Who is your customer

Who is your customer

I got into a rather interesting discussion with a friend recently. He works in higher education and asked me the following question after reading my blog post Considering “workplace levers” in office politics

“At a university, who is your customer…the student or the parent of the student?”

My response was quick..

The student is the customer… the college student is around 18 years of age, and thus  has the final decision to attend the institution. Yes, their parents have great influence in their college decisions; but it’s my opinion that colleges must treat the student as the customer because they’re the folks attending class, living on campus, and being active members of the student body.  Additionally, many student’s take on student loan debt even when parents do have the ability to make payments towards their children’s college education.

Ultimately, students graduate and become alumni. The alumni hopefully become donors to continue the advancement of the institution. If the university mistakenly treats parents as the customer throughout these formative four to five years the student is on campus—there is the potential that the graduates won’t become actively engaged in efforts to both donate and raise donations.

My friend’s response… 

You’re wrong! Parents are the customers because they’re paying the bills!

Who won this argument you might ask?

This round and round again debate got me thinking…

How often do managers ask themselves, “who is my customer and why?” In my scenario the university is the business and the customer(s) are the student and/or parent.

So the business owner and/or manager has a decision to make.

Three questions…  

  1. Who is my customer and why?
  2. What is the criteria in selecting a customer?
  3. When the customer has been selected; how do we market to this segment appropriately?

A short list of factors to consider when selecting and defining your customer: 

  1. Who is the buyer of goods?
  2. Who is the active shopper of goods?
  3. Who influences the purchase?
  4. Who makes the final decision?

Ultimately, the business has to understand who their customer is to effectively market their product. Effective marketing is tough; as marketing to the wrong audience can have a negative effect on the long term health and growth of the company.

For example…does a children’s toy company create an advertisement campaign geared toward the child or the parent? 

Who is your customer? And what decision trees did you employ to come to your conclusion?

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Sam Blakemore is the Pharmacy Manager of Peds Rx Pharmacy Solutions. Connect with him via: LinkedIn

 

Considering “workplace levers” in managing office politics…

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Management can be difficult. As you have read from my previous posts the most important resource of any business is its employees. If a manager is unable to effectively communicate and utilize their employees, he or she will not be managing for very long.

Leverage is a principle often utilized to discuss financial debt in the world of business. Financial institutions and businesses can utilize debt to take on more risks in the hopes of increasing revenue and profit margin. In that same respect the employee and manager utilize forms of “workplace leverage” to ensure status and influence within the organization. Both the manager and employee use various levers to elicit a response.

The manager’s “work place levers” 

  1. Hire versus Fire to influence employee behavior and decisions
  2. Praise versus Write Ups to influence employee behavior and decisions
  3. The power to increase salary and dole out bonuses to influence employee behavior and decisions
  4. Positive evaluation versus Negative Evaluations of employees to influence employee behavior and decisions
  5. Internal politics with ownership and co-workers to maintain status and position while influencing employee behavior and decisions

The employee’s “work place levers”   

  1. Underutilization versus over-utilization of sick and paid days off to effect management behavior
  2. Gifts and Praise of management/co-workers to effect management behavior
  3. Positive versus Negative Evaluations of management/co-workers to effect management behavior and decisions
  4. Habitually early to work versus habitually tardy to work to effect management behavior and decisions
  5. Internal politics with ownership and co-workers to maintain status and position to effect management behavior and decisions

I won’t delve to deep into the details of how these actions can be utilized by both the manager and employee; but briefly review each point. Consider the names and or faces of the people that you can associate with each variable. In short, both the manager and employee utilize forms of leverage to elicit responses.

As I’ve mentioned previously, people are as important as financial capital in maintaining a functional organization. For those in management; please take the time to consider these 10 key points to ensure a functional work environment.

