Q&A with Christian Tadrus: Through the lens of the owner-operator

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DSN had the opportunity to speak with Christian Tadrus, who has been the pharmacist at Sam’s Health Mart in the Colombia, Mo. area, since 1997. Tadrus, a member of McKesson’s Sponsored Clinical Services pharmacy network, participates in a number of SCS adherence support programs, including the award-winning Pharmacy Intervention Program, where pharmacists provide behavioral coaching to patients and StudyLink, which provides pharmacies and patients with the opportunity to participate in local clinical studies. Tadrus also participated in the SCS RxRapid Response program in which pharmacists provide feedback to McKesson via fax-back surveys.

Tadrus was among the 2,000 pharmacy owners, pharmacists and staff members in attendance at the McKesson ideaShare 2013 held late June in Las Vegas, and provided first-hand perspective of how an independent operator views the competitive landscape of retail pharmacy and what community pharmacists need to do to ensure a larger role in patient care.

Below is an abridged version of the interview — listen to the full audio Q&A with Tadrus above for more valuable insights on how to grow and thrive in today’s marketplace. Smartphone users, click here to listen.

DSN: What was your takeaway from this year’s Health Mart Annual Meeting?

Tadrus: Health Mart always does a great job with these annual meetings — they’re vibrant; they’re intense; they really draw you in. Everybody who attends comes out of [the meeting] ready to go, to attack the challenges of the industry with new ideas and a new feel for what McKesson and Health Mart are trying to do to help independent pharmacy.

DSN: What do you see as the key issues affecting independent pharmacy owners these days?

Tadrus: Most, if not all, of us are fighting industry changes. We’re trying to accommodate a new healthcare system. We’re seeing more and more competition. The script volume is increasing but the independents aren’t picking up as rapidly as the chain stores. … What we’re most in need of is a focus on strategies to attract and retain the customer. … We’ve got to think about new strategies, new ways to engage, new ways to earn the trust of the patient and new ways to influence that patient.

DSN: How is that happening at Sam’s Health Mart?

Tadrus: We’ve implemented strategies that involve adherence … making sure the patients are getting the medication that they need [and] that they’re taking them when they need it. We are making more contact with the patient personally, calling them once a month, to review how their medications are working for them, if there’s been any changes in the last month, if there’s been any changes in their health environment so we can be predictive in that. We’re looking though our database to see where people are missing refills, just to make sure they haven’t accidentally fallen off the map, or forgotten to order something. [And] we’re doing more engagement with the physician as well, giving reports back to the providers about the patient’s adherence to help them manage the patient’s care. … They really need to be able to show that their patients are taking their meds and adhering to regimen as prescribed. Pharmacy has a great opportunity to play a facilitative role there that not only ensures the patients are taking what they’re supposed to at the right time on the right days, but also to help build the relationship with the physician and making the pharmacist a more important part of the healthcare team.

DSN: How important is it for community pharmacy to develop that connection between the pharmacist, physician and patient?

Tadrus: Pharmacists need to be comfortable engaging with the patient. They need to be comfortable engaging with the physician. What we’re doing at our practice – and what we’re advocating that even our competitors do – is if you’re not personally tied into that patient, if you’re not caring that the patient is adherent to their medications, that they’re understanding how to take that medication, or that they’re not having side effects, [then] you’re not doing what a pharmacist should be doing, which is to help them get the most out of [that prescription medicine regimen]. What’s most important on the patient side is they understand that you’ve got their back.

Physicians have that same need, but they don’t think about pharmacists that way. We have to prove to them that we can think like that, that we’re looking at the patient as a whole and not as just as [consumers] of products that go by us like widgets on an assembly line. When a pharmacist actually contacts a doctor and says something like, “I just did an adherence review with your patient Mrs. Jones. We’ve noticed she’s been losing five days per month every time she fills [her prescription]. … We called her to find out what was going on [and] were able to determine the problem with that process. … We educated her on that and we’ve recommended a packaging solution that might help keep her on track so she didn’t miss a dose here and there. When she comes in to pick up her medications, we’re doing blood pressure screens so we’re getting data every time she comes in. Here, doctor, is a list of what we’ve been tracking for your patient.” That’s something a doctor can really use to make a care decision, rather than a one-hit visit when the patient comes in to see them.

Yes, we’re inserting ourselves into patient care a bit, we have a legitimate, justified reason to do that. What’s important for pharmacists is we start to do things like that, to prove that we can be part of the healthcare system going forward and offer solutions to doctors that they don’t have right now. We’re a safety net in [the doctor’s] care process in a lot of ways. …

When you are connected to the patient like that and driving toward [comprehensive health services] — whether the service be education or the adherence piece —[and that care] really does impact the bottom line on the spend or on the outcome on the health of the patient, and we measure that over time, then that deserves an reward back to the pharmacist. And we can get that out of the payor systems going forward because of the new model designs. What it dictates is that we actually make a difference, and when there’s a problem, we fix the problem and we track that information and report it back. … That performance-based payment model is something every independent should be thinking about doing because historically [pharmacists] are better performers. …

There’s another piece that’s maybe more tangible and more immediate for the pharmacist engaged in this. When you’re that tied into the patient, you’re going to discover opportunities where you can drive revenues to your bottom line almost immediately. Examples include that patient that’s getting the medication from mail order or from the chain store down the street. Because you’ve built a little trust with that patient by communicating with them over time, you now have the ability to maybe influence them. Trust always comes before the ability to influence. And once you have the ability to influence you can get a lot done. …

Adherence is an entry point, a point of contact that is justified and expected by the patient where you can begin the dialogue…and through regular contact build the relationship with the patient… In the end, if you’re constantly looking for new ways to capture more dollars out of even your existing customers, your business is going to be more than profitable. You’re going to be able to grow. If you can inspire that attitude in every member of your staff, you’re going to see it happen on its own. It will be so organic; you will have so much opportunity to won’t have time to take advantage of it…

I think every pharmacist everywhere should be engaging in adherence strategies to help drive revenue, help drive patients to the health outcomes their doctors are desirous of and build the relationship that allows them to open the next door of opportunity.