Sylester Flowers

1935—

Pharmacist, entrepreneur

Throughout his career as a pharmacist, scientist, and business entrepreneur, Sylester Flowers has maintained his commitment to his full-service community-based pharmacy and his inner-city clients while taking full advantage of the technological advancements that have revolutionized his profession. As founder and chief executive officer (CEO) of the Ramsell Corporation, Flowers expanded into other pharmacy and healthcare-related businesses, particularly the new specialty of pharmacy benefit management (PBM). Ramsell's Public Health Services Bureau (PHSB) was the first and only PBM business in the country to specialize in prescription information and processing for low-income people infected with HIV.

Mentored by Mother

Born on June 30, 1935, in High Point, North Carolina, Sylester Flowers was the youngest of Carrie Flowers Kelly's four sons. At about age three, Syl (as he was known) and his family moved to Pittsburgh, Pennsylvania, where his mother and stepfather, Isaac Kelly, could take advantage of the unionized jobs that were supplying the war effort in Europe. In Pittsburgh the family lived in a poor minority neighborhood. Isaac Kelly worked in a steel mill and, for the most part, Carrie Kelly was a homemaker who motivated her children toward success.

When Flowers was chosen to appear in Aetna's 2005 African American History Calendar focusing on pharmacists, he told them: "My mother would not allow my brother or me to use being African American as an excuse. There is nothing like the opportunity that America provides. I was a kid who grew up in the projects, worked for an education and now has a successful company. Through my mother's mentoring, I learned that anything is possible if you prepare yourself well."

Flowers knew that he wanted to become a professional and improve his economic situation. He told the Aetna Calendar that, although he had planned to eventually become a physician, "I thought that the old-fashioned pharmacist was equally appealing to me because of the way I had always seen people in my community respond to and respect the neighborhood pharmacist. The pharmacy had a soda fountain, something that I thought was charming, and it gave me the best chance to become a health care professional."

Studied Pharmacology

With a scholarship to cover his tuition and fees, Flowers spent his freshman year in college taking required courses at Howard University in Washington, D.C. He then entered Howard's four-year School of Pharmacy, graduating with a Bachelor of Science degree as a clinical pharmacist in 1958. However, during Flowers' student years the pharmacy profession began to undergo a major transformation. While Flowers was becoming an expert at compounding individual drugs, antibiotics and other manufactured pharmaceuticals were coming into widespread use.

Following graduation Flowers spent a year as a research assistant in neuro-pharmacology at the Leech Farm Hospital, the psychiatric unit of the Veterans Administration Hospital in Pittsburgh. He had been a member of the Reserve Officers' Training Corps (ROTC) in college. He fulfilled two years of his military requirement as a medical supply officer at the Brooke Army Medical Center in San Antonio, Texas. Since it was a time of relative peace, Flowers was able to exchange his additional two years of required service for four years in the U.S. Army reserves.

In 1961 Flowers went to work as a pharmacist at St. Luke's Hospital in San Francisco, California. Initially he had planned to go on to medical school. However Flowers told Contemporary Black Biography that, after becoming a pharmacist, "I never looked back for a minute." He discovered that he loved the profession and that—although he had planned to open his own pharmacy in a middle-class neighborhood—there was a tremendous need for pharmacists in underserved communities.

Founded Ramsell Corporation

On January 8, 1964, Flowers opened his own community-based retail pharmacy—The Apothecary—in Oakland, California. He brought to his pharmacy a deep understanding of the community's values and needs, having grown up in a similar neighborhood. In addition to running his own pharmacy, Flowers held other related positions. Between 1970 and 1981 he was an assistant clinical professor of pharmacy at the University of California's School of Pharmacy in San Francisco. As an adjunct professor of pharmacy at the University of the Pacific—a private school in Stockton, California—Flowers supervised and mentored student interns. He also served as pharmacy director for the San Francisco County Mental Health Department's methadone treatment program from 1971 until 1982. There, in addition to making the methadone solutions, Flowers kept the records and performed laboratory tests. He also developed and managed the first outpatient prescription plan for the department.

In August of 1967, Flowers founded Ramsell—named for the street he lived on in San Francisco—as a sole proprietorship. Later he expanded it into an S-type corporation and served as its CEO. Ramsell Corporation at one time owned six community-based pharmacies. However, in keeping with his belief in individually-owned community pharmacies, Flowers sold them off to his managers, keeping only The Apothecary. As of 2005 Ramsell Corporation was a holding company with 36 employees.

