Anyone wanting to own their own pharmacy? or already do

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Doctor M is correct on the issues that are going on in the chain industry today. My wife who is also a pharmacist works for one of these chains and is going thru the same troubles he is. Being in the real world has sure changed the mindset of my friends of work life, work satisfaction, and work compensation. Again most of these people would be more than happy to trade compensation for work satisfaction and a less stressfull atmosphere. The friend of Doctor M is about how my other Pharmacy is producing however compesation is not as great because I own the building (mortgage), I also recently started an insurance brokerage, own a PBM which I am handling a few accounts, own a 18 room motel which is located at my other location and I also just started my new pharmacy 7 months ago so a lot of my compensation is diverted to those previously mentioned items.
My initial start up was probably more around 120K, however I did alot of the construction and work my self. I ordered all my shelving but I did all of the installation for everything in my pharmacy to help cut cost. My initial inventory was 45K and this was financed through the wholesaler. My computer software cost 4K and computers I was able to get at a really good price. For my office I just reused old desk furniture and other such items. So there are many ways to help cut costs. It has been mentioned what to do if you want to do other things and be different. Of course everything cost money and cash flow needs to be assesed before making all major purchases such as compounding equipment, etc. It may be that you have to be a regular independent for a little while before you can branch out. But everything is on an individual basis and things are different for everybody.
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fieldkj said:
Doctor M is correct on the issues that are going on in the chain industry today. My wife who is also a pharmacist works for one of these chains and is going thru the same troubles he is. Being in the real world has sure changed the mindset of my friends of work life, work satisfaction, and work compensation. Again most of these people would be more than happy to trade compensation for work satisfaction and a less stressfull atmosphere. The friend of Doctor M is about how my other Pharmacy is producing however compesation is not as great because I own the building (mortgage), I also recently started an insurance brokerage, own a PBM which I am handling a few accounts, own a 18 room motel which is located at my other location and I also just started my new pharmacy 7 months ago so a lot of my compensation is diverted to those previously mentioned items.
My initial start up was probably more around 120K, however I did alot of the construction and work my self. I ordered all my shelving but I did all of the installation for everything in my pharmacy to help cut cost. My initial inventory was 45K and this was financed through the wholesaler. My computer software cost 4K and computers I was able to get at a really good price. For my office I just reused old desk furniture and other such items. So there are many ways to help cut costs. It has been mentioned what to do if you want to do other things and be different. Of course everything cost money and cash flow needs to be assesed before making all major purchases such as compounding equipment, etc. It may be that you have to be a regular independent for a little while before you can branch out. But everything is on an individual basis and things are different for everybody.
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you are a serial entrepreneur!!!! I love it!!!:thumbup:
 
fieldkj said:
Doctor M is correct on the issues that are going on in the chain industry today. My wife who is also a pharmacist works for one of these chains and is going thru the same troubles he is. Being in the real world has sure changed the mindset of my friends of work life, work satisfaction, and work compensation. Again most of these people would be more than happy to trade compensation for work satisfaction and a less stressfull atmosphere. The friend of Doctor M is about how my other Pharmacy is producing however compesation is not as great because I own the building (mortgage), I also recently started an insurance brokerage, own a PBM which I am handling a few accounts, own a 18 room motel which is located at my other location and I also just started my new pharmacy 7 months ago so a lot of my compensation is diverted to those previously mentioned items.
My initial start up was probably more around 120K, however I did alot of the construction and work my self. I ordered all my shelving but I did all of the installation for everything in my pharmacy to help cut cost. My initial inventory was 45K and this was financed through the wholesaler. My computer software cost 4K and computers I was able to get at a really good price. For my office I just reused old desk furniture and other such items. So there are many ways to help cut costs. It has been mentioned what to do if you want to do other things and be different. Of course everything cost money and cash flow needs to be assesed before making all major purchases such as compounding equipment, etc. It may be that you have to be a regular independent for a little while before you can branch out. But everything is on an individual basis and things are different for everybody.
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Who is your wholesaler?
 
