- Email: [email protected]
Behind the Scenes of the Pharmaceutical Center*
I
Through this doorway patients enter the pharmaceutical center established by Eugene V. White.
n 1950 after four years of pharmacy school, just what was my reaction to the so-called " profession of pharmacy?" Frankly, it could be summed up in three words- utter disillusionment and discouragement Has the picture improved during these 15 years since I graduated? The question could be answered negatively or positively depending upon who is answering it. What were the secrets to success the so-called "experts" were telling us 15 years ago? Regretfully their secrets to success have changed very little. A few of them were (and are)~ The
pharmacist must be a good salesman. Insistthe customer buy the largest sizes for they are the most economical-and don'tforget, Mr. Pharmacist, it increases your profit.
~ The
pharmacist must tie in with newspaper, radio and TV advertising for these items are presold. Let Arthur Godfrey do much of the work for you. Help your image by stocking the newest first.
~ The
pharmacist must merchandise and go self-service for his customers want to see and feel things.
~ The
pharmacist must, by all means, operate a fountain for it is a great traffic builder. If you can serve hot meals, it's all for the better. Remember that word, Mr. Pharmacist . . . traffic. You must have traffic! Also, don't forget the newspapers, comic books, magazines and tobaccos-they are wonderful traffic builders. ~ The pharmacist must display the fast movers all around the cash register. Remember, Mr. Pharmacist, that's the hot spot of the drugstore. Who cares if you ,have no space left to wrap packages. Your goal is money! ~ The pharmacist must learn the true meaning of opportunity. Stock anything as long as it will gain you more profit! After all, what are you in business for? ~ The pharmacist must increase his profit by taking advantage of all deals. This is where the gravy is, man! The larger the deal you buy, the more money in your pocket.
Inside the pharmaceutical center Eugene White hands a patient her medication as a receptionist answers the telephone.
~ The
pharmacist must never let a competitor get the edge on him. Cut his throat, if necessary, by any manner or means. After all, Mr. Pharmacist, this is a battle for survival.
We could go on and on with this satire but I am sure you recognize these socalled "secrets to success. " And what was wrong with this "advice?" The answer was really very simple. It left the health and welfare of the patient
*
Adapted from an address presented at the 17th annual spring pharmacy seminar, University of Georgia, Athens, Georgia, May 20, 1965. Original manuscript copyrighted by Eugene V. White, 1965.
532
Journal of the AMERICAN PHARMACEUTICAL ASSOCIATION
out of the picture. In fact, it even left pharmacy out of the picture. And, most importantly, where does ethics fit into the ugly picture? All of this made me think. Gradually, a mental picture began to form in my mind of a new concept of pharmacy. In this mental picture, the patient was the hub of the wheel, so to speak, and all spokes led to him. If pharmacy were truly a profession, then we must establish a true practice from which all evidence of commercialism must be removed. The seed of this new concept had been planted. Now to care for it, nurture it and watch it grow. After five months of selling lawn seed and paint, cutting glass for window frames and dispensing a few prescription orders in between, I could no longer take it and moved on to a more professional environment. In less than three years, I had a partner and purchased a very nice pharmacy. But, to my dismay, I realized too late that my partner could not be convinced of the merits of professional pharmacy. After three years, I sold my interest to my partner and started all over again. I had an opportunity to purchase a typical community pharmacy on January 1, 1957, at Berryville, Virginia, and did so. Berryville had a population of 1,700 and Clarke County a total of 8,000 people. I was convinced that I would prove a pharmacist could practice almost anywhere if I could successfully practice my profession fulltime in a town with such a small population and only five physicians (now four) and with a Rexall drugstore across the street from me. From the very first day, my goal was to transform this commercial community pharmacy to one conforming to my mental image of a professional pharmacy. This would have been impossible without the assistance and encouragement of my wife. With her aid I was able to overcome many seemingly insurmountable obstacles. search for an ideal My wife and I visited professional pharmacies in many states and in Canada in search of one closely resembling our mental image. N one was to be found. We returned home and started reducing to writing and drawings our ideas, dreams and ideals. We knew the pharmacists must be jolted to reawaken them. How could we help supply this needed jolt? We decided that the two-headed monster must lose its commercial head. It was time to bring pharmacy back to its true purpose-the rendering of the finest professional personalized pharmaceutical services as an integral part of the total patient care concept in the interest and safety of the public health. This was the very basis for our existence as a
