In this clip, Troy Trygstad, Editor in Chief of Pharmacy Times, interviews Jack Vallandinham, the owner of Jack’s Corner Drug Store in Sigourney, Iowa. Jack explains how he works with other health care providers and gets to know patient needs in order to provide them with optimal care.
In this clip, Troy Trygstad, PharmD, PhD, MBA, Editor in Chief of Pharmacy Times, interviews Jack Vallandinham, the owner of Jack’s Corner Drug Store in Sigourney, Iowa. Jack explains how he works with other health care providers and gets to know patient needs in order to take care of them and keep his doors open.
Troy Trygstad, PharmD, PhD, MBA: Hey everybody, Troy Trygstad here with Pharmacy Times. I’m here with Jack.
Jack Vallandingham: Vallandingham
Troy: Vallandingham, that sounds like a very good Iowa name.
Jack: Sigourney, Iowa
Troy: And Sigourney, Iowa is about how many people?
Jack: 2500 people county seat town.
Troy: 2500 people, county seat town, and you’ve been practicing here for how long?
Jack: 18 years.
Troy: 18 years, and so, you grew up…
Jack: I grew up in central Iowa, small town, 800 people or something.
Troy: Did you go to pharmacy school…
Jack: I went to pharmacy school at the university of Iowa, I graduated, and I’ve been practicing ever since 1964.
Troy: 1964…and all in small communities, right?
Jack: All in… well the first 10 years I was in the Los Angeles area.
Jack: So, I worked for chains out there for 10 years and then I came back to Iowa. I’ve been in small communities mainly Fort Dodge, well St. Joe’s Missouri first, then Fort Dodge, Iowa, then Sigourney. I’ve owned a store here twice. I sold it and bought it back and put in a grocery store.
Troy: So, you’ve got a unique perspective because you worked in an urban environment for your first 10 years and then you moved back to the small-town Iowa pharmacy practice. What are the major differences between the 2?
Jack: Well, you get to know the people much more intimately than you do in a big city. Here, I know their parents and probably their kids and their relatives, which makes it good in some respects and problems in other respects maybe.
Troy: And why would it be a problem?
Jack: Well, I don’t know you get to know so and so, and so and so’s kid.
Troy: It’s a small town, after all.
Jack: The good thing about a small town is you know everybody’s business and the bad thing about a small town is that you know everybody’s business.
Troy: So, what are the biggest barriers and challenges to having a small pharmacy? So, Jack’s Corner Pharmacy is embedded in the little supermarket it’s so neat. I ran by there earlier today. What are the barriers and challenges with that practice environment trying to keep that pharmacy open.
Jack: Well, a couple things. First of all, you’ve got a supply of physicians who do the prescribing because in little towns you don’t always have that. Now that’s big worry number 1. Number 2 is probably living with the insurance area today because they don’t like to pay enough to keep guys in small towns is what happens.
Troy: And so, you rely a lot on staff. You have staff from the community that are from here.
Jack: We have staff from the community, yes.
Troy: Now, I have to ask you. We are sitting in front of a very interesting library, and we’re actually at Jack’s house in his basement, and they immediately went from that door to this spot right here. We have original Gray’s Anatomy, Pharmacological Principles of Medical Practice. People started grabbing books off the shelf. Physiological Chemistry. This is an amazing collection.
Jack: My books I’ve acquired over 55 years in pharmacy, and one of the things they taught us in pharmacy school is to have a good library. It’s basically out in the middle of nowhere, a good library now, with modern electronics it’s not quite so important because you can hop on the internet and find all that stuff.
Troy: So, it’s very impressive though. Just because you’re a country pharmacist doesn’t mean you’re not capable of both taking care of patients and knowing the latest and greatest…
Jack: I’m trying because, like I said, probably 60 to 70% of the drugs on my shelves weren’t on the market when I got out of school.
Troy: Sure, so keeping up… but what about care team relationships to then. So, you’ve got a small hospital in town, again compared to that urban environment practice, what’s that relationship with those other care team members? How was that different as well?
Jack: Well, probably good in one way because I know the doctor, and I call and say I’m talking about patient x and they say “oh, yeah I know them” and I say “yeah, I know they’re brother,” or whatever. So, the thing is, they know a lot more about the patient, not their just health lives, but some of the other things that are going on in their lives. You know, they may be taking care of a wife that’s suffering from something that’s probably going to make her die, so they’re trying to live with that. That all gets to be involved in what we’re doing. And you know which ones are going to probably take their medicine right, and which ones are going to say “ah, I’ll take them for a couple days and quit,” you know. The doctor knows those same people too.
Troy: So, I heard from a little birdie that after all these years in owning a pharmacy in Sigourney, Iowa, that you did sell your pharmacy this year, and you sold it to a local hospital, right? And this is still an independent hospital in the county?
Jack: Yes, it is. Yes.
Troy: So, what went into that decision? You probably could have sold to anybody, but why them?
Jack: Well, I wanted to make sure I was going to sell it to somebody that was going to keep it open. You get in a small community anymore and you worry about if the doctor leaves and all the sudden you’re shutting up the pharmacy. You see that go on quite a bit. The University of Iowa is pulling some of their clinics out of small communities. That leaves the community in a bad fix. They’ve got to have a doctor. People need to go to the doctor and he’s not there.
Troy: Yeah, so, going into your decision to sell was making sure that the patients that you’ve been taking care of for a long time, still get taken care of by somebody locally?
Jack: I have some patients that can’t get out of town for one reason or another, does not want to do mail order. You know, they want to know where their stuff’s coming from, so they’re really happy to be able to walk into my pharmacy and get their prescription.
Troy: Do you have any anecdotes or stories about somebody coming in from 5 or 6 miles away, maybe they live on a farm, and having an interaction with a patient that might be different—a different experience that you wouldn’t have anywhere else except rural America, upper Midwest America?
Jack: Well I had one fella come in and I know he was quite upset because his wife had just suddenly gotten diagnosed with cancer, and all of the sudden he was the caregiver. Never been a caregiver before and he’s got 6 or 8 different meds he’s got to give the lady, and he was just about in tears wondering how to do all of this. Well, we set him up with some daily dose stuff, so we could do it and keep track of what was going on.
Troy: So, you found that to be very successful?
Jack: Yeah, well it helped him a lot.
Troy: So, the monitoring and the tracking of patients, maybe is the future of community pharmacy practice because they’re in from of you a lot.
Jack: Well, certainly that’s got to be it, for a fact. We’re more than just dumping from bottle to bottle and counting 50 or 100 or whatever. Those days are gone, okay. We’ve got to be involved in what else is going on in with the patient and the only way to do that is to keep up with it or else.
Troy: If you had a magic wand to pass the torch to other pharmacists, that wanted to work in a community, what advice would you give them?
Jack: Well, it’ll be a lot more rewarding than anything you’re going to do in a big city where you don’t get to know your people, and like I said, you see them in the drug store, you see them on the street, you see them in church. I said you get more involved with their lives.