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It depends on which chain you work for. If you work for WAGs, or CVS then don't expect to practice pharmacy. Expect to be the "green" button pusher and schuking out as many scripts as you can. As an intern, I make it a point to get out from behind the counter to help a patient with a script. (but if I stay a pharmacist with this company, I know I will have no time for patient interaction, except quick consults)I am even uncomfortable counseling on some medications because there is no privacy for the patient. It gets especially rough when you're yelling over the intercom to counsel.

I also work for a grocery store chain pharmacy. It's much more relaxed there as the workload is about 50-60 scripts/day as opposed to 300-400 at the chain store. There we really get to educate the patient about there meds and take the time necessary to talk to them. It does get slow at times but I would rather work there.

If I had a business, I would take the latter. I'm thinking about building a private consultation room into my pharmacy plans. What do you all think?
 
blueclassring said:
It depends on which chain you work for. If you work for WAGs, or CVS then don't expect to practice pharmacy. Expect to be the "green" button pusher and schuking out as many scripts as you can. As an intern, I make it a point to get out from behind the counter to help a patient with a script. (but if I stay a pharmacist with this company, I know I will have no time for patient interaction, except quick consults)I am even uncomfortable counseling on some medications because there is no privacy for the patient. It gets especially rough when you're yelling over the intercom to counsel.

I also work for a grocery store chain pharmacy. It's much more relaxed there as the workload is about 50-60 scripts/day as opposed to 300-400 at the chain store. There we really get to educate the patient about there meds and take the time necessary to talk to them. It does get slow at times but I would rather work there.

If I had a business, I would take the latter. I'm thinking about building a private consultation room into my pharmacy plans. What do you all think?
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:thumbup: Go for it!!
 
I'm glad you started this post...i have 3 questions:

1) how do you compete with the $4 generics?

2) is it realistic to open up in a big city dominated with Walgreens and CVS?

3) Did you open your own pharmacy or did you buy someone else's with an established customer base?

thanks so much...i will be adding my opinions to this thread...
 
what are some other up and coming trends or ideas for opening an independent pharmacy??
 
pharmd2b2009 said:
I'm glad you started this post...i have 3 questions:

1) how do you compete with the $4 generics?

2) is it realistic to open up in a big city dominated with Walgreens and CVS?

3) Did you open your own pharmacy or did you buy someone else's with an established customer base?

thanks so much...i will be adding my opinions to this thread...
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1) Match them, you can still make money off several drugs, although the margin may not be as large.

2) Not every city, this would really be a case by case type situation.

3) Taking over an existing independent would be WAYYYYY easier.
 
I can see how its way easier to take over an already established pharmacy...I was wondering if fieldkj did that.

Also, I'm pretty sure matching the $4 generic is not the best way to compete with walmart; or at least that would not make an business sense. I'm still not convinced that the profit margins are enough.

Compouding, immunizations can temporarily cover the costs...but in the long run with BHRT controversy and big pharma trying to manufacture their own BHRT's, compounding may not be the answer; and immunizations is just a seasonal opportunity.
 
My wholesaler is Mckesson.

I dont know if there is a "best" answer for the $4 generics but i do match and have my own list that is comparable to walmarts. I know that margins are cut dramatically but if I dont match most people will leave and go somewhere else even if my service is greater. The pocketbook is the most influencing thing to get people to change.

I have done both when it is concerning the startup of a new pharmacy from scratch and buying an existing pharmacy. I started my own pharmacy 7 months ago and I am currently in the process of buying my family's exisiting pharmacy.

For the question of new routes or niches, I have started what I call my retail Health Clinic where I am currently doing INR/PT for patients and a doctor, Cholesterol screening, A1c screenings, osteoprosis screening. Also in this health clinic I have physician that comes and treats opiod addiction and I am looking to add another physician to the clinic. For these physicians I do the liver function tests and drug screens for a fee. Of course I also use this clinic for immunizations, counseling, MTMs, etc.
 
