Pharmacy Growth

Becoming a Pharmacy that Dispenses Healthy Solutions – The Bottom Line Pharmacy Podcast

Are you dispensing prescriptions or healthy solutions? Now more than ever, independent pharmacies must continue to carve out their niche by offering services that add value to their patients. On this episode of The Bottom Line Pharmacy Podcast, the team (Bonnie Bond, CPA, Kendell Harris, CPA and Scotty Sykes, CPA, CFP®) welcome T.W. Taylor, from Williamsburg Drug Company, to discuss how he has taken steps to reinvent his retail pharmacy as a community wellness center where he is able to offer diversified health services for his patients.

This episode is for educational purposes only and is not intended as medical or health advice.

The Bottom Line Pharmacy Podcast is your regular dose of pharmacy CPA advice to fuel your bottom line, featuring pharmacists, key vendors, and other innovators.

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If you prefer to read this content, the video transcript is below.

Kendell: So welcome again to another episode of “The Sykes Bottom Line Pharmacy Podcast.” We have me and the host, Scotty Sykes, Bonnie Bond and a very, very special guest, TW Taylor. If you have been to any trade show floor, you have probably seen TW. Very well known, a man of several talents, some of them you can see in the picture behind him if you are watching on YouTube. We have a race car, aviation, pharmacy, and so many other things. TW from Williamsburg Drug out of Williamsburg, Virginia. Thank you so much for joining us today, TW. I know we have a very interesting topic. For those watching on YouTube, there are going to be some slideshows, but we will talk to it if you are listening to the podcast, and we look forward to jumping in, TW, so what are we talking about today?

TW: Perspective. So today I want to talk about perspective, and this means what are you willing to give up in your pharmacy for a bigger gain? And so I wanted to start with a neat way to show you perspective. We talk about millions, billions and trillions like they are all the same. To put perspective on it, a million seconds is 11.57 days, a billion seconds is 31.71 years and a trillion seconds is almost 32,000 years, and that gives you the perspective that just because you say things, what does it really mean? And so for today’s talk, I want to talk to you about all the tools in your toolbox, not just the prescriptions, and as healthcare professionals, we need to practice as a healthcare professional, not as a prescription filler. And everybody needs to know what their personal nutritional needs are, and when usually we talk about that is about eating correctly. Well, today I am not talking about eating correctly. I am talking about what is it that you are missing in your metabolic pathways that is keeping you from being your healthiest, and it does not matter, if you have a single deficiency, whether it is a mineral, vitamin, antioxidant, amino acid, you know, an enzyme process, that can set off a cascade of events where the metabolic processes are disturbed. Conversely, if you replete whatever that deficiency is, you can often resolve it and reverse disease. To give you an example, we have a friend of mine that is a physician that is metabolic, he is thin, works out and his diabetes is getting worse, orders a Dexcom 6, we tested him, he was deficient, a borderline deficient in 11 of the 15 nutritional molecules you need to process glucose. We repleted him. In six days, his blood sugar was back to normal. His next A1C was 4.9, no longer a diabetic just because his body did not have the tools. Your body is best at fixing itself. And you.

Scotty: Let me interrupt you there. Tell, talk to us about, you know, what you and the pharmacy do in terms of testing, what kind of revenue that generates for the pharmacy, how you do that. Maybe kind of dive into that service offering at the pharmacy that you do.

TW: Excellent, excellent question. So we believe in test, therapy, test, and sometimes it can be really simple. You can do a pH test or saliva or urine. If your pH is below seven, definitely below 6.5, you are mineral deficient, and if you want your body to be alkaline, then you need to eat lots of good vegetables, take multi minerals. That is the ways that you could get your pH up. And for example as to how important it is, cancers cannot grow in an alkaline environment. You cannot develop kidney stones, well most kidney stones, there are a few exceptions, in alkaline urine, and so it is just healthy for your body. The trouble is that the normal American diet is very acidic, and that is just one small example. I mean, you can do simple things like blood pressures and blood sugars. We can even do, we have a little machine, we can do an antioxidant study. You can even just do a questionnaire. There are several good questionnaires that are available, and that gives you data, so now you can track the patient, do the repletion of whatever that is, and then get the person healthy and feeling better.

