September 16, 2025 • 25 mins
Pharmacist Career Insights
Have you ever wondered why your neighborhood pharmacy close down while chain stores keep multiplying? The answer lies in a healthcare system that is broken to its core.
Dr. Neal Smoller - an entrepreneur, a holistic pharmacist and owner of Village Apothecary in Woodstock, NY, pulls back the curtain on the job of a pharmacist and the pharmacy industry’s hidden economics.
With refreshing candor, he explains how Pharmacy Benefit Managers (PBMs) – often owned by the very chains they’re meant to regulate – have rigged the system so that independent pharmacies lose money on nearly one in five prescriptions. And yet, despite these odds, independents continue to outshine the chains in patient care and commitment to their communities, staying alive through grit and creativity.
Whether you're exploring new career opportunities in healthcare or simply looking for a job advice, this episode delivers essential career insights and tips that you won’t hear anywhere else.
Pharmacy website https://villageapothecaryrx.com/
Dr. Neal Smoller website: https://drnealsmoller.com/
Woodstock vitamins: https://woodstockvitamins.com/?srsltid=AfmBOop5OAuCTUjTNgfibxtPi9s1Sj5buMlKac_gD8laTp8l_hT-dBps
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Music credit: Kate Pierson & Monica Nation
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:04):
The top 10 medications hasn't really
changed much, except for a lotof the opioids are no longer in
that list because the opioidswere a big part of the top 10
lists for a while, so it'smostly cholesterol and blood
pressure medication.
There has been a really greattrend with these like miracle
drugs, these GLP ones, theweight drugs, but they're very
expensive and difficult to getfor people.
Speaker 2 (00:28):
Welcome back to how Much Can I Make a podcast about
jobs and earnings?
I'm your host, miravo Zeri.
Today we are joined by Dr NeilSmoller, holistic pharmacist,
supplement strategist and theowner of Village Apothecary in
the iconic town of Woodstock,new York.
With 20 years of experience,neil knows the pharmacy world
(00:49):
inside and out.
His passion has always been todeliver great care to patients
and the community, but, asyou'll hear, there are plenty of
challenges that come withrunning an independent pharmacy.
So let's dive right in anduncover the realities of being a
pharmacist and a business owner.
(01:10):
First of all, thank you verymuch for doing it.
Speaker 1 (01:13):
I really appreciate it.
Speaker 2 (01:14):
Let's start with did you always know that you want to
be a pharmacist?
Speaker 1 (01:19):
Yeah, luckily I did.
I was 14.
I took a little stupid homeeconomic assessment like what
kinds of careers would fit youbased on your personality and
health came up.
My mother was a nurse and so Isat in the guidance office and I
scrolled through all thedifferent like A to Z, literally
all the different types ofthings you can do in health care
(01:40):
and I got to pharmacist and Iactually thought of my
pharmacist.
His name was Pete Gage and Ijust thought like how awesome he
always was to everybody and howpeople looked up to him and he
was super smart.
I was like oh yeah, let me trythat, let me go get a job over
there.
So I got a job working forBeatles Pharmacy and almost
immediately it was like yep,this is what I'm going to do.
Did waffle a little bit, but itwas pretty much like that, was
(02:01):
it for me?
I applied to one college and Igot in and it's pretty much been
since age 14 a straight line topharmacy.
Speaker 2 (02:09):
Wow, how many years did you have to study.
Speaker 1 (02:11):
It's six years and you get a doctorate degree now.
Speaker 2 (02:14):
What inspired you to open your own pharmacy, which is
actually a very good one.
I use it, thank you.
Speaker 1 (02:20):
Well, the joke I always say is that I have a
friend who opened a pharmacy andI'm like, if that that idiot
can do it, I can do it.
So I was like that's the jokethat I would say around him.
I was very entrepreneurial at ayoung age and it was very
attractive to me and I had anumber of mentors, that kind of
like fan that lane, and I'vealways wanted to open up my own
place and I really like it waskind of interesting because I
(02:42):
had just taken a job at the BAin Albany and I was like a
clinical pharmacist and was likethis really cool role.
But I wasn't satisfied and Iwasn't going to be satisfied.
So like literally at myhoneymoon, I was like Aaron, I
got it.
I got to do something like Ineed to open up my own place,
and so that was really just meexpressing my entrepreneurial
desires.
I don't need to go work forsomebody and just like be stuck.
(03:04):
I need to be able to kind oflike dream big and then like
have good people do good work.
Speaker 2 (03:10):
But how do you compete with a big pockets of
the corporate like Walgreens andCVS?
Speaker 1 (03:16):
So I believe that the evidence has kind of shown that
there is no competition.
The level of care and patientpreference always has been
predominantly within independentpharmacy.
People love that relationship.
I don't think that there'senough of an advantage outside
(03:36):
of maybe being able to buy yourBenadryl really cheap like a CVS
or a chain pharmacy.
So we've always won.
The reason that it's difficultfor us to compete in a financial
sense is because the chainpharmacies have rigged the
system.
The chain pharmacies havepurchased the go-between, the
(03:56):
intermediaries between aninsurance company and a patient
called a pharmacy benefitsmanager, pbm, and the PBM is the
organization that sets therules for who gets paid what and
what pharmacy you can go to.
So CVS owns Caremark and byowning them they can then tell
patients where they can go andthen they can pay themselves
more than they pay me for thatsame customer if they choose to
(04:19):
not go to a CVS.
And that's just kind of likevery, very, very tip of the
iceberg.
But essentially the reason thatindependent pharmacies have
died off dramatically is becausethis vertical integration, this
monopolistic practices thathave been allowed to happen in
this country around thefinancial side of prescription
business.
When it comes to care, there isno competition If we blow them
(04:43):
out of the water Totally, tocare.
There is no competition if weblow them out of the water
totally I have people that are.
When you have to force someoneto use you as part of the rules
of the game, that reallyindicates to me that you can't
compete otherwise.
I mean it's, it's absolutelyinsane, right?
Imagine if, like we you know,you wanted to buy a hammer from
a hardware store.
(05:03):
You would just go to likewhatever hardware store you have
a relationship with and or likewhatever one was like nearest
to you.
Now imagine if somebodydictated what hardware store you
could be buying your stuff from.
That's literally what happensin healthcare, where the job you
get will dictate what insuranceyou have, which then dictates
which major healthcare systemyou can use right, you can't
just go see a doctor, you'repart of these major systems
which then tellsates which majorhealthcare system you can use
(05:24):
you can't just go see a doctor,you're part of these major
systems which then tells youwhich hospitals you can use,
which labs you can use, whichpharmacies you can use, all
based on that one decision,instead of having any choice or
freedom here.
