The Legal Drug Dealer Podcast

Getting Pharmacy as a profession Closer to The Patient

January 10, 2020

Retail Independent Pharmacies and Hospital Pharmacy

Marilena Grittani, RPh

As a former Retail Independent Pharmacist, I have a specific view of them, I SIMPLY LOVE THEM!!!!

But I will also include general information about them, that is objective.

Hospital pharmacy has also been my passion for years, and I admire and respect all my mentors and colleagues. It is an intense but exciting job, I bet you didn’t know we do all that!

Some of the most relevant points I made are:

  • Independent retail pharmacies are small local businesses 
  • They are focused on the community’s health, simply because the owners are part of that community.
  • Independent pharmacies have more space and time for the patient to interact with the pharmacy staff
  • These pharmacies typically have space for consultations with their patients and for other activities like vaccinations and Medication Therapy Management 
  • The time these pharmacies dedicate to their patients in 3-4 times longer than what big chain does. They simply have fewer patients…

"The environment that we have there (independent pharmacy) is more inviting for conversation, for counseling for recommendations and for a relationship with the patient"

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"Every single medication every single drug, every single recommendation that comes to the patient, specifically from the pharmacy department is made by a pharmacist that works on this"

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Episode Transcripts

Marilena Grittani, RPh 0:07  

Welcome to another episode of the legal drug dealer podcast. Today’s episode number four is about retail pharmacies, specifically about independent pharmacies. In the last episode, we talked about chain pharmacies, retail pharmacists that are considered a chain which means that there are lots and lots and lots of them, most of the time around the country. Independent pharmacies are basically owned by a small group of pharmacists or even just one pharmacist, and they might have just one location or several. I have worked in a few of them. And that is specifically my happy place. I love my independent pharmacies. They have so many reasons to be much better than chain pharmacist, and I know the difference is Better not just for us as pharmacists or employees of the company or the pharmacy, but also for the patient. What I mean by that is that the ambiance is more relaxed. The number of patients are normally less, the demands from the owners are not as excessive, and the help that we normally have is more appropriate than a chain pharmacy. 


What I mean with help is the technicians and the clerks that we normally have in comparison with what we will have in a chain pharmacy. Don’t ask me why, but that’s how it works. 


Also, the type of environment that we have there is more inviting for conversation, for counseling for recommendations, and for a relationship with the patient. We normally Have a little area where we can sit and talk. We can get vaccinations in a private room. We can have consultations for MTM, or medication therapy management, which we’ll be talking about soon. You are going to love that episode, by the way. If you are a Medicare Part D patient, you are going to love Episode Number 11 with Miss colleague and lovely comadre of mine. Swapna Chakrabarti it is about medication therapy management. I don’t want to talk that much about it right now because it doesn’t make any sense. But we do have space in these retail pharmacies that are independent for all these activities. Also, the relationship with the patient and the pharmacy employees is completely different. It’s more relaxed, they understand that we’re more part of the community where local businesses that we the owners belong to The local business groups, they are in the chamber of commerce if their business owners themselves, they have been together in different meetings, and the support for the local and the Small Business mentality makes it up to the different. 


Now, this type of pharmacies work exactly the same as the other retails. What I mean is that they get prescriptions from either yourself that you bought them into the pharmacy via fax via voicemail via phone calls, or via electronic which is, which is called e-prescriptions, which is what we talked about in the previous episode, episode number three. I’m not going to go into too many details about the process because we already talked about it on it and I invite you to go to thelegaldrugdealer.com/3, which is the previous episode, and you will have more details there indicates that you haven’t listened to that. So we receive all these prescriptions the same way And then we have technicians that that process them. We have the insurance going through them. And then we have the pharmacist that checks them, and we dispense them as well. So the focus on community pharmacies or retail pharmacies that are independent is more towards the community is more towards helping the patient in so many aspects. Most likely they have expert pharmacists that are there to provide a type of service that none of the chain pharmacies provide. Some of them do compound and some of them do. And MTM as I said some of them do wellness checkup, they can take your cholesterol, your blood sugar, they can check your blood pressure, they can help you with weight loss, they can help you with tobacco cessation, they can help you with getting shoes specifically for people that are diabetic or have issues with their legs to fit them. They can also help you with a bunch of little cute little presents and stuff that they have at these pharmaicsts because it is a community place where the community comes over and be part of the community with your pharmacist. Normally the relationship with the pharmacist in this type of community pharmacist is much better with any of the patients; they have more time, more relaxed, as I said. And the best part of all is that we see each other at the grocery store in the parking lot at the children’s school, everywhere! Because we belong to the same community. That is why it is so much better in my perception to work in a retail pharmacy that is independently owned versus a chain. 


