Primary Considerations for the Surgical Pharmacist By Richard Yale Miller
Richard Yale Miller is a surgical pharmacist who maintains his practice in Wyckoff, New Jersey. He holds degrees from Syracuse University and the Albany College of Pharmacy, Union University. He is on the faculty of Albany College of Pharmacy where he teaches a course ill surgical pharmacy, and also serves on the faculty of Rutgers University college of pharmacy. He writes monthly articles for the New Jersey Journal of Pharmacy and the Alabama Journal of Pharmacy. /111972, Miller was the recipient of the Academy of Pharmaceutical Sciences Kilmer Award. He is president of the Bergen County (New Jersey) Pharmacy Society , and a member of APhA, NARD, ACA, AACP and the New Jersey Pharmaceutical Association.
T
he net profit of community pharmacies has been declining for years. This decrease has been due to a greater operating expense ratio. To maintain a profitable practice in the future, pharmacists will have to re-emphasize the need for greater efficiency. Departments with smaller profits may have to be discontinued in favor of more lucrative departments. Questions · that should be asked are-
Is the cosmetic department operating efficiently and to capacity? Should it be discontinued? Would the pharmacist be making an intelligent decision by giving o-t-c cosmetic aids such as hair sprays, hair coloring products and rollers a greater display area? Is the display area too large considering the return investment on the department? Is the stress on health and cosmetic aids impairing the pharmacy? If this is so, should the accent be on prescriptions and professionally related departments? If the pharmacist desires to discontinue nonpharmacy entities in favor of a more professional image, is he willing to learn about an area foreign to him? If he is, then possibly a surgical department can be the answer to his dilemma.
Advantages of Surgicals There are many advantages to implementing a surgical department in a community pharmacy. One of the most important is that the pharmacist is being reimbursed for a service, not for merchandise. Just as a professional fee should be an essential component in the cost of prescription medication, a fee is added to the cost of fitting surgical garments. This stress on service rather than on merchandise helps to develop a professional aura within the confines of the pharmacy. The surgical pharmacist demands and receives the respect of the patient by his ability to perform professional tasks such as setting up traction apparatus, correctly fitting a brace and giving in7" struction in ostomy care. This same respect is forthcoming from the physician who depends on him to carry out the instructions of patient care when essential post-operational requirements are necessitated. Chain pharmacies have not become important outlets for this essential field due to the technical knowledge necessary to promote surgicals properly ..,.
The competition of nonpharmacy surgical outlets, such as surgical supply and rental stores, may be somewhat of a threat depending on their ability. However, this competition may be overcome by the very nature of its existence. The surgical pharmacist has had five years (or more) of education and is respected by the community and the physician as a leader in his specialty. The rental store proprietor has none of these advantages and has as a primary source of income nonsurgical rentals such as garden tools and household appliances. The surgical pharmacist satisfies a need. The surgeon is qualified to perform a colostomy operation but the colostomate is oftentimes at a loss to properly care for himself when he leaves the hospital. The orthopedic physician diagnoses the back ailment and prescribes a support, but the surgical pharmacist must correctly fit the garment. Any clerk can sell a wheelchair, but only the professional may determine the proper fit and the correct chair for the patient. The physician will prescribe a truss for the inoperable hernia patient, but the reducing of the hernia' and the proper fitting of the truss is the responsibility of the fitter. The patient depends Vol. NS15, No.5, May 1975
251
The Millers' Pharmaceutical Center features a combinatioll of modern equipment and alltiques, such as the carriage seats and desk. The building, originally a combination railroad station and post office, has housed a pharmacy since 1901.
upon the surgical pharmacist for the best appliances that might be used with his condition. In all, a tremendous void is filled by the trained professional who has a desire to help those in need. A successful surgical department will aid other professional departments such as the prescription and first aid supplies departments. The surgical patient is often in need of dressings and usually must take medications such as tranquilizers, muscular relaxants, oral analgesics and anti-inflammatory drugs. Although the patient may have been obtaining prescription medication elsewhere, the knowledge that the surgical pharmacist can fulfill his everyday health needs is often sufficient knowledge to have him come to the surgical pharmacy. Return of investment on rented appliances usually can be made within four to six months. After that time the rental is considered profit (less operating expense and repairs).