It's really, really perplexing.
If you put into Chad GPT.
Does the business of pharmacymake sense?
Chad GPT will saywholeheartedly no, and we know
(05:45):
this because the communitypharmacy organization just did
it and sent out an email with aresponse.
You know, if you have anorganization like a PBM that is
shrinking how much you get paidwhile your costs are going up,
it doesn't work.
I'll tell you something aboutowning a pharmacy.
During the pandemic, a lot ofpeople wanted to support us.
They wanted to come and give ustheir business and I would have
(06:06):
to say no, wow, because it waslike the worst thing that
somebody could say is that Iwant to give you my prescription
business, which is the oppositeof any other.
Like if a restaurant startsdoing good and gets a good
reputation, you want more peoplein the door, right?
The problem is is that I don'tknow if your prescription plan
is going to have predatoryreimbursement practices, meaning
I could lose money billing theprescription.
Speaker 2 (06:25):
Whoa explain that to me.
How is that possible?
Speaker 1 (06:28):
The PBM, that middleman, is who sets what
pharmacy will get paid todispense a drug.
They know what all the numbersare.
They know how much the drugscost us.
They know how much everybody'sgetting paid for the system.
So they use all of that dataand they say, well, we're going
to only pay you the cost of thedrug and that's it.
So they're just going toreimburse us.
So let's say, your drug is $100.
(06:49):
They're going to pay me $100.
So that means that I have $0 tothen pay my staff to give you
the prescription.
17% of the time, which is upfrom about a half percent or
like a quarter of a percent whenI first started 20 years ago,
it's now 17% of the time, we'regetting reimbursed less than the
cost of the drug.
So when we fill a brand nameprescription like insulin or
(07:13):
heart attack medication, right,blood thinners, stuff like that
we will lose about 6% on everyclaim.
And if the drug costs $500,you're talking about anywhere.
You know like.
You're talking about losing 30bucks every time, but it's
really anywhere between 20 and ahundred dollars that we'll lose
.
Those weight loss drugs thatwere going around.
Those were about a thousandbucks a piece, so pharmacies
(07:35):
were filling them for theirpatients and losing about 80 to
a hundred dollars every timethey were doing it.
So there's no other businessthat exists that does that, that
sells stuff at a loss becausethey kind of have to.
And so these PBMs kind ofcreate these rules in which
pharmacies are disincentivizedto exist and if they do exist
they're disincentivized to takethe prescription, so that way
(07:58):
that the prescription eithercomes back to them through their
mail order pharmacy or goes tothe pharmacy that they own
themselves in the community.
And so it's another way to kindof rig the system.
Speaker 2 (08:09):
So how do you?
Speaker 1 (08:09):
make money?
How do you make money?
How do you make money?
So you really don't.
So the pharmacy business, ifit's managed correctly in
today's terms, you can kind ofbreak even, and then you have to
hope that you're making moneyon other things in, and then you
have to hope that you're makingmoney on other things, and so
so, yeah, it is a it's and thisis why, again, independent
(08:29):
pharmacies basically peakedaround 2016.
That was probably the the.
They were at their highestvalue and probably at the
highest number that they'd everbeen.
Speaker 2 (08:42):
And now they've been on the downward swing.
Speaker 1 (08:43):
We sold our Saugerties store in 2016 and we
didn't know, but that was theheight of it.
That's the most that we wouldever get for the value of our
store, and it's been downhillever since that, because the
reimbursement schemes aregetting worse and worse and our
pay is getting worse and worseand and it's it's horrible.
So so, to to be a pharmacy isis often a losing battle in a
(09:03):
lot of markets, especially inNew York.
Wow, and so it doesn't makesense.
And again, this is anindependent pharmacy.
If you notice, rite Aid hasgone bankrupt for the second
time, has closed all theirstores.
That's not because Rite Aiddoesn't know what they're doing.
It's because Rite Aid issubject to this as well.
Speaker 2 (09:19):
Wow.
Speaker 1 (09:19):
They don't own the PBM, so they're losing money on
all of their stores.
Walgreens just sold uh toprivate equity because they
weren't surviving and they'reowned by the boots company,
which is like a european retailbrand, which is like a very
successful brand and they stillhad to kind of get out.
So it.
Chain pharmacies, hospitalpharmacies, independent
pharmacies are all suffering.
(09:40):
And the other thing aboutpurchasing, so like when it
comes, purchasing because that'sthe first thing that people
will say is like well, you'resmall so you can't buy like CVS.
And that's not true.
I belong to a buying group, oneof the biggest in the country.
There's something like 7,000pharmacies in my buying group,
which is more than what CVS, andwe do billions of dollars in
business and we have one of thebest like buying deals in the
(10:02):
country.
And so like, if I buy a Lipitorprescription, a generic Lipitor,
that might cost me 40 cents tofill your prescription about a
penny a pill but if I'm gettingpaid 45 cents by the insurance
company, it doesn't matter if Ibuy it at 20 cents or if I buy
it at 10 cents, because I'mstill only making 40 cents and
that's not enough to cover ourcosts.
And that's the important pointis like there are two costs here
(10:27):
.
There's the cost of the drugsand then there's the cost of the
service.
So we are buying as best as wereally can when it comes to
those pills, but we're still notgetting paid for our services.
If you can change wherepharmacies are getting paid a
flat fee for their service likebecause I'm just putting pills
in a bottle for people andproviding consultative services
that's pretty much the samething all day, no matter the
different drugs you get.
If I can get a flat fee forthat and I know it's dependable
(10:49):
money that will improve pharmacycare.
There will be less of the chainrelated crappy service.
There'll be more independentpharmacies.
People will be healthierbecause of that change.
Speaker 2 (11:00):
I'm surprised because years ago I remember hearing
that being a pharmacist is oneof the lucrative jobs in the
healthcare industry and thatthey make a lot of money.
Yeah, so for me, a pharmacistis.
Speaker 1 (11:10):
I mean, like a pharmacist today can get
anywhere between 60 and probably$80 an hour in the New York
market, which is a really greatcareer, and I think that that's
great.
I also think that the educationbubble hasn't really helped
pharmacists.
So what that 50, because when Igraduated it was like 50 to 70
bucks an hour, that 50 to $70 anhour.
(11:32):
What that gave us was mobility.
It gave us the ability to likework really hard and then like
go from middle and some of myfriends were lower middle to
upper middle.
You know, if you work reallyhard, you married another
pharmacist, then you have thatmobility, you pay off your debts
and there you are.
And so now, if you get out ofschool, you're getting the 60,
70 bucks an hour, but you have$240,000 in student loan debt.
(11:55):
So now you're locked in for 10,.