When we talk on episode 15 with Marian Hayes studies, a pharmacy technician that we talk about technicians and insurance some prior authorization. I met her in an Independent that has like nine pharmacies and the name is Good Day Pharmacy Hello Vicki, in northern Colorado and everybody else that works and that awesome company. I love you, I miss you all. That’s where I made Marian, and we had a great time there. It was an excellent environment. We love working together, and I met wonderful pharmacists and technicians there and their relationship with the community that this company established it was tremendous. It was awesome. We had somebody that was an expert on on on hormone replacement, we had somebody that would come and talk about breast cancer. They even had a meeting area where people come to get classes or teachings about all this information that the community needed. It was so focused and oriented towards the patient. That’s why I love this type of pharmacist so much. It’s not 100% towards the business, of course, their businesses, and they need to make money because That’s the reason why they exist. But they are not 100% focused on profit, they’re hundred percent focused on the patient and their well being and the health of the patient. And of course, they get their money, but it’s not just that. So that’s why I love to work for them. And if this is the type of pharmacy that you would like to have, and this is the type of treatment that you will like to get with the complication of that, they normally don’t work Sundays. They normally don’t work until 9pm. They are not all over the country. They’re normally in the community, and it’s a little bit harder when you travel and when you need a medication somewhere else. It doesn’t have the capability that the big corporations do. But if you like all the goods that I described community independent pharmacists, I will absolutely recommend that you go to this pharmacist, support local business support local entrepreneurs support your pharmacy that will support you at the same time. It will be a very good relationship, and I guarantee that they will take care of your health more than take care of the owners’ pockets. 


So this is what I wanted to talk about retail pharmacies, specifically the independent, and that is all for today. 


But I also wanted to take the opportunity to talk a little bit about hospital pharmacy because this is quite a short episode, and I didn’t want to forget to mention that. That is another type of pharmacy that we practice and is the pharmacist that are working in a hospital facility for the patients that are in the hospital, whether it is at the ER or if they are on the floors if they had a baby if they had an accident if they had surgery, all those kind of patients are the ones that pharmacists take care of. So every single medication, every single drug, every single recommendation that comes to the patient, specifically from the pharmacy department, is made by a pharmacist that works on this. We do have a distribution of medication within a hospital, but it’s different, a little bit different than what happens in retail pharmacies. 


What it is, is that we have what my daughter would call vending machines for drugs that are machines filled with medications that you normally will use on the floor in the with the patient. Then the doctors write prescriptions, put them on the computer, the pharmacists review them on the computer, everything happens online. we approve the medications that will be dispensed through this equipment or, as I said, My daughter, called them vending machines for drugs. This is a piece of very high technology equipment that has every single patient with every single drug that they take. And the times that they take and specifically with the strength that they take it, and then the nurses just have to go there and look for the patient, specifically that they’re training for. And the machine will give them exactly what they need and the strength and the quantity that they needed the time that they need them, and then they can dispense it to the patient one dose of the time. 


Also, we handle what is called IV medications, which are the medications that got intravenously, which is the drugs that we get directly to in blood, because the patient either can’t swallow or because we need to dispense them really quick or because they’re fluid or type of medications that are needed directly to the blood. Patients are unconscious patients, are in surgery, we make all that. We actually have a very high tech area in the pharmacy that has all the requirements (very much regulated by the law and by the State Board of Pharmacy) that tells us how to clean what to do, how to do dress, it has so many details that we follow to make sure that everything that we make this not only exactly what you need but it’s also at the cleanest and a septic technique that we can for you. We also make chemotherapy or cancer medications. We also do that for patients that are either outpatient that they come on for the infusion to get treated for the cancer treatment or patients that are in the floor that they’re admitted in the hospital, and they need their treatments there, or that is also made by the pharmacy department. We have specific pharmacists that are oncology trained and technicians that are experts on making this type of medication that is specifically for this type of patient. We also have NICU or intensive care units for neonatal. Hence, babies that are newly born, and we have pharmacists and technicians that are trained specifically on how to treat those, dispense, Mix and deliver this types of drugs for these babies that are such delicate human beings that are so tiny and so fragile. We also have what is called TPNs, which is Total Parental Nutrition. That means that for people that are not able to eat to swallow because of surgery because they’re unconscious, or for whatever reason, we have to give them enough nutrition, so they continue to thrive. So we mix that in the pharmacy as well. pharmacists are trained on how to mix this specific amount of carbohydrate, that specific amount of protein a specific amount of fat that the patients need, plus all the electrolytes and other minerals and trace elements that they might need for their


