Posted on

Profiles in Pharmacy — a conversation with Tim Lacey, RPh — 10/03/2018

In this edition of Profiles in Pharmacy — Tim Lacey and I discuss his career and journey as a Practicing Pharmacist.
Tim has been a Pharmacist for over 40 years, and has plenty to share about the profession. To the young Pharmacist and Pharmacy Students that have an opportunity to meet and talk with Tim Lacey, please take advantage of that opportunity.  Ask questions about the profession and learn from his perspective and memories.
In order for us to realize the potential of our future as Pharmacists, we must first pay respect to those that helped to lay the foundation for which we stand upon. I often tell folks that my triumphs in life are just reflections of the parenting, mentoring, coaching, and praying that I received from individuals that cared enough to teach me right from wrong.
Me and Tim often joked that he was my Pharmacy Daddy. Because when it came to Pharmacy, he taught me right from wrong… 
I met Tim, while he was floating at the Walgreens on Greensprings Ave in Birmingham, AL circa 2009. I transferred stores later that year and began working for him when he was the Pharmacist in Charge for the Walgreens located on Richard Arrington Jr. Blvd. I was still finding my way in pharmacy when we met. I still looked at Pharmacy like it would be a good job to have. Under his direction, I began to realize that Pharmacy was more than a job — it truly was a calling. Under his tutelage I began to realize what it meant to be part of a Profession…
I think about Tim often because he practices Pharmacy in the the trenches like a good offensive lineman. He hasn’t always gotten the recognition for the great work that he does, but he still keeps plugging away daily — 40 plus years later he’s still providing each individual with appropriate pharmaceutical care.
_____
Sam: What year did you graduate from Auburn? Since you’re a local Birmingham native, where did you attend HS? 
Tim: I attended Phillips High School (now Phillips Academy) and graduated from Auburn in 1976.
_____
Sam: How did you learn about pharmacy? I remember you telling me about your mom working at a local drug store when you were growing up, how did that impact your decision to pursue a career in pharmacy? 
Tim: I was influenced by the two pharmacists that worked at Cowgill Drug in North Birmingham, where my mother worked as a clerk. The owner, Franklin Little, was classy and professional, highly respected by everyone in the community. Everyone called him “Doctor Little”. The staff pharmacist, George Thompson, was a happy-go-lucky guy that seemed to enjoy his job immensely. I admired both very much and decided that I wanted to be a combination of the two.
_____
Sam: There are foundational lessons I learned from watching you practice. Things like keeping appropriate eye contact with customers, how to keep the pharmacy lighthearted with a few jokes, knowing your patients name when they come to the counter, and always being the early shift pharmacist on Monday mornings when you’re the manager…. Who are some of the men and women in pharmacy that taught you the way of doing things the right way? And in what way did each person influence your practice of pharmacy? 
Tim: In addition to the two already mentioned, I had the privilege of working a number of years for Jimmy Harrison, president of Harco Drugs, and Jerry Thomas, vice president of Harco. They made working for Harco seem like a family business, where everyone was important. When I decided to go back to work for Harco after Big B Drugs was bought out by CVS, I received a personal phone call from Mr. Harrison, telling me how excited he was that I was back. When he made the difficult decision to sell Harco to Rite Aid, he personally hand wrote a letter of apology to each of his pharmacy managers, explaining why he made the decision. It meant so much to all of us. He taught us the right way to treat employees and patients.
_____
Sam: Can you describe your career path — I know about Big B Drugs and helping to open the Walgreens in Pelham, have there been any other stops you would like to discuss? How have your jobs in pharmacy impacted your outlook of the profession? 