Like, how do you save forweddings?
How do you save, which areinsanely expensive?
How do you save for any of thelife things that used to be a
part of American life, likethese big celebrations, buying a
house, starting a family?
How do you do that if you havea mortgage essentially hanging
over your head the minute youget out of school?
I would say that should I go topharmacy school?
(12:17):
Well, you should go to pharmacyschool.
If you're passionate about thepractice of pharmacy, you're not
going to be one of these shits.
Essentially, you can beat andbleep me.
We practice in this country and, being that example of what
could be, then yes, you shoulddo that.
(12:43):
But otherwise I would saythere's better uses of your
skill set that will be far morelucrative so you have to do some
extra things outside theprescription drugs.
Speaker 2 (12:54):
Is that why you started the vitamins?
That's exactly which areactually very good, by the way.
Speaker 1 (12:59):
Thank you, and it's actually also why, when it came
down to like, which store shouldI sell, because the industry
was changing, we got kicked inthe face a bunch and I had these
four stores and I had to make abusiness decision about which
one should stay and which oneshould go.
So the pharmacy in Sorghetti'swas doing three to four times
the volume of our Woodstockstore.
Wow, I chose Woodstock becauseit was way more diversified.
(13:22):
Almost every single person wasbuying a substantial amount of
supplements and the supplementbusiness was very strong.
So that meant that I was notsingle threaded, I was not
subject Like.
If I stayed in Saugerties Ifeel I would probably be
bankrupt at this point becauseof, like, the nature of the
business.
It's not only why I starteddoing supplements, but it's why
I chose Woodstock overSorghetti's or even the Lake
(13:44):
Katrine building.
It's because it was a strongerniche?
Speaker 2 (13:48):
Do you also distribute your vitamins through
other distributors to otherplaces?
Speaker 1 (13:54):
We that is coming now .
Yeah, that's something thatwe're going to be beginning now.
It was actually something thatI'd started in 2020, but
something in 2020 got in the wayand so we've been pretty
distracted.
So, now that everything's kindof settled down, we're going to
be doing that prettyaggressively in the upcoming
days.
And again, if you think aboutit, though, like I'm a
pharmacist, I own a pharmacy, Ishould be practicing pharmacy,
(14:17):
and that should be enough.
The bigger kind of picture tounderstand here is the tension
that I have between how I waskind of raised in pharmacy by
those initial like people Ithought of my mentor and the
people that hired me at Beatlesand like the culture of what I
thought pharmacy was and likewhat it has to be today, whereas
, like I was told, you treateverybody the same and never
think about money.
Yes, if some patients are moreprofitable, some are less
(14:39):
profitable, it doesn't matter.
You serve the community, youserve the people when they come
to you, right, and you just do agreat job.
Now we have to think aboutmoney where it's like I have to
say to somebody I can't takeyour insurance, I can't fill
your prescription, I can't stopyour medication Are the most
(15:01):
popular drugs today the weightloss and the Lipitor.
So you know the top 10medications hasn't really
changed much, except for a lotof the opioids are no longer in
that list because the opioidswere a big part of the top 10
lists for a while, so it'smostly cholesterol and blood
pressure medication.
There has been a really greattrend with these like miracle
drugs, these GLP-1s, the weightloss drugs, but they're very
expensive and difficult to getfor people.
It's not as successful as onewould think.
(15:22):
It's a pretty big business.
Speaker 2 (15:23):
When you order a drug , you order after you get the
prescription or you have tostock them.
Speaker 1 (15:28):
Inventory management is a very important part of our
business because, if you thinkabout it, you have lots of SKUs,
lots of items to manage, andthen each item has different
manufacturers.
So like a Lipitor prescriptioncould have 10 different
manufacturers and at differentcosts, and now there's even
different reimbursements, soyou'll get paid differently by
the different ones that you use.
(15:49):
So we have to kind of identifylike what's the ideal product to
use, right, to get paid thebest, because that's a stupid
thing, right, it should just belike what's the best option for
people.
So we have to manage all thedifferent items and then all the
different like variations ofthe items.
And then you have drugs thatare super expensive and some
that are very, very cheap.
(16:10):
So you have to make sure thatyou don't have too much
inventory because that could befinancially problematic.
And then all of them areticking time bombs because they
all can expire.
You see, in my store there'sstuff on the shelf and we have
mechanisms to make sure thatpeople can get the crucial
things that they need.
At least get started and thenthe next day we can get in the
(16:30):
rest of their medicine.
Speaker 2 (16:31):
During COVID, I saw you administrating vaccine to
hundreds of people and you couldeven go into the pharmacy and
there's a nurse, there's areceptionist that gets you, who
pays you for all of this.
It was all free.
Speaker 1 (16:44):
COVID was very interesting.
Covid is a remarkable time forme in two different pieces.
One, all the stuff that I'dbeen like felt like a washing
machine, vibrating in place whenI was like I'm sitting on a
train track.
But I'm a washing machinebecause there was an opportunity
to be a train and so I feltlike COVID was the first time I
could be a train right, Like Icould literally say here's the
(17:05):
problem I'm energetic, I canhire great people and manage a
big system and we can deliverfor a big group of people.
And it was like the fruition ofeverything I wanted to be when I
was 14, which was to besignificant for the community.
That's what I really wantedfrom pharmacy.
It wasn't because I was good atscience, it wasn't because I
liked the white coat, it wasbecause I wanted to be
(17:26):
significant for my community,like my mentors, right.
So COVID was great from thatperspective.
And then the other side of it,it was really great because it
was the first time in my careerthat we got paid the same for
everybody, no matter what.
Speaker 2 (17:38):
From the government.
Speaker 1 (17:39):
From insurance companies, and then the
government made sure that therewas no games.
Everybody had a minimum thatthey had to pay us, and if they
didn't pay us the minimum, thegovernment would top us up.
Speaker 2 (17:49):
Oh, okay.
Speaker 1 (17:57):
So like it was $40 per vaccine.
So if we gave a vaccine we got$40.
And if we got paid $20 frominsurance, we would tell the
government they would give us$20.
That allowed me to do math andthat's why I was everywhere,
because I would have a community, let's say, like Dover Plains
out in Dutchess County, wherenobody thinks about they.
Had a group of people thatneeded the vaccine but nobody
was providing it in an efficientway.
So then we would know if wedrive me and a nurse basically
(18:18):
two hours away and did 10 shots,that would still be financially
beneficial.
So then we can start to be verygenerous with our time and serve
communities that are outside ofour normal reach and then we
were able to speak up forspecific groups of people that
were being marginalized, becausewe knew, listen, we can go to
this church and we can givethree shots, but at least the
(18:38):
three elders are cared for,where they would have a hard
time getting to someplace andgetting in line and getting
these vaccines.
