening and how little oversight there was. And so it was very much a, just intuitive, deeper knowing, very different from my choice to go into pharmacy.
Host
What were some of the challenges that you faced that were a bit surprising to you when you were taking care of your own father?
Claudia Cometa
You know, I think I expected a higher level of attentiveness and compassion. I think being on the other side of the healthcare system as a healthcare professional, we see through a different lens. We think we're providing the best care. We think that the patients are experiencing our care in a certain way. And we don't really understand that that's not happening until we are on the other side. And so I was just really shocked by
much was missed, how many errors were happening. I mean, they would document, they documented his weight as 300 pounds when he was like 175 on a good day. And these things just happen all the time. And, you know, in some cases that may not be a huge deal, depending on what's happening. But, you know, there's a lot of medications, including chemotherapy, that are very weight-based. And so that type of an error could be life-threatening and often is. And so
Host
How does that happen?
Claudia Cometa
just, you know, seemingly little things that may feel insignificant to others, but can downstream have huge sequela and complications. So, you know, every step of the way, I saw something that was very saddening to me and frustrating, you know, just with the interactions with how my dad was treated by physicians, by nurses. And again, I actually, my husband's a physician, so I don't have any.
Host
Okay.
Host
to present.
Claudia Cometa
ill will toward I actually know that they're amazing people. And so I really think there's this disconnect between what we think we're doing for patients and what they're receiving. And, and so if there's a gray area in there, and that's where I feel like I my zone of geniuses now is in that gray area in that middle zone.
Host
I don't know if you have that. I have it. Sure.
Host
Yeah.
Host
And what did, when you say I was, you know, that you were shocked by the way your father was being treated, can you go into some detail? Was it, was it that he was being dismissed or just kind of not attended to at all?
Claudia Cometa
Yeah, I'll give you some specifics. So a lot of times it was a dismissive feeling. But for instance, when he went in to see a pulmonologist, the fellow who is basically an upper level resident came in first and did his evaluation and documented that he had done a chest exam, which he's a pulmonologist, it would make sense to do a chest exam. He did not do a chest exam, but he documented that he did. And this type of thing, and people are like, how does this happen?
Logistically on the back end of things, there are templates that physicians use, a lot of healthcare professionals use from an electronic medical record system and those templates auto-populate and then you're supposed to go in and change things. Well, the auto-population of those, while it might feel time efficient,
Host
same thing.
Claudia Cometa
also lends itself to errors. So things can get documented that didn't actually happen. And so it's not to say that the fellow went in and said, yes, I did the chest exam and typed that in, but it was likely an auto-population of what was assumed to have been done in a pulmonologist's office. Well, it wasn't done. So the attending physician came in thinking everything was done, also didn't do, and I wasn't at this appointment, also didn't do a chest exam. And two days later, he had a chest tube because his chest was filled with fluid. And he...
and that would have been easily caught.
Host
So how did you find how so here's a here's a really important question. How did you find this out that it wasn't done?
Claudia Cometa
So when it progressed to the point of chest tube, I then went through the records of, because I was like, how could this have gotten missed? So I went through the pulmonologist records, saw that it said the fellow documented or auto-populated and didn't fix that the lungs were clear to auscultation, meaning like the lungs were clear. There's no possible way they were clear two days before the chest tube was placed. And I actually contacted the attending
Host
I'm sad.
Claudia Cometa
pulmonologist about it. And I said, Hey, I know there's nothing that can be done now. It's already done. But you need to know, you need to know as an attending that you can't always trust what the fellow did. And your job as an attending is to come in and make sure you're the quality control. I mean, that's the reality. You can't assume everything was done as it was documented. And he had nothing to say to me. He knew I was right. So
Host
Sure.
Host
Wow.
Claudia Cometa
Yeah, so things like that. I mean, lots of examples like that, but, you know, it's really, most people wouldn't even know, most people wouldn't know that even happened on the backend. They would think, oh, I must've just progressed in two days, you know, like I just got worse. Yeah.
