From our Friend Olga. What do you make of this? Is this America?

Jp Enlarged

Ok so Today of all Days this has to happen to me I AM POSTING THIS SO EVERYONE KNOWS WHAT KIND OF SOCIETY WE ACTUALLY LIVE IN. Since 1992 I have been trying to own a store- a Pharmacy to be exact and for the last number of years I have learned the following: Private Business is allowed to be prejudice, There is no Department of Small Business in the White House, A larger Multinational Corporation or Chain is allowed to keep a small store ‘EMTPY AND MAKE THE NEIGHBORHOOD LOOK LIKE SHIT’ AND KEEP IT empty if they want to sabotage a business…YES A CHAIN IS PAYING FOR A LOCATION TO BE KEPT “FREE FROM A PHARMACY BEING LOCATED IN IT”. THE FINAL PAYOFF for me is the following. Finally I find a store, good location, decent rent, I tell them I am opening a pharmacy and in the pharmacy will be a combination/physicians office as well- I am going to open a Phase I research unit and help young physicians sublet the space and learn their trade until their ready to fly off and open up their own Medical Offices. I am mortified at what I am about to tell you. I explain this to the real estate agent. Suddenly the phone goes dead….as if NELSON MANDELA caused the line to go dead for a reason- I did not know he just died. The guy calls me back and leaves me this message, ” My clients are worried as to what type of business you are going to open up, what kind of people are going to come to your office/out patient pharmacy….we don;t understand what it is you are doing- we are worried- We don;t want you to OPEN UP AN AIDS CLINIC…….when I listened to the message I was ready to have a heart attack- I was upset, I was dismayed, I was so disgusted at my fellow American saying this “UnAmerican shit to me” if I had been on the phone I would have cursed him and lost the store. I composed myself…..an angel must have flown in me and I called him back. I said, “I received your message and I want to let you know that I have no intention of opening an Aids clinic. I am simply going to have a small outpatient pharmacy, with two exam rooms and a small lab- to help young doctors begin their trade……I will dispense FDA approved medication and Specialty Pharmacy supplies”…NOW THIS STORE IS NEXT TO A LIQUOR STORE AND DOWN THE STREET FROM A DAMN PUB!!! What has gotten into the Americans of this country!! I told him I was upset that he would say what he said- he told me we have an Abortion Clinic in a very posh town out east which I won’t mention……and we have people that picket the office once a year. I then reinforced ‘MY BLATANT CHRISTIANITY” AND TOLD HIM I WAS PRO LIFE WHICH IS WHAT HE WANTED TO HEAR…….I am appalled that these idiots have the power to say these things to me…a person who holds the constitution higher than even the Bible……..Can someone please tell me- Am I crazy???

8 Comments

8 Comments

  1. pharmaciststeve  •  Dec 6, 2013 @5:27 pm

    the next time.. tell the agent that you are opening a community pharmacy providing prescriptions and related healthcare services..

    If they ask.. tell them that you are going to provide HME,respiratory/oxygen and/or specialty compounding.

    Don’t give them the chance to jump to conclusion about what you are going to do. As long as you are providing legal services and not directly competing with others in the strip center.

    The landlord could have a non-compete with other occupants in the strip center about competing occupants in the property

    You did not say if this property is in a strip center.. perhaps the landlord is concerned that having doctors in the store will cause their parking lot spaces to be tied up for the other tenants.. because everyone knows that doctors are always behind and parking lots fill up.

  2. broncofan7  •  Dec 10, 2013 @10:46 am

    As a Pharmacy owner who has fortunately never been turned down for financing in my 2 attempts to get it, I must say that this story seems more than odd; it seems simply made up (PLEASE NOTE THE tasteless NELSON MANDELA reference)

    But for others who may be interested in SMALL BUSINESS FINANCING, here’s a couple of things that I’ve learned:

    1) the world of finance isn’t simply about hard numbers; it’s also about how you present yourself as a potential client and how you are able to relay your business vision to the loan officer and underwriters.

    2) Liveoak (Bank) and 1st med financial(broker) are both reputable and will have the knowledge and contacts to get you financing if your business plan is sound or if buying an existing, the #’s from that existing are legitimate and adequate.

    3)IF you are designated a minority or female, the SBA has loan programs that give you and advantage over a white male and their are banks who will take advantage of the incentives to loan to a minority or female (here’s just ONEBANK https://www.unionbank.com/small-business/loans-lines-credit/diversity-lending/)

    The moral of story is, Pharmacists are safer to loan to in the eyes of many banks(particularly the SMALLER BANKS) than the average guy or gal who has a dream of trying to start a donut shop or restaurant. IF you think you’d like to get into ownership then I’d recommend going to an NCPA ownership workshop first and then working with a Pharmacy broker…..BF7

  3. broncofan7  •  Dec 10, 2013 @11:10 am

    Other items to note: the average buildout(that’s the INSIDE OF A BUILDING) of a Pharmacy costs about $60K and that moneyis often provided by the wholesaler that you chose to do the majority of your business with (McKesson, Cardinal, AmerisourceBergen, HD SMITH)–they will arrange for a favorable repayment schedule of that initial build-out loan..As a GENERAL rule of thumb; for every $100K you borrow, your monthly payment will be $1000 dollars over 13 years.