We're going to come to them,get them their vaccines and then
they don't have to think aboutit, right?
And so it allowed us to kind ofdo that.
So it was the first time in mycareer where we got paid for
everything and you saw whathappened right.
Like, I gave 70,000 vaccinesand I have a 1,400 square foot
(19:00):
store.
I didn't know it was that bigof a number.
Speaker 2 (19:06):
Wow, we're one of the biggest in the country and
certainly if you go by squarefoot.
Speaker 1 (19:09):
I think we were the biggest Wow yeah.
So in the situation of COVID,the government paid the drug
companies a flat fee for eachdose and then they paid the
providers a flat fee for theirservice.
And that's the way it should bestructured Right Cover the drug
, pay for the service.
Speaker 2 (19:22):
Exactly.
Speaker 1 (19:23):
And yeah.
So now everything's private.
It's no longer funded by thegovernment, so I pay Moderna for
, like, I ordered 5,000 vaccines.
Those vaccines now cost insteadof $15 that they were paying
the government.
They cost about $100.
But when I order like 5,000, Ihave a half million dollars of
inventory right and I have tomake sure that I use them up.
(19:45):
So you better believe I'm verysweaty during vaccine season.
Speaker 2 (19:49):
Right.
Do you think there's going tobe any kind of problem now with
RFK in charge and he killed theRMA and all of that?
Speaker 1 (19:57):
Chaos and incompetence are definitely the
theme here.
I actually, just, during thisinterview, I got a text message
that the Moderna vaccine hasbeen approved by the FDA and so
that means that we now have theCDC has to say who can get it.
Basically, kennedy is now incharge of the FDA and the CDC in
his role, so he's firedeverybody from the CDC that was
(20:20):
responsible for vaccine stuffand this is some of the most
credentialed, experienced andlike unbiased people, like
well-vetted people in allgovernment, and he fired them so
that way he can put in asycophant, and so it's a problem
on a lot of different levels.
And yeah, if you're listeningto what I'm saying, I'm telling
you that basically, the onlyreason that we even survive is
(20:44):
because of our vaccine business.
If that goes away, it's notthat I would be poor.
What it means is like itdoesn't make sense for me.
The effort and reward doesn'tmake sense Of course.
Speaker 2 (20:55):
What's the biggest reward in your business?
Speaker 1 (20:58):
It's literally the patients.
There's nothing that makes anyof it worth it, except for what
we can do for people.
One of my longtime patientshe's one of the geezer core in
Woodstock.
You know, those guys that eatbreakfast every day and like
they do community services andstuff, the old guys.
He came to me and said that hewas just told by his doctor that
he had bowel ischemia, meaninghis bowel is dying and it's
(21:19):
almost like a heart attack inthe gut and like it's slowly
dying and he's going to die.
He's got about four days tolive to maybe seven, and he said
so I just want to becomfortable, I want to like I, I
eat and I feel sick, and so Idesigned a diet for him that was
like sort of something that Iwould use if somebody's going
through like radiation orchemotherapy, something very
gentle the gut but still getsproper calories and proper
(21:41):
nutrients.
And so use a couple of oursupplements, but not the
supplements aren't the magicpart here, it's the advice.
So he started that diet and, um,it's been like six months wow
yeah, his doctors, hisnutritionists like credited the
advice and everything that westarted him on as being solely
responsible for that?
Speaker 2 (22:02):
wow, I didn't know.
You do things like his designdiet.
I thought that something, thatsomething that his doctor would
do Anything around like anythinghelping people achieve their
wellness goals.
Speaker 1 (22:12):
I look at life very holistically, so prescriptions
and conventional care is justone part of the whole thing we
have, like our diet, sleep,mental well-being, our
environment, exercise all ofthat stuff is very crucial and
it's an important part of themedications and supplements that
you use.
So we always incorporate thatadvice, whether or not it's
(22:34):
taken.
We incorporate that advice intoeverything that we do.
Speaker 2 (22:38):
So what was the one thing you wish you had known
before you started, dr Kahneman?
Speaker 1 (22:42):
The only thing I would say is like I would have
been even more aggressive aboutmy continuing education, because
there does come a point wheremost of my focus is around the
business and not around theclinical stuff.
So now, at this point, if Iwanted to really be sharp again,
it would take a lot of effort,or would just probably make more
sense for me to get one ofthese like hot shots out of
(23:02):
school that are super smart,that are passionate about that
and like just know how to hirethose people and have them do
that work.
Speaker 2 (23:09):
How do you choose your people?
By the way?
Speaker 1 (23:11):
really out of desperation.
I mean, like the pharmacist,like it's a very difficult
market to hire people in, and soI put up a job postings.
You know, we're looking forsmart people and we're looking
people for cultural fit.
So, like, I'm actually going tobe announcing today that we
have a new pharmacist that'sstarting with us.
Her name is Kayla and she'severything that we would all
want.
You know, she's very smart,very efficient and, like I was,
(23:33):
like I need you to go above andbeyond for these people.
She's demonstrated just in afew times, and a few times since
she's been there, that she'slike as obsessed about it as I
am, and so, then, this is goingto be a very good thing.
And so, like it's really likeyou're picking people based on
the cultural fit.
Are they going to fit with yourorganization?
Are they going to fit with yourcurrent co-workers?
Are they going to besynergistic, drama free?
(23:53):
Do they believe in the missionand are they going to, like,
really fulfill it for you?
Speaker 2 (23:57):
How many people do you need working for you in the
pharmacy?
Speaker 1 (24:00):
Technically well and CVS really pushes this.
You don't need very many.
You need a pharmacist to checkthe prescriptions and typically
you have another staff personcalled the pharmacy technician
and that person is responsiblefor, kind of like, the
adjudication of the claims,billing, the insurance and data
entry of the prescriptions andthen putting them into the pills
(24:20):
, into the bottles, repackagingthem that, and then you would
have like a cashier working foryou In a lot of chain pharmacies
them that and then you wouldhave like a cashier working for
you in a lot of chain pharmacies, because the nature of a chain
pharmacy is to increaseproductivity, while I believe
sacrificing care you often willsee in a pharmacy like mine.
So you've been into my pharmacy, you know I have lots of people
working and that allows us toprovide a higher level of care.
(24:42):
In a similar size like volumewise pharmacy, you would
probably see one, maybe twopeople.
It would be the pharmacist andthat's it.
Speaker 2 (24:50):
All right, I really appreciate it.
I learned a lot about thebusiness of pharmacy.
I have to tell you youshattered some ideas I had.
Speaker 1 (24:57):
It was different and hopefully, like with our
concerted efforts, like we cankind of change everything.