Host
Sure. Yeah, I would. I would have no idea that wasn't possible. So as an advocate, now that you're fulfilling that role for other people, what would you just to step in and kind of try and mitigate those issues?
Claudia Cometa
Yeah, so my clients really dictate the and request the level of involvement they want. So I do have a lot of clients who have me either physically if they're in my area or on speakerphone at their appointments. And so and I was in for the most part at most of my father's appointments. I just happened to miss that one. So I am physically able to ask the questions, make sure there's no gaps in what's happening.
Host
Thank you.
Claudia Cometa
We usually also will talk before and after the appointment. So I'm very clear on sort of what's been going on and what questions we should be asking afterwards. We're debriefing. Is there anything we need to follow up on? Are we clear on next steps? I usually send a summary of what I have heard during that appointment. So that way my clients can also confirm that that's what they heard. And if it's not, then we'll talk about what seems to be different. Like I didn't hear that, that seems different. So let's talk about it because
there's a lot that happens in a 10 to 15 minute appointment and a lot of things are said and a lot of instructions are given and that after visit summary that you get is full of fluff and mostly useless information. And so nobody looks at it, you know? And so this is just a streamlined way of making sure the appointment is conducted efficiently and productively for the client and that everybody understands where we're headed afterwards.
Host
Yeah.
Host
And so is that do you find that that's your it's kind of navigating the whole medical process? Is that your main role as an advocate that you get hired for? Yeah.
Claudia Cometa
Yeah, you know, I gave a presentation yesterday and I was I was thinking on the way home from it. I think the medical system and people in general are like, Okay, well, what bucket do you all fall in? What is this patient advocacy? You know, like, are you a case manager? Because we have these concepts already filled for us of this bucket is this social worker, the case manager. So like, where do you guys fit and the visual that came to me as I was thinking through this on the way home is if you think of a bunch of buckets,
and they're round, there are spaces in between. If we were to line them up, there are spaces in between each of those because they're not 90 degree angles. And I see my role, and every patient advocate does a little bit of a different, has a little bit of a different approach, but I really feel my role is in those spaces in between the buckets. It's everything that isn't currently being done, and so it doesn't fall within a current bucket. And I actually think that's what we need in healthcare is what...
what are the gaps and who's gonna fill those. And it really has to be filled from outside the system because there isn't a job description that says, get on a speakerphone call with this person. Like there isn't a job description that fits that. So there's not a bucket that fits that role and title. And so it's all of the things that fall through the cracks. It's the patient who at 10 PM on a Sunday night after he got discharged from the hospital has a question about one of his discharge medications and the doses.
and who is he going to call? There is nobody to call. The primary care doctor doesn't even know he was in the hospital, or doesn't know the discharge information. Yeah, you can't call, and the primary is not gonna answer you at 10 p.m. anyways, unless you have a concierge doctor. But most primary care doctors aren't answering at 10 p.m. And they don't know what happened anyways. You're not called, who are you gonna call at the hospital? There's no 800 number for the person who's gonna answer this question. It doesn't exist. So it's those holes that I'm feeling.
Host
That's what we are doing. Thanks. You have no questions. Thank you.
Host
Yeah.
Host
And what I find so fascinating is that every patient advocate has their own unique background and unique way of coming into the profession. So knowing some of your background, but not so much of it, what do you feel makes you unique as a patient advocate?
Claudia Cometa
Yeah, I love this field because it's, I kind of feel like it's anarchy at its best in the most ethical, amazing way that everybody's coming in. Like I want to give all of myself in every way I know I can without the limitations of a job description, employment contract, et cetera. And so what I feel like I bring to the table is, you know, over a decade and a half of clinical pharmacy work, meaning from a knowledge standpoint,
deep understanding of medications, where they fit, where they maybe don't fit, what questions we need to ask. But also after my dad passed away, I dove into a pretty deep spiritual journey. I started asking questions that I didn't, I was not really the curious kid who asked questions. Like you tell me something and I'm like full force, mostly believing it. So.
