Your independent pharmacy must shift from a dispensing business model to a clinical business model to continue its vital role as a health resource in your community. But where do you as a pharmacist and a small business owner find the time to make that transition?

In this edition of Pharmacist to Pharmacist, Karen Merrill, regional director of franchise operations for Health Mart, shares her thoughts on how you can use your staff and technology to free up more time for direct patient care. The net result? Better clinical outcomes for patients and better business outcomes for your pharmacy.

What are you responsible for in your role at McKesson?

Merrill: I serve as a business consultant for our independent pharmacy customers. My job is to advocate for our pharmacies and offer them the types of programs and services that they need to improve their operations. I spend most of my time meeting with owners and pharmacists onsite at their locations to discuss their challenges and help identify solutions.

When you meet with independent pharmacies, what issues are keeping them up at night?

Merrill: We hear a lot about declining reimbursement and declining margins. They often mention how running a pharmacy is getting harder because of regulatory pressures and industry integration. We get a lot of questions about laws and compliance. We also hear about the need to shift to a clinical business model from a dispensing business model. Most of my conversations with them are about those things and what we can do together to put them on the right track for success.

What types of operational issues prevent independent pharmacies from being on the right track?

Merrill: Pharmacists went to pharmacy school. They didn’t go to business school, even though they’re running a small business. In a lot of situations that we see, the pharmacist owners aren’t good delegators. You try to do everything yourself. You count the pills. You put them in a bottle. You answer the phone. You ring the register. When you try to do all that yourself, you’re slowing down your entire operation. And let’s be honest, there’s nothing magical about doing those things. You really don’t need a pharmacy degree. Trained technicians and staff and new technologies can do all those things. You need to see your operations differently, and you need to see your role differently.

What is the right role for a pharmacy owner in the operations of an independent pharmacy?

Merrill: As an independent pharmacist, the right place for you to be at any given time is with your patients. You need to let your staff and technology do all the other things so that you can engage with patients at each and every opportunity. This is what we mean when we talk about shifting to a clinical model from a dispensing model. It doesn’t mean that you stop dispensing drugs. It means that your focus now is on direct patient care, and the dispensing is done other ways.

What types of clinical services do you think independent pharmacies should provide?

Merrill: You can do all kinds of things. I’d start by expanding your immunization program. If you’re like most pharmacies, you already do seasonal flu shots. What I’m talking about is expanding to a year-round program. You can do age-related vaccines for meningitis, pneumonia and shingles. You can do travel vaccines. You don’t have to cram everything into October just for flu season.

Other than immunizations, what clinical services should independent pharmacies consider?

Merrill: I think the next steps above a year-round immunization program would be wellness screenings and point-of-care testing. The equipment is all safe to use in your pharmacy setting by a trained pharmacist like you. You can partner with local businesses and community groups to check blood pressure, blood glucose, and cholesterol levels. You can screen for influenza and strep infections. You can even do specialty medications.

How do new clinical services address the concerns about declining reimbursement and margins?

Merrill: They are new revenue sources for your pharmacy. As reimbursement and margins drop, you have to think about ways to replace your lost revenue. You have to think about new revenue sources, and that means diversifying your business into niche clinical products and services.

What technologies can independent pharmacies use to free up time for new clinical services?

Merrill: The first thing I hear when I talk about adding clinical services is, “I’d like to, but I just don’t have the time.” This gets back to my earlier point about using your time wisely by delegating the more routine tasks to others. Well, you can delegate some of those routine tasks to machines. You can have an interactive voice response system to take phone calls and handle simple transactions. You can have a mobile app for refills. You should have e-prescribing capabilities. You can have machines that count pills and some that even put them in bottles or do compliance packaging for you. The technologies can be expensive, but they never call in sick and or check email when they should be doing something else.

Other than new technologies, what trends should independent pharmacies stay on top of?

Merrill: One that I mentioned earlier is important, and that’s industry integration. I’m talking about big deals like Amazon buying PillPack or CVS buying Aetna. How will those deals change the landscape for independents? You can’t bury your head in the sand. You have to know what’s going on in your market and how it can affect you. You also have to get involved with your local, state and national pharmacy organizations to help them advocate for you with legislators and regulators. You want a level playing field. And you want patients and payers to recognize you as providers.

How would you describe the daily life of an independent pharmacist five years from now?

Merrill: I think it’s going to be very different in a good way. You will be spending most of your time on patient education and providing clinical services to your patients. There will be more small private areas to have one-on-one conversations and less space devoted to dispensing product. Quite honestly, most of your drugs will come directly to your pharmacy or directly to patients from an offsite central fill pharmacy.

What is one of your most memorable moments as a pharmacist?

Merrill: My most memorable moments as a pharmacist happened when I was an intern at my father’s pharmacy. My dad was a pharmacist, and he owned an independent pharmacy. I grew up watching him take care of his community. It taught me how much small independent pharmacies mean to their towns and the people living there. People didn’t call their doctors in the middle of the night. They called my dad. He’d go down to the pharmacy, open it up, fill the prescription and drive it over to someone’s house. That’s the legacy I want to continue in my work with our customers.

Editor’s note: If you have a question for one of our pharmacists, please leave a comment and let us know. We’ll be sure to cover it in a future edition of Pharmacist to Pharmacist.

Related: Learn more about McKesson’s Health Mart franchise program

McKesson

About the author

McKesson editorial staff is committed to sharing innovative approaches and insights so our customers can get the most out of their business solutions and identify areas for operational improvement and revenue growth.

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