Turning Tragedy into Opportunity When the Nichols) community pharmacy practice was destroyed by Hurricane Andrew) he decided to create an office-based practice. by Allen Nichol
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e weekend of small hallway where we laid our mattress down and August 22, 1992, the weekend Hurricane turned on a battery-operated Andrew hit Florida, I had television. We watched news been spending a few relaxing reports until the wind days in Ohio for a family stopped and we were able to reunion. My wife Debby, also fall asleep. a pharmacist, had encourAt 10:30 am , we were aged me to go, assuring me awakened by a neighbor at that she could take care of the front door. When we opened the door, we were in our pharmacy in Coral disbelief. Our neighborhood Gables, Fla. I had heard news reports had crumbled as if it were that a hurricane was headed made of Tinkertoys . Trees toward the Miami area, but I were scattered everywhere, barely paid attention. Late blocking our driveway and summer in Florida is notoristreet. Power lines draped ous for hurricanes, most of After their community pharmacy was destroyed by over houses like snakes. Bits which sweep through quick- Hurricane Andrew, Allen and Debby Nichol launched an of glass from blown out winly and cause little damage. office-based practice. dows, aluminum siding, and But when my wife called that roof shingles littered the neighborhood. I was happy Saturday, frantically explainto see that the damage to our house was minimal. My next ing the potential force of the hurricane, I realized that this thought was of the pharmacy, and we decided to face the was no typical summer storm. I caught the first flight home. As soon as I arrived, I went directly to South Park Pharmareality of what might have happened. cy where my wife, my intern, and I fmished the last-minute When we arrived at our pharmacy, we were astounded to hurricane preparations-taking out the computer system, see that the metal roll-down shutters that covered the front boxing up the prescription records for storage at a neighwindows had been completely tom off. Eight windows had bor's house, boarding up windows, moving merchandise been blown out and the roof was missing in two sections. away from the windows, and rolling down the metal shutAt first glance, we figured we could board up , replace the glass, put on a temporary roof and be back in operation withters. We then went home to make similar preparations. Knowing we had done all that we could, we went to sleep. in a week. Unfortunately, things did not go that smoothly. It At 3:30 am, I was in bed listening to the wind howl when was impossible to fmd boards for the windows because they the electricity went off. I woke Debby and moved us to a were in such short supply. Glass could not be put in for
AMERICANPHARMACY
November 1992/910
Vol. NS32, No. 11
10-14 days. It was unclear when we could get materials to repair the roof. Two days later, my worst nightmare came true. A rainstorm lasting several hours pummeled the already damaged roof, causing the pharmacy's ceiling to cave in. The destruction was extensive. Everything was completely drenched and covered with ceiling tiles-merchandise, ftxtures, carpeting. It became evident that the pharmacy that we had remodeled last year was gone for good. We were emotionally drained. I was especially drained since this was not the first time I had lost a pharmacy to destruction -a Miami pharmacy I had owned in 1980 had been frre-bombed and looted during the Miami riots. At that point, we made up our minds: we weren't going to be beaten. We were going to rebuild our practice and use the destnlction as an opportunity to convert our pharmacy into a new kind of practice. We decided to tum our retail practice into an office-based practice. The first step was to call a retired physician we knew to ask if his previous office was still unrented. It was. Located in a medical village that housed 16 medical offices, Debby and I thought the location was perfect and started remodeling immediately. We identified a place for an IV room and converted an old chemistry lab into our compounding center. We designated two rooms for patient counseling, one for the dispensary, one for the office manager, and one for the reception area. Debby and I each claimed an office. Our next task was contacting the major dnlg companies to replace the merchandise that we lost that was not paid for by our insurance. Several companies came forward with disaster relief kits that gave us replacement merchandise. Our biggest problem was not having a telephone; all the lines would be down for several weeks. But, we put a sign on the door of our old location with a map describing how to fllld us. We hired a public relations frrm to get the word out to our patients and used the patient list we had secured before the hurricane hit. Patients were sent maps and pictures of the new location of South Park Pharmacy and a description of the services we were going to provide. Three weeks after the hurricane hit, we were in business.