You know, I studied exactly like I was told to study and I just didn't, I wasn't a super curious kid. I was just, I followed the rules like to the T and I started asking a lot of questions after my dad died. Just like nothing makes, all of a sudden, nothing made any sense and I really had to unlearn a lot that wasn't serving me and in that spiritual journey, I found ways to help my clients that.
I would have never been able to do as a traditional pharmacist. I would have never been able to tap into that. So, you know, I mean, I create if my patients wanted and not everybody is on that same path, but, you know, I've created specific tailored guided meditations for my patients, you know, just and, you know, pray with them, like depending on where they're at and what they're needing, there's gaps that I can fill because of where I've been. And
and that spiritual journey. So I really love pulling all of those pieces together and really just being able to sit and actively listen and provide people with peace. There's not always a solid answer and I don't always have a solid answer, but I do believe that most of the time, my clients have access to a deeper wisdom that can provide some guidance. And so sometimes it's leading them to that. And if they tell me,
Host
Thank you.
Claudia Cometa
Hey, which has happened. Hey, I intuitively feel like I need to go to India to have this Ayurvedic treatment. Most of the Western medical system in this particular patient's case would say, that's crazy, you're not well enough to do that. You're not going there. This doesn't even make any sense. There's no peer reviewed randomized clinical trial that says you should have the Ayurvedic treatment. There'd be all the very Western medicine type answers. My answer was, if you feel like this needs to happen, let's...
do everything we need to do to make you get there safely. And so I've got her, you know, an assistant that's going who has a healthcare background. I've talked to the medical team over there, like, let's do this. That's what you feel like you need to do. That's not my call. That's for me to help guide you through that. So yeah.
Host
It's almost a therapeutic role, like a spiritual therapeutic role where combined with this kind of ombudsman of, of medical, you know, kind of concierge service. It's so interesting. Excuse me. What, what do you feel? I mean, you mentioned the kind of the Western view, that notwithstanding, do you feel like there are things broken in the medical system that you would wish would change?
Claudia Cometa
Yeah.
Claudia Cometa
endless things. There's endless I'm actually currently in the book editing process of the book of all of this. And I'm they're not allowing me to share the title yet. But it the subtitle is think like a doctor find peace as a patient. And so to honor my publisher, we're still in like the lead editing part. But the point of it is, is to
Host
What's the book called?
Host
Okay.
Claudia Cometa
explain how the system works from like medical training through medical culture, and you know, my husband's a physician, we've been together since high school. So I have been through the entire, like I have seen all of it. I've seen the medical school process. I've seen the residency process. I see him now. I'm very intimately aware of where the gaps start and where the culture begins and why it continues. And
So I, in the book discuss the context behind what some of the frustrations are, because I think giving some context helps people understand, not to say that now we're okay with it and, you know, we would just be passive, you know, recipients of poor care. But if you have some context, it provides a little bit more of an understanding and informs your ability to navigate it. So...
You know, it really starts from the medical training and culture where the brokenness begins. And so I outlined that in the book. But basically, you know, physicians aren't trained about nutrition. They aren't trained about life. That's shifting, but it's such a slow process. It's shifting. There are some medical schools now that do. But as a whole, what medical students are being trained on is, you know, your basic pathophysiology, you know, your biochemistry, you know, the basic things that you need to know about disease. And then...
how to treat them all. Which basically means medications. Like what medications treat this? And that's the training. And then they go to their residency. But nobody's talking about lifestyle factors that are relating to health. And nobody's talking about how to change somebody's nutritional consumption based on what their needs are and their disease. Because they don't know it. And so the frustration on the patient side is.