Moved into Information Technology

Flowers was at the forefront of the information technology (IT) transformation of the pharmacy business. In 1981 he was one of the first pharmacists in his area to install a computer for managing patient information. He became an IT professional, devoting both time and money to research in health administration technology.

At a Glance …

Born on June 30, 1935, in High Point, NC, son of Carrie Flowers Kelly and stepfather Isaac Kelly; married Susan, 1963 (divorced 1990); married Helen, 1993; children (from first marriage): Eric, Gina, Sylvia. Education: Howard University, BS in pharmacy, 1958. Military Service: U.S. Army ROTC, Howard University, 1953-58; Brooke Army Medical Center, San Antonio, TX, medical supply officer, 1959-61; U.S. Army reserves, 1961-65.

Career: Veterans Administration, Leech Farm Road Hospital, Pittsburgh, research assistant, 1958-59; St. Luke's Hospital, San Francisco, pharmacist, 1961-63; The Apothecary, Oakland, CA, owner-pharmacist, 1964–; Ramsell Corporation, Oakland and Pleasanton, CA, founder and CEO, 1967–; University of California School of Pharmacy, San Francisco, assistant clinical professor of pharmacy, 1970-81; San Francisco County Mental Health Department, pharmacy director for methadone treatment, 1971-82; University of the Pacific, Stockton, CA, adjunct professor of pharmacy, 1975-86.

Memberships: American College of Apothecaries, fellow (F.A.C.A.), 1967–; American Society of Health-System Pharmacists; California Society of Health-System Pharmacists.

Awards: California Pharmacists Association, Academy of Pharmacy Management, Appreciation of Contribution to Pharmacy Management Award, 1980-1985; KQED-PBS California, Hero of the Year, 2004; Aetna African American History Calendar, 2005.

Addresses: Office— 4900 Hopyard Road £282, Pleasanton, CA 94566; 200 Webster Street, Suite 300, Oakland, CA 94607.

In 1992 Flowers was asked to develop an outpatient prescription benefit plan for the San Francisco city and county AIDS Drug Assistance Program (ADAP). ADAPs use state and federal funds mandated by the Ryan White CARE legislation to provide most HIV medications, as well as numerous social services, at low or no cost to qualified HIV/AIDS patients. For the next four years Ramsell managed the San Francisco ADAP as a successful pilot program. The company was chosen to manage ADAPs for Santa Barbara County in 1995 and San Mateo County in 1996.

In 1997 Ramsell's nonprofit subsidiary, the Professional Management Development Corporation (PMDC), was awarded a contract by the California Department of Health Services to consolidate all of the county ADAPs under one centralized program. The centralization was completed successfully within 90 days. The contract was renewed for another five years in 2000. In August of 2001, Ramsell/PMDC was awarded a two-year contract to administer the corresponding program—known as the AIDS Prescription Drug Program (APDP)—in the state of Washington. This contract was later extended for an additional two years.

When the requirement for administration by a nonprofit was dropped, Ramsell's PBM company—the Public Health Services Bureau (PHSB)—took over the programs. As of 2005, PHSB was administering 27 to 29 percent of the Ryan funds for California and Washington, serving HIV-positive, low-income clients who did not qualify for Medicaid.

Sought to Improve
HIV Drug Programs

PMDC became the copyright holder for the software designed by PHSB. The new software, planned for release in July of 2005, was to be used initially for administration of the California and Washington programs. However, Flowers told the AETNA 2005 Calendar, "My driving ambition is to centralize the AIDS assistance programs in the United States so that the level of funding is not based on the policies of individual states but on a centralized federally sponsored program for every eligible patient.… We need to be able to provide a level of care to give patients the best chance across the country. For instance, a single black man in the South may not have access to the medication that he needs." Furthermore, a centralized program would ensure "that treatment would be consistent and accessible when [patients] moved to different states." His experiences in California and Washington convinced him that a centralized program would reduce administrative costs, possibly freeing additional funds for treatment.

Flowers continued to support IT professionals investigating ways to make these programs more accessible and centralized. He told the Aetna Calendar : "There are no shortcuts to experience. This field is highly specialized, and no other company in the U.S. has our level of experience. Technology gives us the tools to efficiently centralize the program and use our nation's health care resources wisely and efficiently."

