RxGenius

Pharmacists Should Hire Other Credentialed Practitioners

This is third in a Series on Transitioning from a Drug Store to a Wellness Store.

Last week I received an email from an independent pharmacist commenting on the shortage of pharmacists and his interest in hiring other credential practitioners.  Most of us know that the shortages are caused by increased demand (one-two punch of increased use of drugs and aging of the baby boom population), shortage of pharmacy schools, and the most intriguing reason, “increases in the volume and range of activities demanded of today's pharmacists”  – specifically patient counseling.  In fact experts are predicting a shortage of 150,000 pharmacists in 2020 in spite of 15 new pharmacy schools due to open by 2010.

For those who are looking for career security, a pharmacy degree is sure bet.  But in the meantime, for consumers need is growing and it’s the body of knowledge and the clinical license to practice that’s important to them.  So independent pharmacists would do well to expand their store staff to include practitioners in other modalities to help with expanding demands for patient information.  Here’s a list of potential modalities that could fit into an independent pharmacy.

Nurses – In spite of the nursing shortage, there’s a host of nurses in the market who are burned out on patient care in traditional settings and want to use their knowledge in a less stressful, more holistic way.  Nurses are super additions to an integrated pharmacy due to the scope of their license, knowledge of physical systems and science, familiarity with drugs and experience with patient communication.  Look for these kinds of nurse specialties: Licensed Practical Nurse, Nurse Practitioner, Nurse Educator, Primary Care Nurse, Clinical Nurse Specialist, and Registered Nurse.

Licensed Dietitian or Nutritionist – Often very valuable in health food stores, dieticians and nutritionists won’t have as much value to an integrated medicine pharmacy unless a large part of their retail floor is food.  Certainly special diets are a big part of many patients health and wellness concerns and weight management seems to be everyone’s issue; but when considering this modality, look for the dominate categories in your store and select the clinician to match the merchandise mix.

Naturopathic Physicians – The often overlooked modality of Naturopathy would be a good fit for an integrated medicine pharmacy.  Still only licensed to practice in 15 states, a naturopathic physician’s body of knowledge is extensive, especially in nutritional supplements and alternative therapies, having had four years of training in a residential naturopathic medical school.  One way to differentiate between a naturopathic physician and a traditional naturopath is to ask for a copy of their degree.  There are only six accredited colleges of Naturopathy in the United States, all other schools are short programs or correspondence schools.  One big advantage of this modality is they qualify to buy and resell professional lines of nutritional supplements from companies like Metagenics, Thorne Research, Standard Process and more.  These supplements could be merchandised behind a counter set up as a high touch personal counseling area.  Pharmacists would need to look into regulations governing scope of practice.

Homeopathic Specialist – Many pharmacists already are familiar with the discipline of homeopathy.  This modality, practiced more widely in Europe and Canada, is still a respected modality offering substantial clinical education.  Like Naturopathy, these clinicians can provide both customer/patient information and support the professional nutrition and therapeutic supplements part of the store.

Licensed Massage Therapist, Estheticians – Many licensed massage therapists and estheticians don’t end up making a living in these professions full time.  LMT’s are excellent for running the body care, therapeutic and medical device departments whereas Estheticians would be good for health and beauty categories in an integrated medicine pharmacy.  The added bonus is their hands-on license.  Sometimes a patient just need a little hand or neck massage to feel just that much better.  These modalities are also great for in-store demos and value-add high touch services like chair massage and natural hair and skin care – rapidly growing categories.

Oriental Medicine, Traditional Chinese Medicine & Herbalists – Of course, Traditional Chinese Medicine is a now a widely practiced primary care modality in the US, licensed in 44 states.  But one of the best integrative medicine pharmacies I saw was in Washington DC where compounding was performed in Oriental and Ayurvedic herbs as well as pharmaceuticals.  Consumers who use Chinese and other herbs would benefit from a more retail like environment where they can replenish their prescriptions and seek additional information. 

Certified Health Coach – These professionals are a hard to find group now, but I predict they will grow especially with respected Duke University’s launch of their Integrative Health Coaching training program.  Integrative medicine pharmacies that want to transition from a drug store to a wellness center would do well to incorporate such a professional into their mix and broadcast this unique service far and wide, especially as a way to compete against the rapidly growing trends to put primary care clinics in supermarkets.      

