Independent Insights, a Health Mart Podcast

Episode 11: Maximizing Operations Through Proactive Workflow

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Join Suzanne Feeney from McKesson Health Mart and guest Josh Borer, a seasoned pharmacy owner, as they explore innovative strategies to enhance pharmacy operations. Discover how synchronizing refills and scheduling patient appointments can revolutionize your pharmacy practice, reduce costs, and improve patient outcomes. Tune in for practical tips and inspiring stories from the frontlines of independent pharmacy. 

Host
Suzanne Feeney, PharmD
VP, Pharmacy Retail Operations
McKesson, Health Mart

Guests
Josh Borer, PharmD
President/Owner
Rex Pharmacy

Resources
Health Mart Pharmacies can access Health Mart University (HMU) for:

  • Helpful CE courses and more on inventory management and med sync
  • Health Mart pharmacists to claim their CE credit for weekly GameChangers episodes 


The views and opinions expressed in this podcast are those of the guest and do not necessarily represent the views or positions of Health Mart, McKesson or its affiliates or subsidiaries ("McKesson”). The information provided herein is for informational purposes only and does not constitute the rendering of clinical, legal or other professional advice by McKesson.

[00:00:00] Are you looking for ideas to grow independent pharmacy and make a greater impact in your community? Look no further. Welcome to Independent Insights, the podcast brought to you by Health Mart. Episodes delve into a wide range of topics to provide you with the practical strategies, expert insights, and inspiring stories to help you and your pharmacy excel.  

The views and opinions expressed in this podcast are solely those of the guest and do not necessarily reflect the views or positions of Health Mart, McKesson, or its affiliates and subsidiaries (“McKesson”). The information provided is intended for informational purposes only and does not constitute clinical, legal, or any other type of professional advice from McKesson.

Pharmacists are expected to exercise reasonable care as dictated by legal and professional standards and are ultimately responsible for decisions related to patient care and medication management. It is your responsibility to review and comply with all applicable state and federal laws, rules, and regulations governing your business operations. This includes laws applicable to businesses [00:01:00] in general, those pertinent to employers, and those specifically regulating the practice of pharmacy.

Suzanne: Welcome to Independent Insights. a Health Mart podcast focused on independent pharmacy. My name is Suzanne Feeney, and I'm a pharmacist on the McKesson Health Mart team. In my day job, I really help to support our McKesson Health Mart pharmacies in nine states. So, I cover the Midwest section of the U. S., and my time is spent visiting pharmacies in person. During these visits, we talk about a lot of things like community health workers, test to treat, immunization, pharmacy operations, Advocacy and really staffing. So, all things pharmacy are what we talk about. And one of the common threads in my conversations is always idea sharing.

So how can I be a collective thought partner to another pharmacist and support their challenges and really bolster success in the community settings. So, after I leave, I always think, gosh, wouldn't it be so great to share these conversations and highlight these amazing pharmacists. With others who are out there doing the same work.

So now we can do that through this podcast, which is really exciting. And [00:02:00] since the podcast is relatively new. I wanted to just highlight how you can best use this as a resource. So, for our listeners out there, this podcast is for anyone who's interested in independent pharmacy.

And if you're in this space, you're welcome here. You can learn here. Each Monday, we actually have a Game Changers podcast episode that releases. And that's really focused on clinical learning. If you're a Health Mart pharmacist, you can earn continuing education for that through Health Mart University.

And then every month we offer episodes like this one, where you can really learn about a topic that will impact your business of pharmacy. And you'll get to hear from your peers and industry experts on timely topics impacting your practice. So, with that, I'm going to jump into today's episode. And I'm really excited to be here with Josh Borer, who I've known for over a decade now, I think, Josh.

So welcome. And thanks for joining us. 

Josh: Yeah. Thanks for having me, Suzanne. I appreciate the opportunity. 

Suzanne: I'm excited for everyone to hear from you. I know I have been to your pharmacy and heard about your pharmacy for years and had the opportunity to visit, I think, [00:03:00] finally like a year or two ago.