Scotty: And that is all cash-based revenue?

TW: All cash-based. And as you know, Scotty, our business is well over 40% cash, and so when we lost track here recently, I did not have to lose any sleep about it.

Bonnie: Right, that is a big thing because, and obviously we work with lots of pharmacies and you go into lots of pharmacies and see that. It is amazing those that are not diversifying their income where they are just doing scripts. What would you say to that, TW, with all the options that are out there now to bring in other, you know, streams of revenue?

TW: I tell you, Bonnie, you are hitting the nail on the head. You know, we at our pharmacy do a lot of things. We do compounding, which is about 96-plus percent cash-based, so in reality, for the pharmacists to practice at the top of our license and get paid at the top of our license, you give people value, and they are willing to pay for the value, and your customers are already going to GNC, they are already going to the internet and Dr. Google, and so why aren’t we taking care of that? We are the healthcare professional. The average GNC sells over $500,000 in supplements a year. My question to the independents are, are you, you are letting a three week wonder outdo you? I mean, it is ridiculous. We should own this market and help our patients get healthy, and people know it. I mean, our average patient comes in, has already seen, you know, 10 to 15 doctors and they are just not getting any relief. A great example is Amazon spends well over $100 million a month in treating sickness because their employees aren’t getting healthy and they cannot work, so Amazon, to fix that, went with Berkshire Hathaway and spent a few billion dollars in the current healthcare system, and it was a complete failure, and I know for a fact that people in the industry that have met with them, that if they had enough touchpoints to treat health, they would pay independent pharmacies to do it because they determined independent pharmacies was the best way to go.

Bonnie: What I love about you, TW, is you are even willing, when you think about this, to give up a script that you could fill to offer something else that maybe a supplement that could take care of the situation, so you are kind of moving that service level to something else that will help them more, maybe get them off of the script, and I do not know about the revenue versus, you know, one script to what maybe the supplements that you can offer, but you are still treating the situation, but maybe in a different way.

TW: Yes, if you want to stay as a order taker and prescription filler and keep your head down, then you are circling the drain. If you want to start practicing where it is actually fun and exciting, you have got to give up something to get the new gain, which means you are going to give up some time to learn new things, and I know that is scary for a lot of pharmacists. Oh, I am too old, my patients, we cannot afford it. I hear all those excuses, but if you are willing to do it, it is so rewarding. I mean, I was downstairs in our pharmacy and saw a lady looking at some supplements last Saturday when I was working and I asked her could I help her, and by the supplement she was getting, I just kind of guessed she was seeing Dr. Reid here. And Jaime, her whole practice for, she is a 4M fellow, is she sees patients. We charge $225 an hour and she is booked into December.

Bonnie: She is amazing.

Kendell: Wow.

TW: Oh, definitely. And so we get, you know, 15, $20,000 a month in cash revenue just from consults, so people will pay for it. And this lady I am helping, I said, you must be seeing Dr. Reid. She says, before she could say yes, she burst out into tears because Jaime was the only person that helped her after seeing all these doctors. And she had gotten her life backwards, her quote, and this is like 30 some-year-old lady, and that is what is so rewarding, and we are just connecting the dots, giving your body the tools it needs to do its job rather than another drug which needs another supplement because it is depleting you of something else, and that is what makes this rewarding for the pharmacist. It is a better paradigm than what we are currently using.

Bonnie: And like you say here on the slide, you are prescribing a healthy solution, so it is the solution and what works best for the patient, not necessarily maybe the script. It could be something else.

TW: Yeah, I am going to give you a quick.

