How Desi Kotis is Leading the Way in Pharmacy

Time has a way of putting things in perspective. Not long ago, Desi Kotis had what she calls a “big birthday.” That means she hit a milestone number. Until then, Kotis had spent her entire thirty-five-year pharmacy career at Northwestern Medicine. As she blew out the candles, she realized something—she may have just one more chance to make a lasting impact.

It was an epiphany. “I knew that if I had one chapter left in my career, I wanted to lead a pharmacy enterprise in a special organization with strong leadership,” she explains.

Kotis found that opportunity at UCSF Health, where she received a dual appointment as chief pharmacy executive for the healthcare network and vice dean of clinical affairs for its school of pharmacy. UCSF Health is anchored by the renowned UCSF Medical Center, the teaching and research hospital founded in 1907. UCSF Benioff Children’s Hospitals has four campuses and physicians from more than fifty specialty areas. Together, health system clinicians provide award-winning care across several regions of Northern California.

UCSF Health is all about providing great care, using the latest technology, and advancing biomedical research. It features not only the medical center, but clinical trials, a school of medicine, a school of nursing, and a school of pharmacy. The unique combination of care, technology, and research was too much for Kotis to pass up.

When she joined UCSF in 2020, Kotis immediately noticed something. “We want to be the best, and we serve the whole community,” she says. “We care for the uninsured, the underinsured, and the most vulnerable, and our leaders go beyond teaching this vision. They live it out every day.”

Officially, the UCSF mission is “caring, healing, teaching, and discovering.” Not only does UCSF aspire to be the best care provider—the organization also strives to be the best place to work and the best place for teaching and research. Kotis says that after four years at UCSF, she’s still “giddy” to be working with the people behind this mission. 

Kotis has helped UCSF break down organizational silos and modernize its structure. When she arrived, the pharmacy department operated independent of the health system. “My main goal was to be more collaborative and transparent with learners, the schools, physicians, and others” she says.

At UCSF, Kotis is embedded in the C-suite as chief pharmacy executive. The strategic move helps the health system use her expertise. Nearly all patients interact with pharmacy. Moreover, pharmacists deal with technology, compliance, clinical practice, and quality improvement. They see the impact of drug costs and policy changes, and they create specialty services that assist clinicians and improve outcomes. “Pharmacy is a business within a business,” says Kotis. “Having a domain expert at the table with the CEO and COO is key.”

Thirty-five years at Northwestern gave Kotis a front row seat to innovation. Clinical pharmacy was in its infancy when she started there in the 1980s. Soon, Northwestern started a meds-to-beds program to deliver medication and personalized instruction to patients before they leave the hospital. Then, the system launched acute care, community clinics, and infusion centers. As its number of residents, specialties, schools, and students all increased, Kotis had the unique opportunity to develop a health system’s future workforce pipeline.

Today, Kotis draws on these experiences as she elevates the pharmacy enterprise UCSF. Since her arrival, Kotis has grown the system’s ambulatory care and patient assistance programs. Her team has also expanded both retail and specialty pharmacy while launching their own meds-to-beds initiative. These efforts together are increasing patient access to information and medication.

An embedded and responsive pharmacy department helps UCSF care for the most vulnerable populations in its region. The health system established pop-up vaccination centers to get COVID-19 vaccinations to unhoused individuals in Northern California. Now, that effort has evolved into roving mobile units that provide COVID, flu, and mpox vaccines, as well as expanded services from vaccine to wound care and harm reduction (which includes fentanyl test strips and naloxone distribution.

Currently, Kotis continues to improve and optimize UCSF’s ambulatory care practice and medication access program. She is also looking at options for in-home infusion services. Meanwhile, the system is expanding through mergers and acquisitions. UCSF has entered into an agreement to bring on both Saint Francis Memorial Hospital and St. Mary’s Medical Center in the spring of 2024.

With four hundred more beds coming into the system, Kotis and her team are once again focused on patient experience and continuity of care. “We want to deliver care from entry to discharge in a safe and effective way that is very patient-centered. We want each patient to know the name of their pharmacists and pharmacy technician,” she says.

Not long ago, Kotis celebrated another milestone birthday. As the big day approached, friends and colleagues asked her about her legacy.

“I don’t care about legacy,” she says. “I care about where we are as a health system. I care about the profession and the value we bring to our patients. We are here on a mission to take care of our patients. Training, education, authenticity, good leadership, and quality care….those are the things that matter to me.”