profession . I was convinced pharmacists could exist as full-time practicing pharmacists. It required nearly four years with a series of planned stages to eliminate commercialism from our pharmacy. The very first day newspapers, magazines and comic books were dropped. Ten months later we made our most daring move and discontinued sandwiches. Jewelry and hardware items were returned to the distributors. Our last act of this nature before transformation was to discontinue the national bus agency which had been at that corner location for 24 years. During this time, we emphasized to the public the professional side of pharmacy. We changed the appearance of the pharmacy to simple lines with no massive displays and no signs in the windows. At the same time, we stressed our professional responsibilities in our relationship with the physicians. We noted many pharmacists presenting more and more gifts to physicians as a means of gaining their favor. In fact, our predecessor presented precooked Smithfield hams to all local physicians at Christmastime. In our indecision and against our better judgment, we continued this gift-giving the first two years. The third Christmas we decided the practice must cease. We felt our relationship with the physicians should be one of interdependence. I wrote a personal note to each physician explaining these annual gitts were a violation of our ethical principles and that in the future we would use the money previously allotted in our budget for hams for the needy in our county at Christmastime. We wondered about the type of reaction to this action. Three of the five physicians made no comment, one phoned to tell me of his approval and the other sent the following note by his personal secretaryDecember 21, 1959 Dear Gene: Just thought I'd drop you a little note and let you know that I heartily approve of your decision regarding the "Christmas ham." My wife and I both feel happier about your donating the money to the needy. This is certainly more in the true spirit of Christmas and I congratulate you on your Christian courage. Best wishes to you and yours for the holiday season.
My point is this-pharmacists can only further degrade their professional image and lose respect if they continue to attempt to attract activity by compromising methods. Returning to the story of the trans·· formation, we had talked with commercial fixture companies about our
goal of a truly professional pharmacy. None seemed to understand until we talked with a designer named Melvin Troutman of Morrison Furniture and Fixture Company of Statesville, North Carolina. After a full afternoon of listening to our philosophy and looking over our crude sketches and drawings of the new concept, he returned the next day with a design that required very little changing. Detailed plans were drawn by the draftsman and the fix" tures were constructed; all equipment was custom-made. We introduced our new patient prescription record system six months before we transformed our pharmacy. This indeed was, and is, one of the keys to success in private practice for this established us on a personal, professional pharmacist-patient relationship. This comprehensive patient prescription history is a means of guarding against the patient's receiving drugs to which he is allergic, drugs which are medical "duplicates" of medicine he is currently taking and drugs which will give undesirable reactions when combined with other medications that he is taking. I t furnishes the pharmacist with a complete picture of his practice. The people of Clarke County were unaware of all these plans. We feared (continued on next page)
The instigato r of the Pharmaceutical Center movement, Eugene V. White, has been in community practice since 1950 when he received his BS from the Medical College of Virginia. A highlight of his career came at the 1965 annual meeting when he was honored as the first recipient of the Daniel B. Smith award. Besides being an APhA member, White has been active as a fellow of the American College of Apothecaries. He also served as president and secretary of the Northern Virginia Pharmaceutical Association and as a member of the executive council of the Virginia Pharmaceutical Association. Vol. NS5, No. 10, October 1965
533
.N . ..,. . ..,.
...~tiplulaAugusty :. :. ..•. :. '.:.,:.: . i. n.,. . . t. e.:. r.• e$t.: :i n the... A . ..:P. HA .W' . . . . '. . l?hru:piaceu•..nounceroe .tica.1 ..C . ..,.,..n. .:.:. .• er .;:e. . .w
waS pany, Inc. " . ensack, New w.ill offer several versions of this ew type: of professional pharmacy. Bergen is the second wholesaler to cooperate with APBAin the development of specific plans Jor the Center. McKesson and Robbins, Inc. which developed, the Urst,: APaAPhannaceutical Center continues to offer its plan nationany~ The Bergen installation will be available '~~e~er J e New York :~nd P?4p.ectic4l areas thEO~~:~ ergen's:qre . ' ution centers.~cKesson .and R09l:iins will exhibit still another new. Pharmaceutical Center at the 1966 APaA annual meeting in Dallas. ,
t.·.
