Hi
I run a discounter model based pharmacy. Ask me anything
[AMA] I am a pharmacy owner, ask me anything
pharm86 on 07/11/2018 - 20:15
closed Comments
If that was true would the profession still be around? Would we be voted one of the most trusted professions? Everyone is entitled to their opinions, but the government keeps us around because we provide excellent healthcare and dispense provide advice than the next best option (true of any profession really)
What about the majority owners cut corners, understaff, push pharmacists to recommended pseudoscience bullshit with ZERO evidence of any benefit (homeopathy, acupressure bands), constantly add more professional services (of which the pharmacist who conducts said services generally gets nothing and the owner who's often not even in store gets the lot) and yet remuneration stays the same.
If you push or even recommend treatments without statistically significant evidence for efficacy; you're a snake oil salesman, not a health professional
What about the majority owners
Citation needed? Not in the industry (or anything related) at all, but "majority of…" is too common a weasel word for anyone to take at face value.
I pay my pharmacists a bonus each quarter if they meet KPIs; you catch more bees with honey. If you aren't getting more than a pat on the back maybe you should look for a new boss
If you push or even recommend treatments without statistically significant evidence for efficacy; you're a snake oil salesman, not a health professional
Very often medical treatments are not evidence based and/or are not backed by rigoourous clinical trials. This is not an appropriate statement.
You didn't exactly answer the question or provide any insights to address the perception/opinion. Let's not confuse the concept of "trusted profession" vs real world VALUE. On a side note, as the world is going through a digital transformation, the disruption of 'trust' is front and center. For example, with Uber Eats, you 'trust' them enough to order (and hand them some $) food from someone that you may not have dealt with before, you 'trust' the driver to handle and delivery your food. We are a lot more trusting of others whether we realise it or not.
Realistically, how much advice does a pharmacist provide? From my experience, if I am unwell, I go see a GP, they provide their diagnosis and where necessary, they prescribe the medication. I take the prescription to the pharmacist, which then gets processed and handed over without much advice, other than "Have you had this before?" "Is this for yourself?" "Did you want our house brand vs brand x?".
In the event that the dispensation activities gets automated, which from my observation, at least the 'medication picking' part is heading that way… then what is the value proposition of a pharmacist in the context of a pharmacy?
Realistically, how much advice does a pharmacist provide?
… then what is the value proposition of a pharmacist in the context of a pharmacy?
The real worth of a pharmacist is when a client presents with multiple drug use that can lead to potential interactions/adverse effects, with existing conditions. The areas most prevalent for this scenario lies in hospitals/aged care facilities/ageing suburbs where multiple disease states/medication intake are more common.
Really depends on the pharmacy when it comes to advice. My GP works in one of those super clinics and the attached pharmacy is fantastic, sure CW is cheaper, but the head pharmacist will spend a good 2-3 minutes explaining everything about each new medication i.e. common side effects, confirm what I've used before, and other current drugs to check for interactions.
Every time I go to CW I get none of that, just a "have you taken this before?" "No." "Make sure you read the insert then" much like you do.
@buckster: We probably spend way too much on wages (ours is on the high end of our group) but that is the tradeoff for providing such services
@buckster: This isn't really pharmacy dependent, more pharmacist dependent. Newer graduates are more likely to want to spend the time to talk to you because that's what the university tries to teach them to do.
The death of a profession is gradual, it won't happen overnight. People also generally don't like change so they will stick with what they know and try to avoid change as much as possible. It's when the younger generation who grew up with the internet and online shopping get older and start needing medications that you will see the true decline of community pharmacy as we know it today.
As a literate, tech savvy adult, I don't actually value any services a pharmacist can provide me. The same cannot be said for a lawyer because reading the law isn't the same as practising law or a doctor because diagnosing a condition usually involves more than just rattling off a list of symptoms. Whereas when a pharmacist counsels someone, they're just regurgitating stuff that's already written on a CMI or other online resources.
