IT IS NO SECRET THAT RUNNING A PROFITABLE pharmacy is harder than ever. But the good news is that it is still possible. I know because I just completed a 3,992-mile road trip and visited nine remarkable pharmacies in Arizona, Utah, Idaho, Montana, and Calgary, Canada. In this issue of ComputerTalk you’ll meet the last four. Information on the first five can be found in the July/August issue. It is my hope, and that of the trip’s sponsors, that something you learn from the pharmacy owners and managers interviewed for this report will inspire you to try something new that will help you be more successful.

ED SNELL’S PHARMACY, Pocatello, Idaho

I met Ed Snell at an American Associated Pharmacies (AAP) meeting in Las Vegas several years ago. I took an immediate liking to him, and it was a thrill to be able to visit him at Ed Snell’s Pharmacy in Pocatello, Idaho.

Snell runs a busy pharmacy supported by an RxSafe and a Parata PillPack unit. He is a compounder and had plans in place to become USP <800> compliant. The pharmacy also features a durable medical equipment (DME) department that includes lift chairs, diabetes shoes, compression hose, canes and walkers, etc., that add to his health care image.

Snell tells me he was one of the first pharmacies to join Associated Pharmacies, Inc. (API), which later merged with United Drugs to become American Associated Pharmacies (AAP), when he attended API’s inaugural meeting at the National Association of Retail Druggists (now the National Community Pharmacists Association) conference in 1988. He has been a member ever since and credits the organization for providing him with both the purchasing power and the business support he needs.

As an innovator he has tried a number of enhanced care programs over the years, and was one of the first to purchase a bone density machine to screen for osteoporosis and to buy a Cholestech unit to screen for high cholesterol. He took the training necessary to become a certified clinical nutritionist in 1995. The pharmacy has a nice display of professional-grade nutritional supplements, which is supported by a trained staff member who sits at a special greeting area right inside the front door.

Idaho has a pharmacist prescribing law, and Snell has taken advantage of that to schedule appointments with many of his diabetic patients; he will take a history and, if appropriate, prescribe and then fill cholesterol prescriptions. He says this not only provides better care for his patients but helps improve his STAR ratings.

Snell feels strongly about two issues. First, that he owns a healthcare center, not just a pharmacy. Second, that the biggest competitive advantage he has is his staff. With a great sense of satisfaction, he told me how his employees consistently go above and beyond, without his prior knowledge, to care for patients. One staff member bought and delivered a winter coat to a patient in need, and another rented a video and stopped in to watch it with a patient who was lonely and going through a tough time.

ELK HORN PHARMACY, Boulder, Montana

Josh Morris, Pharm.D., owns three pharmacies and is a partner in a fourth in Montana. Elk Horn, where I visited, is a leased-space pharmacy in an independent grocery store in the scenic town of Boulder. He also owns a 4,000-square-foot full-line pharmacy in Whitehall. In 2008 he opened the first telepharmacy in Montana in West Yellowstone. That went so well he is a partner in another telepharmacy.

West Yellowstone was the first telepharmacy in Montana, and it is what attracted me to Morris’s operation. Morris opened the pharmacy in 2008 after doing extensive investigation on the technology, regulations, and business practices necessary to operate a pharmacy of that type. He says he grew up in West Yellowstone and thus had an affinity for the town and felt the town was “just right” for the pharmacy.

The pharmacy has three employees and fills about 50 scripts a day. He says that number varies by season, and the pharmacy can be very busy during the summer months. Morris says you’d be amazed at how many people take off on vacations and fail to plan ahead for refills.

Bruce Kneeland extends special thanks to the sponsors whose financial support made this trip possible.
American Associated Pharmacies, AAP, Scottsboro, Ala.,
FLAVORx, Columbia, Md.,
GRX Marketing, West Des Moines, Iowa,
PioneerRx Pharmacy Software, Shreveport, La.,
PerceptiMed Systems, Mountain View, Calif.,
WSPC — formerly the Western States Pharmacy Coalition, Tigard, Ore.,

Like everyone else Morris has been hit hard by declining third-party reimbursements. He and several other pharmacy owners have formed their own GPO (group purchasing organization), Montana Family Pharmacies. His group is trying to combat the PBMs (pharmacy benefit managers) by actually hiring a representative with health insurance expertise to contact employers and help them opt out of a big national PBM by selecting a smaller, more transparent, and pharmacy-friendly one.

Central to the success of a telepharmacy is the right technology. Currently, Morris operates all of his pharmacies on PioneerRx systems, having switched two years ago. He says the PioneerRx team did a great job of integrating its software with the technology provided by Global Media that supports the secure video link necessary for a telepharmacy operation.