Surgicals as a Contemporary Element in Pharmacy Young pharmacists generally are disenchanted with their role of merchant. They desire a change but do not know how to make the adjustment. The purpose of this article is to offer the pharmacist an alternate way to practice and to familiarize him with the essential criteria necessary for the successful operation of a surgical pharmacy. A surgical pharmacy is a pharmacy grossing a minimum of 40 percent of sales in surgical fittings and appliances. A typical surgical pharmacy would have the following ratio-40 percent prescriptions, 40 percent surgicals, and 20 percent health-related o-t-c items such as first aid supplies, analgesics, 252
antacids, and other related products. A pharmacy displaying cosmetics (except hypoallergenic aids), confections , gifts, greeting cards and other nonprofessional products would not be considered a surgical pharmacy no matter how small each display. An exception, however, would be a surgical department physically separated from the general merchandise. Before penetrating into the scope of surgical pharmacy, it is imperative that the pharmacist determine his true inclinations and that the desire to learn is in evidence. The physician will be relying on the professional abilities of the surgical pharmacist, and the pharmacist must rally to that dependence. Five days of instruction at an accredited orthotic school may fortify the pharmacist for that first fitting, but it takes more than a week of instruction to become an experienced fitter. The pharmacist must direct himself to a policy of attendance at surgical seminars during his professional existence to assure the knowledge of new procedures, new products and the restoring of material already known. This, in combination with everyday practical experiences, will eventually give competence and assurance. Medical Detailing Physicians and other professional personnel must be informed of the services that a surgical pharmacist can provide. Although a telephone detail may be sufficient at times, a planned visit with a physician is more effective. The orthopedic physician would be the most important person to detail. His specialty concerns itself with the corrective treatment of deformities, ailments and diseases of locomotor movement.
Journal of the AMERICAN PHARMACEUTICAL ASSOCIATION
The visit should. include such supports as lumbosacral garments, dorso-Iumbar garments, sacroiliac supports, cervical collars and braces, orthotic braces, traction apparatus, convalescent aids such as wheelchairs, walkers, and specific types of crutches and canes. . The surgeon would be attentive to details concerning surgical stockings, prosthetic devices such as artificial breasts, trusses for the inoperable, surgical binders and ostomy appliances. The internist would be interested in information on inhalation therapy and oxygen service, surgical stockings, cervical collars and supports utilized for ptosis (dropped) conditions. The allergist would require information concerning air purifiers, humidifiers, dehumidifiers, inhalation therapy and oxygen service and allergy testing kits. The osteopath would be receptive to the same detail as the orthopedic physician and the internist. The dermatologist would be detailed on ultraviolet lamps and allergy testing kits. Other important details would be to the cardiologist for inhalation therapy and ambulatory aids such as wheelchairs and walkers; the obstetrician for maternity supports and surgical stockings; the ophthalmologist for ocular prosthetic devices (artificial eyes); the otologist for hearing devices; the pediatrician for most of the above and also child supports and pediatric ambulatory aids such as infant wheelchairs; the radiologist for X-ray equipment; the urologist for dialysis equipment, incontinence supplies and ostomy appliances specific for urinary diversion; and the general practitioner for all of the above. The general practitioner often must assume the responsibilities of all the aforementioned specialists and a detail could be planned to include any or all of the surgical pharmacist's specialties. Although it is not ethical for the physician to recommend a specific pharmacist for general pharmaceutical services, the situation is quite different if the surgical pharmacist is the only professional in the area offering specialized services. The visiting nursing service is an excellent source for the rental and sale of convalescent aids such as walkers, commodes, wheelchairs and hospital beds. The nurses are particularly amenable if Medicare assignments are accepted by the surgical pharmacist-something which most nonpharmacy surgical outlets resist. A visit to local hospitals to see the administrator, the physical therapist, the inhalation therapist, the purchasing department and the nurse in charge of education also is important. These details are important for outpatient referrals. If hospital supply service is desired, the surgical pharmacist should have the ability to bid on everything
supply requirements are-with a subsequent offering made either at a future detail or by mail.