But then again, I could be wrong. There are plenty of idiots in the world who can't read labels so they still need to go into the pharmacy and have the pharmacist tell them that the reason their dulcolax suppositories aren't working is because they've been taking them orally.
You keep telling yourself that now when you are relatively young and healthy, but I guarantee you things will be different later in life when you take multiple medications
Would you prefer to buy an established pharmacy or find a new place to lease and set up?
Did you enter with any partners or go in solo?
Both questions depends how much cash you have.
I did enter with partners, but plan to buy them out later (written into the contract)
Thanks for the reply. Did any of your partners or yourself have prior ownership experience?
My partner is a pharmacist and keeps talking about purchasing a pharmacy, i tell her to find someone who has already done it to ask about, or partner with
@idjces: Yes without going into too much detail about myself, it is best to find someone with a lot more experience to partner with who has a lot more experience and buy into a pharmacy with them (I.e. dont buy it off them but buy in at the same time)
do you giggle when you cover the "P" in Pharmacy ?
I dont get this, sorry
Pharmacy
Pharmacy
harmacy
harmacynot what you are supposed to do.
ok
Shittest attempt at humour I have seen on this website - or possible on the internet.
There is a very fine line between pharmaceuticals and harmaceuticals…
Okay I'll show myself out now.
Do you think all the actual medicines be labelled and kept separate. As in so they can easily distinguished from the magic potions, vitamin supplements and wizard spell rubbish that make up 95% of pharmacy stock?
By value, my front of shop is probably 10-15 percent vitamins (so excludes my prescription meds) and supplements, so it is no where near 95% but I digress
It already is kept separate all my vitamins are on the vitamin wall and we actively discourage people from purchasing homeopathic products ar my pharmacy
we actively discourage people from purchasing homeopathic products ar my pharmacy
You might be more effective at this if you didn't stock them… (or maybe not, maybe them coming in gives you a chance to convert them)
Head office force us to keep it.
Head office force us to keep it.
You could play this video of James Randi in a loop on the Homeopathy Counter: Homeopathy, quackery, and fraud - James Randi.
And the person at the counter asks the customer if they've watched the video before allowing them to pay for a homeopathy product. :-)
@pharm86: Why would you stock something/do something you're not comfortable with? Especially if it lacks evidence and may cause harm?
Do you think stocking the product at a pharmacy in some ways subconsciously "legitimises" the product to people, regardless of how much you counsel them against the product?
@OrangeT: Homeopathy wont cause harm… wont cause anything actually.
I keep it because of compliance with head office and there are incentives for being compliant
@pharm86: The harm occurs when people who are unwell and take homoeopathy with the expectation of getting better. This delays seeking help, delays diagnosis and delays proper management. This surely causes harm.
I guess everyone is different, but financial incentives would never make me do or be associated with something I am not personally comfortable with.
People go to a pharmacy because it is a place of trust and legitimacy, and then pharmacies abuse that trust by stocking products that aren't evidence-based.
Do you make any money on filling $5.40 concession scripts.
Provided they're PBS-subsidised medicines, pharmacies will make a margin on all dispensing transactions, even those for PBS Entitlement card holders who pay $0 (until 31 Dec each year)
Yes
Do you sell homeopathic treatments and stupid silicone wrist bands and the like without any scientific evidence under the guise of health benefits or "wellness"?
If so how do you reconcile your science-based university education with such products?Is it just about profit?
Yep, those preparations that MAY help sleep/anxiety/warts/etc……
They do not work at all
The only benefit patients may experience is a psychosomatic benefit
Realistically the only benefit here is to the owners bank account balance
They also bully their staff into pushing these remedies with no evidence for any benefit
I mean, a placebo effect is still an effect. You can just achieve it without that specific product, but you certainly can't achieve it with absolutely nothing.
Doesn't work. I actively discourage my customers from using such products. I find they come back if you give them a solution that actually work
Do you believe in tailor-made meds or "one-size-fits-all"?
