BOSTON -- Community pharmacists "have made dramatic strides over the past year in addressing the most pressing issues confronting our profession -- discriminatory pricing, consumer choice, and documentation and payment for professional services."
So declared Calvin Anthony, outgoing president of the National Association of Retail Druggists, at NARD's annual convention here. Anthony, who is a former mayor of his town, Stillwater, Okla., is currently an Oklahoma state legislator and is a principal in Central Drug and Tiger Drug, a pair of pharmacies in Stillwater.
"The key to our future is to regain control of our professional destiny," said Anthony. "Others are brokering our assets. We have lost control. Drug makers should not control our practice. Insurance companies should not control our practice. Academics should not control our practice. Bureaucrats should not control our practice. We should control our practice.
"Discriminatory pricing remains the root cause of our problems. Without equal access to prices, we cannot compete," said Anthony.
"I will never forget the day a few years ago when a loyal customer and neighbor of several years came up to me in my store and said, 'Calvin, I thought you were a friend of my family. I just went down to the HMO pharmacy and was able to buy my medicine for several dollars less than you charge. You've been cheating me all this time.'
"I was selling the product at cost plus 10%, and my competition was selling it for much less and still making a 50% profit.
"I imagine we have all had that experience. But you never quite get over it, do you? One of my best customers and a neighbor was calling me a crook . . . . That's what motivates me now to do everything in my power to get you and me equal access to prices."
The next way pharmacists will regain control of their professional destiny is to be aggressive about product selection and to intervene routinely on behalf of patients, said Anthony.
"In the new marketplace, you can no longer afford to practice pharmacy passively," said Anthony. "If you can give the patient a product that is equally effective and costs a little or a lot less, you have an obligation to do so. You have an obligation to convince the physician to allow you to switch those products, and you have a responsibility to tell patients what you are doing for them and why.
"If Merck-Medco can convince physicians to switch medications by phone from hundreds of miles away, how well do you think we will be able to do it when we know the physician and he or she is just down the street?" asked Anthony. "Make the patient your very best ally," he said.
"Another way to take control is to document your interventions and use that documentation to your advantage," said Anthony. "No one is going to pay you for services that they don't know you are providing. Document and bill all of your patients for the services you perform, both your private-pay patients and third-party."
Pharmacy technicians are another example of taking control, said Anthony. Technicians must continue to be under the full supervision of the pharmacist, he said. "We do not believe that we need an independent entity to certify them."
Anthony revealed that NARD, working with the National Association of Chain Drug Stores, has developed a Community Retail Pharmacy Technician Training Manual, which will be available in December.
NARD also is working with Eli Lilly, Indianapolis, on an expansion of the Lilly Digest. Anthony questioned the definition of a chain used by NACDS of four or more pharmacies. The U.S. Department of Commerce, said Anthony, defines a chain as eleven or more outlets. "That simple numerical sleight of hand disparages the true strength of independent pharmacy," he said.
Although health care reform legislation ultimately failed to pass Congress, Anthony said pharmacy still accomplished much in gaining recognition for community pharmacists and support for much of NARD's platform, both from Congress and from President Clinton.
"Never before has an American president stood up for our profession," said Anthony. "The president has stood up to the most powerful special interests in Washington on behalf of giving you equal access to drug manufacturers' prices.
"You hold the keys to your own future," Anthony told the crowd. "You must be willing to fight with all of your might to take back control of your professional destiny. For every responsibility we fail to accept, another profession is eager to assume that responsibility. We must not let that happen."