So now you’ve got some ideas of the types of clinically trained health professions that would fit with an integrated pharmacy.  But who can help you with store merchandising, selling, ordering, and marketing?  And how can you find such a person?  Is a clinical person, such as a nutritionist or herbalist the right kind of person to hire?

There’s no single answer to those questions and there are a variety of considerations which sounds like the answers would be a good topic for my next post.

Until then, visit my website, or email me.
Linda O’Hara

The Green Pharmacy

As one of the original attendees of the 1st Earth Day and a third generation ecologist, the concept of ‘going green’ is not new, it is a lifestyle.  Many of us have waited a long time for the rest of the country to wake up to the necessity of caring for the only planet and home that we have.   Astronauts look at our world from space and marvel at its beauty; astounded at the thin layer of atmosphere that protects us from destruction.  Native Americans have encouraged their philosophy of living with nature, not against it. Our country and our corporate structures are the largest contributors of waste in the world. All this is finally changing.  It simply has to. 

Making your home and your life ecologically friendly takes a mind set to make some changes in the daily habits; and pharmacies can help in a great way. 

Pill Return Program:
Making sure you have a standard recycling program for paper, plastic and glass is a start. Research shows that 89 percent of consumers throw their unused pharmaceuticals in the trash or down the toilet.  Since this has been in the news lately, your pharmacy can join a pill return program.
Dumping medications harms waterways and eventually could harm people if we drink the water. 

As a judge in the local school district Science Fair, I had the honor of previewing one of the student’s 2 year studies on the percentage of estrogen that is in the water system. Her award winning study began long before the news announcement we are now familiar with, and the resulting information is being used as part of a longer term county study.

By joining a pill return program, your pharmacy is giving your patients another option. Medication received is sent away to companies that safely disposes of them. The medication is incinerated in an environmentally proper way and in most cases, the service is free.

There are some limitations, such as needles, inhalers, or controlled substances such as Vicodin that are not accepted.  You must assist in educating your patients to remove personal information before they recycle anything.

Totally Green Power Source:
The Village Green Apothecary in Bethesda, MD is the first pharmacy to have all of its electricity supplied by wind power -- a clean, alternative energy that doesn't cause global warming.  The sign on the front door tells customers about it as soon as they arrive, and little windmills throughout the store are whimsical reminders.

"Most people don't realize how easy it is to do something like this," said owner Marc Isaacson.  Isaacson pays wind power association Native Energy a yearly fee to replace the traditional electricity the shop uses with wind power. The wind energy doesn't actually come into the shop but is replaced at the power supply, reducing the amount of carbon dioxide produced.  Native Energy is run by a consortium of tribes from the Great Plains that uses the money to fund more wind farms throughout the country.

The Village Green Apothecary is a health and wellness center that offers a wide array of herbal supplements, organic products and books. Now that the shop is going green, it's encouraging its customers to do so as well. Pamphlets about buying wind energy are available in the essentials to healthy living section, and books on the environment are prominently displayed.  Isaacson said he wants customers to realize they can make a difference.

Recycled Electronics:
Whether you have an old pc or a slightly abused cell phone, there are organizations in your community that will refurbish and reuse this equipment.  Contact your local schools to find out if they have a program. Many refurbish and donate these items to families in need.  Your county may have a program to reuse the valuable metals inside the computers or electronics. 

Adopting An Area:
As a young girl our camping trips always started out by cleaning up the camp site before we settled in.  My mother said “we must leave this area in a better condition, than when we arrived”.   Many towns now offer local retailers the ability to adopt-a-highway or a section of a local park.  This is an excellent opportunity for you to show your sense of community to your customers.  The time required is minimal when it is divided between all of the staff. Many can use this as a family participation, demonstrating to the children the priority of keeping our earth clean.

Organic Products:
Organics are also not new, but are one of the top purchased items in the country.
I used to have to order these products on-line and pay a much higher price.  Mass merchandising chains have realized that there is a great demand and have are stocking/selling at an amazing rate!  Organic products do not pollute the environment nor do they contain the chemicals that contribute to illness. Offering your customers the choice of organic fair trade coffee and food items will bring new customers to your pharmacy and impress upon existing customers your commitment to their health. 