The other avenue that is opening up is accptance of Herbals among physicians resulting in increased sales.

INR/PT monitoring in a retail setting? never heard of that! Do you mind sharing the role of a pharmacist in such a setting? I'm assuming you have to set a protocol with an institution.
 
my role is to monitor the PT/INR for the warfarin patients. I use the finger stick device and patients are much more comfortable with this set up than the usual blood draw. Also i am able to have results to the doctor within 10 minutes in case of a critical value. I do have a protocol for the patients and I charge 10 per test which is equal to most of the patients lab copays. For the cash patients I am saving them a large sum of money. I am currently working with the physican to begin billing the insurance companies through his office.
 
These are all great ideas! Great job fieldkj!

One question, how do you market your services to physicians in the area? Do you go their office and let them know what you are doing?
 
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blueclassring said:
These are all great ideas! Great job fieldkj!

One question, how do you market your services to physicians in the area? Do you go their office and let them know what you are doing?
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I am wondering the same thing- do they get part of your revenue for recommending patients?
 
pharmd2b2009 said:
The other avenue that is opening up is accptance of Herbals among physicians resulting in increased sales.

INR/PT monitoring in a retail setting? never heard of that! Do you mind sharing the role of a pharmacist in such a setting? I'm assuming you have to set a protocol with an institution.
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There are also other avenues of pharmacy that school never mentioned. I am currently managing an independant Long Term Care pharmacy. Its kinda like a mini-hospital. I do easy IV abx, and compliance packaging for nursing home and assisted living facilities. the margin is about 3-5% more than regular retail, and you dont have to match the $4 generic.

You could also start up a small business as an independant pharmacy consultant. Get a few nursing homes to consult (once a month) and the rest is cake.
 
tobie said:
You could also start up a small business as an independant pharmacy consultant. Get a few nursing homes to consult (once a month) and the rest is cake.
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can you explain this a little bit more in detail?? thanks!
 
With the long term care side of pharmacy, it is a good oppurtunity because most home are not happy with their current pharmacy. I consult for one home that is located in my community and I also supply them their meds, I have not yet opened or diversifiend into a LTC pharmacy because of time constraints. However, I am in talks with the home about doing so. The problem that nursing homes and independent pharmacies are having is that most of the LTC pharmacies offer the consulting service for "free". I have worked for LTC pharmacies and they are making so much off of dispensing that they can afford to have consultants on staff and basically not charge the homes. However, in some states such as New Jersey the consultant pharmacist is not allowed to be employed by the dispensing pharmacy.
Another avenue that I am doing for my LTC facility is that with my PBM technology I am auditing the bills from the pharmacy to the home. They are many overcharges to the home that usually are overlooked and I am able to stop this.
 
fieldkj said:
With the long term care side of pharmacy, it is a good oppurtunity because most home are not happy with their current pharmacy. I consult for one home that is located in my community and I also supply them their meds, I have not yet opened or diversifiend into a LTC pharmacy because of time constraints. However, I am in talks with the home about doing so. The problem that nursing homes and independent pharmacies are having is that most of the LTC pharmacies offer the consulting service for "free". I have worked for LTC pharmacies and they are making so much off of dispensing that they can afford to have consultants on staff and basically not charge the homes. However, in some states such as New Jersey the consultant pharmacist is not allowed to be employed by the dispensing pharmacy.
Another avenue that I am doing for my LTC facility is that with my PBM technology I am auditing the bills from the pharmacy to the home. They are many overcharges to the home that usually are overlooked and I am able to stop this.
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do you ever think that you have given rise to too many different areas in working for yourself in pharmacy...meaning do you think that you will ever pick one area i.e. the LTC or your drug clinic and stick with that ??
 
FYi...feildjk i was just talking today to a walgreens pharmacist earlier today and i asked what other clinical avenues was walgreens looking at other that Diabetes,Immunizations,etc. She said anti-coag and HIV clinics were the other ones they are looking at.
 
