McKesson : Why the Future of Your Independent Pharmacy Depends on Patient Care

Today is a challenging time to be a pharmacist and own an independent pharmacy. No one knows that more than Mark DeWoskin. He is a pharmacist, a former pharmacy owner and now franchise director at Health Mart, McKesson's independent pharmacy franchise.

As part of our new series, Pharmacist to Pharmacist, we asked DeWoskin how your independent pharmacy can overcome many common challenges in today's market. We also asked him about the benefits of making patient care the center of your new business model.

What are you responsible for in your role?

DeWoskin: I'm a franchise director for Health Mart. I'm a business consultant and an advocate for independent pharmacies. My job is to understand what's important to independent pharmacy owners and bring them resources and ideas to help them compete. I'm always looking for new opportunities and partnerships to help independent pharmacies continue to thrive and adapt as the industry changes.

What are the biggest challenges independent pharmacy owners face?

DeWoskin: They have the same concerns about lower reimbursement for drugs and DIR impacts to their cash flow. They want to know where the bottom is. They want to know how they can continue to compete. You can do all the right things to bring patients into your store. But business is more complicated when you're not paid adequately for what you do. They want to know how to diversify and stay relevant when the dispensing business model continues to get squeezed.

What about common operational challenges for independent pharmacies?

DeWoskin: Pharmacies have different operational challenges. But the challenges all come down to one thing: time. They know margins are down and the workload is up. They know they must diversify their business model. 'Where do I find the time to change? I'm already working so many hours a day.' Before, they could hire more staff to implement a new program. Now they can't.

What advice do you give them about how to find the time?

DeWoskin: Our independent pharmacy owners need to embrace technology. Many of them haven't or have avoided technology. They believe it takes away that personal touch. They believe it's that personal touch that differentiates them from the pharmacy chains. Just the opposite is true. By doing more things manually, they're taking away from the time that they can spend with patients.

How can technology help independent pharmacy owners the most?

DeWoskin: Refills and inventory are two areas. Patients should be able to refill a prescription online or through an app. The pharmacist doesn't have to take a refill order over the phone, or in person at the store. Medication synchronization, especially through technology, continues to be an underutilized tool to improve inventory and operational efficiency. Unused inventory is killing them and their cash flow. 'I need all this stuff on my shelves or my patients will go somewhere else.' No, you don't. You need inventory management tools to track product turnover. You need to know what and how much to keep at any one time. With money tight, many spend a lot of time ordering products and overseeing inventory management when there is great inventory technology available.

What other business strategies should independent pharmacy owners consider?

DeWoskin: Most independent pharmacy owners are pharmacists and many have not received classic business training. Some don't have a business plan. Others have one but haven't looked at it since their store opened. The first thing would be to have a business plan. The second thing would be to revisit that plan at least on an annual basis. How does that line up with your profit and loss statement? Where are your controllable expenses? Have you created a business case for the services you offer or would like to offer? You can then set financial goals and benchmarks and adjust during the year to stay on track.

Improving patient care is a priority for independent pharmacies. What are your suggestions?

DeWoskin: We talk to our pharmacies about the shortage of primary-care physicians in their markets. We ask them how they can fill that void. We talk about the services they could provide to their patients. That's what they went to school for. That's what they truly enjoy. New value-based care models depend on controlling the total cost of care. Pharmacists are going to be the key to keeping costs down.

What are some clinical services independent pharmacies can provide?

DeWoskin: There are many. Medication synchronization is one. Med sync can help improve medication adherence. Disease management. Vaccine programs. Point-of-care testing. One of the fastest-growing ones I've seen lately is administering antipsychotic medications. There's a big shortage of injection sites. Collaborating with manufacturers to support, administer and bill niche drugs is a huge opportunity for independents that is just beginning to develop. Doctors are feeling overwhelmed, and that creates a need in your community.

What are your thoughts on the expanding role of the pharmacist as a provider?

DeWoskin: Everything we're talking about is within the scope of practice for a pharmacist. They are very capable of providing clinical services. They are very excited about the transition to a provider. Some are afraid of doing something different. Most are excited to do more for their patients. They're also excited that payers will reimburse them for their knowledge and skills.

Are there other trends pharmacists should watch and stay on top of?

DeWoskin: They should be involved with their state and national pharmacy associations. That way, they can stay on top of provider status opportunities. They will know what new things they can do under their licenses. They should stay on top of new health plan benefits and payment models. There are some opportunities to get reimbursed for services today, and I believe we will see those continue to grow. There are also new opportunities to be a part of coordinated-care teams under value-based reimbursement models and incident-to billing.

What will an independent pharmacy look like five years from now?

DeWoskin: Five years from now, most patients will be getting their medications delivered to their homes. It could be from a pharmacy or an online retailer. Most pharmacists won't be dispensing drugs from behind the counter. Five years from now, pharmacists will be spending most of their time on individualized patient care. They will be working with patients on their medication use and other healthcare needs. It will be the individualized care they trained for in pharmacy school.

What was your most memorable moment as a pharmacist?

DeWoskin: I became a pharmacist because you're accessible to patients. You're more accessible than a physician. There are so many ways you can touch patients directly. When you can go out of your way to help a frustrated mom get the right medication for her child in the middle of the night, that's what was most satisfying to me. You very quickly become part of their family.

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 growth and expansion services for independent pharmacies