Actually, I think Zpak has always been hospital based, but had a friend in an independent retail setting in S CA.
However, if you really want to be an independent pharmacy owner in S Ca - you'll have to become really well versed in the finance & changing financial picture for reimbursement.
We are moving away from an AWP based pricing to an AMP based pricing for drugs. Likewise...that reimbursement is so low, you'll really have to offer something besides drug distribution.
If you want to do MTM management....I'd really suggest you need to do an ambulatory care residency. You'll have to have great cliniical skills &/or become specialized - like become a CDE. Reimbursement for that & the concomitant liability has yet to be ironed out. We've also not ironed out in CA who, exactly, is skilled enough to offer these services well & in a manner which can be relied upon & trusted by primary care providers.
That brings up the issue of credentialling, which is being talked about here. I don't have a crystal ball, but not just any pharmacist will be able to do & bill for MTM management services - it will require some kind of credentialling to do so.
No - you don't need hospital affiliation (hospitals don't make any money on outpt pharmacies). But...you will need to get out there & devote time, energy & skill in getting in touch with primary care providers - physicians & either their NP's or PA's. You'll also have to devote money to investing in some kind of electronic medical records systems so you can send & get information back & forth readily.
Unfortunately, in S CA - there are lots of big "clinics" - groups of physicians of all kinds - IM, ortho, nephrology, OB-GYN, peds....all grouped together - sometimes throughout a city (The Harriman-Jones group in Long Beach) comes to mind. They have their own anticoagulation service (pharmacist run), lipid clinic, diabetes clinic, etc...so none of their pts would be available to you since they already have that service provided through this group their physician belongs to. Kaiser is exactly like that as well.
You'll need to do a good demographic study of the area & I'd suggest professional help before you invest any money.
However, as a student.....here are some things you can do - join your student chapters of CSHP & CPhA - we are hoping in time these will merge!!!! Investigate a residency in ambulatory care - the best ones in CA are within the Kaiser setting - unfortunately. However, there are some throughout the country which are non-hospital system based. Some I've seen are in a Walgreens-type setting & some are in a completely independent setting. Just remember - you can't translate from one economy to another. But, keep your mind open - you might just want to move to that kind of economy which more readily supports an independent practice.
Good luck - but do join the associations, become involved in the student affiliations & GO TO THE MEETINGS! Listen to what is being talked about. That will help you know what's coming, who the movers & shakers are within this state & help you start networking - which you'll have to develop a skill for.
Good luck!!!