Not really, I believe that I am just keeping my options open. I will have my wife joining my in the coming year to help with the actuall pharmacy and clinical matter which she wants to do. My parents who are both pharmacists are able to cover the pharmacy while I work on all these avenues of pharmacy for myself. I will also have my brother who is finishing up his MBA to help run the business side of my company. I wont deny that there are times when I am overwelmed with some of the stuff but I am young and I can handle it. Things will eventually pan out and there will be more of a focus at some point but for the time being I will focus on it all. With all of the endevours I hope to someday be able to hire a pharmacist to handle the everyday dispensing and I can work however I want. But for the time being I will continue to drive everything that I have going on.
I have not thought about doing the HIV clinics but it would probably be a good idea but I know that Walgreens is doing this to drive more patients into the store for increased dispensing revenue. I am really enjoying the opiod addcition clinic. 1. I truly feel that we are making a difference in these individuals lives and 2. it helps my bottoms line.
 
I think the idea of clinics inside pharmacies are getting really popular...I know that cvs has purchased the "minute clinic"
 
Yes these clinics are growing in popularity and I think that it would benefit independents to included themselves in this growth. I personally have developed a relationship with multiple physicians that understand that they have to embrace these models and include them into their own business models because they are taking money away from their bottom line. Myself and physicians are putting together a business model to provide this type of clinic to the community. I hope to have it implemented within the next year.
 
If you have a head for business go for it. I initially thought I would run my own business when I went into pharmacy. I found that I did not have the spirit for that to my surprise. I also thought at the time that there were no opportunities in view of the chains, etc. However, after the pharmacy degree I saw many changes in pharmacy. Home infusion moved from the hospital to the market place, nursing home pharmacy became an institution, mail order was created and continues to grow, compounding became a stand alone, etc. Home health care is hot today. I suggest rather than trying to beat the big boys at their game, instead look for the special needs in your community that are not being satisfied. The small business administration people have courses that may help. I believe technology will continue to change pharmacy and along with these changes there will be losers and winners. Watch the trends and perhaps you will be a winner.
 
why start an independent pharmacy with huge initial start-up costs, and big monster chains that can eat you up? seem so risky.

how about an internet pharmacy-related business? drugs.com is founded, i believe, by a group of pharmacists from so-cal. web 2.0 is still the future.
 
Of course its risky, but why work for someone else and have them dictate what I do with my life and how I practice? If this doesnt work out I can always work for someone else, you only get a few chances in life to work for yourself
 
fieldkj said:
Of course its risky, but why work for someone else and have them dictate what I do with my life and how I practice? If this doesnt work out I can always work for someone else, you only get a few chances in life to work for yourself
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:thumbup: What he said!
 
xml2 said:
why start an independent pharmacy with huge initial start-up costs, and big monster chains that can eat you up? seem so risky.

how about an internet pharmacy-related business? drugs.com is founded, i believe, by a group of pharmacists from so-cal. web 2.0 is still the future.
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Treat your patients with compassion and if you open up across the street from where you use to work I bet they will follow. Build a relationship with them and call them by first name (if they are ok with it) and they will love you. You will succeed. The chains can kiss my ...well you know the rest. :laugh:
 
that is the beauty of being an independent pharmacist, and this is why customers will keep coming back!
 
A quick story about an independent who forced a CVS to close, I have a friend in the town next to mine that used to work for CVS and after ten years or so became very frustrated with the chain mentality and the way they were forcing him to practice. So he quit and opened up his own pharmacy in the building NEXT door to the CVS that he had worked at. After about two years most of the CVS patients transfered over to him and then CVS closed its locations. He is now expanding into the old CVS space. Score one for the little guy.
 
It all comes back to how you treat the patient. I love talking to patients about their meds. I spent 5 minutes talking to a guy about mercaptopurine last night. he really wanted the information and it felt great to use that knowledge to help him out.