well being. And we do that not only for adults that might be you know after surgery or they have an intestinal problem or they simply have a blockage, and they cannot consume anything, but we also Do it for babies. Tiny, teeny babies that are born so tiny that they cannot eat that they’re in incubators, and they spent weeks there that they don’t have any other way to eat. We make them for them as well. I remember doing that for years, and that was a very stressful job just thinking about the tiny baby. And using all those stuff that I was mixing for that tiny baby that could technically take the baby’s life at any second if I made the tiniest mistake. It was quite stressful. So when we’re talking about hospital pharmacy, we talk about a wide variety of jobs that are specific for pharmacists in that setting. We do all kinds of medications, all kinds of specific stuff for every single type of patient. And of course, we do it while we also support our nurses because they depend on us 100% for every single drug that they need. While we Support our patients because they have questions, and they need to be educated, and they need to be counsel as well. And of course, our physicians because, as I said in the second episode, they’re not drug experts. We are. If you go back to thelegaldrugdealer.com/2, you will listen there that pharmacies have a lot of education specifically towards drugs. That is for over four years, specifically, well, doctors and physicians, specifically only have two semesters of this education. So when they have a diagnosis when they already found out what’s wrong with the patient, and they know what the problem is, they call the pharmacy, and they say, hey, what is the best option medication wise that I have for this person? This is what I need. This is what I would look for. This is what the conditions are. This is the patient go study what the patient blood tests are on what the circumstances are on what other medications the patient is taken, and tell me what you would recommend, that I will use to dissertation for the best results. That’s what we do on a daily basis in a hospital. I bet you didn’t know that. Now you do. 


So we pharmacists have a lot of different jobs that are not known by the community. And that is exactly the reason why I created this podcast. I just wanted to inform, educate you and giving you an idea of all that we do, as I said before, behind the scenes for the best health care that we can provide for you. So when I say #pharmacistsareawesome! I mean it. We are, we take care of every single patient that is in the hospital because, guess what? every single one of them needs some kind of medication, either pain, sleeping pills, the tummy aches, everything comes from us the pharmacy. So we are in touch with every single patient that is in the hospital. So whenever you are in hospital, and you’re taking your drugs, now you know all that is behind this for that drug to make it towards you so they will help you get better and you can be out of the hospital as soon as possible then go home and continue with your life. 


I hope that this information was educational that is useful for you, and you will have another standpoint in relation to what pharmacists do. Please don’t forget to subscribe to the podcast, give us a review. And if you have a question, please send them to comment@thelegaldrugdeale.com, and I will personally answer them for you. Also, you can go to our webpage, the legal drug dealer calm, and then look around. We have a lot of stuff there. We have information, and of course, we have the show notes for this show, which are specifically at thelegaldrugleader.com/ 4 . There you will see all the information the transcripts of what we talked about today. Of course, the link to download the freebie or the document that I put together for you that has the five tips for non-prescription medications that are built for you is a very cute document that has a lot of information in just one page. And I know you will appreciate everything that is written there.


Don’t forget to follow us on Instagram @thelegaldrugdealer or join our community Facebook group that is the legal drug dealer, podcast community, and don’t forget to join our mailing list. So you will have an email every week telling you that a new episode has dropped every Tuesday, and you will have included in that email, the information that I will prepare for each episode like in this opportunity is the five tips for non-prescription drugs. 


I wanted you to know that the next episode is going to be a recap of what we talked this past 4Episode and something funny that I wanted to say about everything that we talk because this has been a hefty past four episodes and I promise these will be the only four, but I wanted to establish this information since the beginning because I think you guys are going to be seeing pharmacy as a profession much differently now after you know all this that I bet you didn’t. If you have any comments, send them to me at comments@thelegaldrugdealer.com. I’m looking forward to hearing what you think about everything that we talk about. And I know that you will be curious about certain stuff that I mentioned that I didn’t go in-depth, so if you have any questions, please send them to the same email comments@the legaldrugdealer.com The following episode is going to be about compounding. I’m going to have the first interview for this podcast with one of my friends and ex-coworker Angela solace. You cannot miss that one. It’s gonna be awesome. Starting on that episode, I’m going to start having interviews on each episode with a pharmacist or a healthcare provider that is going to come and talk to us about the specific areas that this person is an expert on. And then I will just have a solo episode once a month, just to talk about stuff or to answer your questions. Please don’t forget to send the questions to me to comment@ thelegaldrugdealer.com I think that I mentioned that probably seven and a half times, but I just don’t want you to forget. So that’s it. I’ve talked enough today. You know that I love to talk, so I need to cut myself because oh my gosh, I will do way too much. 


But before I go, and just in case no one has done it yet. I wanted to take a minute to remind you of how awesome you are. And how lucky are those that have you in their lives. Thank you for being THE awesome you that you are. 


Have a wonderful rest of your day. This is Marilena Grittani, The Legal Drug dealer. Bye for now.

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