TABLE J
Literary Sources for the Surgical Pharmacist 1. Blakiston's New Gould Medical Dictionary. Philadelphia-Toronto ; The Blakiston Company, 1294 pages. A modern comprehensive dictionary of the terms used in all branches of medicine and allied sciences, including medical physics and chemistry, dentistry, pharmacy, nursing, veterinary medicine, zoology and botany, as well as medicolegal terms; with illustrations and tables.
2.
Ostomy Quarterly. The United Ostomy Association, Inc., 1111 Wilshire Boulevard, Los Angeles, Calif. 90017.
A quarterly publication for the ostomate and anyone involved with the treatment of the ostomate. The publication also lists manufacturers a nd ostomy associations.
3.
Ostomy R eview. The United Ostomy Association, Inc., 1111 Wilshire Boulevard, Los Angeles, Calif. 90017.
A five-year review of articles previously published in the Ostomy Quarterly.
4. Lowman, Edward, MD, and Klinger, Judith, OTR, Aids To lndependellf Living. McGraw-Hill Book Company, New York, 796 pages. A compendium and reference for the millions of handicapped who are faced with living with a disability. It explains devices used for everyday living ; measurement a nd selection of ambulatory appliances including canes, walkers, crutches and wheelchairs.
5. Boyland, Howard, MD, The Surgical Appliance Handbook, Surgical Appliance Industries, Cincinnati, Ohio, Inc. , 428 pages. A guide to the proper selection and fitting of corrective mechanical appliances.
6.
Wheelchair Prescription, Measuring Tire Patient, Everest & Jennings, Inc., Los Angeles,
Calif., 17 pages. Provides the reader with the basic informatio n needed to evalua te a properly fitted wheelch air.
7. Higbee, Roland K., How To Build the Home Health Care Department, Institutional Industries Inc., Cincinnati, Ohio, 15 pages. A guide to aid the reader entering th e home health care market.
8.
R ental Equipment Rate Guide . The Rental Equipment Register, 2048 Cotner Avenue,
Los Angeles, Calif. 90025. 9.
Camp Technician's Manual.
S.H. Camp, Jackson, Michigan.
A complete fitting guide available to Camp accounts .
10. Sykes, M.K., McNicol, M.W., and Campbell, E.M. R espiratory Failure. Scientific Publications, Oxford & Edinburgh, 373 pages.
Blackwell
A practical monograph which enables the physician to treat respiratory failure; gives the pharmacist an insight into the problems that arise.
11. Patient Aid Digest. Cassak Publications, Inc., 2009 Morris Avenue, Union, N.J. 07083. A bimonthly periodical featuring news in patient aids, legislation of interest to the surgical dealer, new literature.
12.
Urinary Ostomies, A Guidebook for Patiel1fs. The United Ostomy Association, Inc., 1111 Wilshire Boulevard, Los Angeles, Calif. 90017.
