Expert: Community Pharmacies Remain Pillar of Patient Care

In an interview with Pharmacy Times, Chris Peshek, director of pharmacy operations at Discount Drug Mart, assesses the state of the community pharmacy field and discusses the importance of community pharmacists in building relationships with patients. Additionally, Peshek talks about the value of pursuing a position in the community pharmacy field.

Pharmacy Times: Can you go over some of the recent trends you've seen around Discount Drug Mart and the community pharmacy space as a whole?

Chris Peshek: Yeah, so we're in a period of a little bit of flux as far as redefining the profession of community pharmacy. So, continuing that march toward changing the profession from a product-based profession to a service-based profession. And while that transformation is taking place, we also had the pandemic and challenges with reimbursements from third parties, which is an ongoing topic that's very big in the in the news right now. But those are the major the trends right now. We're seeing this shift from product-based to service-based and all the different services that community pharmacy can provide for patients. And then while we're having that transformation, just finding ways to generate revenue and profit within the current infrastructure, and then also kind of coming out of COVID.

PT: How have community pharmacies been able to bounce back since the end of the COVID-19 pandemic?

Peshek: Yeah, it doesn't seem like it's been that long, even though the state of emergency has been over for a while now. I think in some ways, we're still kind of almost feeling that hangover from that incredible period that we went through and the efforts that almost all community pharmacies and pharmacists across the country made during the pandemic. I think the biggest positive that came out of that was that community pharmacies and community pharmacists were able to demonstrate on a scale never seen before the impact that we can make in public health and patient health, by mobilizing in a way that we did, and providing vaccines and tests and other necessary treatments and tests during that time in a way that had never been done before. I think and I hope that the profession demonstrated a significant value to those that maybe didn't realize it before that. And so, trying to carry that forward, and now see, we showed what we could do during a state of emergency; now that we're not in a state of emergency, what else can we do now for public health and for the communities that we serve?

PT: What advantages do you think that community pharmacies and pharmacists have in providing important services to patients?

Peshek: There are a lot, I could probably talk about that for, you know, an hour, but in an effort to try to be efficient and concise, I'll just say that the access to the community itself is fairly unrivaled across other health care providers and professions. And the ability to be so accessible, and to just pick up the phone and call. And you know, if you or I wanted to speak to our doctor, it's probably unlikely that you would get the doctor on the phone within five minutes, right? You didn't have to go through a couple of layers and maybe get a call back. Whereas with pharmacy for the most part, at least speaking for Discount Drug Mart, you pick up the phone and call, without too much hassle or effort, you're going to be speaking with a pharmacist and be able to get some questions you have about, whether it's your medication or your condition, you're going to be able to get those answered and pointed in the right direction. So I think that accessibility in the community is something that puts us in an advantage or puts us in a place where we can really make an impact in community health.

PT: How can community pharmacists work to address underserved communities that may not have a pharmacy close to them, and increase access for these patients?

Peshek: Yeah, trying to find a cure for the pharmacy deserts, or maybe even more broadly, healthcare deserts, like you were speaking to, it's a challenge for us as a company and also just for healthcare in the United States in general. And for pharmacy specifically, I think one of the biggest issues that we're up against – not just us, but the industry – is, because of the very, very, narrow margins that pharmacy is currently experiencing, that to be able to keep in operation of pharmacy in certain areas where maybe you don't have the volume or the efficiency that you would in another area, is really challenging. I think there are different ways to approach that. But in order to solve it kind of systemically, I think what it will require is either changes to the way that pharmacies are reimbursed for prescriptions, and/or some kind of subsidy that's provided to pharmacies in those communities so that they can make sure that they can remain in operation and not go out of business.

PT: How can community and retail pharmacies work together with prescribers and treatment providers to optimize patient care?

Peshek: I think there's a lot of opportunity there. Because, as I mentioned before, being in the community and being so accessible, the pharmacies have a really unique opportunity to engage with the patients at that level. But the prescribers could benefit from the knowledge and the information that the pharmacies are able to gain and the contact that the pharmacies are able to have with patients, and vice versa. Pharmacies could benefit from the data, lab values, office visit notes, and things like that, that the prescribers have. So there's a real opportunity there for data sharing to make a meaningful impact in healthcare. Right now, the problem is there's not a good system for that. So every doctor's office, every pharmacy uses a different system, though systems don't always play nice and share data together. You end up with this disparate data, or data is not flowing back and forth, or when it is flowing, it's too much, and it's information overload. So, moving forward into the future, I would like to see some kind of standard established where that data can be shared back and forth so that it's impactful and actionable, so that both prescribers and pharmacists can kind of collaborate for the patient's healthcare and make better decisions which lead to better outcomes.

PT: How can a career in community pharmacy be rewarding for those who pursue it?

Peshek: Yeah, I'll just I guess I'll just speak for myself because that answer is probably going to be –– if you ask 10 pharmacists, you'll get, you know, 12 different answers. So I'll kind of speak for myself on that one. But for me, and I know I'm just repeating the same thing here, but it really is about that relationship with the patient at the community level. For some pharmacists, maybe that's not something they're looking for, you know, they want to be more clinical, more like hospital-based. And that's good, too, because we need those people in those positions. But for me, the draw to it, and the benefit that I thought I could make in the community space was really being able to meet people where they're at, on their level, and make those connections and kind of make that difference there. Just to give you an example, there was a gentleman at a pharmacy where I used to practice who was very resistant to vaccines. You know, for one reason or another, I won't get into that. He was just – wasn't a big fan. And over time, developing a relationship with him to the point where we had trust in each other and he had trust in me, I was able to kind of get him to see the benefit there for his health care, and receiving, say, for example, an annual flu vaccine. And then he began pursuing that and sought that vaccination, and you know, most likely had improved health outcomes as a result, but that recommendation may never have been accepted and had the relationship not been there first. So that kind of thing is what was really kind of rewarding for me, and the reason I pursued the profession and continue to do so.

PT: What can you do in your position to advocate for the profession and ensure that a new generation of community pharmacists can take the reins?

Peshek: So I tell this to everybody: get involved in an organization, whether it's your state organization or a national organization. I think pharmacists in general, we can be a little bit of like a timid, conservative group, and don't always speak our mind, necessarily. So being involved in that organization gives you an avenue to advocate for the profession, whether that be politically or publicly or just in the public domain and the kind of dialogue that's happening in media and things like that. So get involved in something like that. I try to speak up where I can. Most recently – we operate in Ohio – so testifying before Congress for legislation that's going to affect our profession. Not everybody might have that opportunity. But just speaking up for the profession, speaking up for yourself, especially if you're younger or coming into the profession fairly recently, looking at several decades of professional practice ahead of you, it's important to advocate for the profession, so that you can kind of practice to the full extent of your license for the duration of your career.

I mean, along the lines of what you're asking about trends, I think that attending those conferences, and again, that's not something that everybody has the opportunity or the time to do. So I'm lucky that I'm able to do that and go and learn about what's up and coming for the profession, learn about new ways to advocate for the profession, learn about new technologies that will free up the pharmacists to provide more human interaction and patient care and remove some of the busy work type stuff that maybe can be done by, whether it's AI or technology or, you know, various other processes. So I would say that's something that I look forward to when I go to conferences like TSE, is what's coming and how can I use what's coming to better advocate for the profession as a whole and for Discount Drug Mart as a company?