As independents, we have to go the extra mile and I think customers really look for that. These are my intentions as well.
 
blueclassring said:
It all comes back to how you treat the patient. I love talking to patients about their meds. I spent 5 minutes talking to a guy about mercaptopurine last night. he really wanted the information and it felt great to use that knowledge to help him out.

As independents, we have to go the extra mile and I think customers really look for that. These are my intentions as well.
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I agree and I find for the most part- it isn't really work- most people(not all) like going the extra mile to help others...unfortunately in a fast paced/ busy retail atmosphere you don't get the opportunity to do that!
 
A question we all need to ask ourselves is how much is quality of life worth to us. Maybe if you open your own business you will never make as much as you would at a chain ( i disagree but lets just say you dont), how much is being able to close if you have to, to hire a pharmacist to take a weekend off, to make your own decisions, to practice how you want, to make your own hours worth? These are the questions that have to be asked frequently
 
Best way to start it up is to offer "Short wait times", as it will be short for sure for the first few months or so as you get your bearings and customer base. As the customer comes to drop off/pick up Rx's build up rapport with them, start to know them and their families etc. and then as the client base builds up they might not mind the waiting time as long as there is some short time to talk to you, their favorite pharmacist, be sure to also do the phone call check ups to show them that you care what is happening to them (sfx etc.).

As for lifestyle, I know of three independent pharmacists that makes specialty MD's shake in their pants when discussing salaries (one managed to gross over 1million in a year with online Rx's.. but his salary has died down since new bylaws came into place)... note: I only KNOW 3 independent pharmacists.
 
fieldkj said:
AND I AM QUOTING WHAT SHE SAID INFRONT OF OTHER STUDENTS AND FRIENDS, "You are wasting your life."
Needless to say we didnt get along after that
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What a bitch! I hope you told her off. Owning your own pharmacy is getting harder everyday. The only way I could see one surviving with the big chains is too offer something they don't..ie. compounding (sterile and non sterile), equipments, etc. I used to work for a compounding pharmacy that net about 10mil a year for the owner...his main money maker was the compounding business for pets, HRT
 
collegegirl247 said:
can you explain this a little bit more in detail?? thanks!
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sorry it has taken so long to respond to your post. Look at http://www.ascp.com the American Society of Consultant Pharmacists website. Basically as an independant consultant you contract with a nursing facility (who are required to have a pharmacist look at patient records once per month), show up and spend 4-10 hours going over doctor orders and making therapeutic suggestions to their doctors. sometimes you will need to sit in on a psychotropic meeting too. Depending on how large the facility is your contract would equal about $55-70/hr (remember you will need to pay taxes that is why this is a larger number). To start out, I would suggest working at a regular pharmacy, or LTC pharmacy for behind the scenes stuff, so you will be making your regular salary plus have insurance for the family.

hope this helps
 
I have been reading other posts in this thread concerning starting a pharmacy. While retail will always have its woes, compounding, various selection of natural products and fast/friendly service will keep you afloat. One idea that you must consider is having a contract with a NP and having a clinic in the pharmacy. I know one pharmacy in the entire tri-county area that has one. They are having great successes from it. While the NP can not force the patient to fill at your pharmacy, it is very convenient for them to walk 30 feet and get the Rx fast.

The pharmacist that I work with is considering opening our own assisted living/hospice pharmacy. (our current pharmacy owner sucks and is a b@stard.) Neither of us knows how to run a business, but we do know what it takes to make a pharmacy go. This may be a direction to go in the next 2-3 years or so. there are many resources out there for pharmacists who are looking into buying or starting their own. i would refer you all to www.ncpanet.org

good luck!
 
I attended the McKesson conference in Las Vegas this past Wednesday. They really had great student programming pushing people to get into ownership via the junior partnership model. It was also a fantastic place to network.

I would advise students interested in ownership to attend these events(BTW, ths event was free for students.) The display convention itself featured many different products that would be sold at your pharmacy(ie. if you owned one. different meds, different DME equipment). The next years conference will be in Orlando in July.