Tim: In addition to working at Cowgill as a teenager, I worked at Campus Drugs in Auburn (a Harco store) while in school. After graduation, I did my internship with K-Mart Pharmacy in Huntsville. After I received my license in 1977, I returned to Harco, working briefly in Talladega before opening a new store in Alexander City. I became homesick for my family and friends in Birmingham, and started working for Big B in 1979. I stayed with them for 17+ years until they were bought by Revco, then eventually CVS. By then, Harco had locations in Birmingham and I received an offer from them in 1997. I was glad to be back with the Harco family, but the Rite Aid deal was not long after. I stayed with Rite Aid for about another year. I began hearing rumors about Walgreens coming to Alabama, and started checking about possible employment. I had been told many years before “if you ever get a chance to work for Walgreens, take it!” I had the honor of being one of 3 pharmacists hired to open their first Alabama store, in Pelham. I now have 20+ years with Walgreens.
_____
Sam: In your opinion what have been the differences in curriculum when you compare the  Bachelors Degree in Pharmacy to the Doctor of Pharmacy degree? It seems that when we talked about your curriculum (BS degree) you told me about having to work a full year as an intern after graduation prior to being allowed to register as a pharmacist… In your opinion what were the strengths and weaknesses of the BS in Pharmacy and what are the strengths and weakness of the Doctor of Pharmacy? Has the transition been what you thought it would be — and does the BS in Pharmacy receive enough respect from the younger generations of Pharmacist? 
Tim: The PharmD degree has much more clinical component than the old Bachelors degree. In my opinion, at first, there was a shortage of practical experience with the PharmD students, but I believe that has been addressed and corrected now. When I graduated, the requirements were different in that we had to get the majority of our intern hours after graduation, which gave us about a year of practical experience under supervision. I probably learned as much in that year as I did in 3 years of pharmacy school. The PharmD students get great experience on their rotations in their final year. I think it would have been fun to do that while I was a student. For the most part, I’ve received nothing but respect from my students. They recognize that 40+years of experience counts for something, and that I know what I’m talking about (most of the time).
_____
Sam: What pharmacy law rule do your current prescribers have the most difficulty understanding, thus leading to errors and calls for clarifications? 
Tim: I think, over the years, the one rule that causes the most confusion, is the “two signature lines” rule. Technically, if a prescription blank does not have that, it’s not a valid prescription. I understand there is some talk about eliminating or modifying that rule.
_____
Sam: What would you tell a new grad? 
Tim:  I would tell a new grad that patient safety is the most important thing. If something is unclear, whether it is the drug prescribed, directions for use, potential interactions or contraindications, you must get it right. If you don’t get it right, it doesn’t matter how fast you got it to the patient. Ours is one of the few, if not the only profession, you have to bat 1000, or there’s a problem.
_____
Sam: How has being a preceptor changed for you over your career? Is it harder or easier to teach? How many students do you think you’ve taught over the years? 
Tim: Student pharmacists are so well educated these days. I feel that sometimes I learn more from them than they do from me. As far as being harder or easier to teach, it depends on the student. Some come to me with no experience in retail. There is a learning curve for them. Five or six weeks is not long enough to learn everything we have to deal with. The ones with retail experience are usually the easiest. I would estimate that I have had close to 500 students, including students on rotation and students that worked part time. I often wish that I had kept a scrapbook of all my students over the years.
_____
Sam: Is being a Pharmacist what you thought it would be?
Tim: Yes, and no. Pharmacy, especially retail pharmacy has changed so much over the last 42 years. I never dreamed that I would be administering immunizations. I never imagined the impact that third party payors would have on the profession. I never thought I would have to deal with a drive thru window. 
_____
Sam: Is there anything that you would like to add? 
Tim: The profession has been good to me. It has given me a nice income, and a sense of being a part of something that helps people. I have derived much satisfaction from mentoring students that went on to be good pharmacists, and any time a patient thanks you for what you do for them, well, it doesn’t get any better than that.
_____