 You have a great pharmacy with lots of patient care and a really great staff. 

Josh: Well, I think that's probably the key, right? We have a really great staff. They're on a mission and they do good work? And they keep all the customers happy. they do a great job.

Suzanne: They really do. Well, for today, I know I have you here to talk about pharmacy operations or workflow a pharmacy, and there's a lot of different terms for that. But what we're going to focus on today are kind of achieving three goals for our listeners really looking at in these times, how can we focus on our cost to dispense and creating efficiencies within a proactive versus reactive workflow?

I want to talk a little bit about how to create space within a traditional dispensing pharmacy workflow for patient care or to layer on different revenue drivers and then also hit a little bit on, how workflow can really elevate and diversify staff roles away from traditional dispensing, and I think help with some of the shortages that we're seeing now in staffing. [00:04:00] So before we get into all that, Josh, I'd love for people to hear a little bit about you and your vision statement for your pharmacy or why statement and really how you've developed your team.

Josh: Sure. My name is Josh Boer. I am a pharmacist and a pharmacy owner. I have, four pharmacies, actually. Three, kind of retail combo pharmacies in Iowa. And then a long-term care pharmacy in Nebraska. We really started several years ago.

Developing our workflow around, what our ultimate goal was. And we wanted, to be more of a health care provider. That was kind of our vision of what we wanted to do was really play a more vital role in health care. In addition to the dispensing piece, and then the way we found, that worked better for us was to proactively manage our workflow and as you said, create that space to be able to layer on additional services, opportunities as they came up, and the industry's moved quite quickly over the last few [00:05:00] years, covid obviously kind of accelerated some of that, but the opportunities, changed over that timeframe. And so having that kind of set up, in our operational workflow really allowed us to take advantage of some of those things. 

Suzanne: I love that you said that as the opportunities change, you have had this static workflow.

For such a long time that has allowed you to whatever the opportunity was really embrace that and fit it into your workflow without having to disrupt your workflow. Every time something different came along. 

Josh: Yeah. Absolutely. Even within the industry alone, state to state region to region, those opportunities, depending on what your patient needs are and your patient population, those things can change.

So, having the workflow set up for that type of operation was key for us. 

Suzanne: It's really one of the reasons I love independent pharmacy is because you can be so hyper local to your community and serve your community needs, but really we can all have a dispensing workflow set up that can accommodate whatever those needs are. And when I talk to pharmacies [00:06:00] now in North Dakota, they have an amazing opportunity for assigned CPA to do test and treat and even some medication initiation. So that absolutely makes sense for them to focus on. Whereas maybe in your state, you don't have that.

Although in Iowa, I know you have quite a bit with what's going on with your pharmacy practice act. But in other states, they may have different opportunities that make more sense based on their laws. Or also based on their patient population. I know some people are really jumping in California to community health workers and how do they integrate that into their workflow and have paid opportunities.

 And what I see with pharmacies and workflows and what I've experienced myself working in the pharmacy as. Maybe some pharmacies don't have a workflow. Maybe that term isn't really familiar or thought of. I know some pharmacies have one person there staffing, and some are really busy doing 1,000 scripts a day.

So, I think I've seen it and experienced it all personally and I'm still a firm believer that no matter what the setting is having things. some sort of systematic workflow or structure is going to help you with efficiencies and costs, [00:07:00] as well as being able to take patient care opportunities. So tell me what you think about that and how you've set up your workflow.

Josh: First off, you kind of alluded to trying to hit this ideal of being able to offer different services. And we had to have a workflow set up that, allowed for that, especially this day and age. We can't just keep hiring and throwing on more and more people

the labor costs that doesn't work for us. But I think 1st and foremost for us I look at it in two ways. The first one is a proactively managed workflow allowed us to also proactively manage our inventory.

 And obviously drug costs don't seem to be going down. They're certainly getting higher. And the more sitting on your shelf is the less sitting in your bank, , less able to invest in other opportunities to, meet payroll demands to, whatever the opportunity.