.B~rg'el1 \: Dru
< .
White's pharmaceutical center (continued from preceding page)
their learning in May that the fountain, for example, would be gone in November might build up resentment and cause our patients to leave us before seeing the results of our plans. Our new concept of pharmacy would be strange enough in three-dimension without our attemping to paint a mental picture of it to them. Secrecy was of utmost importance. Not even our own staff knew of our plans until the day we mailed more than 2,000 letters to our patients telling them our plans and objectivesNovember II, 1960 Dear Mrs. Smith: Within the next few days, we shall undertake to remodel our pharmacy and should like to take this opportunity to tell you some of our plans. At the same time, we ask your cooperation and patience during the turmoil and the confusion of the change-over. Many of you have long recognized that" our objectives are of a professional nature with increasing emphasis on your health needs. We in pharmacy have had a significant part to play in the achievements which have given American citizens today scientific medical' care of a 534
on the board of ag:visors are Joseph Dorsch and Victor ¥ptgenroth, Jr. of Baltimore, .Maryland; Daniel Wertz of Johnstown, :pennsylvania and: H. Paul Rhodes of Winchester., Virginia. Other pharmacists who practice in Pharmaceutical Centers ,
4
p. r. Ovl.·. p .d. . . ea vice nsidered .a.n. . •.,.•. d. . ........e. .x. ,. pe.: tienc. . .• .:·.t. . .,. h .. . . e . .~f • . . . ..board also> E . ...con~ a. ch new b y eafor r d. fQrmit . :PRA design . ent$" . '<. . ......: tiqns in some 2 states should be completed by year'$ end. Five different plans will be available for the Pharmaceutital
quality never before obtainable in history. Naturally, drugs have become more complex, differing greatly in composition, action and use from the drugs of animal, vegetable and mineral origin of days gone by. We have found it nearly impossible to keep abreast of new drug developments and, at the same time, tend to the commercial aspects of present-day drugstores. In order to devote virtually full time to the profession, we are eliminating most of the commercial activities of our pharmacy, namely: the fountain, tobaccos, candy, stationery, billfolds, milk glass, toys and all gift items. Many will say, "They only have prescriptions now./I However, we want to emphasize we shall continue sickroom supplies, medical needs, dentifrices, and other healthrelated items. Even though you may be unable to select these items by self-service, our staff will gladly assist you. We have personally informed most of you of the new, individual or family record system maintained on each patient. Countless instances have already proved the merits of this service to the physician, pharmacist and patient. Please remember you may come in at anytime and copy your prescription record for income tax or insurance purposes. Our new daily hours shall be 8:30
Journal of the AMERICAN PHARMACEUTICAL ASSOCIATION
a.m. to 9 p.m. and our new Sunday hours shall be 9 a.m. to 10: 45 a.m. For emergency pharmaceutical services after pharmacy hours and holidays, a pharmacist is on call at his residence. We plan a community bulletin board in our pharmacy and welcome notices of public interest. Obituary notices will also be placed on this bulletin board. Our remodeled pharmacy is the consummation of years of planning. Our goal is to give Berryville and Clarke County one of the most modern, professional pharmacies in the United States. We sincerely hope you will take pride in the establishment of this type of ethical pharmacy- a pacesetter for our profession. With kind regards.
Ten working days: later the fixture men were walking out the new front door of our private practice of pharmacy. Just what had we accomplished? It required nearly four years by a series of planned stages to eliminate certain elements of commercialism so that we could smoothly make the transition. Our emphasis had been on our professional services and, in particular, the development of a personal relationship with our patients. We had attempted to create an empathetic relationship with our patients-a sincere interest in their health and welfare and that
II.' I
.
