FINDING THE RIGHT PATH IN A SMALL CHAIN

KEITH BIBELHAUSEN HAD BEENout of the pharmacy business foryears, working as a senior vice presidentat an office supply company andmaking a home for himself inAnnapolis,Md. In 2001, he received acall from Dick Hartig asking him torun operations for his company,HartigDrug, a small chain of drug storesin the Midwest. Bibelhausen, who hadpreviously worked for national pharmacychains after graduating fromthe University of Cincinnati PharmacySchool, was interested in gettingback to the profession where he beganhis career, so he accepted Hartig'soffer. Soon, Bibelhausen moved fromAnnapolis to Dubuque, Iowa,where ittook some time to adjust from thefaster pace of the East Coast to thelaid-back atmosphere of the Midwest.The move turned out to be a goodone, as it allowed him to becomeembedded in his community. In Iowa,he serves on the board of directors forthe symphony orchestra and workswith the chamber of commerce, BoyScouts, and various other communityprojects. "These are opportunities Ididn't have working for a larger company," says Bibelhausen.

At Hartig Drug,private life is animportant part ofprofessional life, andbeing a smaller chainoffers pharmaciststhe opportunity towork in their professionwhile maintaininga certain quality of life.Hartig pharmaciesare not open as long as others—there are no 24-hour stores; in fact,most are not open past 7:00 PM, andthey are closed on Sundays and holidays.Bibelhausen says this gives Hartigpharmacists the ability to balance homelife and professional life.

According to Bibelhausen, Hartig isoverstaffed with technicians taking careof the dispensing and the preparation,and the work flow is such that pharmacistscan spend more time with physiciansand patients. Because they arelocated in smaller cities and townsthroughout the Midwest, Hartig pharmacistsare absolutely crucial topatients who do not have insurance—their services are used extensively.

BEGINNING OF THE ROAD

At Hartig Drug, a graduate will startas staff pharmacist, then become thepharmacist-in-charge, and eventuallyexecutive director of pharmacy oncethey are out of school 3 years and overseeinglong-term care. From there, theycan move on to director of pharmacyand then to vice president of pharmacyas they approach retirement age.

"We have an extensive internshipprogram and offer rotational sites for6-year students. One to 2 monthsbefore they are licensed, we bring themon, and they are exposed to a long-termcare pharmacy. They learn oursystems and understand our work flow.Once they are out of school,we considerthem experts in the practice of pharmacy.Pharmacy schools do a great jobof preparing students for the profession.Our program can prepare themfor the business side."

Hartig Drug pharmacists dedicatetime to special screenings and clinics;one store may host an anticoagulationclinic, or Hartig may host a companywideDiabetic Day, for example. If apharmacist wants to get involved with aphysician for a special clinic, however,that is supported and encouraged.With the smaller town pharmacies,Hartig pharmacists will work with localhospitals and serve as consultants,offering advice to patients who are notgoing to a primary care physician. "It isa critical part of the community. That'swhat makes it fun," says Bibelhausen."It's ‘how many people did youhelp?'—not ‘How many prescriptionsdid you fill?'"

As a growing company with newstores opening in Wisconsin and Illinois,Hartig needs pharmacy professionalsto help them grow."We're lookingfor people who are passionateabout the profession and who love people.You have to enjoy talking topatients, and you need to be focused onthe needs of patients and their well-being," advises Bibelhausen. "It is alsoimportant to be a team player—onecompany, one family, one profession."

CLIMBING THE LADDER

In the 24-hour environment that isNew York, pharmacists can find a similardedication to family and pharmacy,as Duane Reade pharmacist Gary Melnick,RPh, discovered in his career. For22 years, Melnick owned his ownpharmacy, before selling it and sendingout his resume to the larger pharmacychains and retailers that weredominating Manhattan. One of themany responses he received was fromRock Bottom, a local New York chainwith 32 stores that was later bought byDuane Reade, one of New York's bestknown and busiest pharmacy chains.