Will have wait for the evidence on Taylor made medications
What is your average EBITDA? How long have you had the business for? Do you need to be a pharmacist to own one?
A while, it depends on the year as it can fluctuate. We've done almost 500k on a good year and on a bad year it can be under 100k
I've heard that the Pharmacy Guild is the most powerful lobby group here in Australia.
Any comments on this? Are they powerful, what types of things do they do?
I heard they are the ones preventing Coles/Woolies/etc selling Pharmacy Only medicines but other than that no idea really.
They're not that great
The Pharmacy Guild is one of the strongest in Australia, and their sole focus is for the pharmacist owner and not the employee pharmacists.
They continously lobby against deregulation despite the recommendation made by the competition policy review, as well as to even fight to cut penalty rates for employees so the owners pocket more $$.You seem to be quite bitter that the owner who has invested in most cases a few million dollars into a business and in many cases work over 70 hrs a week wants to make some money. They have no obligations to share the profits with with their employees who have not invested a single cent into the business.
It's not a matter of having the employee have a slice of the profits.
It's more that Pharmacy as a profession is going backwards. There is no future for employees, and it's not getting better by the day.
There's a whole thread on whirlpool over the course of a year of employee pharmacists. Sure it's a bunch of whiney people, but it's the reality of it.
Only hope for employee pharmacists really is for deregulation to occur; in the US employees are paid > 100k USD working in supermarket pharmacies (sure it's a doctor of pharmacy, but if it's not the same profession, we should be).
@charzy: They are quite welcome to try their hand at ownership; ever heard of the term high risk high return? If you are not willing to take risks then you should be happy with what you get.
@pharm86: I don't see how this statement is relevant? I never mentioned anything about the employee wanting a slice of the profits, or how difficult it is to be an owner.
It's about the future of pharmacy and, and where the pharmacist stands in society now and in the future.@charzy: The better future for employee pharmacists has always been about getting into ownership though? If you are still an employee pharmacist by the time you are 40, you probably would not have a great time in any other career
@pharm86: I think it's applicable to any profession that getting into ownership gives you a better opportunity to make more money.
However it's more about letting the average pharmacist earn a half decent living for the workload they go through.
When compared to other healthcare professions, pharmacy is the one to have penalty rates cut, has the lowest award wage, has a retail aspect to worry about (unless hospital pharmacist) and the requirements are just as strict (indemnity insurance, compulsory CPD, registration etc).I applaud that your discount model is working, your employees are well treated and your customers are well looked after. However I think it's fairly safe to say that not all the discount pharmacies follow your example which is evident by the presence of a pharmacy union.
@charzy: I agree more discounters should be doing the same. Cutting 100k from their potential EBIT to increase staff and customer loyalty will pay them dividends in the long term but most are too short sighted
@pharm86: That's complete rubbish. Most careers have many different paths and steps one can follow. For a community pharmacist, you make $40/hr as PIC and then where do you go from there? Ownership? But that's expensive. In what other career do I have to invest $2m to make more than $40/hr? There's also a limit on the number of pharmacies that can exist in Australia and tell me what fraction of pharmacists can become owners?
@Astrohawke: Unfortunately this will always be the case unless two factors are changed.
Deregulation, or limiting the supply of graduate pharmacists.
At the end of the day there's always be someone willing to work cheaper than you, and places are limited due to location laws/ownership rules.
The other option is to exile oneself to a rural area.@Astrohawke: Ownership, working at head office of banner groups all would be great options for an intelligent pharmacist.
@pharm86: @pharm86 that's not entirely the case. For example I'm told the Guild lobbied (successfully) for all HMRs and RMMRs to be paid only to a 'bricks and mortar' pharmacy, even though the services are provided by independent clinical pharmacists; thus preventing a whole sector of pharmacists from being able to establish a new business model independent of supply.
