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THE TOPICS

Case Study: Talking About A Revolution
Lucinda Schmidt
Western Australian pharmacist Grant McGill shares how his pharmacy has recently changed … For good. 

“For me, it’s the sum of the parts of being a health professional … You can have your burn dressed, your baby weighed, your sleep apnoea tested. The message to customers is that these guys are pretty serious about health.”

When Perth pharmacist Grant McGill moved to bigger premises six months ago, he transformed almost every aspect of his business. Out went the hair dyes, perfumes, gifts and most of the makeup. In came products and services for health issues such as sleep apnoea, diabetes and asthma, as well as nurses on staff to check blood pressure, dress wounds and weigh babies.

Grant, who owns the independent Kingsley Village pharmacy in northern Perth, says he’d been mulling over the changes for some time.

“Kingsley had always been a traditional, community pharmacy where the guy who owns the store runs the store and knows 90% of the customers by name,” he says. His vision was to focus on professional, health-related products and services and ditch just about everything else, including two major cosmetic brands.

Talking About A Revolution

“I had often looked at pharmacies as I walked past and seen a stack of toilet paper, washing powder and lipsticks near the front. These are not health-related and are available in other outlets like supermarkets,” Grant says. “I didn’t really like the direction the industry had been going in, becoming more price and retail driven.”

While he acknowledges that these retail products may draw customers into the store, he argues that they can come at a cost to professional gravitas. “I sometimes wondered whether our industry had perhaps forgotten our traditional background as health-focused healers.”

The relocation, to a space more than double the size of his previous shop, gave Grant a chance to back himself. “The ideas had been festering and organically growing, but I’d been limited by space,” he says. “The opportunity to relocate was a definitive line in the sand, the chance to start with a clean slate. Rather than a gentle manipulation, it was the chance to build from the ground up.”

THE NEW GUARD

“It's a culture shift for us and the customers; it's not always tangibly trackable … One of the biggest positives has been the professional rewards – I'm having more meaningful discussions with customers who are seeking proper health advice.”

Now, when a customer walks into Grant’s pharmacy, they see a four-metre stretch of wall devoted to sleep apnoea, three-metres for diabetes and two-metres for asthma. “These three areas have a hell of a lot of space, with lots of brochures and signage, not just stock on shelf,” Grant says. “And there’s a tremendous amount of space given to scheduled medicines.”

As for cosmetics, Grant has reduced his offering to one small spinner stand of a basic “cheap and cheerful” brand, which takes up about one metre of shop floor.

That’s not all. The new pharmacy boasts two private consulting rooms with beds, plus a semi-private area adjacent to the dispensary for customers to discuss their sometimes delicate health issues. Two days a week, a nurse comes in to run an adult health clinic, checking blood pressure, changing wound dressings, removing stitches and the like. On Fridays, a midwife is at the pharmacy to weigh babies and help mothers with advice on breastfeeding, sleeping and nutrition.

Customers pay for any products used such as bandages, but the nurse’s services are free. “For me, it’s the sum of the parts of being a health professional,” Grant says. “You can have your burn dressed, your baby weighed, your sleep apnoea tested. The message to customers is that these guys are pretty serious about health.”

Other services include a one-hour consultation on sleep apnoea, followed by an overnight home sleep study and a teleconference with a specialist physician. The pharmacists and nurses also teach customers how to properly use inhalers for asthma and chronic obstructive pulmonary disease.

THE CHALLENGES OVERCOME

Grant is candid about some of the challenges he faced to make the transformation. The biggest one was self-doubt. “I worried about whether I was building a pharmacy model for me rather than for my customers,” he says.

Another challenge was the cost to do it right. Apart from banishing some of the easy money-spinners, he wanted his new 203-metre square space to look very different from a typical pharmacy. “It was courageous,” he admits. “I fitted this place out like the Taj Mahal.”

He didn’t work as pharmacist for six months, while he consulted with architects and builders over the layout, project managed the fit-out and met with manufacturers, suppliers and educational groups involved in diabetes, asthma and sleep apnoea.

“It was damn hard doing it myself,” he says, adding that it would have been much easier – and cheaper – to join a franchised group, but he didn’t see any that captured his vision.

“The line in the sand has been drawn – I'm not jumping back on the other side. Will I continue with it? Hell, yes.”

REACHING OUT FOR HELP

He discussed ideas and problems with a retail health consultant, who gave him the courage to fully embrace his pharmacy’s new slogan, Destination Health.

