The goal is to create an army of pharmacists that dislikes drugs and wants to change healthcare for the best.

Pharmacy, as an industry, is synonymous with drugs. The more a pharmacy dispenses, the better chances they have at success, right?

Independent pharmacists are realizing this volume-based approach to business isn’t working anymore. Josh Rimany, a pharmacy owner in Charlotte, NC, decided to take a radical stance on patient care after he realized that medications weren’t always the solution. In order to create better outcomes, he turned to functional medicine. Josh has worked in the independent pharmacy industry for 27 years, and his interest in medicine and wellness was inspired by his time spent overcoming leukemia at 16 years old. “In that process, I realized I wanted to be in the health field,” he reflects. “I’ve always stayed with pharmacy. It’s really the only job I’ve ever had.”

Like most pharmacy owners, Josh believed that dispensing alone could account for most of his store’s profit. He quickly realized this mindset would not be sustainable for long-term success for Dilworth Drug & Wellness Center. “I call it the dispensing disease we have in front of us as we make less and less on these commodities. There was an urgency, from a business standpoint, to find another pathway.” He continues, “Within that pathway, I started to see the need for us to be more of an advocate for wellness and nutrition.”

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During the past five years, Josh has explored the realm of functional medicine and how an anti-drug model can work for pharmacies. In an industry that relies on “filling and billing,” it seems detrimental to coach patients to a state of wellness that no longer requires prescriptions. “Functional medicine is so important because chronic conditions aren’t managed by pills alone; they’re managed by a total approach to someone’s health,” he says. Josh’s stories of reversing  unexplained migraines, fibromyalgia, and tremors are evidence that, if pharmacists and their patients work together, they can create a viable model for better outcomes and profitable business.

This dual approach is one that pushed the Dilworth staff to reorganize the store’s front end: they condensed the typical OTC items (bandaids, pain relievers, cold medicine) and created a new layout that optimizes their wellness items. The wellness-centered retail side now offers everything from nutritional supplements to cookbooks, and Josh even hired an on-staff Registered Dietetic Technician Nutritionist (NDTR) to be available to patients who have questions. By shifting the focus to bolstering the retail side, Dilworth is no longer entirely reliant on dispensing, and Josh hopes to instill that mindset in his colleagues. “The goal is to create an army of pharmacists that dislikes drugs and wants to change healthcare for the best,” he says.

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Passion for Value-Based Care

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For functional medicine to truly be effective in healthcare, patients and prescribers need to be on board, as well. Fortunately, Josh has already observed an increase in his patients’ investment towards their health. “People, especially millennials, are flocking to wellness. They don’t want to take pills. Look at how many yoga studios and fitness classes we have on-demand to keep ourselves healthy,” he says. “And who is the healthcare provider driving all the health coaching? Pharmacists.” The wellness model may yield favorable outcomes, but pharmacists have their work cut out for them as everyone else transitions from the prevalent sickness model. “I can get a patient off of their statin,” Josh explains, “but my adherence numbers are going to be skewed in Star Ratings because they’re ‘not adherent.’ This system is slightly broken, so we’ll have to get creative with our metrics.” Pharmacists can work alongside physicians to develop and record these metrics that validate the functional model.        

Although pharmacy is an industry that has embraced change throughout time, Josh feels it is stuck in a “rut” of dispensing, which may be solved with technology and practices like synchronization that free up more time to spend on innovative strategies. Functional medicine isn’t the ultimate solution, according to Josh, but it is one he found and perfected once he had the time to look for options outside of dispensing. “Time is the new currency, and if we have time to spend with our patients, then we can do the transformational change and figure these solutions out.”  

“Time is the new currency, and if we have time to spend with our patients, then we can do the transformational change and figure these solutions out.”