Im the current discussion about pharmacist prescribing, the Guild have also pushed for there to be no separation of prescribing and dispensing (which the AMA then rightly pointed out creates a conflict of interest as there is a commercial benefit from prescribing something to a patient)
Not out there to Guild bash at all -
- I have excellent interactions with the Guild and its local branch - but its interests certainly predominantly relate to pharmacy ownership.
@mingofmongo: To clarify HMRs and RMMRs are tied to the approval number, and the approval number is tied to the physical address. Un-approved brick and mortar pharmacies (those 'express' ones that don't do PBS concessional payments) are not allowed to claim on these services.
Yes they could've decoupled all the 6PCA claims from the approval number to reimburse the pharmacist providing the service, but everyone knows the Guild isn't there for the pharmacy profession….
@mingofmongo: It's such a small market though, if they thought they could build a business around it might not be such a bad thing (for the clinical pharmacists) they aren't able to
What tips would you give someone who is looking to buy a pharmacy?
Any mistakes you made during the process which you regret?If it sounds too good to be true…..
Look into what is involved with being an owner-pharmacist.
Find a good accountant
Find a good bookkeeperThe number one thing to look for is: why on earth is this pharmacy on the market?
Most of the profitable pharmacies never hit the open market; they just get onsold to friends/partners/others within the same group.
Ones that DO hit the market (i.e. rejected by the big wigs already) usually have some warts attached. ALWAYS look for these.
MedAdvisor.
Do you use/promote it?
Is it good?
Do you see growth/future for this product/solution within your chain?
We use it, anything to streamline the process for customers is great
It hard ia guy i went to uni with used own 12 of them sold his now multi-million. it owns he own he S8 are what bring his customer back price match if ask he owns retail shopping center his so he own landlord. woolworths, pay him rent. told years become less of a gold mine.
What?
What did you study at uni?
LOL
wrong med?
You're not allowed to own more than 4 pharmacies so ummmm.
You actually understood that?
Do you have a good bookkeeper?
My accountant is excellent, and he sends one of his employees to do our books once a week
What does this involve? Are they doing a running profit and loss every week?
(Business owner in a different industry)
And if so, did you do this from the start, was this something your business partner did. etc any advise for other business owners.Nah we are a retail business which means we have tonnes of supplier invoices. They come in to do the book keeping as I prefer to spend my time with customers
Would you please clarify one of the terms that has been mentioned in earlier comments. There has been discussion of technicians dispensing prescriptions. Does this mean that someone other than a pharmacist is now authorised to give out prescription medication? If so, when did this change come in and what are the various qualifications of the staff members involved?
Thank you for the insights you have given us so far.
No, a pharmacist always checks (includes checking it is dispensed accurately and is safe according to the patient history) and then hands it out. Their job is to do a lot of the administrative duties such as ordering and a lot of the paperwork to make lives easier for my pharmacists
is safe according to the patient history
How would a pharmacist ascertain the patient's history?
Dispensing history, and a big one that is overlooked is actually talking to the patient and asking questions
Do you sell the same baby formula as coles/ woolies ? If so do you have Asians raiding your shelves too ? If so what effective procedures do you have in place to mitigate this?
I hold them for my core business: the local mums. I have stacks out the back and if they are a mother (doesn't matter the nationality) I will have stock for them. The GP in baby formula is very low anyway so no point selling it all to one person. I prefer to generate goodwill from my customers rather than have my shelves empty
This. Good on you for this. Too much articles about formula snatching in the supermarkets. As a parent, 100% would go to your shop and pay a premium.
More pharmacies should be doing the same; very short sighted to sell it all to one customer
@pharm86: Is there really such a shortage that selling it all to one customer leaves your sheilves empty? Like you can’t get enough from ur suppliers?
@cloudy: We would have enough if everyone did what I do, but some people sell (in some isolated cases) to a customer in pallet quantities (3-400tins I think).
Do you provide MAT pharma86 and if not how would you feel about offering that service?
@charzy: Hi there, just wondering whats your current job now?