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Ray Bannister purchased Saskatoon Medical Arts Pharmacy in early 1992. He had spent over 15 years in a rural practice setting before moving to Saskatoon where he worked as a pharmacy manager for a number of years. At the time Ray purchased the pharmacy, the main floor space consisted of the existing dispensary area and cash counter that cut the store in half. It was exactly the same layout the pharmacy had when it first opened thirty years ago.
Ray soon realized that the future of pharmacy practice would be based on the provision of cognitive services, as opposed to the traditional dispensing role of the pharmacist. Saskatoon Medical Arts Pharmacy decided to concentrate its efforts on these cognitive services. The provision of specialty services would not only allow for further professional satisfaction, but it would also ensure the success of the pharmacy. Initially, Ray was asked by a local club in Saskatoon to give a talk about sexual dysfunction and treatment options. Calls for appointments began to pour into the pharmacy soon after his first talk. This led to other speaking engagements and even more public interest in erectile dysfunction at Medical Arts Pharmacy. The number of patients receiving penile injections began to rise, and demand for private consultations grew. The public interest grew so much that patients were willing to pay $60 for one hour of private consultation. Ray soon made inquiries to local urologists about their perception of his consulting service. Their reactions were very positive. Ray soon had close to 500 patients receiving specialty therapy for erectile dysfunction.
As Saskatoon Medical Arts Pharmacy continued to develop innovative products, and services, Ray realized that he could not do things alone. The pharmacy was already a member of Health Outcome Pharmacies, and Ray became very involved in the organization. As a result, he has established many contacts across the country with other leading pharmacists. Now that the pharmacy was becoming very heavily involved in compounding, Ray felt that the only way he could grow this service would be to align himself with other compounding pharmacists.
Some of the most innovative community pharmacies in North America have had the advantage of being completely designed and constructed from scratch. Their designers have had the freedom and flexibility to mold the pharmacy into whatever they had imagined. Pharmacy journals across North America have profiled these pharmacies that have extensive compounding facilities, innovative dispensing areas and/or beautifully designed modern interiors. While the size and renovations of these pharmacies are impressive, they don't teach us how to transform existing pharmacies into visionary practices. Pharmacists are now realizing that they do not need 5000 square feet of floor space and tens of thousands of dollars worth of renovations to transform their practice into something more innovative. Saskatoon Medical Arts Pharmacy is the story of one pharmacist who understood this and had a vision of an innovative pharmacy. He did not let structural or financial limitations restrict the way he wanted to practice pharmacy. It is the story of how you can teach an existing practice new tricks.
The Transformation of an Existing Practice
Ray Bannister purchased Saskatoon Medical Arts Pharmacy in early 1992. He had spent over 15 years in a rural practice setting before moving to Saskatoon where he worked as a pharmacy manager for a number of years. At the time Ray purchased the pharmacy, the main floor space consisted of the existing dispensary area and cash counter that cut the store in half. It was exactly the same layout the pharmacy had when it first opened thirty years ago.
Given his extensive experience in both rural and urban community practice settings, Ray realized that the dated pharmacy design was extremely inefficient. He set about to redesign the floor plan. However, he was confronted with two major obstacles: first, Saskatoon Medical Arts Pharmacy only had about 900 square feet of front store space available, and second, having just purchased the pharmacy, he was not in a position to spend substantial amounts of money renovating the store. His first priority was to open up the layout of the store. He moved the dispensary to run lengthwise against the wall. In doing so, the dispensary moved right inside the front doors and opened up much more floor space.
Developing Niche Markets
At the time Ray assumed ownership of the store, he understood that the key to survival for independent pharmacy would be the development of niche markets. Ray thought that areas with the most growth potential were the sports medicine and compression hose markets. He began to develop these specialty areas. Unfortunately, the number of general practitioners in the building dropped from six to two within a few years. This was proof that the only way to survive would be to aggressively pursue other niche markets.
When Ray pursued the orthotic market, he decided that a trained and dedicated staff was essential. Ray currently has two full-time and one part-time certified orthotic fitters on staff. As a result, business in this area has increased four-fold. On any given day, up to 15 patients may be seen for orthotic fittings. Interestingly, almost half of his clients are from out of town providing proof that this niche market has had a huge impact on his business.