Speaker 2 (25:04):
It's amazing how the whole healthcare and all aspects
of healthcare in this countryis totally screwed up.
Speaker 1 (25:09):
Completely rigged.
Yeah, yeah.
Speaker 2 (25:13):
All right, all right, thank you.
Thank you, okay.
That's a wrap for today.
If you have a comment orquestion or would like us to
cover a certain job, please letus know.
Visit our website athowmuchcanimakeinfo.
We would love to hear from you.
And, on your way out, don'tforget to subscribe and share
(25:33):
this episode with anyone who iscurious about their next job.
See you next time.
The top 10 medications hasn't really
changed much, except for a lotof the opioids are no longer in
that list because the opioidswere a big part of the top 10
lists for a while, so it'smostly cholesterol and blood
pressure medication.
There has been a really greattrend with these like miracle
drugs, these GLP ones, theweight drugs, but they're very
expensive and difficult to getfor people.
Speaker 2 (00:28):
Welcome back to how Much Can I Make a podcast about
jobs and earnings?
I'm your host, miravo Zeri.
Today we are joined by Dr NeilSmoller, holistic pharmacist,
supplement strategist and theowner of Village Apothecary in
the iconic town of Woodstock,new York.
With 20 years of experience,neil knows the pharmacy world
(00:49):
inside and out.
His passion has always been todeliver great care to patients
and the community, but, asyou'll hear, there are plenty of
challenges that come withrunning an independent pharmacy.
So let's dive right in anduncover the realities of being a
pharmacist and a business owner.
(01:10):
First of all, thank you verymuch for doing it.
Speaker 1 (01:13):
I really appreciate it.
Speaker 2 (01:14):
Let's start with did you always know that you want to
be a pharmacist?
Speaker 1 (01:19):
Yeah, luckily I did.
I was 14.
I took a little stupid homeeconomic assessment like what
kinds of careers would fit youbased on your personality and
health came up.
My mother was a nurse and so Isat in the guidance office and I
scrolled through all thedifferent like A to Z, literally
all the different types ofthings you can do in health care
(01:40):
and I got to pharmacist and Iactually thought of my
pharmacist.
His name was Pete Gage and Ijust thought like how awesome he
always was to everybody and howpeople looked up to him and he
was super smart.
I was like oh yeah, let me trythat, let me go get a job over
there.
So I got a job working forBeatles Pharmacy and almost
immediately it was like yep,this is what I'm going to do.
Did waffle a little bit, but itwas pretty much like that, was
(02:01):
it for me?
I applied to one college and Igot in and it's pretty much been
since age 14 a straight line topharmacy.
Speaker 2 (02:09):
Wow, how many years did you have to study.
Speaker 1 (02:11):
It's six years and you get a doctorate degree now.
Speaker 2 (02:14):
What inspired you to open your own pharmacy, which is
actually a very good one.
I use it, thank you.
Speaker 1 (02:20):
Well, the joke I always say is that I have a
friend who opened a pharmacy andI'm like, if that that idiot
can do it, I can do it.
So I was like that's the jokethat I would say around him.
I was very entrepreneurial at ayoung age and it was very
attractive to me and I had anumber of mentors, that kind of
like fan that lane, and I'vealways wanted to open up my own
place and I really like it waskind of interesting because I
(02:42):
had just taken a job at the BAin Albany and I was like a
clinical pharmacist and was likethis really cool role.
But I wasn't satisfied and Iwasn't going to be satisfied.
So like literally at myhoneymoon, I was like Aaron, I
got it.
I got to do something like Ineed to open up my own place,
and so that was really just meexpressing my entrepreneurial
desires.
I don't need to go work forsomebody and just like be stuck.
(03:04):
I need to be able to kind oflike dream big and then like
have good people do good work.
Speaker 2 (03:10):
But how do you compete with a big pockets of
the corporate like Walgreens andCVS?
Speaker 1 (03:16):
So I believe that the evidence has kind of shown that
there is no competition.
The level of care and patientpreference always has been
predominantly within independentpharmacy.
People love that relationship.
I don't think that there'senough of an advantage outside
(03:36):
of maybe being able to buy yourBenadryl really cheap like a CVS
or a chain pharmacy.
So we've always won.
The reason that it's difficultfor us to compete in a financial
sense is because the chainpharmacies have rigged the
system.
The chain pharmacies havepurchased the go-between, the
(03:56):
intermediaries between aninsurance company and a patient
called a pharmacy benefitsmanager, pbm, and the PBM is the
organization that sets therules for who gets paid what and
what pharmacy you can go to.
So CVS owns Caremark and byowning them they can then tell
patients where they can go andthen they can pay themselves
more than they pay me for thatsame customer if they choose to
(04:19):
not go to a CVS.
And that's just kind of likevery, very, very tip of the
iceberg.
But essentially the reason thatindependent pharmacies have
died off dramatically is becausethis vertical integration, this
monopolistic practices thathave been allowed to happen in
this country around thefinancial side of prescription
business.
When it comes to care, there isno competition If we blow them
(04:43):
out of the water Totally, tocare.
There is no competition if weblow them out of the water
totally I have people that are.
When you have to force someoneto use you as part of the rules
of the game, that reallyindicates to me that you can't
compete otherwise.
I mean it's, it's absolutelyinsane, right?
Imagine if, like we you know,you wanted to buy a hammer from
a hardware store.
(05:03):
You would just go to likewhatever hardware store you have
a relationship with and or likewhatever one was like nearest
to you.
Now imagine if somebodydictated what hardware store you
could be buying your stuff from.
That's literally what happensin healthcare, where the job you
get will dictate what insuranceyou have, which then dictates
which major healthcare systemyou can use right, you can't
just go see a doctor, you'repart of these major systems
which then tellsates which majorhealthcare system you can use
(05:24):
you can't just go see a doctor,you're part of these major
systems which then tells youwhich hospitals you can use,
which labs you can use, whichpharmacies you can use, all
based on that one decision,instead of having any choice or
freedom here.
It's really, really perplexing.
If you put into Chad GPT.
Does the business of pharmacymake sense?
Chad GPT will saywholeheartedly no, and we know
(05:45):
this because the communitypharmacy organization just did
it and sent out an email with aresponse.
You know, if you have anorganization like a PBM that is
shrinking how much you get paidwhile your costs are going up,
it doesn't work.
I'll tell you something aboutowning a pharmacy.
During the pandemic, a lot ofpeople wanted to support us.
They wanted to come and give ustheir business and I would have
(06:06):
to say no, wow, because it waslike the worst thing that
somebody could say is that Iwant to give you my prescription
business, which is the oppositeof any other.