I
Through this doorway patients enter the pharmaceutical center established by Eugene V. White.
n 1950 after four years of pharmacy school, just what was my reaction to the so-called " profession of pharmacy?" Frankly, it could be summed up in three words- utter disillusionment and discouragement Has the picture improved during these 15 years since I graduated? The question could be answered negatively or positively depending upon who is answering it. What were the secrets to success the so-called "experts" were telling us 15 years ago? Regretfully their secrets to success have changed very little. A few of them were (and are)~ The
pharmacist must be a good salesman. Insistthe customer buy the largest sizes for they are the most economical-and don'tforget, Mr. Pharmacist, it increases your profit.
~ The
pharmacist must tie in with newspaper, radio and TV advertising for these items are presold. Let Arthur Godfrey do much of the work for you. Help your image by stocking the newest first.
~ The
pharmacist must merchandise and go self-service for his customers want to see and feel things.
~ The
pharmacist must, by all means, operate a fountain for it is a great traffic builder. If you can serve hot meals, it's all for the better. Remember that word, Mr. Pharmacist . . . traffic. You must have traffic! Also, don't forget the newspapers, comic books, magazines and tobaccos-they are wonderful traffic builders. ~ The pharmacist must display the fast movers all around the cash register. Remember, Mr. Pharmacist, that's the hot spot of the drugstore. Who cares if you ,have no space left to wrap packages. Your goal is money! ~ The pharmacist must learn the true meaning of opportunity. Stock anything as long as it will gain you more profit! After all, what are you in business for? ~ The pharmacist must increase his profit by taking advantage of all deals. This is where the gravy is, man! The larger the deal you buy, the more money in your pocket.
Inside the pharmaceutical center Eugene White hands a patient her medication as a receptionist answers the telephone.
~ The
pharmacist must never let a competitor get the edge on him. Cut his throat, if necessary, by any manner or means. After all, Mr. Pharmacist, this is a battle for survival.
We could go on and on with this satire but I am sure you recognize these socalled "secrets to success. " And what was wrong with this "advice?" The answer was really very simple. It left the health and welfare of the patient
*
Adapted from an address presented at the 17th annual spring pharmacy seminar, University of Georgia, Athens, Georgia, May 20, 1965. Original manuscript copyrighted by Eugene V. White, 1965.
532
Journal of the AMERICAN PHARMACEUTICAL ASSOCIATION
out of the picture. In fact, it even left pharmacy out of the picture. And, most importantly, where does ethics fit into the ugly picture? All of this made me think. Gradually, a mental picture began to form in my mind of a new concept of pharmacy. In this mental picture, the patient was the hub of the wheel, so to speak, and all spokes led to him. If pharmacy were truly a profession, then we must establish a true practice from which all evidence of commercialism must be removed. The seed of this new concept had been planted. Now to care for it, nurture it and watch it grow. After five months of selling lawn seed and paint, cutting glass for window frames and dispensing a few prescription orders in between, I could no longer take it and moved on to a more professional environment. In less than three years, I had a partner and purchased a very nice pharmacy. But, to my dismay, I realized too late that my partner could not be convinced of the merits of professional pharmacy. After three years, I sold my interest to my partner and started all over again. I had an opportunity to purchase a typical community pharmacy on January 1, 1957, at Berryville, Virginia, and did so. Berryville had a population of 1,700 and Clarke County a total of 8,000 people. I was convinced that I would prove a pharmacist could practice almost anywhere if I could successfully practice my profession fulltime in a town with such a small population and only five physicians (now four) and with a Rexall drugstore across the street from me. From the very first day, my goal was to transform this commercial community pharmacy to one conforming to my mental image of a professional pharmacy. This would have been impossible without the assistance and encouragement of my wife. With her aid I was able to overcome many seemingly insurmountable obstacles. search for an ideal My wife and I visited professional pharmacies in many states and in Canada in search of one closely resembling our mental image. N one was to be found. We returned home and started reducing to writing and drawings our ideas, dreams and ideals. We knew the pharmacists must be jolted to reawaken them. How could we help supply this needed jolt? We decided that the two-headed monster must lose its commercial head. It was time to bring pharmacy back to its true purpose-the rendering of the finest professional personalized pharmaceutical services as an integral part of the total patient care concept in the interest and safety of the public health. This was the very basis for our existence as a