  1. Be upfront and honest about the role each person plays in maintaining a functional business.
  2. Value the opinion of every member of the team, and actively demonstrate this by listening to their opinions and actively considering these opinions when creating changes within the organization.
  3. Even in times of disagreement; work diligently to maintain a level of respect for that person
  4. Focus on the value created for the shareholders when trying to create a unified vision between management and employee.
  5. Focus on the quality of the product created for the consumption of your customer when trying to create a unified vision between management and employee.
  6. At a minimum evaluate employees biannually; when evaluating always have a third person involved to witness. This reduces the possibility of arguments and misunderstandings.
  7. Be respectful of the goals your employees have; most likely they do not want to be employees for life. And that is fine. Work with them on creating a 1 year, 5 year, and 10 year plan so that they don’t feel stuck in a rut.
  8. Create rubrics to grade yourself and employees; this shows thoughtfulness and reduces bias when grading employees on their abilities.
  9. During reviews, offer each employee a time to have a moment of reflection. Ask them, “do you have an issue with management, a co-worker, or the organization that needs to be resolved?”
  10. Practice being able to discipline without bias; this practice helps maintain uniformity in the organization, and builds a level of trust for the employee in relation to management.

You will never be able to keep people completely happy. And following this plan will not eliminate every employee’s discontent. I still implore each manager to have a plan, and  stick with that plan during both the good and bad times. Work with diligence to ensure the employees you manage have enough space to consider their place and role in the organization.

We work and work till we are tired. The days and months will pass us by, and before we realize it our most important employees are desiring to leave the organization and often we don’t even see it coming.

Please review my 10 key points; by reviewing these points I hope that you’re able to improve employee satisfaction. It is important that managers ensure that an employee’s concerns are heard. There should be open lines of communication in all phases of hierarchy; ownership–>management—>employee. Communication is paramount to ensuring business success.

A company can quickly collapse under the duress of organizational stress. To prevent this collapse managers must pride themselves on using “workplace levers” in an appropriate manner to maintain balanced scales of power in these “workplace courtrooms” that house office politics in every business and industry.

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Sam Blakemore is the Pharmacy Manager of Peds Rx Pharmacy Solutions. Connect with him via: LinkedIn

 

Customer service — Alert Active Engagement vs. Distracted Passive Engagement…

A worker with voice low, eyes down, distracted by smartphone in their hand, “welcome to _______ how may we assist you?”

Distracted Passive Engagement is a buzz kill.

Customer service in it’s simplest form is an opportunity to tell the story of your business.

When a customer steps into your business, on the surface they’re looking for a product to purchase. However, consider that the shopper has an ability to purchase a given product in a variety of other ways besides coming to your business.

How many places can you buy coffee?
How many places can you rent cars?
How many pharmacies are there in a five mile radius? 

Managers should treat their customers as smart and knowledgable.  Typically at their disposal is a smartphone that can answer most of their general questions.

It’s easy to run a business as an accumulation of transactions; you sell and they buy. But if you manage a business in this manner you’re losing an opportunity to convey that theres meaning and substance in the what, why, and how you provide the product and/or service.

When a customer visits your business, visualize them screaming at the top of their lungs,  “Gimme a reason to shop here!”

Are you adequately providing the foundations of customer service?

Clean—there’s no bigger turnoff for the shopper than to walk into a business that’s unclean and unorganized.

Time—in providing your service you respect your customer’s time and if there’s a delay in providing the the service or product you apologize and/or inform the customer as to why there is a delay.

Care—the employees care about what they do. They’re engaged fully to the mission of the business and want to be of service to the customer.


The focus on the remaining sections of this article is to discuss how to find those that care. I often tell new applicants the following;

” I can teach them how to perform their job, but I can’t teach them how to care about their job.”

When an employee is simply going through the motions of performing his or her job this can be detrimental for both the customer and business.  Poor customer engagement will lead to a decline in generating revenue.

 In my own experience as a manager there are two options in how your employees provide customer service.  

  1. Distracted Passive Engagement (DPE) 
  2. Alert Active Engagement (AAE) 

Both AAE and DPE can induce the sell of a given product. However, only AAE can induce the sell of a product while also increasing the potential of retaining customers. This customer retention induces customer loyalty and creates the businesses “brand”. Think about it from this perspective…

How does a business create a brand from one-time shoppers of their service?

