Going Toe-to-Toe With the Goliaths

I work for Medicap Pharmacy, a locally owned franchise, in Austin, Minnesota.

Austin is where Spam is produced, and it is also within striking distance of the renowned Mayo Clinic. Our pharmacy is the underdog when it comes to big business. Building our business is kind of like planting and growing a 4-inch-tall tomato plant in a garden that already has 4-foot-tall weeds surrounding it. The challenge can be stressful and tiresome but also rewarding. Let me share some tricks that I use to help attract customers and keep our pharmacy in the game with the Goliath chains.

I have always wanted to establish point-of-care services in our pharmacy, specifically, flu and strep throat testing. We have done well in offering immunizations. However, with more of the large chains catching on to our ideas, we needed to expand even further. My enthusiasm to start testing was in place. The technical pieces to run the tests were at my fingertips. Our biggest challenge was finding a collaborating physician to work with us on building our new niche. I read in many magazines about chains working with medical or pharmacy schools to establish the practice but not much about independent pharmacies moving into this new frontier. I was surrounded by the fear of liability by local physicians or the attitude of “what’s mine is mine, and what’s yours should be mine also.” This David did not give up.

Three years ago, our wholesaler Cardinal Health called to ask whether I would be interested in a pilot project to offer flu and strep testing to our customers. This included not only testing but also prescribing. It was a miracle that this landed in my lap. Throughout my career as an independent pharmacist, I had done the grunt work to establish services. I had created the relationships with local providers and then manifested the collaborative practice agreements. Suddenly, it was all laid out for me: a doctor who was going out on a limb and a collaborative practice agreement for me just to sign. I had a choice between continuing to bang my head against the wall and trying to make this work and taking the money and running. I did the latter.

To practice my technique, I studied YouTube videos and practiced on my technicians. They especially loved the nasal technique for the flu tests. I promised I would not try to tickle their brains. Day after day, I thought about how this new flow would work in our pharmacy. Do I get our techs involved? I decided to work at it alone from start to finish. The pharmacists initiated the entire assessment, and we also ran the tests. If we needed to prescribe, we dosed the patient, ran the prescription, and then offered counseling about any medications we had suggested.

We did a lot of in-store marketing with bag stuffers and flyers. However, my biggest driver to get people into the store was running radio advertisements and calling or writing all the day care centers, public health services, and school nurses in town and in the surrounding communities. I always kept Go-Gurt in my freezer and offered it free to both my patients and their parent or guardian while they waited. I figured that a little frozen probiotic would be a nice touch in these situations. We also offered to flavor the kids’ medications using our FlavorRx machine and designed a adherance chart for children. If they colored in their compliance charts and brought them back to the store, we gave them a free voucher for an ice cream cone at the Dairy Queen across the street.

I was very scared during the first couple of tests I ran. There were so many unknowns, but the biggest was whether my technique was good enough to create a positive test if the patient truly was infected. When my first “positive” flashed on my rapid strep test machine, the jitters were gone.

One takeaway I got from this experience is that as a provider, you must be confident in your technology and, more important, confident in yourself. In addition, I truly believe that follow-up is key. I do my best to follow up on patients in about 5 days to find out how they are doing and whether they are complying with their medications. I hope this shows that service is our priority and we care about patients’ well-being.

We have done well, and I hope it continues. I am proud of our staff for trying something new and stepping it up when a pharmacist is taken out of the workflow. We have been honored to speak about this service at the Cardinal Health trade show and have won honors for pharmacy innovation and local business awards.

There are other things about working in an independent phar- macy each day that makes this all worthwhile. My boss gives me the wings and trusts that I will lead our pharmacy to profits. In addition, we do not bill insurance for the tests, only the prescriptions, so it is strictly cash. Not having an insurance noose makes me feel great.

Recently, after I had performed an assessment and a strep test on a young girl, she asked whether I could be her doctor. I had not felt that shiver race up my spine for quite a long time. It reinforced why I am an independent pharmacist.

Not only are we standing toe to toe with the Goliath pharmacies, but we are leading the pack.

Chris J. Meyer, PharmD,RPh, is a pharmacist at Medicap Pharmacy in Austin, Minnesota.