Start Charging for Your Time

Across the country, independent pharmacists are partnering with patients and physicians in new and sometimes lucrative ways.

Many are reaping the rewards of patient coaching to improve medication adherence. And some are finding that taking patient coaching to new levels — offering one-to-one, fee-based counseling on a range of healthcare issues — has opened the door to a whole new way of doing business.

Building a Fee-Based Business

“It’s crazy that pharmacists give away their advice for free,” says Christine Jacobson, owner of Wasatch Pharmacy Care in Ogden, Utah. So, soon after she opened her store in October 2000, she decided to see if people would be willing to pay for personal healthcare consultations.

“I started by charging $25 for about 30 minutes of my time,” she says. Advertisements in the newspaper explained the services Jacobson offered, which focused on “getting medications right” and “feeling better with bio-identical hormones.”

Over time, she raised her fees, eventually charging $100 per appointment, cash up front and out of pocket. Even at that price, she was booked about three months in advance. In 2007, Jacobson enrolled in a certification program at the American Academy of Anti-Aging Medicine in Florida. And after she graduated in 2009, she began charging patients $150.

Jacobson says that she bases the decision about how much to charge on business fundamentals: The less she charges, the less compliant patients tend to be. “I need to attract the people who are serious about their health. That leads to better outcomes.”

Currently, she sees an average of seven patients per day, Monday through Friday, and is still booked three months out. Consultation fees — along with lab fees and supplement sales — account for approximately 30% of her revenue. The top two reasons people consult with her are unexplained fatigue and weight control; other concerns include sexual dysfunction, pain management, depression, nutrition and more.

Working with Physicians

When Jacobson first started offering personal health consultations, she received a lot of negative feedback. A few of her colleagues even petitioned the state to close her pharmacy. Efforts to shut her down didn’t go far, but the complaints did cause her to question whether she was going about things in the best way.

“Trying to do it on my own was seen by some as a competition with physicians, and that’s not what I wanted,” she says. “So I contacted several doctors directly and said let me work with your most difficult patients … your brittle diabetics … your brittle thyroid patients.” Many doctors responded positively, and today, Jacobson frequently works as part of a team-based effort to improve patient health.

Still, she is very cautious not to overstate her role. “I tell everyone who comes through the door that I do not prescribe and I do not diagnose,” she explains. “It’s always a referral back to a physician with a recommendation to consider a ‘possibility.’”

Tips for Getting Started

Jacobson’s best advice for independent pharmacists who want to follow in her footsteps: Don’t be afraid; have the courage to try something new. However, also take these steps to investigate whether consultations are right for you:

• Talk to physicians. Determine if there is a need in your market and get a feel for how local physicians will react. Position yourself as a healthcare partner, not a replacement.
• Talk to patients. Select a few test patients and ask, “Would you be willing to schedule a time to come in before the pharmacy opens?”
• Talk to her. Connect with Jacobson via email or at a trade show.
• Get certified. Look for opportunities to earn certification in niche markets such as diabetes, weight management or anti-aging.

Another Option

McKesson’s Sponsored Clinical Services (SCS) Network offers several ways for distribution customers to provide an increased level of patient support. These programs give independent pharmacies the opportunity to impact their patients’ adherence, resulting in benefits for their business from increased refill rates and patient loyalty. Many SCS programs even enable participating pharmacies to earn service fees from pharmaceutical manufacturer sponsors. Those programs include:

• Pharmacy Intervention Program (PIP). This program supports medication adherence through brief behavioral coaching sessions that take place at the pharmacy counter.
• Patient Education Refill Reminder Letter Program (PERRLP). This program provides patients with personalized reminder letters that educate them about their medications and disease(s).
• StudyLink. This program supports patient recruitment for clinical studies.
• RxRapid Response Program. This program involves sharing feedback regarding a range of industry topics through occasional fax surveys.

According to Jacobson, the SCS Network (in which she participates) is a great way for independents to develop stronger patient relationships and boost refills. SCS programs also elevate the role of the independent pharmacist as a healthcare provider: “The fact that the manufacturers are willing to pay shows the value of our channel of communication to the patient,” Jacobson added.

Did you know?

Top performing SCS pharmacies are generating 4.0 incremental prescriptions per participating patient over 12 months — think what this could mean to your business! To learn more, call 800.903.7884 (8 a.m.–5 p.m. PST) to speak with a McKesson SCS advisor, or email scs@mckesson.com.

Bottom Line

“In our industry right now, we’re basically counting pills,” Jacobson points out. “How is that helping anybody?”

Patient-support services, whether involving just focused medication adherence coaching or full-scale consultations, are proven methods for improving patient health. Just as important, they are a way to promote your role as a healthcare partner and to generate increased revenue.