DPE equals going through the motions. The employee shows up to work on time, the employee says all the right things, and they make adequate sells of your product line. The manager should ask themselves the following regarding employees that may be distracted and passive in their engagement with customers:

  1.  Do they know the details of the products they sell?
  2. Do they know the attributes of your traditional shoppers?
  3. Are they able to quickly deduce what the buyers want and need?

Employees that perform AAE  don’t just go through the motions.  General statements about employees that are actively engaged with the needs of the customer are as follows:

  1.  Typically these employees are in tune with the needs of the customer.
  2. Employees that actively listen to the needs of the shopper and make appropriate recommendations to meet customer need and satisfaction.
  3. Employees that strive to find new ways to provide quality service.

Remember the difference between AAE and DPE lays in the foundation that active engagement with the customer leads to greater success in retaining customers over a lifetime as opposed to simply making a one time sell.


Qualities…

In regards to a job applicant; reflect on the following questions regarding the person’s interview:

  1. Do they have a passion for the service your business provides?
  2. Are they equipped to serve the public in this capacity?
  3. If they’ve never been in customer service;  can they adapt to a service oriented work culture?
  4. Are they curious? Good questions during the interview process can mean that they will be equally active and engaged with customers.
  5. Problem solvers? Do they like to help folks solve their problems. This can be of value to both the customer and the business.

Educate…

Once they’ve become a member of your staff; harness the potential that you saw both in their application and during the interview process by educating employees on these key points:

  1. A focus on the long term instead of short term—be willing to lose a sell on a product if it’s in the best interest of the customer to get a given product elsewhere. In being up front and honest regarding the customer’s needs you will build trust. Trust will build customer retention.
  2. Awareness—be aware of customer body language. An awareness in how customers are feeling provides direction in how to engage with them to meet their needs. This awareness shows the customer that you understand what they want from the service or product that you provide.
  3. Listen—actively listen. Only by listening can your employees make appropriate recommendations.
  4. It’s okay—-it’s okay if you don’t know the answer. It’s better to state that you don’t know up front with customers. This builds trust with the customer. Be up front with customers and state, “I’m not sure, but I may be able to find the answer to your question if you give me a moment to research it.”
  5. Expert—your employees won’t know it all, but go over with them some key topics. Of those topics, find out which topic they feel most knowledgable about. Harness this knowledge and teach them to be experts in this area. Their expertise in a given area can be the difference in making the “sell”.

The goal…

Good customer service is one step in forming a relationship of trust. It demonstrates that your business can provide the customer with what they need. Once that relationship is built, continue to add layers of trust by maintaining outstanding customer service.

On the surface, customer service seems simple. Be nice, be courteous, and say thank you.

But it takes more to retain customers in this marketplace.  The owner/manager that doesn’t consider customer service to be a differentiator does not fully consider the threat of decreased  revenue from a decline in customer retention. In the retail space there’s an old saying…

“The customers you really like and want to keep don’t tell you they’re leaving…they just leave.”


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Sam Blakemore is the Pharmacy Manager of Peds Rx Pharmacy Solutions. Connect with him via: LinkedIn

A B-school essay from a Pharmacist’s perspective

My Operations Management (OM) Professor in B-school had one question for our final exam.

Explain if this course will or will not be relevant in your chosen profession or career path?

I revisited my short summary a few days ago and considered the role of the Pharmacist in relation to the current healthcare model. How can Pharmacists help create efficiency when we see inefficiency? How can individual Pharmacists help bring order to a process and fill in the gaps when we see an opportunity to help?

I believe the Pharmacist can fill in the “gaps” and find an opportunity to serve in new ways.  This will further our value to the healthcare team. Dispensing medications correctly should always be the foundation of our Profession, yet there are more bricks to be put in place to create the final framework in our bid to be seen as “healthcare providers”. With the broad knowledge base that Pharmacists have in their toolbox, there is an opportunity to be more than “retail or clinical.”


December 4th 2015 at 9:53PM I submitted the following.


Sam Blakemore, PharmD

Personal Operations Management

I have been a practicing Pharmacist for three years.  In that time period, Walgreens purchased Alliance Boots, CVS Caremark purchased Target’s in store pharmacies, and most recently Walgreens made another large investment in agreeing to purchase Rite Aid Pharmacies.

