Dr. Mollie Scott on contraception and public health

Not everyone has the opportunity to work in the place where they grew up. Asheville native Dr. Mollie Scott, chair of the Department of Pharmacotherapy at UNC Health Sciences at Mountain Area Health Education Center, knows she is lucky in that respect. Scott first pursued her interest in health care at an animal emergency clinic while attending Enka High School (now Enka Middle School). Recently, the regional associate dean for UNC and associate professor in clinical education has been working “right up the road” — less than a mile away — from her former high school at MAHEC’s Enka-Candler campus. 

Scott also completed rotations at MAHEC and worked at Mission Hospital in intravenous care as a pharmacy student. She settled here for good in 2001 and has raised children and a gaggle of animals. (Her husband is a veterinarian, and “it’s very hard” to say no to adoptable animals, she says.) 

Scott spoke with Xpress about a new grant to train pharmacists on providing contraception, working at the nexus of social issues and public health, and what she wishes more people knew about pharmacy. 

This interview has been condensed for length and edited for clarity.

The Duke Endowment recently awarded you a $705,000 grant to support training pharmacists to provide hormonal contraception — birth control pills and birth control patches — across the state in order to reduce unintended pregnancies. Can you tell us about it? 

North Carolina passed [House Bill 96, enabling pharmacists to provide hormonal contraception and other medications] a little over a year ago. I was very involved in a task force on contraception for our state society, North Carolina Association of Pharmacists [Task Force on Pharmacist Prescribed Hormonal Contraception], looking at how other states have handled this [issue]. A lot of states have legislation [to allow pharmacists to dispense hormonal contraception, but] didn’t really move things forward at a rapid pace. We wanted to accelerate the uptake of pharmacists providing the service because we think it’s important for the health of women in North Carolina. We saw a grant with the Duke Endowment, and we were fortunate enough to get that.  

Which geographic areas or demographics will the grant focus on? 

We’re focusing on any woman in North Carolina who is seeking contraception. We know that there are gaps in care for different demographics of women. There are areas within the state where folks may not have access to a health department or a gynecologist or a family physician. There may be women who have difficulty getting off of work to go and seek care, or [they] have to figure out child care or transportation. We’re particularly interested in women of color because we know that African American women are suffering higher rates of maternal mortality. 

Focusing on access to contraception so that women can plan their family — when and if they want to have a family — is really important. It’s important that a woman be able to use a contraceptive she likes, that she can get it when she needs it and that we can work with her and her family going into a pregnancy and hope that [this relationship] then positively impacts maternal mortality [rates] down the road.

With access to contraception in mind, how do you feel about the pharmacist’s role in where public health intersects with social issues? 

I think the role of the pharmacist in public health is becoming more and more recognized. We teach our students how to care for patients, no matter their belief system. That can come into play as you’re caring for patients who maybe don’t want to be vaccinated. It could come into play where maybe there’s a pharmacist who has conscientious objection to initiating hormonal contraception or providing emergency contraception. There’s a stance from the [North Carolina Board of Pharmacy, a state public health department,] that says if you are not able to provide care for a patient because of conscientious objection, then we have a duty to facilitate care for that patient and help them to go to a provider who can help. 

We teach our students at [UNC] and we talk a lot about ethics around contraception, emergency contraception [and] certainly medication abortion. Because we know that there are different opinions that people have toward the way those medications work and whether they believe they’re helpful or harmful. 

But how do you personally feel about the role that pharmacists have? How does it feel to be, in some ways, on the front lines of those intersections of public health and social issues?

We think about this concept of reproductive justice, which is something that’s been championed by SisterSong [a reproductive justice coalition for women of color]. I really do embrace their philosophy that reproductive justice involves ensuring that women have access to care — and that’s a right — and that they also have bodily autonomy to be able to make decisions about their own health care, what medications they’re going to use and how they would manage an unintended pregnancy. That is their decision between them and their provider. Those are things that I believe strongly. I know that not everyone believes those things, so I try to be respectful and listen and be open to others’ opinions. 

[This contraceptive grant] is one way that I feel like I can give back to women in North Carolina, by creating an additional access point for women to go to see a trusted health care professional who is on the front lines of health care and serving important public health roles and is knowledgeable and can help the woman and select a contraceptive that will be safe and effective for her. If it’s something that we’re not able to provide because we can’t do all the products, then [we can] connect her with another health care professional within her community who can meet that need. 

What do you wish people knew about pharmacists? 

So many things. Pharmacists have a doctorate degree. I think that’s important for people to know. And we are kind of that last line of defense for the public before they get their medications. Our goal is to make sure that the medication is safe and effective for the patient, that their medications are optimized and that they’re achieving the goals that we want for them and that they want to achieve for their health. 

[And] pharmacists are everywhere. We work in so many places. If you’re in an ICU, there’s a pharmacist behind the scene. If you are somebody who just had a heart attack and you’re over at the Heart Tower at Mission, there’s a cardiology pharmacist there who’s working with your physician in the team. If you have a loved one in skilled nursing, there’s a pharmacist reviewing your loved one’s medications every single month. People think of us in community pharmacy settings. But we are in lots of other places behind the scenes working to make sure that medications are safe and effective.