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This is going to be long. But it may be worth it. I don't post on this forum frequently, so spare me the leniency.
Opening an independent pharmacy:
1) in the middle of a recession (1.5 years ago)
2) in the worst hit Canadian city of Windsor, Ontario (close to Detroit; heavily dependent on automobile manufacturing)
3) with 11 established pharmacies within a 1.5 mile radius (many of them big chain pharmacies)
4) with little financing
5) with no business background
6) with kids and family as responsibility
7) with business hours of 9-5 on weekdays, 9 to 4 on saturdays, not open on sundays
8) without waiving any fees or co-pays
9) new to the city, where he knew no one
10) with the surrounding MDs telling him directly that they won't be able to help
This is the story of Peter Dumo, independent pharmacist owner of Novacare Pharmacy. He wanted to show his peers, professional associations, pharmacy faculties and other pharmacists, that if he can not only survive, but thrive in the condition described above...then maybe we all have a reason to be hopeful.
Not only we have a reason to be hopeful, but now, more than ever, we need to be innovative, show some clinical entrepreneurship, and show some cojones to change the core business model of pharmacy. His message is: innovation is the only way we will survive as a profession. A year and a half later, he has a thriving business, he is on his way to hiring a second pharmacist besides himself.
I am writing about him, because this man came to the "pharmacy school" and gave the faculty and students lectures on some of the fundamental flaws in the business model of pharmacy right now, and what we need to do to change it.
His idea?
He created a specialty pharmacy that focuses on clinical services to draw in patients: anticoagulation, diabetes management, HF, Mental health etc etc. He has effectively captured various niche markets that no other pharmacy in that area can reach. He does things that MDs don't want to spend a lot of time doing, but don't mind having someone credible do it for them and the patients. His main focus right now is warfarin dosing with point of care INR testing. He bills the government for these clinical services under Ontario's Medscheck program. The program has been available in various forms since 2006, but no one has really utilized the money available, because they haven't figured out a way to do it.
So this man really had a lot of balls to pull this off. He made a lot of mistakes initially, and I know he is not the only one doing these kinds of things in North America, but he has left us all inspired. His point:
"Economic reality will always trump professional obligation and eduation"
Unless we find a way to make money off of clinical services - we will always complain about our working conditions and all the ways we are underutilized as a profession.
A lot of us have a negative outlook regarding this profession. Mainly because, in the retail setting, we get paid for distributive functions only. We buy drugs in bulk, put them in smaller packages and sell them at a higher price. Add on front shop items with high margin and you have your quintessential pharmacy. So no matter how we put it (we prevent/resolve drug therapy problems, we provide pharmaceutical care, TDM, MTM etc), at the end of the day, we get paid for the volume of scripts that are churned out. So the profession in his opinion has been dependent on this core function for the last few decades with no real innovation.
On the other hand, pharmacy schools, professional associations and a lot of industry leaders for years have been trying to move the profession away from distributive functions towards pharmaceutical care. But there is a huge disconnect between what students are being asked to do through training, and what they end up doing in the retail setting out in practice.
I am putting up the lecture he made available for students:
http://rapidshare.com/files/428588479/Lec008_Innovation_Handouts.pdf
My question to you is, what other unique specialty practice settings have you heard of (other than compounding/TPN pharmacies)? What other ways can you think of charging for "clinical services"?
Opening an independent pharmacy:
1) in the middle of a recession (1.5 years ago)
2) in the worst hit Canadian city of Windsor, Ontario (close to Detroit; heavily dependent on automobile manufacturing)
3) with 11 established pharmacies within a 1.5 mile radius (many of them big chain pharmacies)
4) with little financing
5) with no business background
6) with kids and family as responsibility
7) with business hours of 9-5 on weekdays, 9 to 4 on saturdays, not open on sundays
8) without waiving any fees or co-pays
9) new to the city, where he knew no one
10) with the surrounding MDs telling him directly that they won't be able to help
This is the story of Peter Dumo, independent pharmacist owner of Novacare Pharmacy. He wanted to show his peers, professional associations, pharmacy faculties and other pharmacists, that if he can not only survive, but thrive in the condition described above...then maybe we all have a reason to be hopeful.
Not only we have a reason to be hopeful, but now, more than ever, we need to be innovative, show some clinical entrepreneurship, and show some cojones to change the core business model of pharmacy. His message is: innovation is the only way we will survive as a profession. A year and a half later, he has a thriving business, he is on his way to hiring a second pharmacist besides himself.
I am writing about him, because this man came to the "pharmacy school" and gave the faculty and students lectures on some of the fundamental flaws in the business model of pharmacy right now, and what we need to do to change it.
His idea?
He created a specialty pharmacy that focuses on clinical services to draw in patients: anticoagulation, diabetes management, HF, Mental health etc etc. He has effectively captured various niche markets that no other pharmacy in that area can reach. He does things that MDs don't want to spend a lot of time doing, but don't mind having someone credible do it for them and the patients. His main focus right now is warfarin dosing with point of care INR testing. He bills the government for these clinical services under Ontario's Medscheck program. The program has been available in various forms since 2006, but no one has really utilized the money available, because they haven't figured out a way to do it.
So this man really had a lot of balls to pull this off. He made a lot of mistakes initially, and I know he is not the only one doing these kinds of things in North America, but he has left us all inspired. His point:
"Economic reality will always trump professional obligation and eduation"
Unless we find a way to make money off of clinical services - we will always complain about our working conditions and all the ways we are underutilized as a profession.
A lot of us have a negative outlook regarding this profession. Mainly because, in the retail setting, we get paid for distributive functions only. We buy drugs in bulk, put them in smaller packages and sell them at a higher price. Add on front shop items with high margin and you have your quintessential pharmacy. So no matter how we put it (we prevent/resolve drug therapy problems, we provide pharmaceutical care, TDM, MTM etc), at the end of the day, we get paid for the volume of scripts that are churned out. So the profession in his opinion has been dependent on this core function for the last few decades with no real innovation.
On the other hand, pharmacy schools, professional associations and a lot of industry leaders for years have been trying to move the profession away from distributive functions towards pharmaceutical care. But there is a huge disconnect between what students are being asked to do through training, and what they end up doing in the retail setting out in practice.
I am putting up the lecture he made available for students:
http://rapidshare.com/files/428588479/Lec008_Innovation_Handouts.pdf
My question to you is, what other unique specialty practice settings have you heard of (other than compounding/TPN pharmacies)? What other ways can you think of charging for "clinical services"?
). The pittance of new funding set aside for direct pharmacist-provided patient care initiatives still hasn't been formalized. 
