Here's a business model for ya...

Sam searched her email trash folder, scrolling… scrolling… ‘dammit’ she thought, ‘I KNOW I saw it in here….’ As Sam stood hunched over her desk a technician offered her a finished order to be checked; it was a refill, an ‘easy’ verify. Sam checked the NDC number, the quantity and the patient’s name then ran through a list of mental checks that kept her from waking in a cold, dread-filled, sweat during the night.

It had only happened twice in her career but waking in the middle of the night, wondering if she’d given a patient the wrong medication, was far from pleasant. Sam was pretty good at her job, there was no question, albeit more from a self-driven sense of competition than a love for what she did; and both bouts of middle-of-the-night panic were unfounded. 

Oh, she wasn’t perfect, her humanness had reared it’s ugly head a few times in her 18 years as a pharmacist; but, while no error is ok, her’s were more administrative in nature; which is to say she had erred on a quantity or doctor name, not by handing a patient the wrong the medication.

With everything checking out she handed it all back to the tech, “That’s good, thank you. Hey, let me keep the insurance response….”

The girl handed over the part of the label that clearly outlined her costs and the insurance reimbursements; basically the information that kept Sam from sleeping.

Sam looked down to see her profit… (-) 38.62. The angry tears were pushing at her eyes but in a show of strength she didn’t actually feel, she blinked them back; she would NOT cry. 

A quick glance at her wholesaler prices showed that her loss was actually only $32.15… she picked up her phone and texted her husband, “filled an insulin, thought I lost $38.62, was relieved to check my cost and see we only lost $32.15… I’m excited to ONLY lose $32 vs. $38… how sad is my life?”

His response was fast and furious… and typical. He was a pharmacist, too and was as entrenched in this farce of an industry as she was, but it was different for Sam. Sam had pushed for and masterminded the purchase of their pharmacy; Sam was 51% owner, the only staff pharmacist as well as the CEO, CFO, bookkeeper, manager, handyman and the only pharmacist in the family not bringing home a paycheck. 

Brett’s support was unwavering and exculpatory but Sam still spent most evenings explaining herself, questioning herself… Frankly, she spent most of her time trying to convince herself she wasn’t a failure.

She dropped into her chair and started to rest her head on the keyboard when she remembered her purpose; she forced her head up and her eyes back to her trash folder and, as if a gift from heaven, immediately spotted the email she so arrogantly deleted 4 months ago. She sent Brett a quick text, “hey… found that email. I’m gonna call this guy after we close… not sure when I’ll be home.”

She spent the last 4 hours of her 10-hour day shopping for cheaper drugs and being jealous of all the lives playing out on Facebook. She tried to stay away from Facebook, mainly for this reason, but to be honest, her days were gruelingly long; business wasn’t great (town was small and most people were forced by the dictates of their insurance companies to mail-order or the bigger chains) and she, herself, was legally bound to be at the pharmacy during operating hours. Yeah, she snuck out for things like her oldest daughter’s induction into the National Honor Society but she did so with knowledge she could be hit with a $25,000 (or larger) fine. That alone was enough to hold her hostage for 57 hours every week but it was actually the thought of dealing with the wrath of a customer who had to wait longer than 4 minutes for a prescription that made her exceptionally selective when choosing which events warranted her attendance.

So, for the most part, she didn't leave the building when the pharmacy was open. She'd missed a lot of her kids' activities while being tethered to the store not getting paid but the worst part was - the kids accepted it... graciously. The guilt was all-consuming and hung over each day as a not-so-gentle reminder that her life was spiraling out of control and her family was paying dearly for her choices.

She had to admit, though - searching for cheaper meds had a certain adrenaline-releasing affect; so while she begrudgingly learned of her kids' athletic highlights via texts from parents in attendance and while she definitely didn’t spend years in pharmacy school envisioning this, at least she got some enjoyment out of it. 

Truth be told, her favorite part of the day was the hours between 10 and 12; with the initial morning rush over, she was able to chat with her patients and be the community pharmacist she dreamt of being. Actually, Sam did more clinical work during these chats than a true clinical pharmacist would ever give her credit for, as it was during these interactions that she learned about her patients on a deeper level. She encouraged a customer who’d just lost his wife to ask his doctor for an antidepressant, she offered to call for a change of blood pressure medication for a customer who laughed off the crazy dreams that affected her sleep, she insisted a customer go to the ER when he was trying to buy a 3rd bottle of antacid in 2 days, the list went on and on. Her results were pretty good, too - no antidepressant for the grieving husband but he did join a grief support group, a quick call on the blood pressure medication yielded a change and the end of the dreams and the ER guy? Well, 2 weeks later he brought her flowers and 3 prescriptions, fresh from a cardiac intensive care stay. Making people’s lives better was her romantic dream of her life as a pharmacist; that was what she wanted to do.

Instead, she was forced to spend most of her day in her office; searching for cheaper drugs, pouring over financials to make ends meet, writing letters to government officials asking, no! BEGGING for help in fighting the unfair practices she faced as an independent pharmacy owner, and appealing ghastly reimbursements to the very people financing the reimbursement; this was not pharmacy… this was not what she had signed on for.

At precisely 7pm she turned the key in the lock, flipped the breakers controlling the lights and sat down at her desk. She took a deep breath, closed her eyes and exhaled a ragged breath as she reached for the phone…

“Hi, my name is Samantha Rodgers and I’d like to start the process of selling my pharmacy…”

She held her breath while the guy on the other end gave his spiel and asked the $64,000 question…

She exhaled and with more emotion than she’d wanted to show, answered:

Well, we bought it 10 years ago. The owner at the time had run the pharmacy pretty much into the ground. My options were - look for another job an hour away or save my job by buying him out; at the time the independent pharmacy industry was such that an owner could still make a living… that’s no longer the case. To be honest… it was never my intent to be a pharmacy owner…