Well, all I'm being given is medication options. That's all I'm being given. And then this medication is causing a side effect and now I'm getting another medication. And so I usually coach my clients through understanding where the Western medical system does have a zone of genius, you know, it's surgery. Like if I need surgery, there's not really anywhere else I'm gonna be able to go. I can't really go to a chiropractor for surgery. So there's some areas where Western medicine does an amazing life-saving job. And there's some areas where
Host
Right.
Claudia Cometa
there's just an obvious and blatant weakness. And if we can understand that, rather than banging our head on a door that isn't going to open for us, let's use the system for what it's great at. And then if we feel like we need to seek assistance elsewhere, we'll go elsewhere. But I don't really know that answered your question. There's a lot of brokenness in the system. And the physicians and the staff are completely overburdened and not supported. So you have people treating you who...
Host
and never.
Host
So.
Host
Yes, yes.
Claudia Cometa
haven't slept in days, you know, for more than two hours at a time, who, you know, can barely go, I mean, you know, surgeons barely go to the bathroom, they they're in 12 hour surgeries, you know, sometimes they have to catheterize themselves. I mean, there's no time for the bathroom, there's no time for drinking water or eating, you're dealing with staff who are just depleted. So their ability to give to you from a overful filling cup is non existent.
Host
Yeah.
Host
Yeah.
Claudia Cometa
And so there's just a need to understand all of these pieces. And yeah, so that might have been more than what you wanted.
Host
No, I think that speaks to the volume of things that need a bit of a shift. And, you know, the, the common consensus that I've gathered is that there's a lot, there's a lot that needs to be revisited and rethought. Um, most of what I've heard from you just in that little blip was kind of the physician and the educational institutions approach. Let me phrase, uh, kind of a follow-up question here is if you could give,
a patient, someone listening, one piece of advice on what they could do to kind of better their chances at having successful healthcare, what would it be?
Claudia Cometa
to give yourself permission. Give yourself permission to do what you know is right. That might mean give yourself permission to change doctors. That might mean give yourself permission to tap into your intuition and listen to what your body's telling you. I think a lot of symptoms, most all symptoms are messages to us rather than little bits of segmented pieces that we need a physician to tell us what's going on. We're ultimately experts. Experts in a way that a physician can never be.
and a deeper knowing. So I feel like there's this knowing from a knowledge standpoint, and then there's a knowing from just a deeper wisdom, and nobody can have that knowing for you, the second knowing. And so permission to tap into that and listen to it.
Host
advice. I you are the expert on your body, essentially. That's essentially what I'm getting. And it's true, nobody can tell you what pain feels like for you. That's why we have this arbitrary on a scale of one to 10. Where are you? And it's like, well, my 10 is different than your 10. So interesting. Tell me about your company, the peace advocacy group and kind of what
Claudia Cometa
Mm-hmm.
Claudia Cometa
Mm-hmm. Right, right.
Host
what it is that you do. I know you have your own podcast and you have a course as well on patient advocacy. Talk to me about those efforts and what the goals are.
Claudia Cometa
Yeah, so my podcast is Minding Wellness. And so I talk all topics, mind, body, spirit with a variety of guests. And so my company Peace Advocacy Group started, I was the group, I was the solo group for many years and I now have I moved from my original location where I started my company in Gainesville, Florida, and I moved to the Tampa Bay area and I now have an RN.
Host
Yes.
Claudia Cometa
who is sort of my boots on the ground in Gainesville since that area still has a pretty strong word of mouth for the services that I provide. And so we sort of in tandem take care of our clients in our local areas. And then I also absolutely handle all kinds of client needs throughout the country virtually. So that includes...
I'm a radical remission coach as well, which is a body of research by Dr. Kelly Turner with sort of a spiritual intuitive look at how people end up going into remission from cancer that is very outside of what Western medicine expected. And radical remission, yes, absolutely recommend to you and your guests to look into it. You can go to the website, read tons of stories. There's a docu-series.