 That's obviously a one-time cash reduction, but that's pretty significant in many pharmacies when you look at the amount of dollars sitting on a shelf. So being able to proactively manage that I think can help [00:08:00] reduce that liability and free up some cash. And then over time, just in general, the ability to reduce your cost to dispense, right?

How much does it cost you? And everyone probably should be measuring that and have a good metric they're utilizing, using their P and L's and, what is it that it costs for every prescription, for you to send out and have a benchmark. And, over time with efficiency you can reduce that number.

There's several ways to do that, but I think having that benchmark and being able to measure it and follow it lets you know where you're at, particularly when you're comparing it to your gross profit per prescription, those are two good metrics to know, because if they're out of balance, you're going to be in a world of hurt.

 Those are the main things we were looking at. And then over time as we talked about the opportunities that came up, particularly I'll start in Iowa and our state, tech technician, in tech immunization, for example. And that's been a way for, not only our technicians to, [00:09:00] expand their role and grow in their role, within the pharmacy, but also a way for us to expand that service without increasing our cost to dispense significant amounts. 

Suzanne: And is it fair to say that kind of decreases it because the payroll of technician, it's offering a career pathway for them and then the payroll is lower. So, it almost decreases that a little bit more. 

Josh: Yeah. And if you're looking at that ratio of gross profit and the cost of dispense, it's obviously a huge, because increasing your immunizations it's going to increase your gross profit prescription, versus the cost to dispense. I like to really look at that ratio and so it's hitting it on both fronts, expanding immunization services and opportunities, as well as, reducing your cost to dispense. 

Suzanne: Those are really key points. And what we're alluding to with this workflow that Josh has in his pharmacy and I've had the chance to experience it. When you walk in, I will say this appointment-based model workflow, like the first thing I notice is it's calm in your pharmacy.

It's calm. The phones are [00:10:00] not ringing. There's not a lot of paper all over the place and people are at stations, if you will, which are almost on the back end of the pharmacy. So, you have this beautiful walk in with a large front end and there's someone who can talk to patients as they're picking up their prescriptions.

But then really all the magic kind of happens in the back of the house at these different stations. And if I'm remembering correctly, I think you even had some like cubicle areas where technicians could sit down and do some work. Talk us through what your setup looks like.

Josh: Some of it can be managed just with a few tweaks, set up a table here, table there, back behind the pharmacy, but create the space for it and that can be a challenge in some pharmacies, but even just a corner desk or something, small desk, where someone can actually sit there and focus on, the management, the calling piece if, reaching out to customers, but I do think it's important to have it as a defined workflow step, as you're developing it, at least, once, when it starts to grow, you have to have someone that's kind of a champion of that cause. And our technicians are [00:11:00] usually in best position to do that.

I don't know. Maybe most pharmacists aren't like me. I'm kind of a helicopter making a mess every time I swoop in. So, I try to stay out of that role. We had the idea of what we wanted to do, but I was not definitely the person to necessarily lead that. So, I think it's important for a lot of pharmacists and pharmacy managers to, to pick the right person, to champion that, as well.

 Now as we've grown, I don't know how many thousands of patients we have proactively managed now. So, it's obviously grown quite a bit from, where we started at zero. But we definitely have, multiple people who are focused. primarily on that role. And you're right it is a little bit less chaotic, less phone calls, ringing in, interrupting everything, that still happens. It's still pharmacy, but it does create a little bit of a sense of peace and calm. 

Suzanne: Well, with the appointment-based model, I think there's so many different definitions and terms out there.

I hear, MedSync and. Autorefill and appointment-based model and all integrated [00:12:00] services. So, I hear all these terms. And so, for our listeners today I found a definition that I think really sums it up really well from NIH. And it says community pharmacies typically require patients to request refill medications.

It's like. Yeah, that's how it's done, right? You get a prescription and then you request your refills. And this is really flipping that model on its head. And I think it's an important point because we live in such a subscription model that where else in your life do you have to call to get that next refill of whatever it is.