Kendell: Oh, go ahead TW. I want to hear this example.

TW: Give you a quick example. You know, like the dreaded Krebs cycle that all of us had to learn in biochemistry. If you look at all the places that that, and to make energy, you have to have all the different nutritional molecules: CoQ10, B12, B5, zinc, magnesium. If you do not have all those in sufficient qualities, then it cannot work correctly, and it is a great opportunity, and it is so many little things you can do in your pharmacy. Just start with one thing. Nitric oxide. Nitric oxide repletion, you can test a patient, you can give them a nitric oxide product, you can retest them and prove to them that they are healthier, and it is basic for vein health, and you are as old as your veins. I mean, it is a win-win. I cannot tell you how many people we have gotten off of blood pressure medicine. It is really rewarding.

Kendell: And when did you, TW, realize, you said that the kind of the system, that it is a broken medical system, and you, it seems like you are taking tools that are readily available, but in the way you are thinking about it of I am just going to find a solution, so you are going to use these tools to not just fit them in the same mold of just filling prescription. You are going to use these tools, but when did you realize that okay, the way things are being done traditionally is not the way TW wants to do it? And was there an epiphany, an a-ha moment or how did you come to that conclusion that, I am just going to approach this.

Scotty: It is day one.

Bonnie: He is a go-getter. He is always out there looking for a different way to do it.

TW: Yeah, that is very true. I have always done a lot of unique stuff. I had a home care company one time that we did, you know, blood transfusions at home and babies on ventilators, so I have always been very interested in, you know, pushing the envelope. In this particular case, I bought these pharmacies, and this was I guess five or six years ago, and just before then I had started helping this lady and we would do a, like a saliva test, a ZRT test for a postmenopausal woman. We would know exactly what she needed as far as hormones and we would make the perfect bioidentical hormone replacement therapy for and give it to her, and I had follow up with her like two weeks or a month later, and not only was she not better, she would be worse, and that would make absolutely no sense. And so when you start looking for the reasons, you find out, it is really basically two. One is adrenal fatigue, so her body is doing a pregnenolone steal, and if you do not fix that system then you, she will never get her hormones straight. And on top of that, if you do not have all the nutritional molecules, and most of those are B vitamins, they cannot utilize. A good example on men is you need boron and zinc and vitamin D and a number of things to process testosterone, and if you do not have them, I do not care how much testosterone you give the person, IM, transdermally, it is not going to work. And so once we started finding out, I just started going down this rabbit hole. And you got to remember, there is nothing special about me doing this. All this is informa-…, I did not do any basic research on any of this, but I started connecting the dots.

Bonnie: You know, a lot of it kind of almost seems common sense. I have never really given it a lot of thought until I spoke with you years ago about some of this stuff. But you are right, I mean, you know, a patient goes in, maybe they have a heart attack and obviously, the doctor is going to do what he was taught to do. He is going to prescribe these certain drugs for different things. But maybe there is, like you said in your last slide, a root cause for many of the things that that person has going on.

Scotty: No more cheeseburgers.

Bonnie: Obviously.

Scotty: Or fried chicken.

Bonnie: If there is something else that could be, if you can get down to that reason, then maybe you do not need two of the four drugs that you are on, there could be something else.

TW: 100%.

Bonnie: Yeah.

TW: 100%. And you are exactly right. So, if you look at the American diet, you eat three pounds of sugar a week on average. That messes up your gut. It all starts there. You have nine, you have more bacterial cells in your gut than the rest of your body by factor of nine. It tells you how important your gut health is. And almost everybody because of the sugar has candida, which leads to a leaky gut, and then you have autoimmune diseases. So, it is nothing magic. So it is, the three most inflammatory things we do is gluten, because wheat has nine times more gluten than it used to because of short stalk, the amount of sugar we eat and dairy. Those are the three most inflammatory things, and if you can eliminate those from your diet, you will start feeling better because it is creating inflammation, and inflammation is the enemy. And I wanted to get a couple real quick things in. The most valuable currency in life is your health. I do not care how much money you have, what race you are, what economic background you have, it does not matter if you do not have good health, and you can either take time to work on your health now or you will be forced to work on your illness later. And another way to say it is most people have, want to have a financial retirement plan. What is your health retirement plan? And the earlier you start, the healthier you will be.