Environmentally Friendly Products:
Environmentally friendly soaps and washer detergents, diapers/baby items, and paper products will bring you more devoted customers. There are so many more choices and selections now available for you at reasonable prices.  If your supplier doesn’t offer them find out why.  If they don’t have an answer, find a supplier that will include them in your inventory selections.  It won’t be long until that supplier begins to realize they need to make some changes.

Pharmacy Technologies:
Talk to the vendors that supply you with the various automations and technologies in your pharmacy as well as those that you are considering purchasing products from.  Thankfully, it has become an appealing attraction for corporations to show that they are environmentally friendly in both the production of the products as well as their factories/locations.  They know that people are making product choices based on how ‘green’ the company is.  A quick phone call or e-mail to existing vendors might get a few recommendations for adjustments in your technology that could reduce electric use or use the technology in a more efficient manner.

Plastic or Paper = Neither:
The City of Seattle is considering a fee to be added to all purchases using plastic or paper bags. Part of the fee would go to the retailer, the rest to the city for the cost of recycling the waste.  Although this is the most radical move in any city so far, they are also considering extending it into the restaurant business for using foam and non-recycled plastic containers. This may seem like a longer term scenario of acceptance for the shoppers in the U.S. as they slowly make the transition from plastic bags to reusable, environmentally friendly carriers.  However, most of the large mass retailers have already begun following the path of the health stores by offering these bags at the front of the store at very inexpensive prices.  This is a lifestyle change that people will be happy to adjust to, if they realize they will be charged extra for items that are not ‘earth friendly’.

Conscious Purchasing Choices:
Many consumers are examining the packaging of the items they are seeking to buy:  The face moisturizer that is packed in 2-3 different plastic containers so that it will look appealing – is no longer popular.  Vegetables prepackaged in foam and plastic wrap is passé. Foam packing peanuts are being replaced by recycled paper with further r&d into alternatives. 

Your pharmacy can make the same environmentally friendly choices in the products that you offer to your customers.  From how your supplier ships the products to what you put on your shelves, every effort makes a difference.

Karen Sulprizio
Email Me or Call Me: 1-866-312-8324

Bucking Bronco Health News Requires Information to Cushion Consumers Landing

News headlines and industry emails last week compressed the usual see saw of news about drugs and supplements into a few days that felt like riding a bucking bronco.  No consumer could possibly keep up with the conflicting messages and sort thru the confusion without a lot of research time or – here’s where pharmacists come in – an easily accessible, knowledgeable clinician.  Without one, most consumers just get thrown off.

I read the electronic edition of the New York Times every day.  Last Sunday, I read news that pharmaceutical companies may be close to a legal shield from lawsuits if the Supreme Court rules so in a case involving Johnson & Johnson, makers of the Ortho Evra birth control patch, and over 3,000 women and families who have sued over claims that the drug caused injury and even death.  Called “pre-emption,” the legal argument is that since the drug was previously approved by the FDA, manufacturers cannot be sued, even if the manufacturer did not disclose to consumers correct information about the ingredients.  I wondered how pharmacists reacted to this news…

Two days later, Jane Brody, the NYTimes Personal Health editor, wrote a stinging article calling use of dietary supplements “substance abuse.”  In it she threw punches at the industry with oversimplified statements, a couple of extreme consumers examples and quotes and testimony from Center for Science in the Public Interest, a Washington DC based education (read lobby) organization known for it’s conservative views on nutritional supplements.  There were no balancing viewpoints from the Council for Responsible Nutrition, the Dietary Supplement Information Bureau, or the Natural Products Association, industry education (more lobby groups, but these are friendly to or created by the natural products industry).  This same story was respun the very next day for the television audience on CBS, this time using a nutritionist.

By Thursday, the biggest health headline in the New York Times and Pharmacist eTalk was the news that heparin, a blood thinner manufactured by Baxter International and approved by the FDA, was suspected in 62 deaths, most likely due from – yep, you got it, tainted ingredients from China.

The fact is that science, industry (both pharmaceutical and natural products), government and media have been creating wave after wave of conflicting information for decades that causes confusion and fear among consumers, especially those who do not have the time, the resources or even, perhaps the education, to understand the stories, put the information in context and make their own informed decisions.  Most consumers, just like I did for the first 30 years of my life, take doctors words and government regulatory proclamations as the “gospel.”  But when science and consumer experience is showing that doctors advice and government agencies are flawed, where can consumers go to sort things out?  Just take the 2002 hormone replacement therapy (HRT) revelations and the current responding backlash from pharmaceutical companies against bioidentical hormone replacement therapy (BHRT). 