Everything is on a subscription. Like I don't, call Netflix every month and say, yep, I want my access to my movies or, the vitamins that I have, they're just auto sent to me. So, all of that is really on a subscription basis. So, I think for pharmacies that was kind of an aha moment for me is like, why are we still having people have to call in and get their refills?

But I think with appointment based model and I think this is where you really excel in your team excels is that what you're doing is having this proactive approach that synchronizes refills and the key [00:13:00] is schedules patient pharmacist appointments and so part of that which you were alluding to is your team has a pre appointment call, and so an appointment may not be the best word because sometimes we think of appointment as like, you're sitting down for 30 minutes, you have a PT appointment or a doctor's appointment and they don't really have to be these big drawn out appointments. But you're creating time.

So, when the patient is picking up their medication, all those problems with, I don't need it. I've changed my dose. All of those are already taken care of and they're picking up the medication. It really gives the pharmacist that opportunity or the technician to layer on immunizations or talk about, whatever your monthly theme may be.

So, an appointment-based model, to me, the two keys are that there's a pre appointment, and no one can see me, but I'm air quoting it. Pre appointment phone call that the technician manages and then on the end when they pick up the script, it's not just a transaction. It's more of a, Hey, you're on hypertension medication.

So, every time you pick this up, we're actually going to check your [00:14:00] blood pressure and see what that is month to month, because you may only see your prescriber every six months, every year. And you may have white coat syndrome like many of us. So, you know, let's come into the pharmacy and do that check or that monitoring and then layering on the capability.

And this is a whole other podcast, but how do you bill for those types of interventions? So that's where this is going and I think having everybody realize that this is not auto refill if it becomes auto refill It becomes more work because then people pick it up You didn't do the pre appointment and you're still gonna have the oh my dose changed.

Oh, I stopped taking this so josh, you alluded a little bit to the pre appointment phone call and maybe let's start with that because that I think is a hard thing to maintain and I'd love to know how for the past however many years your pharmacy has really been able to make sure that's a key part of your workflow.

Josh: I think that's also probably a hiccup or hurdle if you will to building a model, the assumption is, Hey, we put these patients on sync and [00:15:00] everything works perfect. Like clockwork, month after month after month. And we all know that as humans, we're not that predictable or reliable.

So, I think getting misconception out there, knowing that, Hey, there's going to have to be some ongoing management. And some ongoing work and you're going to have to adapt to your environment and individual patients. So, it's important to note that not every patient is going to, be handled in the same manner.

And you'll figure that out pretty quickly. Some patients want the phone call and they want the discussion prior to some people want a Text message, letting them know that we're starting to prepare and, , let us know if there's any issues and, and some, we just, you just know, or probably not going to respond and you do your best to proactively manage and then you manage at the point of pickup.

So. Just know that you'll have all kinds and you'll have to adjust, to how that works. But I think that's been the key one, accepting that it's not going to go perfect, you know, adherence. I think the definition is like, [00:16:00] 80 percent PDC. So. Even the adherent people are 20 percent off and one month that can get you an entire week behind in a fill cycle.

And you're already up against, insurance issues, when you're talking about a week difference and when you can bill versus when you dispense. So, it is always going to be a, so understanding it's going to be an ongoing management thing. And then I just think adjusting to individual patient preferences has been key because we try to call and talk to everybody and that would be our ideal. but getting them on the phone, everyone's busy. That's tough. Sometimes it becomes a quick text check in. So, those capabilities become important in the management and then sometimes just catch them at the end and then just repeat and realize that the management of that cycle and the ongoing adjustment is really the name of the game. So, it won't go perfect. So don't expect it to, but progress over perfection essentially. 

Suzanne: Having right sizing expectations is definitely important.

But all that being said, you're still seeing the huge benefits to your ratio, of [00:17:00] profitability to your staffing.

Josh: I mean, it's been critical in order for us to be able to, depending on where you're at, there are still some pretty good pharmacist shortages in particular in some rural areas.

So, when you look at trying to expand some of these services, it can be daunting. You have one pharmacist that's answering 800 phone calls at a time and trying to check and fill and data entry, and you think of layering on a service and the thought can just keep you up at night.