Explains what urinary ostomys are, preparation for surgery, postoperative period, care of skin, appliances, etc.
from a relatively inexpensive wheelchair cushion to an expensive whirlpool apparatus. Manufacturers are most willing to aid the pharmacist in his bidding although specific items are not generally inventoried . If the pharmacist is interested in the extended care facility, he might offer a complete package of pharmaceutical needs, convalescent aids, surgical fittings
and possibly a computerized billing arrangement to round out his services. Some pharmacists stress physician supplies while others avoid this because of low mark-up and high inventory. The needs may include injectables, syringes and needles, stethoscopes and other specialized apparatus, and examining table paper. When detailing the physician it may be ascertained what the
Location Close proximity to a hospital or physicians' group practice is beneficial but not essential for the success of a surgical pharmacy. The physical ability to fit a hospitalized patient within minutes of a request is certainly advantageous and having the orthotic inventory nearby also helps minimize problems arising from difficult fittings . However, being capable of satisfying the physician'S request, and having an adequate inventory reserve, has advantages that prevail over a close location . Advertising If the surgical pharmacy is not .in a populated area the pharmacist may be required to promote his services extensively. Although "word of mouth" is the most effective means of advertising, publicizing the pharmacy by means of direct mail or the classified pages may be necessary. The direct mail might include a circular made up of colored 20pound bond paper, folded to give four pages of 8 Y2" X 11 " copy each . This size is considered ideal by many advertisers. The top third of the first page could be limited to the "logo" with room for postage and the address. The postage could be preprinted by using a permit number printed on the copy or the use of a postage meter would be an alternative. Although many pharmacies have their own postage devices, business services in most locales are equipped for bulk mailing. The surgical pharmacist has the professional responsibility to aid the patient in filling out the forms so that the patient might collect directly from Medicare. Pre-addressed envelopes (form comb. 70212) also are available at no charge. It would be advisable to subscribe to Surgical Business which is published by Cassak Publications, 2009 Morris Avenue, Union, New Jersey. Subscribers annually receive the Surgical Trade Buyers Guide which lists manufacturers, manufacturers· representatives, export agents, trade or brand names, hospital and physician supplies, laboratory suplies, oxygen therapy supplies, patient aid products, X-ray supplies, and an orthopedic appliance section. Table I (above) lists other sources important to the surgical trade. Labels should be imprinted for affixing to the surgical appliances. Equipment owned by the pharmacist is placed in the patient's home for an indeterminable period of time and it is imperative that this equipment be identified . • Vol. NS15, No.5, May 1975
253
Richard Yale Miller is a surgical pharmacist who maintains his practice in Wyckoff, New Jersey. He holds degrees from Syracuse University and the Albany College of Pharmacy, Union University. He is on the faculty of Albany College of Pharmacy where he teaches a course ill surgical pharmacy, and also serves on the faculty of Rutgers University college of pharmacy. He writes monthly articles for the New Jersey Journal of Pharmacy and the Alabama Journal of Pharmacy. /111972, Miller was the recipient of the Academy of Pharmaceutical Sciences Kilmer Award. He is president of the Bergen County (New Jersey) Pharmacy Society , and a member of APhA, NARD, ACA, AACP and the New Jersey Pharmaceutical Association.
T
he net profit of community pharmacies has been declining for years. This decrease has been due to a greater operating expense ratio. To maintain a profitable practice in the future, pharmacists will have to re-emphasize the need for greater efficiency. Departments with smaller profits may have to be discontinued in favor of more lucrative departments. Questions · that should be asked are-
Is the cosmetic department operating efficiently and to capacity? Should it be discontinued? Would the pharmacist be making an intelligent decision by giving o-t-c cosmetic aids such as hair sprays, hair coloring products and rollers a greater display area? Is the display area too large considering the return investment on the department? Is the stress on health and cosmetic aids impairing the pharmacy? If this is so, should the accent be on prescriptions and professionally related departments? If the pharmacist desires to discontinue nonpharmacy entities in favor of a more professional image, is he willing to learn about an area foreign to him? If he is, then possibly a surgical department can be the answer to his dilemma.