The number of patients that the healthcare system takes care of will continue to rise due to more people having access to healthcare with the implementation of the Affordable Care Act.  Yet, the reimbursements for these services has become more competitive due to increased demand for better pricing by federal and state funded programs.

The Affordable Care Act has made mergers the new norm. Hospitals, Pharmacies, and Home Health Care Agencies have decided that the key to survival is to become as “lean” as possible. In becoming “lean”, the merged companies streamline operations by initiating new workflow processes, retire outdated facilities, and layoff under-performing workers in the hopes of increasing productivity and profits.

Mergers within the pharmaceutical industry are creating shifts in the supply chain. This will impact the drug companies, wholesalers, and retail pharmacies both independent and chain. In the article Drug Partnership Could Trigger Major Supply-Chain Changes, the author states the following:

For now, drug manufacturers mostly use wholesalers like AmerisourceBergen to ship their product to pharmacies. But if manufacturers are squeezed too much by the arrangement, some could opt to bypass wholesalers altogether and peddle their drugs straight to the drug stores…1

Pharmacy mergers have increased for the purpose of survival in a market with a reimbursement structure that changes by the day. In the article, Reassessing the pharmacy supply chain for a healthier bottom line, the author states the following:

The unpredictable and shrinking reimbursement landscape requires these organizations to reassess expenses and processes –especially within the supply chain—across all facilities and departments to determine cost-effective operational strategies.2

Forecasting reimbursement and cost of drugs in pharmacy is key to success. As an example, Rite Aid Pharmacies earnings per share decreased due to a cut in Medicare reimbursement rates.

Rising generic drug prices are hurting drug store operators as insurers and pharmacy benefit managers have been slow in raising reimbursement rates for those drugs…reimbursement rates for Medicare Part D drug plans, which cover prescription drugs for senior citizens and the disabled, are falling due to growing competition to win these contracts.3

Appropriately forecasting revenues and expenses, using lean/six sigma principles to eliminate drug errors, and having a firm grasp of inventory management are the big three principles I will remember from this course. Having a firm grip on these concepts can be the difference between thriving and failure in this market. It is imperative that a pharmacist have a firm grasp of operations management to thrive in this market and differentiate one’s self against other pharmacists they’re competing against for a job.

I want my patients to have a good experience. I want them to receive the right drug, at the right dose, at the right time, and for the right price. With that in mind, this quote grabbed my attention when I first read it.

“With the country focused on controlling the escalating costs of healthcare, every entity in the healthcare system is under increased pressure to lower costs—while at the same time not jeopardizing the quality of care that patients receive.”4

It is my opinion that schools of medicine, nursing, pharmacy, public health and so forth should require or offer as an elective an operations management course. This course has challenged me to reconsider how I manage employees and myself. This operations management course offered me the information, vocabulary, and resources that I’ll be able to draw from in a healthcare environment that is rapidly undergoing change due both to increased competition and decreased net margins.

References

1.) Martin, Timothy W. Drug Partnership Could Trigger Major Supply-Chain Changes. 22 March 2013. http://www.wsj.com/articles/SB10001424127887324373204578374801163395308. Accessed 23 Nov. 2015.

2.) Piotrowski, Cary. Reassessing the pharmacy supply chain for a healthier bottom line. 17 July 2015. http://www.beckershospitalreview.com/finance/reassessing-the-pharmacy-supply-chain-for-a-healthier-bottom-line.html, Accessed 18 Nov.

3.) Ramakrishnan, Sruthi. Rite Aid cuts full year forecasts citing reimbursements. 17 Sept. 2015. http://www.reuters.com/article/2015/09/17/us-rite-aid-results-idUSKCN0RH1I920150917#BMoHOwRPdPZFJMVo.97. Accessed 18 Nov. 2015.

4.) Pharmacy Inventory Project: Improving Inventory Management at Genesis Healthcare System Pharmacies. 19 Nov. 2014. http://fisher.osu.edu/supplements/10/14252/white_paper_genesis_2014_2.pdf. Assessed 18 Nov. 2015.


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Sam Blakemore is the Pharmacy Manager of Peds Rx Pharmacy Solutions. Connect with him via: LinkedIn

Rebaked PIE…Pharmacist Industry Engineer


It’s not always about how much money a business makes; oftentimes its more important to understand how much money the business can save.