So, it's a good place to start, to set up your operation to be able to offer, new services that can benefit you, that can benefit your community, other stakeholders, healthcare stakeholders in the community and your patients. 

Suzanne: I love that you highlighted individual patient preferences and that you're able to honor that because just on a personal note, my daughter, plays soccer and she had some issues with her knees. And so, we've been trying to get her into PT and I was going through one system and there's all these phone calls and then they're like, Oh, she's over 13. So, she has to be with you to make this appointment.

It just became this big thing. And [00:18:00] so I found a local, p. T. That actually I could go online, put in the information and they rolled a text me back and forth and the appointment got scheduled and she's already been seen. So having that ability to meet the patient in the way that works for them, I think is really important in this day and age.

You're listening to Independent Insights, a McKesson Health Mart podcast with host Suzanne Feeney, VP Pharmacy Retail Operations for McKesson/Health Mart. And guest Josh Borer, pharmacist and president of Rex Pharmacy, Inc. 

Let's continue. 

Suzanne: And that leads me to ask you with technology, for people who are getting started, how are you able to text certain patients or call others? Like, how do you manage all of that? And I'm guessing you leverage technology. So, I'd love to hear a little bit about that.

Josh: In our case, we do have the capabilities to do that right through our pharmacy management system, which is nice because then we have a log piece in one place. , but I think in most cases people are used to texting their local pharmacist, so it wouldn't be that unheard of just copy and [00:19:00] paste a note on your phone, you know these phones or computers these days. To be able to send out just a standard script, for example, via text message, probably wouldn't be that difficult. That'd be one way to leverage that. But the technology piece does help. I think the other, maybe kind of a hangup, and we had this at the beginning is the assumption that, oh, a lot of our patients are older.

They're less tech savvy. They don't want a text message and that is true for some of them, but you'd be surprised how many, that if you were trying to, pigeonhole them into are they tech savvy or not, and they want the text message. They don't want the phone call. People are busy. So, it's not just the younger generation that likes the text message. A lot of the older generation likes it too. 

Suzanne: I think of my mom. She's in her 70s. Well, actually, she's 69. So good thing she doesn't listen because she'd be mad at me for saying that, but she would be all about texting and my dad would be calling.

So yeah, absolutely. It's just, it's that individual preference. And I think there's so many ways to do that today that, allows us to be aware of PHI and all the requirements with [00:20:00] HIPAA. And so there's safe systems that are set up. So for those of you who are looking out there, I think the technology can support that.

And you can ask those questions and make sure you're assessing all of that but that is a nice capability. I think back to the day when MedSync started and, or appointment-based model was really all paper based and now I would encourage everybody to not do that paper system, but.

You know, leverage your PMS. I think most of them out there have a system for that so that's definitely something that people should ask for. When you were talking to you about it, you mentioned a little bit, some of the insurance challenges that can come up and that's one barrier, I think, to people getting started with this appointment-based model is they're unsure of how to manage that short fill.

So, if the insurance covers it, if it doesn't cover it, if there's a cash piece of it and For those of you listening, when we are enrolling people in, the appointment based model or MedSync, we're syncing all those medications to one anchor date and technology really makes that simple compared to how it used to be done manually.

But there still is the, how do you align all the fills to the [00:21:00] same day and making sure that you can get some of those short fills covered on insurance. So, Josh, maybe speak a little bit about overcoming that 

Josh: I think it's, we've been doing it for so long that I think our team is pretty good at it.

So, I have to think back, but it was a huge setback when we were initially going and through the initial growth phase of it, is always, well, how do we get them lined up? Someone on particularly the people we're targeting five plus meds, they have all sorts of, next fill dates.

So, lining them up is obviously challenging. Yeah. Technology does help in order just to take the thinking out of it. It's like, how many do they need to get lined up. And, you always want to anchor around the most expensive items, because those are the more challenging, ones to get shifted.

Usually with short fills, MedD and some of those usually have have codes where you can, where you can bill for a short filled amount in order to line up to MedSync. A lot of the pharmacy management systems will, if they have a MedSyncs, they will automatically do that when you're trying [00:22:00] to short fill them.