profession . I was convinced pharmacists could exist as full-time practicing pharmacists. It required nearly four years with a series of planned stages to eliminate commercialism from our pharmacy. The very first day newspapers, magazines and comic books were dropped. Ten months later we made our most daring move and discontinued sandwiches. Jewelry and hardware items were returned to the distributors. Our last act of this nature before transformation was to discontinue the national bus agency which had been at that corner location for 24 years. During this time, we emphasized to the public the professional side of pharmacy. We changed the appearance of the pharmacy to simple lines with no massive displays and no signs in the windows. At the same time, we stressed our professional responsibilities in our relationship with the physicians. We noted many pharmacists presenting more and more gifts to physicians as a means of gaining their favor. In fact, our predecessor presented precooked Smithfield hams to all local physicians at Christmastime. In our indecision and against our better judgment, we continued this gift-giving the first two years. The third Christmas we decided the practice must cease. We felt our relationship with the physicians should be one of interdependence. I wrote a personal note to each physician explaining these annual gitts were a violation of our ethical principles and that in the future we would use the money previously allotted in our budget for hams for the needy in our county at Christmastime. We wondered about the type of reaction to this action. Three of the five physicians made no comment, one phoned to tell me of his approval and the other sent the following note by his personal secretaryDecember 21, 1959 Dear Gene: Just thought I'd drop you a little note and let you know that I heartily approve of your decision regarding the "Christmas ham." My wife and I both feel happier about your donating the money to the needy. This is certainly more in the true spirit of Christmas and I congratulate you on your Christian courage. Best wishes to you and yours for the holiday season.
My point is this-pharmacists can only further degrade their professional image and lose respect if they continue to attempt to attract activity by compromising methods. Returning to the story of the trans·· formation, we had talked with commercial fixture companies about our
goal of a truly professional pharmacy. None seemed to understand until we talked with a designer named Melvin Troutman of Morrison Furniture and Fixture Company of Statesville, North Carolina. After a full afternoon of listening to our philosophy and looking over our crude sketches and drawings of the new concept, he returned the next day with a design that required very little changing. Detailed plans were drawn by the draftsman and the fix" tures were constructed; all equipment was custom-made. We introduced our new patient prescription record system six months before we transformed our pharmacy. This indeed was, and is, one of the keys to success in private practice for this established us on a personal, professional pharmacist-patient relationship. This comprehensive patient prescription history is a means of guarding against the patient's receiving drugs to which he is allergic, drugs which are medical "duplicates" of medicine he is currently taking and drugs which will give undesirable reactions when combined with other medications that he is taking. I t furnishes the pharmacist with a complete picture of his practice. The people of Clarke County were unaware of all these plans. We feared (continued on next page)
The instigato r of the Pharmaceutical Center movement, Eugene V. White, has been in community practice since 1950 when he received his BS from the Medical College of Virginia. A highlight of his career came at the 1965 annual meeting when he was honored as the first recipient of the Daniel B. Smith award. Besides being an APhA member, White has been active as a fellow of the American College of Apothecaries. He also served as president and secretary of the Northern Virginia Pharmaceutical Association and as a member of the executive council of the Virginia Pharmaceutical Association. Vol. NS5, No. 10, October 1965
533
.N . ..,. . ..,.
...~tiplulaAugusty :. :. ..•. :. '.:.,:.: . i. n.,. . . t. e.:. r.• e$t.: :i n the... A . ..:P. HA .W' . . . . '. . l?hru:piaceu•..nounceroe .tica.1 ..C . ..,.,..n. .:.:. .• er .;:e. . .w
waS pany, Inc. " . ensack, New w.ill offer several versions of this ew type: of professional pharmacy. Bergen is the second wholesaler to cooperate with APBAin the development of specific plans Jor the Center. McKesson and Robbins, Inc. which developed, the Urst,: APaAPhannaceutical Center continues to offer its plan nationany~ The Bergen installation will be available '~~e~er J e New York :~nd P?4p.ectic4l areas thEO~~:~ ergen's:qre . ' ution centers.~cKesson .and R09l:iins will exhibit still another new. Pharmaceutical Center at the 1966 APaA annual meeting in Dallas. ,
t.·.