“I’d say to her (the consultant) ‘I’m worried that Mrs Jones will come in to buy her favourite lipstick and it won’t be there’,” he says. “She’d say, ‘That doesn’t fit. Draw a line in the sand, decide what you want to be and stay there. Do things that are congruous with your brand. You don’t go to Dick Smith Electronics looking for a lipstick’.”

The transformation also required staffing adjustments and extra training. Grant now employs two full-time and one part-time pharmacist as well as two part-time nurses, three full-time shop assistants and about 10 casuals. He’s done several full-day courses with various sleep apnoea suppliers and educators and all his pharmacists and nurses undertook a full-day seminar at Asthma WA.

“We were the first in WA to be accredited by the Asthma Foundation as an asthma-friendly pharmacy,” says Grant, who suffers asthma himself and believes the condition is often under-treated. The pharmacy’s other two focus areas, diabetes and sleep apnoea, were chosen because Australia has an ageing, fattening population.

“It is an 18-month to two-year project before we can say this is bearing fruit … Things are heading in the right direction but it's a constant evolution. This is a rebirth.”

HERE TO HELP

A fourth focus area, mental health, is now being developed. “We want people to know we’re a safe place, we’re non-judgmental. We’re here to help, we’re not just here to sell them stuff. We do care,” Grant says. Down the track, the pharmacy will also offer an immunisation service, if the laws in WA change to allow this.

“In my head, it’s a practice, not a shop,” he says. “In my head the customers are patients, but I call them clients because people don’t see themselves as a patient at a pharmacy.”

Information technology has also played a big role in the transformation, although Grant says changes were already underway in his old shop as he is passionate about the role of IT in improving efficiency and delivering better service. His nurses, for example, use iPads to photograph wounds for their files and the pharmacy has more than 300 customers using MedAdvisor to order their scripts in advance and keep track of when they need a new one.

CAUSE AND EFFECT

“I sometimes wondered whether our industry had perhaps forgotten our traditional background as health-focused healers.”

Six months on, the reaction has been mainly positive. At the Australian College of Pharmacy conference in Hobart in August, Grant spoke about his experience in a session aptly titled ‘I did it my way’. He says other conference delegates were interested in and supportive of the path he has chosen. Since then, he’s had a steady stream of pharmacists visiting him or ringing to have a chat about how he’s doing.

Customers, too, have reacted positively. “No one has come in and said, ‘Oh my God, you’ve got rid of hair colours’,” he says.

People are asking if the nurse is on, for advice about which bandage to buy, for example, or to have stitches out. While customer numbers are about the same as before the move, he’s had 7% growth in prescriptions filled. “I wonder if we’ve lost the random cosmetic buyer but gained customers who need professional advice.

“It's a culture shift for us and the customers; it's not always tangibly trackable,” he says. “One of the biggest positives has been the professional rewards – I'm having more meaningful discussions with customers who are seeking proper health advice.”

The Friday clinic averages about 10 mothers and babies and the twice-weekly adult clinic treats 12-15 people each day. Close to 20 people have used the overnight sleep apnoea study and follow-up. Grant would like to see more customers using the asthma and diabetes services but says six months is not a long time. “It’s slow, but Rome wasn’t built in a day.”

The reaction from local doctors has been mixed. “I think there’s some turf issues,” Grant says. “Some doctors love it, some say nothing.” His hope is that eventually local GPs will suggest to patients that they go to his pharmacy for services such as changing dressings, in between doctor appointments.

KEEP ON KEEPING ON

As to the sustainability of the changes, Grant says his new approach requires constant diligence. “We’ve drawn a line in the sand on what we stand for. You’ve just got to keep at it. The market has changed and we have to change too. It’s all about sustainability.”

“It is an 18-month to two-year project before we can say this is bearing fruit … Things are heading in the right direction but it's a constant evolution. This is a rebirth.”

He’s encouraged by the reaction of one doctor, who was impressed by the referral written by one of Grant’s nurses and co-signed by a pharmacist. The doctor asked if he could use the referral as an example of how to communicate properly, in a university course he taught.

Grant, who became a partner in the Kingsley pharmacy in 2000 and the sole owner in 2005, says his pharmacy has always been an expression of himself. “A large part for me is the professional positioning of the business for my own personal satisfaction. Some people have said it’s revolutionary, but I don’t see it that way. I just had the nerve to do what others have been thinking about for years.”