I asked a Pharmacist the following question:

“Who is probably the most famous and richest industrial engineer? Your hint… he grew up in Mobile, AL?”

He paused and thought about it for a few moments…

Then he said, “I’m not sure…who?”

I said, “look at your smartphone… Tim Cook  ring a bell…”

Tim Cook…iPhone…ring a bell…”HAHA.” I know…I know…so funny, not really. Our discussion began when he asked me about my experiences in B-school (business graduate school).  I discussed various points in my journey as a manager, and how I sought some  answers to my many managerial questions. B-school helped fill some of those gaps.

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Quantitative Analysis for Managers I explained was an interesting but difficult course. I really had to work hard to put all the concepts together. It was business math on steroids.  A taste of algebra with a pinch of calculus and a dollop of excel spreadsheet.  One week we were discussing linear programming models; the next week we were discussing transportation models.

I felt like I could study all week for the tests, and still not feel good about my prospects of passing. The Professor would allow us to have a formula cheat sheet, but that was of little  value.  The course took time and was intense. The tests were tough. He ended up curving our final grades that semester.

It was tedious work. It took time to wrap your mind around some of the concepts; but studying those concepts gave me satisfaction. My mind was being pushed and thats what I wanted as a student. It made me appreciate the skill and art it takes to make complex business processes less complex. I began trying to understand the formulas behind business principles. I enjoy learning about a Professor’s educational background. It always explains why some concepts just feel so natural to the teacher/lecturer. Turns out our Professor that semester was an expert in the field of industrial engineering. I had heard about civil engineering, chemical engineering, electrical engineering, etc.. But I had never heard of industrial engineering.

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Pharmacist in general have an appreciation for math and science.  So I decided to show my Pharmacist “buddy” an old video on linear programming that the Professor had uploaded on the web. The Pharmacist became “giddy” with anticipation on how to setup the correct mathematical equation to reach an appropriate business decision based on profitability.

We then lightly touched on transportation models

I said, “driving a 18-wheeler seems simple enough…but then imagine all the routes and paths those trucks can take to get to their destination.”

He said, “yea…that’s right…isn’t that why some mail couriers only take right hand turns? That’s why they have people doing that research…think of all the money they save on gas, and all the time they save by making routes more efficient…”

I said, “you know where most of these principles fall under? Industrial engineering…”

Industrial engineers bring science to our everyday lives by engineering efficiency; they use math to bring order to a process. Pharmacists practice the same methods with medications. We ensure patient safety by being the medication experts of the healthcare team. We bring order and create efficiency in the dispensing and consumption of medications.

So what’s stopping Pharmacists from reaching our full potential as the “industrial engineers” of drug management? Gaining status as “healthcare providers” will go a long way in creating a structure for the reimbursement of our services. But until that “provider status” reaches all 50 states; what can our Profession do to show the “system” our value?

Currently the market is focused on volume to magnify shrinking profit margins. However, the market will gradually shift to a focus on reducing costs. In part because rising costs will lead to skyrocketing debt in our current healthcare model. The market is at risk of collapse due in part to rising medication costs.  While we can’t control how Pharma prices new drug regimens.. Pharmacists can be on the front lines of change by initiating the following principles:

  1. Limit “defects”–use “lean” principles to ensure patient safety and accurate dispensing of medications with appropriate operations management principles
  2. Improve discharge planning—ensure patients receive the appropriate medications upon discharge.
  3.  Improve access—ensure that upon discharge from hospitals or clinics; patients have access in the community to the appropriate medications from local pharmacies, mail-orders, and patient assistance programs.
  4. Engage in dialogue with prescribers—regarding the prior authorization process, formulary additions and deletions, an analysis on patterns seen at the pharmacy in the local community.
  5. Build an alliance—with social workers, churches, community organizers so that when patients need help the Pharmacist can give guidance.
  6. Data mine–effectively gather data about medication usage and prescriber patters; then turn data into usable information to enhance quality of care.
  7. Reduce expense—have an active engagement in knowing the costs of medications, and the copay tiers of pharmacy benefit managers. Have an active discussion with patient’s and their families regarding their ability to manage these expenses.