Bonnie: That is a great point.

Scotty: Good way of looking at it, isn’t it?

TW: And for the pharmacists out there, you know.

Scotty: I better get in the gym.

TW: The secret sauce is really simple. You just got to talk to your clients. The people that walk into your store are dying to tell you the story. All you got to do is listen, and you do not have to know all the answers. You can research them. It is easy to do. I mean there is, Jim Lavelle. Read anything he writes, or you know, Mark Hyman. I mean, any of these people are just, Pam Smith. They are just wealths of information, and there are all kinds of stuff out there. A4M you can even, or IFM or Arizona State, there are a number of two-year programs to become a fellow, and this is how it gets rewarding and you step up your license where you are practicing at the top of your license and getting paid.

Kendell: In a sentence, how do you start that conversation? Do you have a go-to sentence that kind of gets the conversation going, or where?

TW: Well, it really depends on the person. So like, you know, I had a lady come in yesterday and she is getting an antibiotic, right? I think she is getting Augmentin. Well, you know that is going to be a tough one. It is going to mess up her gut, it is going to take her a year for her bacteria to get normal again, so the first thing you need do is give her a good probiotic. Now, in those cases we use a lot of, you know, saccharomyces boulardii because it is more resistant and you just wait an hour or so after they take the antibiotic and give the probiotic and help keep the bacteria straight. Well, one out of nine is going to get diarrhea, one out of 25 is going to get C. diff, so it is in their best interest to take it, and it is the pharmacist’s responsibility to tell them about it. It is not the pharmacist’s responsibility to figure out what is in their pocketbook. The patient will decide how to spend their money. And so you need to offer it to them, and I would say three times out of four I sell them a probiotic. Now, I made more money on a probiotic probably by double than I did the prescriptions, and I did something to help the patient more.

Bonnie: That is a good point. And one other thing.

Scotty: What is a good probiotic?

Bonnie: Oh yeah, that is good.

TW: Well.

Scotty: Because I am taking Augmentin right now, as a matter of fact.

TW: Oh yeah, well yeah, you need to, about an al-raft of Augmentin, you need to take a good saccharomyces boulardii. We use Biotics Research for that. It is pretty cheap. I would take two, three, four of them, about an al-raft each dose, and then I would continue that until you finish the bottle, even if you have finished your dose, and then I would go to a good daily probiotic that you need, and the more billions is better, usually, you know? Another thing we can do is we do a GI map that we can actually test your gut to find out where you are at and then we can zero in at what is best for you.

Bonnie: Interesting.

Kendell: Wow.

Bonnie: So on our latest podcast, TW, we were talking about OTC and just different offerings and that sort of thing, and we talked about, this is what made me think of it. We were talking about how important it was for your staff to understand these items that you are kind of, that you are selling and and talking to these patients that are coming in about, so how do, talk to us a little bit about that. How is your staff, with this particular thing, do you spend some time educating them on kind of what they are talking about, what they are selling?

