Never Give Up; Never Give In; Never Quit!
I remember reading a book in junior high school, title “Winners Never Quit” by Phil Pepe. The paperback book was a compilation of stories about athletes from different sports who, against all odds and setbacks, fought through adversity, injuries, and life challenges to forge through some of the most difficult times in their life. Whether or not they were able to make a comeback in their respective sport was not the theme of the book, but rather how they lived their lives with fortitude and determination. Although the entire book and each person’s story was inspirational to me, it was the one person I didn’t know that affected me the most. His name was Jim Hurtubise, an American race car driver, who in 1964 suffered serious injuries and burns from a fiery accident during a race he was competing in. By the time they were able to extract him from the cockpit, he had suffered 3rd degree burns over 40% of his body requiring three months of rehabilitation. The part of the story that impacted me, was when his doctors informed him that muscle and tendons from his hands were burnt off, his right pinky was amputated, and pins were inserted in for the other fingers. The legend of his story is that when told by his doctors the extent of his injuries and that they could mold his hands into one position, he asked that they be molded so he could grasp a steering wheel. And if that was not inspirational enough, he did go on to race again within 10 months of his accident suffering through pain and discomfort.
So, what does this story have to do with me today? Being an owner and CEO of eight pharmacy practices (6 community, 1 LTC, and 1 cash-based practice focused on non-sterile compounding and functional medicine), I would say I am committed to the success of our corporation due to my financial commitments. But beyond my monies that are tied up in my practices, I helped to build our corporation, so my ideas, vision, and brand are also intimately tied into our practices. So, I care deeply about our practices not just surviving, but thriving in the future. Add to that, that our corporation employs over 75 employees who are caring for twelve to fifteen thousand patients, I also feel a tremendous obligation to have our practices succeed. And that is how I tie the story I began this post to what I am experiencing today—the threat of the existence of my practices, my livelihood, my passion—and I absolutely, positively refuse to quit in the face of the biggest challenge in my career. The challenge that I am talking about is the financial viability of my practices in 2024 given the “DIR Cliff” that will hit pharmacy practices in the next twelve months.
So how am I fighting back (and this is a fight)? First and foremost is making sure that our practices are financially sound—optimizing our non-dispensing revenue, evaluating and eliminating expenses that have no payoff in the next twelve months, ensuring that we are right staffed, improving our inventory management, reducing our cost of dispensing (med sync and central fill) and securing lines of credits with our bank partner. Additionally, we need to maximize our revenues from our non-traditional practice models including our cash-based practice, medical at home, and our cost-plus direct contracting with self-insured employers. We will need to maximize our cash-based clinical services using our critical thinking and problem-solving skills to identify our patients’ medication needs and wants and deliver consistent high-quality care. And we will need to optimize our collaborative working relationships with other providers and our community partners.
The next twelve months will be challenging, but we will survive. Survival is such a basic instinct of all living organisms. And though I am not talking about a physical survival of my body, I am talking about the survival of my my vision/beliefs/convictions that pharmacists are critical to the health care system. That there is tremendous value in pharmacists providing medication optimization services. That we are stronger when we work as a health care team with pharmacists taking responsibility for medication management of their patients. That pharmacists can and do have impact on patient outcomes using their skills and knowledge to ensure patients are achieving their therapeutic outcomes with safe and effective medications. So, much like the characters from the book that I read in junior high school, quitting is not an option for me! I want to survive, I want my practice to survive, I want my patients to receive care locally from a trusted health care provider. Last week, during a meeting with another provider, the individual said that he appreciates my “can do” attitude—my response to him was simple—it’s not just an attitude, it is a belief at the very core of who I am—“Stand up for your beliefs and your convictions and when they are threatened, never give up, never give in, and never quit”