Specialty compounding existed at the pharmacy before Ray took over the operation. He was intrigued by some of the things that were being done in this area, particularly with respect to what some of the urologists in the building were prescribing for erectile dysfunction. Initially, the pharmacy had about 20 patients who were receiving penile injections. After conducting some research on penile injections for erectile dysfunction, Ray began developing a closer working relationship with the urologists in the building. As the word began to spread that Ray specialized in therapies for erectile dysfunction, he was being called upon more often by patients for counseling sessions.
Switch to Service Oriented Practice
Ray soon realized that the future of pharmacy practice would be based on the provision of cognitive services, as opposed to the traditional dispensing role of the pharmacist. Saskatoon Medical Arts Pharmacy decided to concentrate its efforts on these cognitive services. The provision of specialty services would not only allow for further professional satisfaction, but it would also ensure the success of the pharmacy. Initially, Ray was asked by a local club in Saskatoon to give a talk about sexual dysfunction and treatment options. Calls for appointments began to pour into the pharmacy soon after his first talk. This led to other speaking engagements and even more public interest in erectile dysfunction at Medical Arts Pharmacy. The number of patients receiving penile injections began to rise, and demand for private consultations grew. The public interest grew so much that patients were willing to pay $60 for one hour of private consultation. Ray soon made inquiries to local urologists about their perception of his consulting service. Their reactions were very positive. Ray soon had close to 500 patients receiving specialty therapy for erectile dysfunction.
Ray had to revisit the floor plan he had updated a few years earlier. It became clear that there was now a demand for a dedicated compounding laboratory, and more sophisticated lab equipment. As a result, he constructed a small, closed off room in the rear of the pharmacy that could house a laminar flow hood. This would store the ever-increasing amount of compounding equipment he began to accumulate. Now that he was able to compound a large volume of specialty products, he then focused on increasing the product line of specialty compounded items.
Generally speaking, pharmacists have not been known to effectively market the products and services they provide. Ray was an exception. He began to market his products to physicians in the area, letting them know what treatment options he had available for different disease states. Ray expanded the compounding operation to include the development of transdermal creams and ointments, veterinary products, topical solutions, opthalmics and suppositories.
A Little Help From Some Friends
As Saskatoon Medical Arts Pharmacy continued to develop innovative products, and services, Ray realized that he could not do things alone. The pharmacy was already a member of Health Outcome Pharmacies, and Ray became very involved in the organization. As a result, he has established many contacts across the country with other leading pharmacists. Now that the pharmacy was becoming very heavily involved in compounding, Ray felt that the only way he could grow this service would be to align himself with other compounding pharmacists.
Last year, Saskatoon Medical Arts Pharmacy joined the National Association of Compounding Pharmacists, a group based out of Amarillo, Texas. Ray brought his chief pharmacist, Helen Hay, and a second year pharmacy student with him for a training course last January. It was here that the staff were introduced to new formulas and compounding techniques that would take the department to the next level. Ray was particularly interested in the natural hormone replacement therapy products they compounded. He saw this as his next niche.
In March of this year, Ray attended a workshop seminar on natural hormone replacement therapy. The main focus was on how pharmacists could counsel women on the subject and act as a liaison on behalf of the patient with the family physician to ensure a positive treatment outcome.
The pharmacy staff created a small brochure containing patient information for women. The counseling sessions, which usually run about 30 minutes, include topics such as weight control, exercise programs and stress reduction. The pharmacists attempt to empower women to become more proactive in their hormone treatment plans. The pharmacist consults with the patient's physician following the counseling session and then follows up with the patient by phone after two weeks. Another fifteen minute appointment is scheduled one month later to discuss progress.
Saskatoon Medical Arts Pharmacy has also begun to provide public seminars on natural hormone replacement therapy. In the fall of 1999, Dr. Roby Mitchell of Amarillo, a specialist in women's health issues, will be giving a seminar in Saskatoon. Ray has planned for as many as 600 women to attend. He also scheduled a separate seminar for physicians looking to acquire more knowledge on the subject.
The innovations within his practice have allowed Ray and his staff to move from the traditional dispensing style of community practice into a more knowledge-based practice. Saskatoon Medical Arts Pharmacy is a perfect example of how any community practice, regardless of size, can adopt innovative ideas, and expand the scope of their practice. With relatively little financial investment, Ray has transformed the pharmacy that he inherited seven years ago into an operation that is well known across the province. He has succeeded in teaching an existing practice new tricks.
Copyright Keith Health Care Communications Nov 1999