Like if a restaurant startsdoing good and gets a good
reputation, you want more peoplein the door, right?
The problem is is that I don'tknow if your prescription plan
is going to have predatoryreimbursement practices, meaning
I could lose money billing theprescription.
Speaker 2 (06:25):
Whoa explain that to me.
How is that possible?
Speaker 1 (06:28):
The PBM, that middleman, is who sets what
pharmacy will get paid todispense a drug.
They know what all the numbersare.
They know how much the drugscost us.
They know how much everybody'sgetting paid for the system.
So they use all of that dataand they say, well, we're going
to only pay you the cost of thedrug and that's it.
So they're just going toreimburse us.
So let's say, your drug is $100.
(06:49):
They're going to pay me $100.
So that means that I have $0 tothen pay my staff to give you
the prescription.
17% of the time, which is upfrom about a half percent or
like a quarter of a percent whenI first started 20 years ago,
it's now 17% of the time, we'regetting reimbursed less than the
cost of the drug.
So when we fill a brand nameprescription like insulin or
(07:13):
heart attack medication, right,blood thinners, stuff like that
we will lose about 6% on everyclaim.
And if the drug costs $500,you're talking about anywhere.
You know like.
You're talking about losing 30bucks every time, but it's
really anywhere between 20 and ahundred dollars that we'll lose
.
Those weight loss drugs thatwere going around.
Those were about a thousandbucks a piece, so pharmacies
(07:35):
were filling them for theirpatients and losing about 80 to
a hundred dollars every timethey were doing it.
So there's no other businessthat exists that does that, that
sells stuff at a loss becausethey kind of have to.
And so these PBMs kind ofcreate these rules in which
pharmacies are disincentivizedto exist and if they do exist
they're disincentivized to takethe prescription, so that way
(07:58):
that the prescription eithercomes back to them through their
mail order pharmacy or goes tothe pharmacy that they own
themselves in the community.
And so it's another way to kindof rig the system.
Speaker 2 (08:09):
So how do you?
Speaker 1 (08:09):
make money?
How do you make money?
How do you make money?
So you really don't.
So the pharmacy business, ifit's managed correctly in
today's terms, you can kind ofbreak even, and then you have to
hope that you're making moneyon other things in, and then you
have to hope that you're makingmoney on other things, and so
so, yeah, it is a it's and thisis why, again, independent
(08:29):
pharmacies basically peakedaround 2016.
That was probably the the.
They were at their highestvalue and probably at the
highest number that they'd everbeen.
Speaker 2 (08:42):
And now they've been on the downward swing.
Speaker 1 (08:43):
We sold our Saugerties store in 2016 and we
didn't know, but that was theheight of it.
That's the most that we wouldever get for the value of our
store, and it's been downhillever since that, because the
reimbursement schemes aregetting worse and worse and our
pay is getting worse and worseand and it's it's horrible.
So so, to to be a pharmacy isis often a losing battle in a
(09:03):
lot of markets, especially inNew York.
Wow, and so it doesn't makesense.
And again, this is anindependent pharmacy.
If you notice, rite Aid hasgone bankrupt for the second
time, has closed all theirstores.
That's not because Rite Aiddoesn't know what they're doing.
It's because Rite Aid issubject to this as well.
Speaker 2 (09:19):
Wow.
Speaker 1 (09:19):
They don't own the PBM, so they're losing money on
all of their stores.
Walgreens just sold uh toprivate equity because they
weren't surviving and they'reowned by the boots company,
which is like a european retailbrand, which is like a very
successful brand and they stillhad to kind of get out.
So it.
Chain pharmacies, hospitalpharmacies, independent
pharmacies are all suffering.
(09:40):
And the other thing aboutpurchasing, so like when it
comes, purchasing because that'sthe first thing that people
will say is like well, you'resmall so you can't buy like CVS.
And that's not true.
I belong to a buying group, oneof the biggest in the country.
There's something like 7,000pharmacies in my buying group,
which is more than what CVS, andwe do billions of dollars in
business and we have one of thebest like buying deals in the
(10:02):
country.
And so like, if I buy a Lipitorprescription, a generic Lipitor,
that might cost me 40 cents tofill your prescription about a
penny a pill but if I'm gettingpaid 45 cents by the insurance
company, it doesn't matter if Ibuy it at 20 cents or if I buy
it at 10 cents, because I'mstill only making 40 cents and
that's not enough to cover ourcosts.
And that's the important pointis like there are two costs here
(10:27):
.
There's the cost of the drugsand then there's the cost of the
service.
So we are buying as best as wereally can when it comes to
those pills, but we're still notgetting paid for our services.
If you can change wherepharmacies are getting paid a
flat fee for their service likebecause I'm just putting pills
in a bottle for people andproviding consultative services
that's pretty much the samething all day, no matter the
different drugs you get.
If I can get a flat fee forthat and I know it's dependable
(10:49):
money that will improve pharmacycare.
There will be less of the chainrelated crappy service.
There'll be more independentpharmacies.
People will be healthierbecause of that change.
Speaker 2 (11:00):
I'm surprised because years ago I remember hearing
that being a pharmacist is oneof the lucrative jobs in the
healthcare industry and thatthey make a lot of money.
Yeah, so for me, a pharmacistis.
Speaker 1 (11:10):
I mean, like a pharmacist today can get
anywhere between 60 and probably$80 an hour in the New York
market, which is a really greatcareer, and I think that that's
great.
I also think that the educationbubble hasn't really helped
pharmacists.
So what that 50, because when Igraduated it was like 50 to 70
bucks an hour, that 50 to $70 anhour.
(11:32):
What that gave us was mobility.
It gave us the ability to likework really hard and then like
go from middle and some of myfriends were lower middle to
upper middle.
You know, if you work reallyhard, you married another
pharmacist, then you have thatmobility, you pay off your debts
and there you are.
And so now, if you get out ofschool, you're getting the 60,
70 bucks an hour, but you have$240,000 in student loan debt.
(11:55):
So now you're locked in for 10,.
Like, how do you save forweddings?
How do you save, which areinsanely expensive?
How do you save for any of thelife things that used to be a
part of American life, likethese big celebrations, buying a
house, starting a family?
How do you do that if you havea mortgage essentially hanging
over your head the minute youget out of school?
I would say that should I go topharmacy school?
(12:17):
Well, you should go to pharmacyschool.
If you're passionate about thepractice of pharmacy, you're not
going to be one of these shits.
Essentially, you can beat andbleep me.
We practice in this country and, being that example of what
could be, then yes, you shoulddo that.
(12:43):
But otherwise I would saythere's better uses of your
skill set that will be far morelucrative so you have to do some
extra things outside theprescription drugs.