There are more PharmD’s graduating with dual degrees; Pubic Health, Business, and Law. There are more PharmD’s entering pharmacy school having already obtained a bachelors degree. The “Millenial PharmD” has the potential to step outside the box to meet the changing demands of the market.

My version of the Pharmacist Industry Engineer (PIE) does not epitomize  the traditional meaning of Pharmaceutical Industrial Engineering   in that traditionally the framework of the definition was focused on manufacturing for “Big Pharma”.  I simply seek to use this term to reframe how we are defined as agents of change in the current marketplace.

A PIE as defined by me—both optimizes and individualizes pharmaceutical care, creates new processes to improve pharmacy access, improves operations to ensure patient safety, and builds communication channels with both prescribers and patients to reduce waste and expense for the individual and healthcare system.

Efficiency. Accuracy. Reduced Defects. Reduced Costs. 

 

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Sam Blakemore is the Pharmacy Manager of Peds Rx Pharmacy Solutions. Connect with him via: LinkedIn

Buckets in the Pharmacy? A look at pharmacy operations…

I’m a visual person.

In the pharmacy, visual cues help me make quick decisions regarding prescription status. As a student at a “chain pharmacy” I would put prescriptions in blue buckets or red buckets. Blue buckets for folks picking up their prescriptions in one to two hours, and red buckets for folks picking up in 30 minutes or less.

Throughout pharmacy school it was blue bucket versus red bucket. It’s a pretty efficient model. So efficient I took the practice up at the independent pharmacy that I manage. These buckets can easily be purchased online.

Then I went to business school and started studying operations management. I started to gain an appreciation for the blue bucket/red bucket workflow process. It was an effective method of ensuring customer satisfaction. It gave the Pharmacist visual cues as to what order prescriptions needed to be filled. Lastly, it helped maintain organization, thus decreasing “defects“. With the buckets you can simply drop the prescription in the bucket with the drug. Thus, things matched up when it was time to enter the order and fill the prescription.

I began reading articles on how other Pharmacist maintained organization. I read an article by a man that discussed how he used multiple colors of buckets. When I read the article, I felt like a pharmacy nerd when I read the article and became giddy. For me I had only known blue bucket and red bucket. How could I incorporate more buckets? I know I know…sounds lame!

I began writing up a method and came up with the following:


WORKFLOW

DROP OFF —> DATA ENTRY—>FILL PRESCRIPTION–>VERIFY PRESCRIPTION–>PICKUP PRESCRIPTION

BUCKET COLORS (Pharmacy Tech/Pharmacist organize accordingly

BLUE- prescription to be picked up in 1 to 2 hours

RED– prescription to be picked up in 15 to 45 minutes

GREEN– prescription medication is high dollar; pickup likely next day  

YELLOW-prescription has an issue ( order needs clarification, call pharmacy benefit plan, etc.)

BLACK– prescription to be compounded

WHY we WORKFLOW

Workflow improves patient safety. Please keep with the workflow to better serve our patients.


 

This is what works for me as the manager of a pharmacy. The buckets allow me to remain efficient and organized. Both Technicians and Pharmacist can be on the same page with a simple color cue.

I know some people will think this is entirely too much! I would completely understand if you felt that way. It’s an idea…consider it and think of ways that you can tailor it to fit your own practice. I use this technique for pharmacy, however this same technique could possibly be used in the operations of other business models.

Is your business predicated on “volume” to maintain appropriate profit margins? Colored buckets are a cheap investment and can potentially increase your worker’s efficiency. Increased efficiency will increase worker output. Maintaining appropriate output very well could be the difference in business success or failure. IMG_3806


Sam Blakemore is the Pharmacy Manager of Peds Rx Pharmacy Solutions. Connect with him via: LinkedIn

Life of the manager— Think. Reflect. Improve!

What are you doing? Are you faking it till you make it? What’s the plan? Solve the problem! You don’t know what you’re talking about!

The more education I attained the more I realized that I had built a catalog of reference points. We read, we learn, and hopefully when the time comes we are able to reach back into the card catalog of our memories to find that one bit of information that will help serve the person staring at us looking for any bit of help.

