A Swede's Passion

Originally published in the "Minnesota Pharmacist," the journal of the Minnesota Pharmacists Association.

I freely admit to a life-long passion for community pharmacy. I have worked in hospital and chain pharmacy and I learned from each of these experiences. I recognize the value of each. I also understand how important it is for all these practices to be interdependent in providing for the total care of patients.

But I chose community practice because it met my career goals and played to my values of community involvement, interaction with consumers, personal responsibility and the opportunity to see directly the results of the application of my professional and business skills. The recognition by customers and patients of my contribution to their wellbeing clinched the deal for me.

I first experienced community pharmacy as high school senior in a “corner drug store” in Elizabethton, Tennessee. Much like community practice jobs today, it was multi-tasking. I worked the fountain, the cosmetic department, the OTC department, swept the floors, made deliveries and, at times, helped fill the occasional prescription. My hourly wage was about the same as the $1.25 that many of the current health plans pay for filling a prescription.

My chain experience came while a pharmacy student at the University of Minnesota. I worked at the Walgreens on 9th and Nicollet in Minneapolis. (They gave me a tuition scholarship that paid my $85 a quarter tuition, in exchange for a commitment of 1000 hours after graduation.)

I learned a lot about community pharmacy while at Walgreens because all the employees saw themselves as part of the downtown community – 9th and Nicollet was a virtual small town. We were acquainted with the people in our community who worked up and down the street – their comings and goings – their promotions and transfers – the births and deaths. All the elements of community. With this familiarity came a feeling of personal responsibility for their wellbeing.

I also worked at Northwestern Hospital before joining the army. The hospital was a community also – a corporate community. Each employee depended on the others to do our job. It taught me that engaged employees are critical to achieving the mission and each is important no matter their standing in the hierarchy. This was learning experience that gave me skills that served a professional lifetime.

We bought our own community pharmacy in 1966. It was a typical drug store of the 60’s: soda fountain, cosmetics, greeting cards, tobacco, and all the rest. We delivered prescriptions to people who had two cars in the driveway, and groceries from the local Tom Thumb to the people at the nursing home. (One elderly resident, to show her gratitude for our service, gave us a self-portrait of herself – in the nude!)

Like all community pharmacies we supported many community activities. We bought ads in the high school yearbooks, in the many church bulletins, gave door prizes to more clubs that I knew existed and gave the Little Sisters of the Poor free gift wrap at Christmas. Why did we do these things? I don’t believe it provided many new customers. We did it because as a community pharmacy we didn’t just work in the community, we saw ourselves as a part of the community.

As the owner of the pharmacy these decisions were mine to make. There was no higher authority that I needed to check with. Like many decisions that a small business owner must make the “higher authority” is the reality of whether or not they achieved the goal. Quality service. Good will. Community acceptance. And, ultimately did the sum of all the decisions – large and small – result in a profit.

Like life, the success or failure of a small business is less a matter of the BIG decisions than the sum of the many small decisions.

In 1984 we had an epiphany. At the prescription counter we worked to provide a level of service that would improve our patrons health. While in the front to of the pharmacy we sold tobacco products that we knew diminished their health. We made the decision to no longer sell these products because we felt they made a mockery of our goals as professionals.

It was a slow day in the newspapers so we got a front page above the fold color picture of us taking cigarettes off the display rack. One of the tobacco reps came in and threw all her inventory on the floor and stormed out. We got national coverage! To this day, people remember the pharmacy as the one that stopped selling tobacco. Some of our customers said they took our action as an opportunity to stop smoking. Others stopped by to say thanks for taking a stand on something that was good for the community but had a cost to us in lost sales. It was good for business!

Why is this important? Because, in an independently owned community pharmacy the timeline from idea to action is short. By this simple act, we addressed a public health issue and got people’s attention. We acted on principle and were able to make a difference.

Obviously at the center of any pharmacy must the services that the pharmacists provide. In community practice the relationships are such that you know families, not just the patient. Because of these direct and ongoing relationships the pharmacist is able to truly serve as a supplier, primary care provider, health resource and ombudsman for patients, customers and the community. One has to try really hard to not be involved when in community practice. And, if you are successful at not being involved – you will not be successful!

As a small business we relied heavily people from the community for our staff: Second workers in households, retirees and students. The students in particular were a joy. We would hire at age 16. Many of these hires stayed with us through high school and college.

I think that we underestimate the value of community pharmacies, and other small businesses, in providing first jobs and training our workforce for rewarding work lives. In the history of Minnesota, I wonder how many people got their first work experience in a pharmacy.

As the first employer for many students, we had an opportunity to positively affect the work ethic of these people for their entire careers. If they learned that work had purpose and that it could be also be fun, we had been a success. We had fun doing it and we have watched those students establish careers, families and reputations. Community practitioners everywhere feel this same pride when their “graduates” return to bring them up to date on their lives progress.

My career in community practice also gave me the ability and the opportunities to be involved beyond the community in which I practiced. To the extent that my community knew of my outside activities they reciprocated my feelings of pride in my community by expressing their pride in “their” pharmacist.

We often hear, and some of us even believe, that the independently owned community pharmacy is a business of our country’s past. To be certain, there are fewer independents. Those who remain do so, however, because they are good professionals and innovative managers and have established their value to their communities.

The independently owned practices of pharmacy in our communities will survive. They will survive as long as they provide value. Surely, practice and business will continue to evolve as creative practitioners and managers adapt to changing environment, take advantage of new opportunities and continue as important parts of the community – not just someone who owns a building or works in the community.

Lowell J. Anderson, D.Sc., FAPhA, practiced in community pharmacy for most of his career. He is a former president of MPhA, Mn Board of Pharmacy and APhA. In addition he has held positions in the Accrediting Council on Pharmacy Education, National Association of Boards of Pharmacy and the United States Pharmacopeia. Currently he is Co-director of the Center for Leading Healthcare Change, University of Minnesota; Manager MTM Network, UPlan MN; and co-editor of the International Pharmacy Journal. He is a Remington Medalist