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Tuesday, January 18, 2022

Seeking Replenishment: Aging Pharmacists Leave Pharmacies Vacant in Rural Colorado

Markian Gavrilyuk, Kaiser Health News

Ted Billinger Jr. liked to joke that he would work until his death. It turned out to be prophetic.

When Billinger died of a heart attack in 2019 at the age of 71, he was still working at the Teddy B’s pharmacy, which his father opened over 65 years ago in Cheyenne Wells, Colorado. Since there was no other pharmacist in the store, the prescriptions already counted and sealed in bottles were suddenly locked up in the pharmacy, where no one could enter. And fewer than 800 Cheyenne Wells residents were suddenly left without a pharmacy.

Once upon a time, pharmacies were usually passed down from one generation to the next, but in interviews with more than a dozen pharmacists, many said that pressure from an independent pharmacy is forcing them to push their children towards another career. And when they are looking for a buyer, they often find it difficult to attract new pharmacists, especially in rural areas. As a large group of pharmacists approaches retirement age, more communities may lose their only pharmacy.

“It will be more difficult to attract people and pay them,” said David Kreling, professor emeritus of the University of Wisconsin-Madison School of Pharmacy. “Unless there is a generation where someone can sit down with their son or daughter and say they can take over a store, there is a good chance the pharmacy will evaporate.”

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Tom Davis, Billinger’s friend and co-owner of Kiowa Drug in Eads, stepped in to sort out the Cheyenne Wells mess. With the permission of the State Board of Pharmacy, the county sheriff let Davis into the Teddy B restaurant in eastern Colorado to take an inventory of the remaining drugs. Customers who refused prescriptions before Billinger’s death were able to collect their medications.

Davis then bought a pharmacy on the Billinger estate. He runs it like a convenience store and delivers recipes there six days a week from Eads, 44 miles out of town.

“By the time you paid the pharmacist, this place was practically unprofitable,” Davis said.

He has received many requests to open pharmacies in other cities in eastern Colorado, but this will be difficult financially. Insurance plans have shrunk and their customer base has collapsed as health insurance companies push patients to ship by mail.

“I write prescriptions every day when my reimbursement is less than the cost of the drug,” Davis said. “In other settings, you might say to the patient, ‘We don’t have this available,’ or ‘Why don’t you go down the street to the network? “But here we just take care of our patients and just eat.”

Rachel Wolfe, for Kaiser Health News

A woman walks into a Teddy B store in Cheyenne Wells, Colorado.

According to him, he can survive because after 48 years he no longer has business debts.

“I look at my bottom line,” Davis said. “With the amount of profit I made at the end of the year, it wouldn’t be enough if I had to pay on my mortgage.”

Research has shown that the number of pharmacists at the national level is sufficient, even more than sufficient to meet current needs, although supply and demand do not always match. Finding pharmacists is more difficult in rural areas.

“Once they get a taste of the big city,” Creling said, “it’s hard to get them back on the farm.”

Labor force data also show alarming trends. Fears of a shortage of pharmacists led the federal government to pour money into pharmaceutical schools in the 1970s, resulting in a temporary increase in graduate numbers. People who got into this hillock of pharmacists have reached retirement age.

“Many of them owned independent pharmacies and worked in rural communities,” said John Schommer, professor of pharmacy at the University of Minnesota, who studies labor force issues.

Now that pharmacists’ demand for testing and vaccinations increases during the COVID-19 pandemic, pharmacy chains are offering incentives such as big salaries, signature bonuses, and school loan assistance – often more tempting than anything at a rural pharmacy. … could collect.

The way pharmaceutical graduates represent their careers has also changed. Many of them no longer want to own a pharmacy and are satisfied with working in pharmacy chains or other health care organizations, according to several professors of pharmaceutical schools. As of 2018, only about half of pharmacists worked in traditional retail pharmacies.

This makes recruiting in rural areas difficult.

Seeking Replenishment: Aging Pharmacists Leave Pharmacies Vacant in Rural Colorado

Rachel Wolfe, for Kaiser Health News

Pharmacy technician Jess Sierra prepares prescriptions at Kiowa Drug in Eads, Colorado.

Denise Robins worked at the family-owned R&R pharmacy in Springfield, Colorado for 18 years when the owner retired. She and three family members bought a pharmacy in a last-ditch effort to keep it open.

“None of us are pharmacists, so it made things a little difficult,” Robins said. “We just knew it would really be difficult for people here if they had to drive an hour to get to the pharmacy.”

But finding a pharmacist to work in a city in southeastern Colorado with a population of less than 1,400 was not easy. The first pharmacist Robins discovered was 48 miles one way from Lamar. But after a year and a half, the trip became unbearable.

She then hired someone who wanted to work just a year to make enough money to travel. Robins then interviewed two University of Colorado School of Pharmacy alumni. She hired one, but nothing came of it. Therefore, she called back the second candidate, who never found a permanent job. He had two young children, and he and his wife worked on different schedules. He took the job two years ago and has remained there ever since.

In Berryville, Virginia, pharmacist Patricia White opened a Battletown pharmacy in 2011 because she wanted to continue the family business. Her father owned a local pharmacy and recently died. But when making a profit from Battletown proved to be a problem, White decided to step down.

She lined up two potential buyers, but neither sold the sale. She then hoped to hand over the pharmacy to a recent graduate, but didn’t want to burden him with a failed business.

“I told him he couldn’t make any money, and he said, ‘Thanks for the honesty,’” White recalled.

Closing seemed like the only viable option. Battletown closed at the end of August. “I didn’t want to sell to the network,” she said. “This has always been my mentality.”

When a chain buys a pharmacy, it doesn’t always decide to open one. Instead, he can close the pharmacy and transfer the pharmacy prescription files to one of his outlets. According to David Zgarrick, a professor of pharmacy at Northeastern University, retired pharmacists who have served the community for decades usually don’t want this to happen.

“They would like to sell their pharmacy to another pharmacist who would continue to operate in the same manner,” he said.

Seeking Replenishment: Aging Pharmacists Leave Pharmacies Vacant in Rural Colorado

Rachel Wolfe, for Kaiser Health News

Dia Chiron, manager of Teddy B convenience store in Cheyenne Wells, Colorado, moves the prescriptions into a locked drawer after Kiowa Drug delivers them.

Some plan ahead by hiring another pharmacist and offering that person a stake in the business. Over time, a new pharmacist can buy back from the owner. Many independent pharmacist owners plan to live off the profits from the sale of their pharmacy, its inventory and prescriptions.

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