    Lease rates will vary greatly depending on the part of the country and the part of town that you are attempting to lease from; for a startup, You’d want to do a tiered lease with minimum payments in the first 24 months and have it gradually increase –and don’t sign for more than 5 years generally speaking.

    MAKE NOTE:

    -the average Pharmacy in America that does 100 rxs a day equates to about $1.4 million in sales

    - multiply that $1.4 million by 22% (low end GROSS MARGIN national average forPharmacy)and that leaves you with $308,000

    - pay yourself a salary of say $125K/year
    -your Tech a salary $30K
    - a clerk a salary $20K

    -electricity, pharmacy computer system, pharmacy switching fees, alarm system, Phones, Water, vials and other supplies all can vary but it should amount to no more than $25,000 PER YEAR.

    SO: $308,000 minus ($125K RPH+ 30K TECH+ $20K Clerk+ $25K for supplies electricity etc + debt and rent service/taxes of about $40K/YEAR= $68,000 a year as the OWNER–that’s just at 100 RXs per day…just think of how many rx’s you are filling at WAG, CVS, Walmart etc per shift (250+) and the way they treat your support staff as though the store is going to go our of business if your tech stay until closing………it’s simply done out of their corporate greed; not from any underlying financial reason. Empowering yourself is empowering our profession.

  4. Peter  •  Dec 10, 2013 @11:21 am

    Broncofan,

    Great summary above. I don’t see why more pharmacists don’t open their own practices, rather than hating their current jobs. The numbers are even more attractive in Ontario. 100 Rx’s per day = about 1 million in sales, but with a gross margin of 30-35%. There are indies in my town that do 600 Rx’s on a Mon/Tues, 300 the rest of the week. They are killing it and liking their jobs.

  5. broncofan7  •  Dec 10, 2013 @3:57 pm

    Don’t rub it in Peter!;)

    For those who have a true understanding of how the US pharmacy market works(IE our prices are DICTATED by the insurance companies; not negotiated)you would be SHOCKED at how Canada allows Pharmacists to charge whatever they’d like their DISPENSE FEE to be..(please clarify Peter if I misrepresented the Canadian system)…..BF7

  6. Peter  •  Dec 11, 2013 @10:34 am

    You’re right, Broncofan. The exception is Ontario Drug Benefit. You can only charge an 8.62 dispensing fee (12.68 if you’re rural). And drug mark-up is capped at 8% of their list price (in reality, your mark-up is closer to 8% after wholesaler upcharge.

    But with private plans, you can charge whatever fee you like. Now, the insurance company usually has a cap/max dispensing fee (ie 10.99 or 7.99 or 4.99), so the patient would then pay the difference between your fee and the cap. Depending on the spread, some pharmacies don’t pass on the fee difference.

    The major difference – 75% of dispensary revenues are driven by dispensing fees. Another 25% from drug mark-up and 25% from generic incentives. In the US, I understand that a very small amount (maybe 25%) of dispensary revenues are driven by fees, with the rest being driven by product pricing spread.

    Although these differences seem academic, they dramatically shape the business/economics. It is much easier for an insurance/PBM to “go after” product pricing spread as this turn the whole operation into a retail distribution network. But going after dispensing fees attacks the professional services provided by pharmacists. That is bad PR.

    We are actually trying to make changes here where the pharmacy is no longer paid any fees, they all go the pharmacist who checked the Rx. But we’re going to start off with trying to move “clinical revenues” that way. These include flu shots, Medication Reviews, pharmaceutical opinions and refusal to fill. These are not MAJOR sources of revenue, but would get the ball rolling to have dispensing fees also move to the pharmacist.

  7. Peter  •  Dec 11, 2013 @10:39 am

    But there’s one problem up here in Canada. Discounting. In the US, collecting the co-pay is legally required (it would also be suicide not to, given the thin margins). Here, a lot of pharmacy discount or waive part or all of the co-pay in an effort to drive up numbers. It is becoming a disease and makes us all easy targets for third party payers to REDUCE reimbursement.

  8. broncofan7  •  Dec 11, 2013 @5:18 pm

    Thanks for the terrific information Peter. With the typical dispense fee in America being in the $1.50 range and the AVG Gross margin per RX being around $12.50, the dispense fee in the US market is more like 12% of GROSS revenue……

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