Melnick started asa staff pharmacistand soon began assistingin schedulingissues. His hardwork paid off, andhe was offered asupervisory pharmacyposition. Aftera year, he got a callfrom Duane Reade'sdirector of pharmacy operations,who was looking for someone with athorough knowledge of policies andprocedures. Melnick was the rightman for the job and soon began trainingnew employees, despite havingbeen with the company for only 2years.After 8 months,Melnick becamea pharmacy district manager. Hestayed in that position for 3 years untilhe became district manager for 8months. From there, he was promotedto director of pharmacy operations.

His swift climb up the career laddermay seem unique, but Melnickswears it is typical of Duane Readeand offers it as a perfect example ofhow they take care of their pharmacists.Pharmacy students can get theirstart at Duane Reade as graduateinterns, where new recruits workunder the supervision of an experiencedpharmacist and learn the company'sprotocol. Upon licensure, theywill be well prepared to take on thechallenging role of a Duane ReadeRPh, says Melnick.

"Most—if not all—graduates willstart in the stores. They will have theopportunity to gain real-time experienceregarding the operation of aretail health care business.This is a particularly excitingtime to be part of DuaneReade. We have new leadershipthat is keenly aware thatDuane Reade is a health careprovider. Pharmacy, theheart of our business, is ourmain focus," says Melnick.

New pharmacists atDuane Reade may work instores as staff pharmacists,or they may elect tobecome coverage pharmacists or"floaters" to broaden their generalexperience. Once they are comfortablewith the system, they canbecome pharmacy managers. Thosewho show the ability and expressthe desire to take on corporate positionswill have that opportunity, asDuane Reade prefers to promotefrom within.

MAXIMIZING TIME

One of the ways in which DuaneReade ensures the best use of theirpharmacists'time is through its CentralFill Facility, the only one in NewYork City. A refill is called in throughan automated phone system, andDuane Reade's Central Fill Facilityintercepts the message and fills theprescription within 90 minutes. If astore fills 1500 prescriptions, centralfill gets 300 of them, which eases theworkload.

Duane Reade also employs a pharmacykiosk that allows their pharmaciststo spend more time attending topatient care and reviewing records.This kiosk allows patients to drop offprescriptions without waiting. It alsoallows the patient to connect realtimewith a pharmacist to obtainmedication and health information,and it lets the pharmacist provide liveconsultation to a patient.

"Our chain provides pharmaciststhe opportunity to have direct contactwith a broad spectrum ofpatients," says Melnick. On manyoccasions, Duane Reade pharmacistsbecome the primary health careproviders for the patients; it is thepharmacist who explains the relationshipbetween the drug and thedisease state.

A typical day for a Duane Readepharmacist runs the gamut from fillingprescriptions, reviewing patientprofiles, speaking with patients anddoctors, supervising staff, helping thepublic select OTC products, speakingwith insurance companies, orderingdrugs, and working with store andcompany management, according toMelnick. Many Duane Reade pharmacistsare certified diabetes specialistswith opportunities to participatein a number of outreach programs.

ESTABLISHING VALUES

At Hartig Drug, because the companyis a privately held, family-owned,pharmacist-run company,they do not operate for the benefit ofshareholders. "Decisions are made tofurther the professions and our business.We are customer-and employee-friendly,and there is a genuine familyatmosphere. There is not a lot ofpolitics as one might find in a largerorganization," says Bibelhausen. "Ourphilosophy is to ‘do the right thing,'be honest and upfront, and operatein a straightforward, caring way."

Melnick firmly agrees with thatapproach. "Philosophically, we arehere to serve our public, to providethe best health care services that NewYorkers can hope to receive from anysource," says Melnick. "We create aculture that believes that cost reductionand quality are not opposites."

Ms. Farley is a freelance medical writerbased in Wakefield, RI.