Embracing change in my pharmacy in Gibsons, B.C.

In Gibsons, B.C., an independent pharmacy's patient-centred care model guarantees engagement with a pharmacist on every visit.

“Our entire care model is based on as much patient–pharmacist contact as possible,” says pharmacist Chris Juozaitis, owner and manager of Howe Sound Pharmacy. “Not only does this improve clinical care, but we have shown that it is also a viable business model with increased profitability.”

The pharmacy has four intake stations so that all patients—whether they have a new or refill prescription—see a pharmacist at the start of the process. That allows the pharmacist to assess the patient’s needs and provide appropriate counselling before the prescription is filled. Registered technicians, skilled pharmacy assistants and automation take care of all technical aspects of prescriptions.

This patient-care model, in which each team member practises to their full scope, is at the core of Howe Sound’s ability to adapt to the evolving pharmacy landscape while generating revenue for the pharmacy, says Juozaitis, who has owned the pharmacy since 1988.

Juozaitis stresses that this model can work in any size pharmacy or dispensary. Even the intake stations are optional. “When we started down this path, we had a 1,000-sq. ft. pharmacy with no intake stations and a counselling area the size of a small closet,” he says. “It wasn’t ideal [but] our patients felt and saw the difference—there was no looking back.”

The extra patient contact generates revenue in several ways, he says, including payments for cognitive services for which the province will pay. “It is not unusual to bill over $10,000 per month in cognitive service fees all while improving patient care,” he says. “With practice, a pharmacist can easily bill four to six fees per day when it is part of your daily routine.”

The pharmacy set-up has also had a positive impact on pharmacists’ job satisfaction and retention, as well as patient response. “My dispensing fees are 40 per cent higher than the eight other pharmacies in my local area,” says Juozaitis. “I rarely lose or transfer prescriptions to other pharmacies due to the fees.”

In fact, during COVID-19 patient numbers went up thanks to word of mouth in the community around Howe Sound Pharmacy’s ability to take better care of patients. He urges independent pharmacy owners not to be afraid to raise fees. “You will not lose your patients if you provide better care,” he says. “Customers and patients are acutely aware of the value you are giving them.”

The pharmacy model has also boosted profitability by increasing patient adherence to medications. “Most worldwide studies have shown that patient adherence is about 50 per cent after six months of starting any new chronic prescription,” notes Juozaitis. “Simply put, most Canadian pharmacies still have 50 per cent unfilled chronic prescriptions sitting in their pharmacy software.” 

With greater pharmacist-patient touch points and proper medication management, he says pharmacists can help patients adhere to their medications as needed. “This means that an average Canadian pharmacy will fill thousands more prescriptions with their existing customer base and their existing staff.”

The increased time that pharmacists spend with patients opens up unlimited opportunities, adds Juozaitis. “This allows for expanded scope of practice and prescribing that most provinces are adopting [and] it allows us to respond to the increased needs of our community due to doctor shortages and more telehealth appointments,” he says. “Whatever those needs are, the pharmacists are in the best position possible to help address them.”