Our Nevv Practice In our new office-based practice, when the patient walks in, he or she is greeted by a pharmacist -either Debby or me. The patient hands the prescription order to the pharmacist, who passes it either to our pharmacy technician or intern in the dispensary. The patient is then taken to one of the private, patient-consultation rooms, which are equipped with comfortable chairs and a table. While the medication is being prepared, the pharmacist reviews the prescription order and checks the patient's profue to see if there are compliance problems or any other factors that must be discussed. When the medication is ready, Vol. NS32, No. 11 November 1992/ 911
the pharmacist takes it to the patient and discusses all aspects of pharmacy care including any other medications the patient might be taking. If appropriate, the pharmacist also asks if the patient needs any over-the-counter (OTC) medications, vitamins, or related items. If the patient is interested, the pharmacist takes the patient to the OTC and vitamin counseling room where all OTC medications are on display. Together they choose the best therapy. Afterwards, the pharmacist walks the patient to the office manager's room, where the patient pays for the goods and services. So far, we do not charge our patients for cognitive services, but we are looking into it and plan to experiment with charging in the near future. The other important aspects of our practice are the IV center and the compounding center. We see compounding, in particular, as an area that is continuing to grow. As more and more physicians write special prescription orders, they recognize that pharmacists like us can provide compounding services. Soon, we also plan to offer hypertension and diabetic screening. We believe that by providing such services, we can be role models for the future practice of pharmacy. In the frrst few days of reopening South Park Pharmacy we were dispensing 20 to 30 prescription orders, which is about 40% of what we did in our old business. At this point, we think that the drop in patients is because people haven't fotmd us yet, so we're optimistic that our business will continue to grow. Our public relations firm is also marketing our services to neighboring phYSicians, promoting that we practice pharmacy the way pharmacy should be practiced: offering patient care, consultation, individuaUzed dosage forms, high-technology pharmacy practice- alltmder one roof.
Looking to the Future We were the only pharmacy in Coral Gables that was knocked out by Hurricane Andrew, which makes me think that this happened to us for a reason. Perhaps it was divine intervention. But whatever the reason, we realize that good can come out from bad, opportunity from destruction. The hurricane has indeed led us to an unexpected opportunity: a new "pharmaceutical care" practice. We're not sure that everything we do is correct since much of what we do is trial and error, but when you are pioneering, you don't have much of a choice. So far, we've been able to handle whatever has been thrown our way. It's been tough, but it's also been quite fulftlling. Allen Nichol coowns South Park Pharmacy, Coral Gables, Fla., with his Wife Debby. You can contact them by writing to 1544 Venera Avenue, Coral Gables, FI33146.
AMERICAN PHARMACY
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e weekend of small hallway where we laid our mattress down and August 22, 1992, the weekend Hurricane turned on a battery-operated Andrew hit Florida, I had television. We watched news been spending a few relaxing reports until the wind days in Ohio for a family stopped and we were able to reunion. My wife Debby, also fall asleep. a pharmacist, had encourAt 10:30 am , we were aged me to go, assuring me awakened by a neighbor at that she could take care of the front door. When we opened the door, we were in our pharmacy in Coral disbelief. Our neighborhood Gables, Fla. I had heard news reports had crumbled as if it were that a hurricane was headed made of Tinkertoys . Trees toward the Miami area, but I were scattered everywhere, barely paid attention. Late blocking our driveway and summer in Florida is notoristreet. Power lines draped ous for hurricanes, most of After their community pharmacy was destroyed by over houses like snakes. Bits which sweep through quick- Hurricane Andrew, Allen and Debby Nichol launched an of glass from blown out winly and cause little damage. office-based practice. dows, aluminum siding, and But when my wife called that roof shingles littered the neighborhood. I was happy Saturday, frantically explainto see that the damage to our house was minimal. My next ing the potential force of the hurricane, I realized that this thought was of the pharmacy, and we decided to face the was no typical summer storm. I caught the first flight home. As soon as I arrived, I went directly to South Park Pharmareality of what might have happened. cy where my wife, my intern, and I fmished the last-minute When we arrived at our pharmacy, we were astounded to hurricane preparations-taking out the computer system, see that the metal roll-down shutters that covered the front boxing up the prescription records for storage at a neighwindows had been completely tom off. Eight windows had bor's house, boarding up windows, moving merchandise been blown out and the roof was missing in two sections. away from the windows, and rolling down the metal shutAt first glance, we figured we could board up , replace the glass, put on a temporary roof and be back in operation withters. We then went home to make similar preparations. Knowing we had done all that we could, we went to sleep. in a week. Unfortunately, things did not go that smoothly. It At 3:30 am, I was in bed listening to the wind howl when was impossible to fmd boards for the windows because they the electricity went off. I woke Debby and moved us to a were in such short supply. Glass could not be put in for
