In the past, it wasn’t uncommon for communities to have both an independent primary care physician and an independent pharmacist. Over the years though, many primary care practices have been acquired by hospital systems and some independent pharmacies have decided to sell their records to chain pharmacies such as Rite Aid or Walgreens, instead of struggling to survive on their own.
As the days of rural health care seem to be slipping into the past, there are a few independent pharmacies still operating in Wayne County. For those pharmacists, running an independent pharmacy can be a struggle, but they find the personal relationships they have with patients much more rewarding.
John Hale is the pharmacist at Wolcott Pharmacy LLC. He began his career working for a chain pharmacy and then for Wal-Mart. At Wal-Mart, Hale said that the pharmacy began to be heavily focused on profit margins.
“They were always using these things called metrics – which is when you took 30 seconds to key [a prescription] into the computer and it took the other technician another minute and 32 seconds to count it out,” Hale said. “Every prescription that went through the system was a statistic, and you would have a district manager who would come in and look at the statistics. They would use that as a way of grading you, not based on the number of patients you have that keep coming back to you.”
Wolcott Pharmacy opened in 2012. After the previous independent pharmacist in Wolcott retired and sold his patient records to Rite Aid, Hale said there was a demand for another pharmacy, other than Rite Aid, in the town. Hale became the head pharmacist in 2014 and since then, he said business has been steadily increasing.
David Stachnik opened Palmyra Pharmacy in 2013. He had previously operated a pharmacy in Hammondsport, N.Y., for 24 years before moving to Rochester, where he worked at Walgreens for a while. Stachnik said that he was friends with former Palmyra Mayor Vicky Daly, who suggested that he open a pharmacy in Palmyra.
“I thought about it, but I had two kids in college, and I didn’t know if I wanted to go through the whole thing again,” Stachnik said. “She kept after me and said ‘Why not? You’re not getting any younger.’”
Once he found a location in January of 2013, Stachnik said that it took him until late September that year before he could open because of all of the credentialing and administrative work that goes into opening a pharmacy.
“For a full year, I didn’t have any employees,” Stachnik said. “When you’re starting out, you’re doing a low number of prescriptions. You’re becoming part of the community, you’re joining the Rotary, you’re going to church there, you belong to the Chamber of Commerce, you’re doing what you can to be visible.”
Bob Montemorano has been in business in Wayne County much longer than Hale and Stachnik. Montemorano opened Galen Pharmacy in 1981. Since then, he’s seen independent pharmacies go away one by one. Montemorano said that the Affordable Care Act has made it nearly impossible for independent pharmacies to succeed because reimbursements are so low.
“Reimbursements for all health care providers – doctors, hospitals and pharmacies – are at an all-time low,” Montemorano said. “All expenses are up, yet the reimbursement to all pharmacies, not just independents, is significantly down.”
Despite the financial struggles involved, Montemorano has declined offers from chain pharmacies to sell his records. He’s had to cut the size of his store by two-thirds and reduce his number of employees.
“It started as a husband and wife business and lately, because of all of the pressures of the Affordable Care Act on profit margins, we’ve reverted right back to where we started,” Montemorano said.
The fourth, and oldest, independent pharmacy in the county is Dobbins Drugs in Lyons. They’ve been in business since 1943 and the pharmacy has been passed down through three generations, according to their website. Sean Dobbins currently operates the pharmacy.
Through the financial difficulties and the large amount of administrative work, each of the three independent pharmacists said that the biggest advantage that they have over chain pharmacies is the attention they can give to each of their patients and the relationships they’ve been able to build with them.
Stachnik said that one of things he started doing was to personally deliver medicine to people that had been released from the hospital, after major events like a heart attack, with many different types of medication. By doing so, Stachnik said he was able to set up their medication charts, explain to them what the side effects are for each one and be there to discuss any questions they had.
“I found that doing that helped the people remember, and they had better outcomes because they had better compliance,” Stachnik said. “They stuck to the regiments that the doctor intended. In the long run, you have a little bit healthier people and less cost to the system, because they’re not readmitted to the hospital.”
According to Hale, his favorite part of being an independent pharmacist is his ability to go above and beyond for his patients. He gave one example of when he recently helped a hospice patient whose prescriptions had not come in as they were expected on a Friday.
“When all of the offices were closed, I went to bat for the hospice patient to get them something so they wouldn’t be left without stuff over the weekend,” Hale said. “With that one incident alone – I don’t know if you can call it a firestorm of positive publicity – but word got around town pretty fast.”
When Montemorano decides to retire, his goal is to work with the local hospital systems and healthcare organizations to integrate their practices.
“I think you’ll see more independent pharmacies aligning with hospital systems, which I think is big positive for everybody because we can help coordinate the care in the communities,” Montemorano said.
“By ourselves, we won’t survive much longer and rural health care will go away, and it’s kind of a shame that America is going to lose most of their rural health care, unless politicians wake up.”
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