In the pharmacy the realization that I’m consistently learning and re-learning is always upon me. On any given day, I can learn patience from a child, a bit of humor from a grandpa, and reminders of how to not take myself too seriously from co-workers.

A manager that knows how to motivate realizes that educating employees on how to do things the right way everyday is the difference between a success and failure. It’s the vital component to providing a service the public wants and the level of compassion needed to ensure the consumers of your product are retained.

Education isn’t just for classrooms. What are you doing to improve your chops as a communicator and as a teacher? Do you take the time to be quiet and watch those that are gifted perform their gifts? Are you capable of listening to an employee’s new idea?

As a manager of people be willing to learn from both those you manage and the customers you serve. Things can always be better, performances are never perfect and can always be improved. Never take for granted the opportunity each day that you have to serve the public. Focus on the foundational topics of your profession. How are you going to multiply if you haven’t learned to add and subtract? Hopefully, with reflection, you’re able to find reference points of education that were learned in the classroom and on the job that will allow you to expand and grow your business.

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Sam Blakemore is the Pharmacy Manager of Peds Rx Pharmacy Solutions. Connect with him via: LinkedIn

 

Prior Authorizations: what can you do to help your prescribers

Prior Authorizations (PAs) are forms that are completed by the prescriber or prescriber’s agent (person that completes the form for the prescriber’s signature) for the patient to receive his or her medication. Reason’s for prior authorizations include: cost of the medication, the quantity of medication prescribed, early refills, off label use of a medication, or simply because the medication is not on the patient’s drug formulary.

Out of the many questions and answers regarding prior authorizations, the key information that the pharmacy will need to provide the prescriber with are as follows:

  1. National Provider Identification (NPI) of the Pharmacy
  2. Street Address, Fax Number, & Phone Number of the Pharmacy
  3. National Drug Code (NDC) of the medication in format 00000-0000-00 (first five digits are drug manufacturer, second four digits are drug identifier, last two digits are drug package size)
  4. Inform the prescriber of the package sizes that are available; some drug products only come as kits, unit dosed packages, or need to be reconstituted.
  5. The patient’s pharmacy benefits Identification number

The prescriber or prescriber’s agent can complete the process by adding the following information to the PA:

  1. Prescriber’s NPI, if unknown this can be searched via: NPI Lookup
  2. ICD-10 code that matches the diagnosis of the patient
  3. Street Address, Fax Number, & Phone Number of the Prescriber
  4. Last, but certainly not least..Get the Prescriber Signature!

Lastly, a good resource for prescribers and pharmacies is the website covermymeds. The site can be linked into your pharmacy’s software and faxes can be automatically sent to the prescriber with some rejection codes. For prescribers this is a great resource to complete PA’s electronically, and it gives you electronic access to the correct PA forms that correlate with the patient’s pharmacy benefit plan.

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Sam Blakemore is the Pharmacy Manager of Peds Rx Pharmacy Solutions. Connect with him via: LinkedIn

The cost of pharmaceutical compounding…

“Ya’ll charged me $45, and the pharmacy up the street said they were gonna charge me $400!”

When searching for a pharmacy that compounds; ask the pharmacist if they’re able to file a claim for the prescription under the patient’s pharmacy benefits policy.

If a member of the staff states that the pharmacy can not file the claim under the pharmacy benefits ask the following questions:

  1. Did you attempt to file the claim under the benefits policy?
  2. If an attempt was made to file the claim on the policy; why was the claim rejected? What were the rejection codes?
  3. When the claim was filed under the benefits plan did the rejection message include a phone number?

A typical rejection for a compound claim is ingredient(s) non covered/ product service non covered. The phone number listed on the rejected claim can be used by the prescriber or pharmacist to call on your behalf and gain additional information as to why the claim rejected and if additional paperwork can be submitted on the patient’s behalf to get the compound covered under the patient’s benefits policy.

In regards to pricing — the things that a pharmacy takes into consideration when setting a price are as follows:

  1. Cost of Drug
  2. Cost of Suspending Agents/Flavorings/Preservatives
  3. Compounding Dispensing Fees — this factors in the overhead of producing the final product (labels, tech time, gloves, equipment, etc.)