Host
It's called radical remission. So this is new for me. That's why I said radical remission. Okay.
Claudia Cometa
two books, Radical Remission, Radical Hope, looking at, basically she looked at over 1,500 cases of people who were sent home to basically die that lived the rest of their years because they were end-stage cancer and they're still living. So she was like, this is what I wanna do my research on. Why are they still living and why aren't we hearing about these cases? And what did they do that we don't know to do in the traditional conventional medical system? And so that's that body of research. So I'm a coach on that.
And, you know, interestingly, I have a new client with radical remission. And he said something last week that was so powerful. And he said Western medicine doesn't feel like a resting place. It doesn't feel like home. And like, it makes me want to cry just saying that because that's where I feel like peace advocacy groups help group helps is giving people a home to come to. You know, when they come to me and tell me.
hey, you know, I think I'm having this weird reaction to this medicine, none of the doctors believe it because it's not a reaction that anybody else has. I'm that person who's willing to listen and say, I absolutely believe you, let's talk through it. And so I feel like home is such a great, and I really didn't sort of put that together until he said that. And I feel like home is such a great.
Host
Thank you.
Host
Mm hmm.
Claudia Cometa
visual and we all feel like what an idealistic home would be, which is someplace you can go that's non-judgmental where there's a champion if something were to occur, a kid's bully or somebody's a champion in the home who's gonna step up and take care of that. And then there's times when you might just sit on the couch and be an active listener with the person. And so I feel like that definitely encompasses kind of what our feel is. And then I do host a course for, I have a free course for patients that just to...
Host
Thank you.
Claudia Cometa
overview of how to organize your medical records and get them sort of ready to go if you need them. And then I also host a course for others to become a patient advocate if they're interested in it. And really diving into the mindset shift first before we get into the meat of the program because it really is a mindset shift to go from a traditional clock in, clock out. I work within the confines of my job description to now.
Host
Mm-hmm.
Claudia Cometa
I do, I literally do. I mean, I've been asked to pick up Worcestershire sauce on the way to a patient's house. And I'm gonna, if that's what my patient needs, I'm gonna do it, you know? And so it's a mindset shift. So yeah.
Host
All right. Awesome. All right. We'll be right back.
Host
That's so interesting that the mindset that the worst sure I can never say the word, but the, that, that story is a great example of like what is at the heart of advocacy is like you're essentially you become family in many ways. And so it's like, I don't know. What do you, what do you need is the question. I think that the bigger question for most advocates is where's the line that you can't cross, not the job description. Um, and learning those, you know, few legalities that you have to obviously is really important.
Claudia Cometa
Hahaha
Claudia Cometa
Right.
Claudia Cometa
Mm-hmm.
Host
I think what you're saying, especially with being your own advocate and dictating your own thing, it's so interesting in the DSM five, I think there's a new diagnosis of medical non-compliance. So it's like, if you have this approach as a patient that you disagree, they can actually stick you with a label now that you have a mental disorder of sorts. And so it kind of speaks to the Western approach and how...
Claudia Cometa
Mm-hmm.
Host
Maybe it's not always spot on with what the patient needs. And I feel it in a very deep way. To get to the course and the podcast that you're talking about is the best place to go to your website, peaceadvocacygroup.com.
Claudia Cometa
Yep, everything's housed there, so that's the easiest place. My podcast is also on whatever podcast platforms anybody who's listening listens to. So, you know, if you wanted to pull it up on Apple, that's fine too, but all of it is housed on the website, so that's the easiest.
Host
Well, Claudia, thank you so much for being with us and sharing your journey and your wisdom. It was definitely insightful for me. I'm going to look into radical remission myself because always fun to look up new approaches and I wish you the best of luck and maybe we'll have you back on the show and kind of get an update at some point.
Claudia Cometa
Yeah.
Claudia Cometa
Fantastic, thank you so much.
Host
Thank you.