They'll automatically submit those billing codes. And sometimes, if you're doing the less expensive ones, it's kind of a cash out type system, Hey, let's get this on track and I think the key there is being able to highlight to patients, the importance of it.

And we were always upfront that, hey, we want to do this for. You as our patient, but there's also a huge benefit to us you mentioned how quiet, sometimes is in our pharmacy and being able to point to the back of the pharmacy and say, Hey, we can do this.

We can take this time to spend with you. Because we're proactively managing these fills. So, it's a huge benefit to us, allows us to expand our accessibility to you as a patient. So, I think, making sure you highlight that, that it is helpful to patients are pretty receptive, like, Oh yeah, if it's more helpful to you.

I'm happy. I'm happy to participate, and then I think that uses the conversation when it comes to short fills and things like that

Suzanne: I've seen that approach for how to [00:23:00] offer med sync or appointment based model, to patients handled differently in, in different locations.

And, based on what I've seen, if I were owning a pharmacy, for me, it would be, this is our standard workflow. So, when people came in and I know this is easier said than done, cause this is my imaginary pharmacy. But when people came in, it would be, this is how we operate here.

and just trying to make that, standard of care. Because one of the things I do see is that there's pharmacies out there that have maybe 30 percent of patients med synced and then the rest not. And what I fear is then you're running two different workflows. And it's doubly as hard because You're not under one operating system, so you're not really getting the full benefits of MedSync from what you talked about with reducing your cost to dispense and being able to layer on additional services to grow revenue and patient care.

So you're not really getting that benefit, and then you're still running a traditional workflow, so people can't be as focused on what their roles are because it's two different ones. So I think that sometimes can be a pitfall is okay. I'm going to get started. But like you [00:24:00] said, it can be hard.

It can be a little bit uphill until you get there. And if you kind of give up, if you will, and only have a certain percentage there, I just think that makes it more challenging. 

Josh: Yeah. And I forget, we used to talk a lot about what that kind of critical point was. And I don't, I feel like it was in the third, we started to get up to third, 30, 

Suzanne: Get your first 100 patients, right? Your first 50, your first hundred and kind of build but I think it's fair to say, if you can have 80 percent of your patients on this, and then you're going to have the acute meds or people that this just doesn't work for and that's okay. And that's the other space. 

Josh: It is a challenge as you grow. And, and I think, making it fun, make it a game out of it for your team. And then some pharmacies and I remember we did this back in the day, you know, carrots and sticks? How do we create an incentive even for the patients, right?

Maybe it's free delivery for your med sync people, for example, or something like that. There's some things you can do, to really, as you said, make it, this is the standard operating procedure in our pharmacy. This is how we operate and knowing that there's always some [00:25:00] that it's not a fit for, for whatever reason.

But I think if you kind of go in with that mindset, this is the standard operating, sometimes fake it to make it beginning. You get started, you grow little by little and before, you know, it is the standard operating procedure. 

Suzanne: And with that, as your SOP one of the other concerns people bring up to me is, well, Suzanne, I can't lose the foot traffic.

So, what are your thoughts on that? I have some thoughts, but what are your thoughts on if people are only coming into the pharmacy once a month to pick up their medications, do you lose that foot traffic? 

Josh: That's always been a concern that people have, have discussed and I guess I've never, for me, that's never been something that's I've ever seen come to fruition as far as a threat to our pharmacy, to be honest. But, we also don't have as big of a front end as maybe other people do. We don't have a huge gift section, for example.

And so that might be a concern for people. One of the things that we looked at, whether, one of the great services to layer on at first, because it [00:26:00] doesn't really require anything outside is start training your team on up solutions. I forget who either Patty Mara or Chris Cornelis and one of them coined that term up solutions, right?

It's not upselling. We're making sure that our patients are aware of the opportunities that are out there. And I think just getting your staff used to that when you make that appointment-based call or whatever you want to call it, that pre call, you can have that as part of the script, you can have that conversation with them about any other needs and highlight them at that time.