Speaker 2 (12:54):
Is that why you started the vitamins?
That's exactly which areactually very good, by the way.
Speaker 1 (12:59):
Thank you, and it's actually also why, when it came
down to like, which store shouldI sell, because the industry
was changing, we got kicked inthe face a bunch and I had these
four stores and I had to make abusiness decision about which
one should stay and which oneshould go.
So the pharmacy in Sorghetti'swas doing three to four times
the volume of our Woodstockstore.
Wow, I chose Woodstock becauseit was way more diversified.
(13:22):
Almost every single person wasbuying a substantial amount of
supplements and the supplementbusiness was very strong.
So that meant that I was notsingle threaded, I was not
subject Like.
If I stayed in Saugerties Ifeel I would probably be
bankrupt at this point becauseof, like, the nature of the
business.
It's not only why I starteddoing supplements, but it's why
I chose Woodstock overSorghetti's or even the Lake
(13:44):
Katrine building.
It's because it was a strongerniche?
Speaker 2 (13:48):
Do you also distribute your vitamins through
other distributors to otherplaces?
Speaker 1 (13:54):
We that is coming now .
Yeah, that's something thatwe're going to be beginning now.
It was actually something thatI'd started in 2020, but
something in 2020 got in the wayand so we've been pretty
distracted.
So, now that everything's kindof settled down, we're going to
be doing that prettyaggressively in the upcoming
days.
And again, if you think aboutit, though, like I'm a
pharmacist, I own a pharmacy, Ishould be practicing pharmacy,
(14:17):
and that should be enough.
The bigger kind of picture tounderstand here is the tension
that I have between how I waskind of raised in pharmacy by
those initial like people Ithought of my mentor and the
people that hired me at Beatlesand like the culture of what I
thought pharmacy was and likewhat it has to be today, whereas
, like I was told, you treateverybody the same and never
think about money.
Yes, if some patients are moreprofitable, some are less
(14:39):
profitable, it doesn't matter.
You serve the community, youserve the people when they come
to you, right, and you just do agreat job.
Now we have to think aboutmoney where it's like I have to
say to somebody I can't takeyour insurance, I can't fill
your prescription, I can't stopyour medication Are the most
(15:01):
popular drugs today the weightloss and the Lipitor.
So you know the top 10medications hasn't really
changed much, except for a lotof the opioids are no longer in
that list because the opioidswere a big part of the top 10
lists for a while, so it'smostly cholesterol and blood
pressure medication.
There has been a really greattrend with these like miracle
drugs, these GLP-1s, the weightloss drugs, but they're very
expensive and difficult to getfor people.
It's not as successful as onewould think.
(15:22):
It's a pretty big business.
Speaker 2 (15:23):
When you order a drug , you order after you get the
prescription or you have tostock them.
Speaker 1 (15:28):
Inventory management is a very important part of our
business because, if you thinkabout it, you have lots of SKUs,
lots of items to manage, andthen each item has different
manufacturers.
So like a Lipitor prescriptioncould have 10 different
manufacturers and at differentcosts, and now there's even
different reimbursements, soyou'll get paid differently by
the different ones that you use.
(15:49):
So we have to kind of identifylike what's the ideal product to
use, right, to get paid thebest, because that's a stupid
thing, right, it should just belike what's the best option for
people.
So we have to manage all thedifferent items and then all the
different like variations ofthe items.
And then you have drugs thatare super expensive and some
that are very, very cheap.
(16:10):
So you have to make sure thatyou don't have too much
inventory because that could befinancially problematic.
And then all of them areticking time bombs because they
all can expire.
You see, in my store there'sstuff on the shelf and we have
mechanisms to make sure thatpeople can get the crucial
things that they need.
At least get started and thenthe next day we can get in the
(16:30):
rest of their medicine.
Speaker 2 (16:31):
During COVID, I saw you administrating vaccine to
hundreds of people and you couldeven go into the pharmacy and
there's a nurse, there's areceptionist that gets you, who
pays you for all of this.
It was all free.
Speaker 1 (16:44):
COVID was very interesting.
Covid is a remarkable time forme in two different pieces.
One, all the stuff that I'dbeen like felt like a washing
machine, vibrating in place whenI was like I'm sitting on a
train track.
But I'm a washing machinebecause there was an opportunity
to be a train and so I feltlike COVID was the first time I
could be a train right, Like Icould literally say here's the
(17:05):
problem I'm energetic, I canhire great people and manage a
big system and we can deliverfor a big group of people.
And it was like the fruition ofeverything I wanted to be when I
was 14, which was to besignificant for the community.
That's what I really wantedfrom pharmacy.
It wasn't because I was good atscience, it wasn't because I
liked the white coat, it wasbecause I wanted to be
(17:26):
significant for my community,like my mentors, right.
So COVID was great from thatperspective.
And then the other side of it,it was really great because it
was the first time in my careerthat we got paid the same for
everybody, no matter what.
Speaker 2 (17:38):
From the government.
Speaker 1 (17:39):
From insurance companies, and then the
government made sure that therewas no games.
Everybody had a minimum thatthey had to pay us, and if they
didn't pay us the minimum, thegovernment would top us up.
Speaker 2 (17:49):
Oh, okay.
Speaker 1 (17:57):
So like it was $40 per vaccine.
So if we gave a vaccine we got$40.
And if we got paid $20 frominsurance, we would tell the
government they would give us$20.
That allowed me to do math andthat's why I was everywhere,
because I would have a community, let's say, like Dover Plains
out in Dutchess County, wherenobody thinks about they.
Had a group of people thatneeded the vaccine but nobody
was providing it in an efficientway.
So then we would know if wedrive me and a nurse basically
(18:18):
two hours away and did 10 shots,that would still be financially
beneficial.
So then we can start to be verygenerous with our time and serve
communities that are outside ofour normal reach and then we
were able to speak up forspecific groups of people that
were being marginalized, becausewe knew, listen, we can go to
this church and we can givethree shots, but at least the
(18:38):
three elders are cared for,where they would have a hard
time getting to someplace andgetting in line and getting
these vaccines.
We're going to come to them,get them their vaccines and then
they don't have to think aboutit, right?
And so it allowed us to kind ofdo that.
So it was the first time in mycareer where we got paid for
everything and you saw whathappened right.
Like, I gave 70,000 vaccinesand I have a 1,400 square foot
(19:00):
store.
I didn't know it was that bigof a number.
Speaker 2 (19:06):
Wow, we're one of the biggest in the country and
certainly if you go by squarefoot.
Speaker 1 (19:09):
I think we were the biggest Wow yeah.
