FINDING THE RIGHT PATH IN A SMALL CHAIN

Author: Susan Farley

KEITH BIBELHAUSEN HAD BEEN out of the pharmacy business for years, working as a senior vice president at an office supply company and making a home for himself in Annapolis,Md. In 2001, he received a call from Dick Hartig asking him to run operations for his company,Hartig Drug, a small chain of drug stores in the Midwest. Bibelhausen, who had previously worked for national pharmacy chains after graduating from the University of Cincinnati Pharmacy School, was interested in getting back to the profession where he began his career, so he accepted Hartig's offer. Soon, Bibelhausen moved from Annapolis to Dubuque, Iowa,where it took some time to adjust from the faster pace of the East Coast to the laid-back atmosphere of the Midwest. The move turned out to be a good one, as it allowed him to become embedded in his community. In Iowa, he serves on the board of directors for the symphony orchestra and works with the chamber of commerce, Boy Scouts, and various other community projects. "These are opportunities I didn't have working for a larger company," says Bibelhausen.

At Hartig Drug, private life is an important part of professional life, and being a smaller chain offers pharmacists the opportunity to work in their profession while maintaining a certain quality of life.Hartig pharmacies are not open as long as others—there are no 24-hour stores; in fact, most are not open past 7:00 PM, and they are closed on Sundays and holidays. Bibelhausen says this gives Hartig pharmacists the ability to balance home life and professional life.

According to Bibelhausen, Hartig is overstaffed with technicians taking care of the dispensing and the preparation, and the work flow is such that pharmacists can spend more time with physicians and patients. Because they are located in smaller cities and towns throughout the Midwest, Hartig pharmacists are absolutely crucial to patients who do not have insurance—their services are used extensively.

BEGINNING OF THE ROAD

At Hartig Drug, a graduate will start as staff pharmacist, then become the pharmacist-in-charge, and eventually executive director of pharmacy once they are out of school 3 years and overseeing long-term care. From there, they can move on to director of pharmacy and then to vice president of pharmacy as they approach retirement age.

"We have an extensive internship program and offer rotational sites for 6-year students. One to 2 months before they are licensed, we bring them on, and they are exposed to a long-term care pharmacy. They learn our systems and understand our work flow. Once they are out of school,we consider them experts in the practice of pharmacy. Pharmacy schools do a great job of preparing students for the profession. Our program can prepare them for the business side."

Hartig Drug pharmacists dedicate time to special screenings and clinics; one store may host an anticoagulation clinic, or Hartig may host a companywide Diabetic Day, for example. If a pharmacist wants to get involved with a physician for a special clinic, however, that is supported and encouraged. With the smaller town pharmacies, Hartig pharmacists will work with local hospitals and serve as consultants, offering advice to patients who are not going to a primary care physician. "It is a critical part of the community. That's what makes it fun," says Bibelhausen. "It's ‘how many people did you help?'—not ‘How many prescriptions did you fill?'"

As a growing company with new stores opening in Wisconsin and Illinois, Hartig needs pharmacy professionals to help them grow."We're looking for people who are passionate about the profession and who love people. You have to enjoy talking to patients, and you need to be focused on the needs of patients and their well-being," advises Bibelhausen. "It is also important to be a team player—one company, one family, one profession."

CLIMBING THE LADDER

In the 24-hour environment that is New York, pharmacists can find a similar dedication to family and pharmacy, as Duane Reade pharmacist Gary Melnick, RPh, discovered in his career. For 22 years, Melnick owned his own pharmacy, before selling it and sending out his resume to the larger pharmacy chains and retailers that were dominating Manhattan. One of the many responses he received was from Rock Bottom, a local New York chain with 32 stores that was later bought by Duane Reade, one of New York's best known and busiest pharmacy chains.

Melnick started as a staff pharmacist and soon began assisting in scheduling issues. His hard work paid off, and he was offered a supervisory pharmacy position. After a year, he got a call from Duane Reade's director of pharmacy operations, who was looking for someone with a thorough knowledge of policies and procedures. Melnick was the right man for the job and soon began training new employees, despite having been with the company for only 2 years.After 8 months,Melnick became a pharmacy district manager. He stayed in that position for 3 years until he became district manager for 8 months. From there, he was promoted to director of pharmacy operations.

His swift climb up the career ladder may seem unique, but Melnick swears it is typical of Duane Reade and offers it as a perfect example of how they take care of their pharmacists. Pharmacy students can get their start at Duane Reade as graduate interns, where new recruits work under the supervision of an experienced pharmacist and learn the company's protocol. Upon licensure, they will be well prepared to take on the challenging role of a Duane Reade RPh, says Melnick.

"Most—if not all—graduates will start in the stores. They will have the opportunity to gain real-time experience regarding the operation of a retail health care business. This is a particularly exciting time to be part of Duane Reade. We have new leadership that is keenly aware that Duane Reade is a health care provider. Pharmacy, the heart of our business, is our main focus," says Melnick.

New pharmacists at Duane Reade may work in stores as staff pharmacists, or they may elect to become coverage pharmacists or "floaters" to broaden their general experience. Once they are comfortable with the system, they can become pharmacy managers. Those who show the ability and express the desire to take on corporate positions will have that opportunity, as Duane Reade prefers to promote from within.

MAXIMIZING TIME

One of the ways in which Duane Reade ensures the best use of their pharmacists'time is through its Central Fill Facility, the only one in New York City. A refill is called in through an automated phone system, and Duane Reade's Central Fill Facility intercepts the message and fills the prescription within 90 minutes. If a store fills 1500 prescriptions, central fill gets 300 of them, which eases the workload.

Duane Reade also employs a pharmacy kiosk that allows their pharmacists to spend more time attending to patient care and reviewing records. This kiosk allows patients to drop off prescriptions without waiting. It also allows the patient to connect realtime with a pharmacist to obtain medication and health information, and it lets the pharmacist provide live consultation to a patient.

"Our chain provides pharmacists the opportunity to have direct contact with a broad spectrum of patients," says Melnick. On many occasions, Duane Reade pharmacists become the primary health care providers for the patients; it is the pharmacist who explains the relationship between the drug and the disease state.

A typical day for a Duane Reade pharmacist runs the gamut from filling prescriptions, reviewing patient profiles, speaking with patients and doctors, supervising staff, helping the public select OTC products, speaking with insurance companies, ordering drugs, and working with store and company management, according to Melnick. Many Duane Reade pharmacists are certified diabetes specialists with opportunities to participate in a number of outreach programs.

ESTABLISHING VALUES

At Hartig Drug, because the company is a privately held, family-owned, pharmacist-run company, they do not operate for the benefit of shareholders. "Decisions are made to further the professions and our business. We are customer-and employee-friendly, and there is a genuine family atmosphere. There is not a lot of politics as one might find in a larger organization," says Bibelhausen. "Our philosophy is to ‘do the right thing,' be honest and upfront, and operate in a straightforward, caring way."

Melnick firmly agrees with that approach. "Philosophically, we are here to serve our public, to provide the best health care services that New Yorkers can hope to receive from any source," says Melnick. "We create a culture that believes that cost reduction and quality are not opposites."

Ms. Farley is a freelance medical writer based in Wakefield, RI.