Tim Cernohous is senior vice president and president of Community Retail and LTC Pharmacy at Cencora, where he oversees the company’s retail and long-term care pharmacy businesses. In this Q&A with Pharmacy Times, Cernohous discusses why patient trust alone no longer guarantees satisfaction with brick-and-mortar pharmacies, how automation can protect pharmacists’ time without displacing the in-person relationship, and what independent community pharmacies can learn from medically integrated dispensing models as reimbursement pressure and staffing shortages continue to mount.
Pharmacy Times: Patients still say they trust their local pharmacist, so where specifically is the brick-and-mortar experience letting them down day to day?
Tim Cernohous: The challenge is that trust alone is no longer enough to determine the patient’s experience. The JD Power 2026 US Pharmacy Study sums up the day-to-day friction in brick-and-mortar pharmacy and its impact on patient experience and satisfaction. Issues like long prescription fill and pickup times, limited staff availability, communication gaps around prescription status and medication information, checkout inefficiencies, and out-of-stock medications are cited as common patient frustrations contributing to a continued decline in overall patient satisfaction with brick-and-mortar pharmacies and a continued increase in mail-order satisfaction.1
With advancements in technology, patients now expect greater visibility, faster updates, and more seamless service across nearly every aspect of their lives, including healthcare. Gen Z is leading this shift, with an estimated 79% turning to digital care channels like telehealth and online prescription services at least monthly.2
However, this change in customer preference is not simply a matter of patients choosing digital over in-person care. JD Power’s study also captured that mail-order gains are driven in part by stronger satisfaction with human support, while digital channels emerged as a meaningful opportunity for brick-and-mortar pharmacies to build trust. In sum, the path forward for brick-and-mortar pharmacies is to bring together 2 things patients clearly value, which are trusted relationships and a seamless, digitally enhanced patient experience.1
Pharmacy Times: What is the single biggest workflow change a retail pharmacy can make to feel more convenient without losing that face-to-face relationship?
Cernohous: The most significant changes are ones that increase efficiency in ways that protect pharmacists’ time. This starts with reducing administrative work and workflow inefficiencies that keep pharmacy teams tied up behind the counter and contribute to rising rates of burnout.3
Automation is often misunderstood as replacing the human side of pharmacy; in reality, it helps protect and strengthen it. Using technology to streamline meticulous tasks like refill processes, prescription status updates, and front-end workflows can reduce friction for both patients and staff, ultimately freeing up pharmacists, technicians, and coordinators to stage high-value patient interactions that—aside from building trust and contributing to patient satisfaction—create opportunities to expand the availability of clinical services and interventions, ultimately helping drive adherence, close care gaps, and support community health. These enhanced interactions also present opportunities for pharmacies to strengthen their financial sustainability, with health plans and payers continuing to see value in and reimburse patient outcomes.
Pharmacy Times: How should community pharmacists talk to patients who are drifting toward mail-order or online options for their prescriptions?
Cernohous: The conversation should begin by understanding what is driving the patient’s decision to make the switch, which usually comes down to a specific need—like greater convenience, lower cost, better refill timing, or easier communication—or reflects frustration with a past experience that can be useful in identifying opportunities to improve pharmacy workflows and better meet patient expectations in general.
Pharmacists should be ready to explain how their pharmacy can address the patient’s specific concerns, whether through better refill coordination and synchronization, delivery options, affordability support, or more proactive communication. They should also be confident in articulating the unique value of community pharmacy. While mail-order and online options offer logistical convenience, they cannot replicate a trusted, in-person relationship built over time. A pharmacist who knows the patient can answer questions in context, spot potential issues early, and provide support that feels personal. The value of this in-person, relationship-based model cannot be overstated—especially when it comes to patients in rural areas with limited health care options and ones with chronic conditions who might otherwise fall through the cracks. However, it must be supported by an experience that feels as responsive and convenient as patients now expect.
Pharmacy Times: What can independent community pharmacies realistically learn from how medically integrated dispensing practices handle specialty medication access?