One of the major features he likes about PioneerRx is its inventory and purchasing support software. He says the company has created a system that allows him to shop from a handful of alternate suppliers and purchase products at prices lower than he can get from his primary wholesaler. And, he adds, the system has the ability to monitor his generic rebate so that he can stay compliant with his wholesaler’s contract parameters.

SANDSTONE PHARMACIES, Calgary, Alberta, Canada

The Sandstone Pharmacy is a well-merchandised traditional drugstore. The 2,500-square-foot location features OTCs (over the counter items), cards, gifts, seasonal, and other items. These are all carefully merchandised, and the front-end manager uses lots of shelf signs to draw attention to new items and special offers.

Daniel Makas, R.Ph., is the manager of the location I visited in Calgary. It is part of a 20-store chain with locations throughout the Canadian province of Alberta. The small chain has grown by acquisition and thus has a variety of store types, including a 15,000-square-foot store and a small one located in the Calgary airport. The chain strives to be on the cutting edge of pharmacy practice, and the location I visited in Calgary gets involved in a number of pilot programs since it is near the corporate offices.

Bruce Winston, president of the company, says it is in the final stages of evaluating the new scripClip will-call bin system offered by PerceptiMed.

Makas says he has been impressed with how the LED-embedded clips the system uses help him improve customer service. He says that by scanning every finished prescription into the system he is able to find any prescription for any patient in an instant. He especially finds the flashing light helpful as he looks for scripts in what he calls the “owing” area. This is the area where the staff puts prescriptions filled for people for whom they were originally only able to do a partial fill.

One thing stands out from my visit. When the prescription is presented to a patient the pharmacist counsels, the prescription is given to the patient and the patient is directed to the front of the store to pay. This practice helps to improve front-end sales and keeps the conversation at the pharmacy counter focused on the medication.

When I queried Makas about what happens when a patient leaves without paying, he smiles and says, “Yes, it happens, but when we close out the register at the end of the day, we know who didn’t pay and we simply give them a call.” He adds that people apologize and return quickly ­­— and often buy something else. He recommends this practice to any pharmacy interested in improving front-end sales.


Vic Allen, R.Ph., owns two pharmacies and a DME company in Nampa, Idaho. His flagship pharmacy is housed in a former bank building that he bought and converted a few years ago. He says the physical features of the building serve him very well. The building is on a busy street corner and has a covered drive-up window that his customers love. One thing that really stands out is his digital exterior sign.

The front end of Vic’s Family Pharmacy would best be described as professional. It is clean, well lit, and tastefully laid out. It features a variety of high-end supplements, diabetic shoes, OTCs, and other healthcare items.

While visiting, Allen showed me a new gizmo he is experimenting with called Pointy. It allows him to scan front-end items as they are received and have them automatically posted on the internet so that as people search for a specific item, they can see it is stocked in Vic’s Family Pharmacy. He hopes it will bring in more customers, but since it is not operational yet he says he will just have to wait and see.

Allen serves as a board member for his group purchasing organization, WSPC (formerly Western States Pharmacy Coalition). He says, “WSPC is an excellent business partner. The programs, purchasing contracts, and business advice WSPC provides have made it possible for me to remain profitable.”

Perhaps the most unique service Allen provides is a weight loss program. The program is managed by a certified pharmacy technician who was trained by the sponsoring company. That training includes learning how to use the proprietary equipment to create a customized diet and exercise program and helping patients to set realistic goals. The program includes providing the pharmacy with a special scale and computer program that allow the counselor to capture body composition data such as weight, percentage of body fat, lean muscle, water, and metabolic rate.

The program charges a person an enrollment fee of about $200. Patients are provided with meal planning guides that help them eat a well-balanced meal once a day. Then it calls for them to use the program’s shakes, meal replacement bars, and supplements for their other meals and snacks. Allen says the program works well for most people, and he routinely has 15 people enrolled at any one time.


Well, there you have it, a glimpse into what nine successful pharmacies are doing to profitably serve their patients. None of the stores would claim to be exceptional. But I would. Judging by what I saw they have all found ways to incorporate new, healthcare-related services that generate profitable sales and provide consumers with reasons to recommend their pharmacy to their friends, family, and neighbors. Here’s hoping that something you read here will inspire you to try something new. CT

Bruce Kneeland specializes in helping independent community pharmacies to increase sales, improve profits, and simplify their lives. He writes regularly for ComputerTalk. He can be reached at Read his blog at