Because you can get that all set up and ready for them. And they like that convenience for it they like that. Yeah. Like, oh yeah, I forgot. I do need, some ibuprofen or some, Claritin or Flonase. And can you throw one of those together for me as well? And they like that. So I think that not only does that kind of get your staff, trained on being proactive and providing those solutions.

But then when you talk about layering on other services, whether it be [00:27:00] functional medicine, I'll call them specialty vitamins. The more therapeutic, medical grade stuff, your team, is already set up for that, they know the process and you can start having conversations about those.

Suzanne: I love that up solution because that is really what it is. And, I remember. Long time ago in my residency, when people would pick up their prescriptions and just spending the time to say, hey, you're getting this medication. You also should probably have a stool softener or spending that time.

It's not, I'm not selling them something to sell them something. I'm trying to make sure I'm looking at them holistically. And what do you need, for your healthcare? Because the reality of it is. People are buying those OTCs and those vitamins and doing that in the pharmacy and making space so the pharmacist can advise on that is really the safest way to offer that to patients because it's that one single source of all the medications.

Josh: Yeah, and I think that the one thing that bothers me is look at the other side of that coin, right? If you don't offer and you're not educating your patients, so, if you have a patient that comes back and [00:28:00] maybe they've been on a pain med, post-op pain medication and they come back with constipation, you are like, oh, you should be on a stool softener or a laxative and they look you in the face and say.

I didn't know. To me, that's worse offer educate up front if you can, to the extent you can and make sure that they're being treated proactively. There's always a flip side to that coin when people are concerned about overselling things.

Like you're not trying to sell anything. Um, Yeah, right. Offer solutions and what we think the patient would benefit from and allowing them to make a choice basically. 

Suzanne: And preventing adverse outcomes or side effects or all of those things to really have a healthier patient.

Yep. That's what it's all about. And that to me is where it's really fun. And that's what being a pharmacist is. It's not necessarily like I'm all for definitely, checking the dose and making sure that's all accurate, but we are fortunate to have really strong technology to help support us in that.

But having those conversations and using motivational interviewing techniques to help ensure that people [00:29:00] are safe and getting the treatment they need, I think is what it's all about.  

Josh: And I think right now the thing I would emphasize the most and where it comes in, I think it's most important in the current environment in that, we're obviously being squeezed financially from just a dispensing piece and you have to have a framework to be able to expand your service offerings.

And that's where a proactively managed workflow, whether you're starting, at zero or you have, 100 and need to get to 200 patients, whatever it is. I think it is important as a framework and operating framework in order to be able to start tackling some other opportunities, the most successful pharmacies and pharmacy owners I know out there all have, they're all going after some of these niche services and they have these niche offerings and there's no way to do that if you don't have kind of the background set up for that. 

Suzanne: Yeah, we've been set up to be dispensing medications. And so flipping that workflow. And like you said, having that infrastructure to layer on other things is so important.

And I think this [00:30:00] really does allow that to happen in a pharmacy. In a way that makes sense and can be done. And maybe, the first month, the first two months are going to be hard. But after that, it gets vastly easier and allows you to layer on other opportunities. 

Well, it's always great talking with you. You know, I really appreciate your time. 

 Josh, any closing words for our pharmacy listeners? 

Josh: Just I appreciate the opportunity to chat with you today, Suzanne. It's been a while, so it's always good to see, what other pharmacies are doing. So yeah, don't be afraid to just take that, whatever that next step is and, and wish you luck.

Suzanne: And to our listeners out there, we hope you'll join us each week as this podcast delves into all the topics out there for clinical support on Mondays and then monthly for episodes like these. And I invite all of our listeners to plug in, to hear more innovative ways to strengthen your health of your pharmacy business and take care of your patients in your communities. So, we hope you'll listen in wherever you listen to podcasts. 

I'm Suzanne Feeney, Health Mart Pharmacist, signing off. Stay tuned, stay inspired, and keep [00:31:00] making a difference in your communities.

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