Advantages of Surgicals There are many advantages to implementing a surgical department in a community pharmacy. One of the most important is that the pharmacist is being reimbursed for a service, not for merchandise. Just as a professional fee should be an essential component in the cost of prescription medication, a fee is added to the cost of fitting surgical garments. This stress on service rather than on merchandise helps to develop a professional aura within the confines of the pharmacy. The surgical pharmacist demands and receives the respect of the patient by his ability to perform professional tasks such as setting up traction apparatus, correctly fitting a brace and giving in7" struction in ostomy care. This same respect is forthcoming from the physician who depends on him to carry out the instructions of patient care when essential post-operational requirements are necessitated. Chain pharmacies have not become important outlets for this essential field due to the technical knowledge necessary to promote surgicals properly ..,.
The competition of nonpharmacy surgical outlets, such as surgical supply and rental stores, may be somewhat of a threat depending on their ability. However, this competition may be overcome by the very nature of its existence. The surgical pharmacist has had five years (or more) of education and is respected by the community and the physician as a leader in his specialty. The rental store proprietor has none of these advantages and has as a primary source of income nonsurgical rentals such as garden tools and household appliances. The surgical pharmacist satisfies a need. The surgeon is qualified to perform a colostomy operation but the colostomate is oftentimes at a loss to properly care for himself when he leaves the hospital. The orthopedic physician diagnoses the back ailment and prescribes a support, but the surgical pharmacist must correctly fit the garment. Any clerk can sell a wheelchair, but only the professional may determine the proper fit and the correct chair for the patient. The physician will prescribe a truss for the inoperable hernia patient, but the reducing of the hernia' and the proper fitting of the truss is the responsibility of the fitter. The patient depends Vol. NS15, No.5, May 1975
251
The Millers' Pharmaceutical Center features a combinatioll of modern equipment and alltiques, such as the carriage seats and desk. The building, originally a combination railroad station and post office, has housed a pharmacy since 1901.
upon the surgical pharmacist for the best appliances that might be used with his condition. In all, a tremendous void is filled by the trained professional who has a desire to help those in need. A successful surgical department will aid other professional departments such as the prescription and first aid supplies departments. The surgical patient is often in need of dressings and usually must take medications such as tranquilizers, muscular relaxants, oral analgesics and anti-inflammatory drugs. Although the patient may have been obtaining prescription medication elsewhere, the knowledge that the surgical pharmacist can fulfill his everyday health needs is often sufficient knowledge to have him come to the surgical pharmacy. Return of investment on rented appliances usually can be made within four to six months. After that time the rental is considered profit (less operating expense and repairs).
Surgicals as a Contemporary Element in Pharmacy Young pharmacists generally are disenchanted with their role of merchant. They desire a change but do not know how to make the adjustment. The purpose of this article is to offer the pharmacist an alternate way to practice and to familiarize him with the essential criteria necessary for the successful operation of a surgical pharmacy. A surgical pharmacy is a pharmacy grossing a minimum of 40 percent of sales in surgical fittings and appliances. A typical surgical pharmacy would have the following ratio-40 percent prescriptions, 40 percent surgicals, and 20 percent health-related o-t-c items such as first aid supplies, analgesics, 252
antacids, and other related products. A pharmacy displaying cosmetics (except hypoallergenic aids), confections , gifts, greeting cards and other nonprofessional products would not be considered a surgical pharmacy no matter how small each display. An exception, however, would be a surgical department physically separated from the general merchandise. Before penetrating into the scope of surgical pharmacy, it is imperative that the pharmacist determine his true inclinations and that the desire to learn is in evidence. The physician will be relying on the professional abilities of the surgical pharmacist, and the pharmacist must rally to that dependence. Five days of instruction at an accredited orthotic school may fortify the pharmacist for that first fitting, but it takes more than a week of instruction to become an experienced fitter. The pharmacist must direct himself to a policy of attendance at surgical seminars during his professional existence to assure the knowledge of new procedures, new products and the restoring of material already known. This, in combination with everyday practical experiences, will eventually give competence and assurance. Medical Detailing Physicians and other professional personnel must be informed of the services that a surgical pharmacist can provide. Although a telephone detail may be sufficient at times, a planned visit with a physician is more effective. The orthopedic physician would be the most important person to detail. His specialty concerns itself with the corrective treatment of deformities, ailments and diseases of locomotor movement.