AMERICANPHARMACY
November 1992/910
Vol. NS32, No. 11
10-14 days. It was unclear when we could get materials to repair the roof. Two days later, my worst nightmare came true. A rainstorm lasting several hours pummeled the already damaged roof, causing the pharmacy's ceiling to cave in. The destruction was extensive. Everything was completely drenched and covered with ceiling tiles-merchandise, ftxtures, carpeting. It became evident that the pharmacy that we had remodeled last year was gone for good. We were emotionally drained. I was especially drained since this was not the first time I had lost a pharmacy to destruction -a Miami pharmacy I had owned in 1980 had been frre-bombed and looted during the Miami riots. At that point, we made up our minds: we weren't going to be beaten. We were going to rebuild our practice and use the destnlction as an opportunity to convert our pharmacy into a new kind of practice. We decided to tum our retail practice into an office-based practice. The first step was to call a retired physician we knew to ask if his previous office was still unrented. It was. Located in a medical village that housed 16 medical offices, Debby and I thought the location was perfect and started remodeling immediately. We identified a place for an IV room and converted an old chemistry lab into our compounding center. We designated two rooms for patient counseling, one for the dispensary, one for the office manager, and one for the reception area. Debby and I each claimed an office. Our next task was contacting the major dnlg companies to replace the merchandise that we lost that was not paid for by our insurance. Several companies came forward with disaster relief kits that gave us replacement merchandise. Our biggest problem was not having a telephone; all the lines would be down for several weeks. But, we put a sign on the door of our old location with a map describing how to fllld us. We hired a public relations frrm to get the word out to our patients and used the patient list we had secured before the hurricane hit. Patients were sent maps and pictures of the new location of South Park Pharmacy and a description of the services we were going to provide. Three weeks after the hurricane hit, we were in business.
Our Nevv Practice In our new office-based practice, when the patient walks in, he or she is greeted by a pharmacist -either Debby or me. The patient hands the prescription order to the pharmacist, who passes it either to our pharmacy technician or intern in the dispensary. The patient is then taken to one of the private, patient-consultation rooms, which are equipped with comfortable chairs and a table. While the medication is being prepared, the pharmacist reviews the prescription order and checks the patient's profue to see if there are compliance problems or any other factors that must be discussed. When the medication is ready, Vol. NS32, No. 11 November 1992/ 911
the pharmacist takes it to the patient and discusses all aspects of pharmacy care including any other medications the patient might be taking. If appropriate, the pharmacist also asks if the patient needs any over-the-counter (OTC) medications, vitamins, or related items. If the patient is interested, the pharmacist takes the patient to the OTC and vitamin counseling room where all OTC medications are on display. Together they choose the best therapy. Afterwards, the pharmacist walks the patient to the office manager's room, where the patient pays for the goods and services. So far, we do not charge our patients for cognitive services, but we are looking into it and plan to experiment with charging in the near future. The other important aspects of our practice are the IV center and the compounding center. We see compounding, in particular, as an area that is continuing to grow. As more and more physicians write special prescription orders, they recognize that pharmacists like us can provide compounding services. Soon, we also plan to offer hypertension and diabetic screening. We believe that by providing such services, we can be role models for the future practice of pharmacy. In the frrst few days of reopening South Park Pharmacy we were dispensing 20 to 30 prescription orders, which is about 40% of what we did in our old business. At this point, we think that the drop in patients is because people haven't fotmd us yet, so we're optimistic that our business will continue to grow. Our public relations firm is also marketing our services to neighboring phYSicians, promoting that we practice pharmacy the way pharmacy should be practiced: offering patient care, consultation, individuaUzed dosage forms, high-technology pharmacy practice- alltmder one roof.
Looking to the Future We were the only pharmacy in Coral Gables that was knocked out by Hurricane Andrew, which makes me think that this happened to us for a reason. Perhaps it was divine intervention. But whatever the reason, we realize that good can come out from bad, opportunity from destruction. The hurricane has indeed led us to an unexpected opportunity: a new "pharmaceutical care" practice. We're not sure that everything we do is correct since much of what we do is trial and error, but when you are pioneering, you don't have much of a choice. So far, we've been able to handle whatever has been thrown our way. It's been tough, but it's also been quite fulftlling. Allen Nichol coowns South Park Pharmacy, Coral Gables, Fla., with his Wife Debby. You can contact them by writing to 1544 Venera Avenue, Coral Gables, FI33146.
AMERICAN PHARMACY