TW: That is exactly right. Communication is key. You have got to continually educate, have your people go through classes. So what we did at our store is that every Thursday morning from eight to 8:30 eastern, we started where we would have a subject matter expert speak on some supplement, and we started doing it just for my staff, and then other people found out about it, so we started sending it to other people, and then POA, Pharmacy Owners Alliance picked it up, so now they store all of our Thursday mornings on their website, and we have probably done hundreds of these things. So you can, does not cost anything to be a member. You can go in and look at all of them. We did a six-part series on fish oil with a PhD that is world renowned. Dr. Harris. We just finished a seven-part series on minerals by a PhD. We will have somebody come on and speak about, you know, whether it is inflammation or gut health or, and so we are constantly training our people, and it is simple things like vitamin D. 85% of the people are probably vitamin D deficient or not optimized. It is a big difference between being within normal limits and being optimized. Normal limits for vitamin D can be 20 or 30 to 100, but you really want to be around 80 to be optimized, at least 75. That is where you prevent cancers, Alzheimer’s and those kind of things. And so if you could actually give, if you had vitamin D levels on all your staff and you are able to turn that in to the insurance companies, the actuaries would actually give you better ratings because they have data to go from.

Bonnie: Nice.

TW: And like vitamin D, a good rule of thumb is people should take about 45 international units per pound. You always take D3 because it is 85% more absorbable than D2 and it is, of course, natural as opposed to D2 is synthetic. So we try to focus in and teach our staff, to answer your question, and also our pharmacist because we did not learn that stuff in school.

Bonnie: Right, and like you said, when someone walks up and you see what kind of prescription they are getting, you need to understand what you could offer as a maybe a substitute or something to help them along with that particular thing.

TW: And by the way, Bonnie, you are not a salesperson.

Bonnie: Right.

TW: You are an educator, you are a professional, and if my physician did not tell me stuff I need to know, because they did not think I could afford it, that would be malpractice.

Bonnie: I agree. This is really interesting to me. I mean, because honestly, I do not think I have ever had, and not that I have been a terribly sickly person, but I do not think I have ever gone into a pharmacy to get my prescription filled and someone say, hey, I see you are getting this. Why not think about taking this with it? This will help maybe with this, that and the other. I do not think that is ever happened to me, so it is a.

TW: And just think, now they are taking.

Bonnie: That would be awesome.

TW: Yeah, they are taking a real interest in you, right, and…

Bonnie: Which is what independent pharmacy is, right? That is the difference. I mean, if you are going to just walk in to a big box and pick up your script and not have any kind of personal conversation about anything else in your situation, that is what you would expect from a big box, and to me this is a great way to stand out as an independent pharmacy.

TW: Healthier patients, healthier profits.

Bonnie: Yep.

Scotty: So I hear, TW, a lot of pharmacies say, well my patient mix, this is not a good fit for my patients. I am in a low income area. What do you say to push back when folks push back on that on cash-based revenue items?

TW: I hear that all the time, and I can give you some examples of pharmacies that are, one pharmacy is in a 95% Medicaid area and they were able to pull this off, because you got to remember. What is frustrating to me is I will talk to a pharmacist and they will tell me exactly what you just said and they have told me that they cannot do it, and they are correct. If I talk to the pharmacist next door and they tell me they can do it, they are also correct. And so it is really a big mindset. And so again, back to perspective. If you had 3,000 people in your database and you got 10% of them that wanted to be healthy and really were interested in staying healthy, they would probably spend an average of $300 a month with you. 300 patients spending $300 a month is $1,080,000 a year at 50%. This is not rocket science. I mean, and again, healthier patients, healthier profits, it is a win for both of you, because if you are not in business, you cannot help yourself, your patients, your family, your community, nobody else.

Bonnie: And I think I remember you speaking at, maybe it was the Ananda conference a few years ago about this particular subject, and I think I remember you saying that you have, over the years have been surprised. Like, you cannot just assume what maybe a certain community or group may or may not spend when it comes to their health, that you have been surprised over the years to see that maybe people that you would not expect, maybe people that will, you know, will spend the money and do it.