Key Takeaways
- Trust isn't enough to retain patients anymore: JD Power's 2026 study links declining brick-and-mortar satisfaction to slow fills, staffing gaps, and poor communication, even as mail-order satisfaction climbs.
- Automation should protect pharmacists' time, not replace their role—freeing staff for higher-value clinical interactions that support adherence and financial sustainability.
- Independent pharmacies can borrow from medically integrated dispensing by tightening prescriber communication and standardizing referral/follow-up processes, as shown by Desert Hospital Outpatient Pharmacy's ~10% readmission reduction.
Cernohous: One of the clearest lessons is the value of using information more intentionally to reduce barriers and support patients more proactively.
Medically integrated dispensing models often benefit from closer coordination with physicians and care teams, which can make it easier to identify access barriers earlier, respond to therapy changes more quickly and support patients through the transition from prescription to treatment. Independent community pharmacies may not be embedded in the same way, but they can still apply that mindset by strengthening communication pathways with prescribers, standardizing referral and follow-up processes, establishing standing protocols with providers, or creating more consistent ways to identify and escalate common affordability, adherence or access issues.
We are already seeing examples of what that can look like. At Desert Hospital Outpatient Pharmacy in Palm Springs (a member of Good Neighbor Pharmacy, recognized for their excellence in clinical care at Cencora’s ThoughtSpot conference), pharmacists became part of the discharge planning process, delivering medications at the bedside and helping address access barriers before patients left the hospital—ultimately contributing to an approximate 10% reduction in readmissions and an average 2% improvement in A1c among patients in its diabetes program.
Community pharmacies already spend a lot of time helping patients navigate prior authorizations, payer issues, affordability challenges, and therapy questions. They can expand that impact when they use insight, coordination, and patient relationships more deliberately to improve access and continuity of care.
Pharmacy Times: As reimbursement pressure and staffing shortages keep mounting, what should a pharmacist prioritize protecting first in their daily operations?
Cernohous: The priority should be protecting the pharmacy’s capacity to help patients access their medications safely, affordably, and with the support they need to stay on therapy.
Pharmacy teams are being asked to do more within the same constrained time and resources. In addition to reimbursement complexity, they are balancing dispensing, patient support, staffing pressures, and expanding into services that improve community health and generate additional streams of revenue. In that environment, not every task carries the same value.
Pharmacists should prioritize the work that most directly affects medication access and adherence—and ultimately, care continuity. Then they should look closely at what is pulling time away from that work, especially repetitive tasks, manual processes, sources of administrative burden, and operational inefficiencies that could be reduced or redesigned.
With reimbursement pressures mounting, dispensing alone is often no longer enough to sustain operations, which is why many pharmacies are broadening their service offerings to include immunizations, point-of-care testing, medication therapy management, long-term care at home, and specialty support, based on community needs and state scope-of-practice rules.
For brick-and-mortar pharmacies, sustainable business growth is what makes continued access to care possible. The goal is to build workflows and services that create more capacity for teams, strengthen financial sustainability, and allow pharmacies to keep delivering trusted care in the communities they serve.
REFERENCES
1. Care & convenience: the new Rx for pharmacy satisfaction. News release. JDPower. Released July 28, 2026. Accessed September 21, 2026. https://www.jdpower.com/business/press-releases/2026-u-s-pharmacy-study/
2. PwC’s 2025 US healthcare consumer insights survey: The consumer-first era of health. News release. PwC. Released October 20, 2025. Accessed September 21, 2026. https://www.pwc.com/us/en/industries/health-industries/library/healthcare-consumer-insights-survey.html
3. Administrative burdens and inefficiencies continue to fuel provider burnout, Surescripts survey finds. News release. Surescripts. Released September 30, 2025. Accessed September 21, 2026. https://surescripts.com/press-releases/administrative-burdens-and-inefficiencies-continue-fuel-provider-burnout-surescripts-survey-finds