From there, the pharmacy calculates pricing based on the following principles:

  1. The “Breakeven Price”— this is the price that can be set where the business loses no money.
  2. The price markup factors — Imagine if the cost of producing the product is $5. The business can then say their markup factor is 2. A markup factor of 2 means the selling price is $10. Gross profit margin can then be calculated as (Revenue-Cost)/Revenue. Thus, profit margin in the above scenario is 50%.
  3. Supply and demand — The greater the supply the less the demand and the less supply garners greater demand. Price therefore can shift up and down based on conditions in the market.
  4. Drug shortages in the market can induce price increases.

Be an informed customer at your community pharmacy. Asking questions about compounding can lead some of your pharmacist friends to talk your ear off.

Questioning your pharmacist on this topic will provide that pharmacist with an opportunity to teach, learn, and build trust with a member of their community.

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Sam Blakemore is the Pharmacy Manager of Peds Rx Pharmacy Solutions. Connect with him via: LinkedIn

A Pharmacist’s role in the community…

As a pharmacy student I was fortunate to have the opportunity to be a Pharmacy intern in Eutaw, AL. The Pharmacist that served as my preceptor played a major role in serving that community.

First, he owned one of the two local independent pharmacies in the community. Thus, he filled folks prescriptions and provided jobs for people in the town.

Second, he served as the pharmacist for the local hospital that was licensed for 20 beds. You can’t have a functioning hospital without a pharmacist to dispense and order the medicine.

Third, he served as a consultant for the local nursing home which by law has to have medication chart reviews.

Fourth, my preceptor at various points in time owned multiple businesses in the community. One of his technicians told me that at one point he owned the “bait shop” in town. I mean you have to have good bait if you want to catch some fish!

Fifth, and just as important as anything aforementioned; he gave back to his community in the form of time, service, and money.

I remember a man in his early 50’s walking into the pharmacy and asking to speak with my preceptor. My preceptor walks down the steps of his pharmacy; his pharmacy was “old school” and the counters and shelving for dispensing the medication sat at an elevation in the back of the store. He and the gentleman discussed the need for the high school football team to have good uniforms that fall. The team had to be presentable for it’s Jamboree game which was coming up in a few weeks. Without hesitation my preceptor verbally committed a donation. The football team after all was a representation of the community.

On another occasion he helped folks by making sure people got their medications even when they couldn’t afford them due to lack of insurance. He frequently allowed customers to have charge accounts; allowing the customers to come up with the money and pay the pharmacy back in installments.

My preceptor that month had a lasting impression on me. It made me understand what a Pharmacist can accomplish in a day. One month with him helped me to define the level of impact that a Pharmacist can have on their community.

As a student I sat in class and listened to plenty of lectures regarding pharmaceutical science and pharmaceutical practice. In Eutaw I was forced to consider the social sciences (socio-economics, history, politics). These factors are just as important to consider when educating folks about medication and lifestyle modifications. I learned there was a reason why they call it “pharmacy practice”. Pharmacy like life isn’t always black and white — but rather shades of gray.

I’m blessed to have had the experience. It helped me to identify opportunities in the community that I serve presently. Imitation they say can be a form of flattery. I don’t plan on fully imitating the role my preceptor played in Eutaw, AL. However, I write this because at times Pharmacists can undervalue the role we play in the community and in the lives of the folks we serve and manage.

I do believe that each Pharmacist, including myself can identify their God given talents to play a greater role in the communities that we serve. Our main objective in the pharmacy is to dispense medications correctly. But outside of the pharmacy what can we do to show folks who we are and what we represent!? Hopefully by trying to figure this out, we can be more like my preceptor from Eutaw, AL and increase the value of the things we can accomplish in a day of work. This type of thinking I believe will uplift our profession and the communities that we serve.

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Sam Blakemore is the Pharmacy Manager of Peds Rx Pharmacy Solutions. Connect with him via: LinkedIn

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Image created by Pearson Scott Foresman: https://openclipart.org/detail/230387/mortar-and-pestle