.B~rg'el1 \: Dru
< .
White's pharmaceutical center (continued from preceding page)
their learning in May that the fountain, for example, would be gone in November might build up resentment and cause our patients to leave us before seeing the results of our plans. Our new concept of pharmacy would be strange enough in three-dimension without our attemping to paint a mental picture of it to them. Secrecy was of utmost importance. Not even our own staff knew of our plans until the day we mailed more than 2,000 letters to our patients telling them our plans and objectivesNovember II, 1960 Dear Mrs. Smith: Within the next few days, we shall undertake to remodel our pharmacy and should like to take this opportunity to tell you some of our plans. At the same time, we ask your cooperation and patience during the turmoil and the confusion of the change-over. Many of you have long recognized that" our objectives are of a professional nature with increasing emphasis on your health needs. We in pharmacy have had a significant part to play in the achievements which have given American citizens today scientific medical' care of a 534
on the board of ag:visors are Joseph Dorsch and Victor ¥ptgenroth, Jr. of Baltimore, .Maryland; Daniel Wertz of Johnstown, :pennsylvania and: H. Paul Rhodes of Winchester., Virginia. Other pharmacists who practice in Pharmaceutical Centers ,
4
p. r. Ovl.·. p .d. . . ea vice nsidered .a.n. . •.,.•. d. . ........e. .x. ,. pe.: tienc. . .• .:·.t. . .,. h .. . . e . .~f • . . . ..board also> E . ...con~ a. ch new b y eafor r d. fQrmit . :PRA design . ent$" . '<. . ......: tiqns in some 2 states should be completed by year'$ end. Five different plans will be available for the Pharmaceutital
quality never before obtainable in history. Naturally, drugs have become more complex, differing greatly in composition, action and use from the drugs of animal, vegetable and mineral origin of days gone by. We have found it nearly impossible to keep abreast of new drug developments and, at the same time, tend to the commercial aspects of present-day drugstores. In order to devote virtually full time to the profession, we are eliminating most of the commercial activities of our pharmacy, namely: the fountain, tobaccos, candy, stationery, billfolds, milk glass, toys and all gift items. Many will say, "They only have prescriptions now./I However, we want to emphasize we shall continue sickroom supplies, medical needs, dentifrices, and other healthrelated items. Even though you may be unable to select these items by self-service, our staff will gladly assist you. We have personally informed most of you of the new, individual or family record system maintained on each patient. Countless instances have already proved the merits of this service to the physician, pharmacist and patient. Please remember you may come in at anytime and copy your prescription record for income tax or insurance purposes. Our new daily hours shall be 8:30
Journal of the AMERICAN PHARMACEUTICAL ASSOCIATION
a.m. to 9 p.m. and our new Sunday hours shall be 9 a.m. to 10: 45 a.m. For emergency pharmaceutical services after pharmacy hours and holidays, a pharmacist is on call at his residence. We plan a community bulletin board in our pharmacy and welcome notices of public interest. Obituary notices will also be placed on this bulletin board. Our remodeled pharmacy is the consummation of years of planning. Our goal is to give Berryville and Clarke County one of the most modern, professional pharmacies in the United States. We sincerely hope you will take pride in the establishment of this type of ethical pharmacy- a pacesetter for our profession. With kind regards.
Ten working days: later the fixture men were walking out the new front door of our private practice of pharmacy. Just what had we accomplished? It required nearly four years by a series of planned stages to eliminate certain elements of commercialism so that we could smoothly make the transition. Our emphasis had been on our professional services and, in particular, the development of a personal relationship with our patients. We had attempted to create an empathetic relationship with our patients-a sincere interest in their health and welfare and that
II.' I
.
I