In addition to PHSB and The Apothecary, as of 2005 Ramsell operated Alta Tierra, a community investment property, and the Flowers Heritage Foundation, funded by Ramsell profits to support programs at Howard University and other pharmacy schools. The foundation also funded a class on diversity at the University of the Pacific. Flowers told CBB that he viewed diversity training as essential for pharmacists with multicultural practices since they are the ones who counsel patients on numerous healthcare and lifestyle issues.

Pharmacy Remained His Avocation

As of 2005 Flowers continued to manage The Apothecary, a 1900-square-foot, state-of-the-art pharmacy, stocking some 3000 drugs and using robotics to fill several hundred prescriptions per hour. Located in Oakland's Wellness Center, The Apothecary remained committed to its ethnically diverse, low-income neighborhood. Flowers told CBB that the community he served both fulfilled his needs and provided him with inspiration.

Flowers believes that, in the age of information, the pharmacist's role has become even more critical. With physicians forced to choose among a multitude of available drugs—about which they may not be well-informed—it has become imperative for pharmacists to keep up with the latest scientific information. Computers can provide pharmacists with information about the known allergic reactions, side effects, and interactions of any drug. Flowers told CBB : "Do you have a question about a drug? Ask us. We are information managers." Nevertheless, information exchange has remained a barrier to good healthcare and Flowers stressed the necessity of clients staying with a single independent or chain pharmacy to ensure that their records remain intact.

Flowers always has viewed himself as a "client-centric" professional. The Aetna Calendar quoted him: "The pharmacist is the most accessible person of the health care team. You don't need an appointment to see a pharmacist. We have the opportunity to take care of the underserved within their environments." Flowers told CBB : "No matter how many doctors you see, you always end up seeing me."

Flowers's children from his first marriage include Eric, president of a Ramsell subsidiary, Gina Nightengale, a deputy director of the U. S. Environmental Protection Agency, and Sylvia, a teacher at a Paris business school. His first marriage dissolved in 1990, in part because of his time-consuming career. As of 2005, Flowers lived in Pleasanton, California, devoting as much time as possible to his second wife and two stepchildren.

Sources

On-line

"About Us," Ramsell Corporation, www.ramsellcorp.com/about.php (January 5, 2005).

"Sylester Flowers, R.Ph." Aetna 2005 African American History Calendar, www.aetna.com/diversity/aahcalendar/2005/aprprofile.html (January 5, 2005).

Other

Additional information for this profile was obtained through an interview with Sylester Flowers on January 7, 2005.

—Margaret Alic

Pharmacist

A pharmacist dispenses drugs prescribed by doctors and health practitioners, and gives information to patients about medicines. Additionally, pharmacists advise physicians on the selection, dosages, interactions, and side effects of drugs. Pharmacists understand the use, composition, and effects of drugs. In a hospital or clinic, they may also make sterile solutions and help doctors and nurses plan and monitor drug regimens. In home health-care settings, they monitor drug therapies and prepare infusions, or solutions that are injected into patients. Many pharmacists specialize in specific drug therapy areas, such as psychiatric disorders or intravenous nutrition.

A pharmacist must have a solid grounding in mathematics. Some of the math is basic and includes fractions, decimals, and percentages. Pharmacists have to understand the metric system and convert measurements such as ounces into their metric equivalents. To read and understand pharmacological research studies, they also must have a working knowledge of algebra, calculus, and especially statistics .

Statistics is a crucial discipline for pharmacists. To measure the effectiveness of drugs, researchers and drug companies use statistical concepts such as population samples, significance levels, statistical errors, statistical power, and mean, standard deviation, and variance. For example, a pharmacist needs to be able to interpret a statement such as this: "The difference in outcomes between drug X and drug Y was significant with p 0.05." This means that the probability of observing this difference in outcomes would be less than 5 percent if X were no better than Y.

see also Measurement, Metric System of; Statistical Analysis.

Michael J. O'Neal

Bibliography

Dosage Calculations Made Incredibly Easy. Los Angeles: Springhouse Publishing, 1998.

Gray, Deborah C. Calculate with Confidence. St. Louis: Mosby, 1998.

phar·ma·cist / ˈfärməsist/ • n. a person who is professionally qualified to prepare and dispense medicinal drugs.

pharmacist (farm-ă-sist) n. a person who is qualified by examination and registered and authorized to dispense medicines.

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