The next big thing coming up is the NCPA conference in Orlando. They have great student programming there as well, and it is fantastic way to network
 
I agree that trade shows and any conventions that you can attend will only help you with ambitions of opening you own pharmacy. Networking is very important and will open many diffrerent oppurtunities for you.
 
I think that we need to bring back the importance of health care...I blame the chain retail stores for making prescription drugs "no big deal"...

this is why:
1.) customers have their prescriptions at 10 different pharmacies (can anyone say "duplicate therapy and interactions?!?!")
2.) They want all their prescriptions to be free or $4.00 (" do you match Krogers price?")
3.) They want it to be filled in 10 minutes ("all you have to do is put a label on it, right??!!??")

I want to be an independent specialized pharmacy who cares about my patients and who knows all their medications. I want my patients to care about their health- and not to treat it like its "no big deal"...this is your life- you only get 1!!!
 
collegegirl247 said:
I think that we need to bring back the importance of health care...I blame the chain retail stores for making prescription drugs "no big deal"...

this is why:
1.) customers have their prescriptions at 10 different pharmacies (can anyone say "duplicate therapy and interactions?!?!")
2.) They want all their prescriptions to be free or $4.00 (" do you match Krogers price?")
3.) They want it to be filled in 10 minutes ("all you have to do is put a label on it, right??!!??")

I want to be an independent specialized pharmacy who cares about my patients and who knows all their medications. I want my patients to care about their health- and not to treat it like its "no big deal"...this is your life- you only get 1!!!
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.....and what makes you think an idependant would be any different?
 
Independents are different because we ARE different. I run my pharmacy the way that is the best for myself and my patients. Yeah, i match prices but I have never had to because my prices are always and I mean ALWAYS lower that the big box stores and chains. I fill RX's faster than any of the big boys, I run my own opiod addiction clinic (I HIRED A DOCTOR), I even started my own insurance brokerage to help the elderly with their medicare part D. So yes, I am different and am successfull at being so. I have made it so that a robot cant replace me from my position as it is with most chain retail stores.
 
i was speaking to my pharmacy manager about my plans to open up a pharmacy, and was "lectured" to over an hour about why it can't/couldn't work. it's funny because most of the know it alls have never run a business or even attempted to. they have all the knowledge in the world...
 
I know what its like, there is always opposition to people doing something on their own. I would ask the pharmacy manager why is he so scared of you trying something. All the chains,big companies, CEO's making millions, etc started small. This country was built on entrepeneurs and is a big reason why our country is as powerfull as it is. Small business is the biggest employer in the country.
 
blueclassring said:
i was speaking to my pharmacy manager about my plans to open up a pharmacy, and was "lectured" to over an hour about why it can't/couldn't work. it's funny because most of the know it alls have never run a business or even attempted to. they have all the knowledge in the world...
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Dont listen to him/her. You can do fine filling 600-750 rx's per week + a niche! Go for it.
 
I was told that if I wanted to open my own pharmacy...just work a year of retail first so I know exactly what NOT to do!~! haha I thought that was pretty funny advice :laugh:
 
Hi fieldkj, if you don't mind, do you think can tell me the process of opening your independent pharmacy few months ago? I know that the requirements may be different from states to states, but for you how do you start?

Like you have to buy/lease the premise first to get the address to start applying for the permit...??? Do you ask the city/county first or the board of pharmacy first for permit? Then for wholesaler, to finance thru them you you have to have collateral, good credit? things like this.

I have looked for these answer to ease the stress of starting up, but not a lot of independent rph's my area want to share the experience.
Thanks ahead!
 
I am wondering the same thing...also is the process any different based on whether you own or rent space??...also how did you hire a doctor, what paperwork etc was required for that??
 
I am CA. Recently, I was doing my research about starting my own pharmacy and I stumbled upon some upon a concern! I was talking to one of my pharmacy managers and he told me that CA gov. has cut down the Medical and Medicare benefits by 10% so the profit margins for the private pharmacy stores have dereased considerably and in some cases making loses. Is this right?

Prk
 
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