Journal of the AMERICAN PHARMACEUTICAL ASSOCIATION
The visit should. include such supports as lumbosacral garments, dorso-Iumbar garments, sacroiliac supports, cervical collars and braces, orthotic braces, traction apparatus, convalescent aids such as wheelchairs, walkers, and specific types of crutches and canes. . The surgeon would be attentive to details concerning surgical stockings, prosthetic devices such as artificial breasts, trusses for the inoperable, surgical binders and ostomy appliances. The internist would be interested in information on inhalation therapy and oxygen service, surgical stockings, cervical collars and supports utilized for ptosis (dropped) conditions. The allergist would require information concerning air purifiers, humidifiers, dehumidifiers, inhalation therapy and oxygen service and allergy testing kits. The osteopath would be receptive to the same detail as the orthopedic physician and the internist. The dermatologist would be detailed on ultraviolet lamps and allergy testing kits. Other important details would be to the cardiologist for inhalation therapy and ambulatory aids such as wheelchairs and walkers; the obstetrician for maternity supports and surgical stockings; the ophthalmologist for ocular prosthetic devices (artificial eyes); the otologist for hearing devices; the pediatrician for most of the above and also child supports and pediatric ambulatory aids such as infant wheelchairs; the radiologist for X-ray equipment; the urologist for dialysis equipment, incontinence supplies and ostomy appliances specific for urinary diversion; and the general practitioner for all of the above. The general practitioner often must assume the responsibilities of all the aforementioned specialists and a detail could be planned to include any or all of the surgical pharmacist's specialties. Although it is not ethical for the physician to recommend a specific pharmacist for general pharmaceutical services, the situation is quite different if the surgical pharmacist is the only professional in the area offering specialized services. The visiting nursing service is an excellent source for the rental and sale of convalescent aids such as walkers, commodes, wheelchairs and hospital beds. The nurses are particularly amenable if Medicare assignments are accepted by the surgical pharmacist-something which most nonpharmacy surgical outlets resist. A visit to local hospitals to see the administrator, the physical therapist, the inhalation therapist, the purchasing department and the nurse in charge of education also is important. These details are important for outpatient referrals. If hospital supply service is desired, the surgical pharmacist should have the ability to bid on everything
supply requirements are-with a subsequent offering made either at a future detail or by mail.
TABLE J
Literary Sources for the Surgical Pharmacist 1. Blakiston's New Gould Medical Dictionary. Philadelphia-Toronto ; The Blakiston Company, 1294 pages. A modern comprehensive dictionary of the terms used in all branches of medicine and allied sciences, including medical physics and chemistry, dentistry, pharmacy, nursing, veterinary medicine, zoology and botany, as well as medicolegal terms; with illustrations and tables.
2.
Ostomy Quarterly. The United Ostomy Association, Inc., 1111 Wilshire Boulevard, Los Angeles, Calif. 90017.
A quarterly publication for the ostomate and anyone involved with the treatment of the ostomate. The publication also lists manufacturers a nd ostomy associations.
3.
Ostomy R eview. The United Ostomy Association, Inc., 1111 Wilshire Boulevard, Los Angeles, Calif. 90017.
A five-year review of articles previously published in the Ostomy Quarterly.
4. Lowman, Edward, MD, and Klinger, Judith, OTR, Aids To lndependellf Living. McGraw-Hill Book Company, New York, 796 pages. A compendium and reference for the millions of handicapped who are faced with living with a disability. It explains devices used for everyday living ; measurement a nd selection of ambulatory appliances including canes, walkers, crutches and wheelchairs.
5. Boyland, Howard, MD, The Surgical Appliance Handbook, Surgical Appliance Industries, Cincinnati, Ohio, Inc. , 428 pages. A guide to the proper selection and fitting of corrective mechanical appliances.
6.