Sam Blakemore IMG_1742 is the Pharmacy Manager of Peds Rx Pharmacy Solutions. Connect with him via: LinkedIn Support the effort and PURCHASE MERCH.

Posted on

How to determine if a candidate “cares”..

The interview begins—and you have already reviewed the candidate’s resume’. They meet all the qualifications, and even have some excellent references. You hire the candidate, and around six months to one year later after their up and down performance you and the employee decide that it’s best to part ways.

So what happened? The interview went well…check. The references seemed to be great…check. Yet, once the candidate got the job — they had a fatal flaw that was impossible to overcome.

They just didn’t seem to care.

They didn’t care about the customers, didn’t care about their daily performance, didn’t even seem to care about their evaluations… Which ultimately meant that the product they were serving up to your loyal base was average at best. They had just enough good days to make you think maybe it would work out, interspersed with enough bad days to make you shake your head.

It’s pretty weird when you think about it. And naturally, you have to feel a bit disappointed. Typically, I’ll even replay their interview over in my mind; trying to figure out what I missed during my evaluation. Going through this process forces the manager to ask themselves what checkboxes are the most important to be checked before making a commitment to offer the candidate a position.

A few days ago, a colleague reminded me of her words on the hiring process prior to me taking on a management position. She’s held multiple management positions. And she said, “when you hire someone, find a person with good customer service…if the person has good customer service, you can typically work around some of their deficiencies…”

I would add to her statement — that the job candidate’s deficiencies can even be remedied with appropriate teaching and training. So, then the manager must ask themselves, “am I a good enough teacher/trainer to remedy the candidate’s deficiency or do I currently have someone on staff that can be an appropriate educator/mentor for the job candidate?”

I don’t know of any degrees/diplomas to my knowledge that are being conferred by colleges and universities in the field/study of CARING @ WORK. Thus, what questions could be asked to determine if a candidate meets your standards? I guess… you could simply just ask the magical question, “do you care… or will you care? But, unfortunately you will most likely just get a canned answer.

So I suggest going through what-if scenarios with your candidate using a diagram for what you consider to be right and wrong answers for each of your scenarios. This I believe is the best method for gaining a little more insight into determining if a candidate truly possesses the traits required to serve your customer base.

______

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

Posted on

Managing conflict…

Screen Shot 2017-07-27 at 12.31.09 AM.png

You don’t have to be a manager to run into circumstances that make you want to claw your hair out. Managing conflicts in the retail market space is like pouring a cold cup of water in a glass during the summertime. What I’m trying to get at folks, is that you’re going to have to learn how to deal with the emotions of your staff, your customers, and your family, and most importantly yourself.

First, I would like to come clean… I can be the worse at dealing with conflict. I’ve yelled and kicked many garbage cans.

Any person that is passionate about their craft strives for excellence; and if excellence is not achieved there will be frustration.

Before we get into managing conflict…Let’s consider the following:

  1. On a scale of 1 to 5; how do you manage stress?
  2. Who do you talk to about your stress?
  3. What is your outlet for your stress?
  4. When was your last vacation from your work?
  5. Do you actively take time to de-stress during your workday?
  6. Have you considered quitting your job due to stress?
  7. How often do you raise your voice in a day, a week, a month?
  8. How is your family life; do you spend enough time with friends and family?
  9. How is your sleep? Have you been getting enough rest?

I bring up those questions to lead into how conflict arises. Conflicts arise with much more earnest and ease in times of stress and exhaustion. To ensure you’re at your best; make sure you at least attempt to take care of your daily needs. Eat lunch at an appropriate time, step away for a 15 minute break to clear your mind, or take a brief walk to get away from the office.

Back to conflict! Haha…

When facing conflict with customers, employees, peers, or even family— the first thing you should do is pause. The second step should be to gather your thoughts. The third step should be to listen before speaking. Pause, gather, listen. 

What does it mean to pause you ask? The pause should be intentional. It helps you to refocus your energy into not speaking. Oftentimes I’ve found that immediately speaking, only pours fuel on a “gasoline conflict”.

Gather… To gather means to collect your emotions, your feelings, your worries, your fears, your anxieties. Conflict is an adrenaline rush. Having someone out the blue, just begin yelling or cursing can be a shock to your nervous system. Thus, gather yourself and consider why you’re standing presently in conflict. The pause allows you to actively choose to gather your thoughts and emotions.

Lastly, listen with intent. Your mind will without a doubt be racing toward the hills. This person did me wrong. This person is not right. This person is crazy. Be an active listener in the process towards solving the underlying issues of both your customers and staff. I’ve found that 9 times out of 10 a customer or staff member just needed a moment to be heard. It’s easy to underestimate the value of listening. It’s very easy to want to solve a problem; oftentimes the problems are simple problems that can be solved in 30 minutes or by the end of the business day. The big problems that can lead to conflict often are the problems that have been festering for months.

Conflict is around the corner. But…

  • Reflect and honestly evaluate your personal stressors

Next, when presented with conflict: 

  1. Pause and breathe
  2. Gather your thoughts and emotions
  3. Listen with the intent to understand

 

_________________

Screen Shot 2017-07-01 at 9.37.41 PM

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

 

 

Posted on

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?

____________

Screen Shot 2017-07-01 at 9.37.41 PM

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

 

Posted on

Considering “workplace levers” in managing office politics…

Screen Shot 2017-07-23 at 9.47.16 PM

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.

_____________

Screen Shot 2017-07-01 at 9.37.41 PM

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

 

Posted on

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.”


Screen Shot 2017-07-04 at 8.26.42 PM


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

Posted on

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.


Screen Shot 2017-07-01 at 9.37.41 PM

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

Posted on

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

Posted on

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.

______________________________________________________________________

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

 

Posted on

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.

______________________________________________________________________

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