So in the situation of COVID,the government paid the drug
companies a flat fee for eachdose and then they paid the
providers a flat fee for theirservice.
And that's the way it should bestructured Right Cover the drug
, pay for the service.
Speaker 2 (19:22):
Exactly.
Speaker 1 (19:23):
And yeah.
So now everything's private.
It's no longer funded by thegovernment, so I pay Moderna for
, like, I ordered 5,000 vaccines.
Those vaccines now cost insteadof $15 that they were paying
the government.
They cost about $100.
But when I order like 5,000, Ihave a half million dollars of
inventory right and I have tomake sure that I use them up.
(19:45):
So you better believe I'm verysweaty during vaccine season.
Speaker 2 (19:49):
Right.
Do you think there's going tobe any kind of problem now with
RFK in charge and he killed theRMA and all of that?
Speaker 1 (19:57):
Chaos and incompetence are definitely the
theme here.
I actually, just, during thisinterview, I got a text message
that the Moderna vaccine hasbeen approved by the FDA and so
that means that we now have theCDC has to say who can get it.
Basically, kennedy is now incharge of the FDA and the CDC in
his role, so he's firedeverybody from the CDC that was
(20:20):
responsible for vaccine stuffand this is some of the most
credentialed, experienced andlike unbiased people, like
well-vetted people in allgovernment, and he fired them so
that way he can put in asycophant, and so it's a problem
on a lot of different levels.
And yeah, if you're listeningto what I'm saying, I'm telling
you that basically, the onlyreason that we even survive is
(20:44):
because of our vaccine business.
If that goes away, it's notthat I would be poor.
What it means is like itdoesn't make sense for me.
The effort and reward doesn'tmake sense Of course.
Speaker 2 (20:55):
What's the biggest reward in your business?
Speaker 1 (20:58):
It's literally the patients.
There's nothing that makes anyof it worth it, except for what
we can do for people.
One of my longtime patientshe's one of the geezer core in
Woodstock.
You know, those guys that eatbreakfast every day and like
they do community services andstuff, the old guys.
He came to me and said that hewas just told by his doctor that
he had bowel ischemia, meaninghis bowel is dying and it's
(21:19):
almost like a heart attack inthe gut and like it's slowly
dying and he's going to die.
He's got about four days tolive to maybe seven, and he said
so I just want to becomfortable, I want to like I, I
eat and I feel sick, and so Idesigned a diet for him that was
like sort of something that Iwould use if somebody's going
through like radiation orchemotherapy, something very
gentle the gut but still getsproper calories and proper
(21:41):
nutrients.
And so use a couple of oursupplements, but not the
supplements aren't the magicpart here, it's the advice.
So he started that diet and, um,it's been like six months wow
yeah, his doctors, hisnutritionists like credited the
advice and everything that westarted him on as being solely
responsible for that?
Speaker 2 (22:02):
wow, I didn't know.
You do things like his designdiet.
I thought that something, thatsomething that his doctor would
do Anything around like anythinghelping people achieve their
wellness goals.
Speaker 1 (22:12):
I look at life very holistically, so prescriptions
and conventional care is justone part of the whole thing we
have, like our diet, sleep,mental well-being, our
environment, exercise all ofthat stuff is very crucial and
it's an important part of themedications and supplements that
you use.
So we always incorporate thatadvice, whether or not it's
(22:34):
taken.
We incorporate that advice intoeverything that we do.
Speaker 2 (22:38):
So what was the one thing you wish you had known
before you started, dr Kahneman?
Speaker 1 (22:42):
The only thing I would say is like I would have
been even more aggressive aboutmy continuing education, because
there does come a point wheremost of my focus is around the
business and not around theclinical stuff.
So now, at this point, if Iwanted to really be sharp again,
it would take a lot of effort,or would just probably make more
sense for me to get one ofthese like hot shots out of
(23:02):
school that are super smart,that are passionate about that
and like just know how to hirethose people and have them do
that work.
Speaker 2 (23:09):
How do you choose your people?
By the way?
Speaker 1 (23:11):
really out of desperation.
I mean, like the pharmacist,like it's a very difficult
market to hire people in, and soI put up a job postings.
You know, we're looking forsmart people and we're looking
people for cultural fit.
So, like, I'm actually going tobe announcing today that we
have a new pharmacist that'sstarting with us.
Her name is Kayla and she'severything that we would all
want.
You know, she's very smart,very efficient and, like I was,
(23:33):
like I need you to go above andbeyond for these people.
She's demonstrated just in afew times, and a few times since
she's been there, that she'slike as obsessed about it as I
am, and so, then, this is goingto be a very good thing.
And so, like it's really likeyou're picking people based on
the cultural fit.
Are they going to fit with yourorganization?
Are they going to fit with yourcurrent co-workers?
Are they going to besynergistic, drama free?
(23:53):
Do they believe in the missionand are they going to, like,
really fulfill it for you?
Speaker 2 (23:57):
How many people do you need working for you in the
pharmacy?
Speaker 1 (24:00):
Technically well and CVS really pushes this.
You don't need very many.
You need a pharmacist to checkthe prescriptions and typically
you have another staff personcalled the pharmacy technician
and that person is responsiblefor, kind of like, the
adjudication of the claims,billing, the insurance and data
entry of the prescriptions andthen putting them into the pills
(24:20):
, into the bottles, repackagingthem that, and then you would
have like a cashier working foryou In a lot of chain pharmacies
them that and then you wouldhave like a cashier working for
you in a lot of chain pharmacies, because the nature of a chain
pharmacy is to increaseproductivity, while I believe
sacrificing care you often willsee in a pharmacy like mine.
So you've been into my pharmacy, you know I have lots of people
working and that allows us toprovide a higher level of care.
(24:42):
In a similar size like volumewise pharmacy, you would
probably see one, maybe twopeople.
It would be the pharmacist andthat's it.
Speaker 2 (24:50):
All right, I really appreciate it.
I learned a lot about thebusiness of pharmacy.
I have to tell you youshattered some ideas I had.
Speaker 1 (24:57):
It was different and hopefully, like with our
concerted efforts, like we cankind of change everything.
Speaker 2 (25:04):
It's amazing how the whole healthcare and all aspects
of healthcare in this countryis totally screwed up.
Speaker 1 (25:09):
Completely rigged.
Yeah, yeah.
Speaker 2 (25:13):
All right, all right, thank you.
Thank you, okay.
That's a wrap for today.
If you have a comment orquestion or would like us to
cover a certain job, please letus know.
Visit our website athowmuchcanimakeinfo.
We would love to hear from you.
And, on your way out, don'tforget to subscribe and share
(25:33):
this episode with anyone who iscurious about their next job.
See you next time.
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