Pharmacists are perfectly positioned to help us.  I use the word “us” intentionally, because as a leading edge baby boomer, I, my friends and my family, are all riding the same horse and we've been riding this bucking bronco for three decades.  To whom can we turn to help us? 

To walk into a integrative medicine pharmacy with professionals who have the knowledge, education and an unbiased viewpoint about both drugs AND supplements and herbs would be a blessing and here’s why:

• Community pharmacies are walk-in retail environments.  I don’t have to get permission from a doctor or an insurance company to talk to a pharmacist.  I could have more than 7 minutes to share my history and ask my questions.  I’m even willing to pay for this access to professionals and their time out of my pocket, like most integrative medicine consumers do.
• Integrative pharmacies that sell remedies across the spectrum demonstrate their acceptance of an integrative, whole health point of view, and therefore, acceptance of me.  I don’t have to worry that I am being judged, or that I have more education about health and wellness than the person to whom I am speaking.
• Many of the newer pharmacists are female, making personal, private conversations easier.  The older ones schooled in “weeds and seeds” decades ago start out with accepting the breadth and depth of available, affordable remedies beyond drugs.
• Pharmacists help explain what I need to pay attention to – from nutrient depletions caused by drugs to all the potential interactions – and can help me manage my own health in a more informed way.

And I’m not talking about Walgreens or CVS here.  Only independent, community pharmacies can deliver the kind of personal attention and information over my lifetime that will help cushion the jolts and bumps from the bucking bronco health headlines.

Linda O’Hara
Visit my website, or email me.

Do It Yourselfers - Learn A Lesson

My husband and I are self-proclaimed do-it-yourselfers.  We have a history that involves fixer-upper older homes with the desire to learn and take pride in having accomplished a well-done project ourselves.  From tiling, painting and building our own enclosed back porch – our construction jobs have been many!

This positive attitude changed when Hurricane Charley hit.  Our older asphalt roof came off in so many pieces, that they were found 8 houses down.  We still had a roof, which, is a lot more than I could say for the people in Charlotte Harbor, FL.. So, we told our insurance company to wait on stopping by and pay attention to those that really needed their attention.

3 months later, the insurance estimator told us that only the front half of the house needed to be done; get an estimate on half a roof – and they would give us $2,000.   Since a roofer will never do half a roof – the cost for a new roof was $10,000 for our 1 ½ story, 1400 sq ft home.

My husband and I looked at each other – and began doing the research.  Roofing materials alone were impossible to find due to the hurricane. 8 weeks later – we were ready to roll up our sleeves and start the project ourselves.

To begin with, I am terribly afraid of heights.  So, I took off my glasses, climbed on the roof and we began the project.  Electric nail guns, asphalt cutters for the custom edge pieces and the ‘black tar’ goo that was needed to seal the peaks.  We spent every weekend for 3 months. For the 2nd story portion, we got an electronic ‘lift’ – and it did help a bit – when carrying the 50 lb wrapped bags of asphalt roofing materials. 

It was a long, horrible, hot and terrible project.  It took every minute of every weekend; and we both were having nightmares where we could hear the pop-pop-pop of the nail gun.

When we were done, we had professional roofers check the job – and they marveled at the excellence and care that we took. 

The moral of this story is – that we learned our lesson.  If I had to do this over again – we would take a loan out to pay a roofing company. It took hours and hours to finish; all of our free time, and we realized that there is a reason why people hire professionals!

We may still paint and tile our own home – but, we measure the amount of time it will take and balance that against the cost of hiring someone.

Our time is valuable.   We have learned the lesson the hard way.

You are a Pharmacist – specializing in customer and patient service.  Your time is valuable as you have so little free time.

When considering any technology, including a web presence or Loyalty program for your pharmacy –  Don’t try to do it yourself.  In most cases, it will take long involved hours and days of your time and, will probably not look professional. 

You want products that reflect the high standards that you take pride in.

Karen Sulprizio
Email Me or Call Me: 1-866-312-8324