When one joins a wholesale club—and thus pays a membership fee—one expects a few things: the lowest price and a high level of service and quality. It is under this philosophy that Sam's Club—with over 580 locations across the United States, most of which feature in-house pharmacies— operates, emphasizing accuracy and convenience in the rapid processing of prescriptions.

Mike Pitzl, a pharmacist and director of operations of the pharmacy division at Sam's Club, notes that a modest OTC department combined with a significant cash-based customer base frees up the time that its pharmacists would otherwise spend on dealing with OTCs and insurance documentation.

"The people who come to a wholesale club are a little bit different: they are used to service, and generally they are small-business people," he explained. "They are more cash-conscious. They are not spending as much time with insurance or multiple insurance policies. Our pharmacists generally have more time to spend with patients."

Pitzl adds that everyone visiting a Sam's Club location can fill a prescription, not just members. "There is a misconception that you need a membership card to get a prescription filled. That is not true; anyone can get a prescription filled at a Sam's Club and take advantage of the wholesale-club philosophy—the philosophy of excellent pricing, excellent service, and the way that we process prescriptions accurately and quickly," he explained.

While Pitzl concedes that price is on the top of the minds of those who join wholesale clubs, he underlines that Sam's Club's goal is to provide top-notch service. "Pharmacists are very well aware of the fact that if we do not differentiate by offering service, we are the same as everyone else," he said. "No one will travel by 8 or 9 other drug outlets if there is something special that we do not offer. Price is important, but the service is more important."

The demand for good service is, in part, driven by consumers' desire to know more about what it is they have been prescribed. Pitzl, who has worked in the industry for over 35 years, observes that when he started out, pharmacists rarely talked to anyone. "It was a huge mystery," he recalled. Over the years, counseling has become a crucial element in the pharmacy profession. "It is the piece of our profession that separates us from the product—the service, counseling, and professionalism that makes us different from anyone else." Focusing solely on product is not a solid model for future progress, he says. "The professional pharmacy will never survive at all if it is just about product."

At the same time, pharmacists should be properly compensated for the counseling they offer. "If we are going to provide cognitive services, or MTM [medication therapy management], or whatever you want to call it, there is a value," Pitzl said. "If people put any precedent on it at all, as in a physician's office, they have to be compensated for it. If we are able to, in the long run, provide greater health to the community, there should be some compensation for that."

The nature of the Sam's Club model attracts those who enjoy interacting with patients, and, according to Pitzl, pharmacist turnover within the company is extremely low. "Because of the interaction that we allow, because of the practice, and because we are only open from 9:00 to 7:00 and we are not open on Sundays, we attract people that are looking for something other than spending the entire day processing prescriptions," he said. "They want something more, and we have something more, because they do have time to talk to the patients and to give counsel. It is probably the best-kept secret out there."