Wheelchair Prescription, Measuring Tire Patient, Everest & Jennings, Inc., Los Angeles,
Calif., 17 pages. Provides the reader with the basic informatio n needed to evalua te a properly fitted wheelch air.
7. Higbee, Roland K., How To Build the Home Health Care Department, Institutional Industries Inc., Cincinnati, Ohio, 15 pages. A guide to aid the reader entering th e home health care market.
8.
R ental Equipment Rate Guide . The Rental Equipment Register, 2048 Cotner Avenue,
Los Angeles, Calif. 90025. 9.
Camp Technician's Manual.
S.H. Camp, Jackson, Michigan.
A complete fitting guide available to Camp accounts .
10. Sykes, M.K., McNicol, M.W., and Campbell, E.M. R espiratory Failure. Scientific Publications, Oxford & Edinburgh, 373 pages.
Blackwell
A practical monograph which enables the physician to treat respiratory failure; gives the pharmacist an insight into the problems that arise.
11. Patient Aid Digest. Cassak Publications, Inc., 2009 Morris Avenue, Union, N.J. 07083. A bimonthly periodical featuring news in patient aids, legislation of interest to the surgical dealer, new literature.
12.
Urinary Ostomies, A Guidebook for Patiel1fs. The United Ostomy Association, Inc., 1111 Wilshire Boulevard, Los Angeles, Calif. 90017.
Explains what urinary ostomys are, preparation for surgery, postoperative period, care of skin, appliances, etc.
from a relatively inexpensive wheelchair cushion to an expensive whirlpool apparatus. Manufacturers are most willing to aid the pharmacist in his bidding although specific items are not generally inventoried . If the pharmacist is interested in the extended care facility, he might offer a complete package of pharmaceutical needs, convalescent aids, surgical fittings
and possibly a computerized billing arrangement to round out his services. Some pharmacists stress physician supplies while others avoid this because of low mark-up and high inventory. The needs may include injectables, syringes and needles, stethoscopes and other specialized apparatus, and examining table paper. When detailing the physician it may be ascertained what the
Location Close proximity to a hospital or physicians' group practice is beneficial but not essential for the success of a surgical pharmacy. The physical ability to fit a hospitalized patient within minutes of a request is certainly advantageous and having the orthotic inventory nearby also helps minimize problems arising from difficult fittings . However, being capable of satisfying the physician'S request, and having an adequate inventory reserve, has advantages that prevail over a close location . Advertising If the surgical pharmacy is not .in a populated area the pharmacist may be required to promote his services extensively. Although "word of mouth" is the most effective means of advertising, publicizing the pharmacy by means of direct mail or the classified pages may be necessary. The direct mail might include a circular made up of colored 20pound bond paper, folded to give four pages of 8 Y2" X 11 " copy each . This size is considered ideal by many advertisers. The top third of the first page could be limited to the "logo" with room for postage and the address. The postage could be preprinted by using a permit number printed on the copy or the use of a postage meter would be an alternative. Although many pharmacies have their own postage devices, business services in most locales are equipped for bulk mailing. The surgical pharmacist has the professional responsibility to aid the patient in filling out the forms so that the patient might collect directly from Medicare. Pre-addressed envelopes (form comb. 70212) also are available at no charge. It would be advisable to subscribe to Surgical Business which is published by Cassak Publications, 2009 Morris Avenue, Union, New Jersey. Subscribers annually receive the Surgical Trade Buyers Guide which lists manufacturers, manufacturers· representatives, export agents, trade or brand names, hospital and physician supplies, laboratory suplies, oxygen therapy supplies, patient aid products, X-ray supplies, and an orthopedic appliance section. Table I (above) lists other sources important to the surgical trade. Labels should be imprinted for affixing to the surgical appliances. Equipment owned by the pharmacist is placed in the patient's home for an indeterminable period of time and it is imperative that this equipment be identified . • Vol. NS15, No.5, May 1975
253