TW: I mean, I will tell you some bizarre stories. I had a lady that is extremely wealthy come to us and she did some testing and, and she says that we did not tell her she had to pay for the consult and was just irate, and I said, well, I will tell you what, at the end of the consult, you pay me for what you think it is worth. Now you know, we charge $225 an hour. If you think it is worth nothing, do not pay me anything. If you think it is worth a dollar, pay me a dollar. If you think it is worth what we charge, pay me what we charge. After the consult, she called me back and said, I would have paid you double. And so pharmacists have to look at it, if you are giving value for what the patient is paying for, they are willing to pay you for it, and people that are interested in staying healthy and are sick and tired of being sick and tired, I do not care, they will give up. Just like us, you got to give up to get something. They will give up something else, that, you know, $50 meal twice a week in order to be healthier.

Bonnie: That is a good point.

Scotty: Yep.

TW: And you know, this goes back, this is nothing new. Hippocrates, 2,000 years ago said, our food should be our medicine and our medicine should be our food, and the reason that is important is, I learned this recently. If you ate an apple in 1914, in 1992 to get the same amount of iron out of that apple, you would have to eat 26. If you ate a serving of beef in 1963, in 1992 it had no vitamin A in it, where in 1963 it had a daily serving of vitamin A. Spinach in 1950 went from 150 milligrams of vitamin C per serving to 1994, 0.13 milligrams of vitamin C, and it just shows you that the minerals have been depleted out of the soil, and so the only way you can get some of these minerals back is to take a supplement, and you cannot use normal supplements like at GNC or Costco. They are junk. I had a guy come in that was a PA, retired and needed, he was just feeling terrible, so we ended up doing a micronutrient test on him, intercellular micronutrient test, and he told me that he knew his CoQ10 level was going to be great because for three years he has been buying it at Costco and it was the best absorbed, advertised on TV, and his CoQ10 level was hardly detectable. And so you got to make sure you get high quality supplements from places like Biotics Research or Designs for Health or Ortho Molecular, and they are not cheap, but I got to make sure that if I am testing my patients and I want them to get healthier, I am selling them something that will actually work.

Bonnie: Can I ask a question about that, just out of curiosity? So how are these groups able to sell these supplements that technically are not anything, they are not doing anything?

TW: Great question. So when you go to the supermarket and you buy your carrot, do they guarantee how much vitamin A is in it?

Bonnie: Nope.

TW: Nope. They just guarantee a safe consumption, so supplements are nothing but dietary supplements, and so they test it to be safe for consumption. They do not test it for content. So there was a lawsuit in New York in 2015 and they went to four different places, Costco, GNC, Target and Walmart or something, and they pulled off all the supplements and tested them. 80% were not what they said they were, and the herbs, none of them had any herbs in them, and so.

Bonnie: It is terrible.

TW: And now you see that they will put USP approved and stuff on the bottles to try to make you think that it is better, but you really have to get true, third-party tested supplements.

Kendell: And so for your pharmacy in your community, those who are coming to you, they are getting these tests, I am assuming they pretty quickly have a knowledge that what you are offering is different than GNC and then also what you are offering, you actually have a level of care that is different than let’s say, a big box pharmacy. So you are different than the GNC guys and you are different from the pharmacies. How do you get that message out there? How do you get that message that what you are doing is different? Is that something that they find out after they experience the Williamsburg Drug experience, or is that something that you are advertising and getting that message out there?

TW: Well, we do a number of things. We do talks to the public and we give speakers, we have speakers that we will give to any group, so the Lions Club, Rotary Club, Kiwanis, you know, Bible study groups, whoever it is that wants, the garden group, if they need a speaker, we will provide them on any number of subjects, and that gets our pharmacist out making relationships. And we have tons of word of mouth, obviously, and we now have a lot of practitioners sending us patients. So what happens is a practitioner, you know, a nurse practitioner, Dr. Dio, whoever it is, they will have their patients come back to them and tell them like, the experience they had with us. Well, they cannot do that. They are not trained. But the biggest thing is they are not allowed to, so they have to practice the standards of care, so the ones that are really interested in their patients, they will send them to us, we will put up a nice report and with a little bow wrapped around it and send it back to them and then they will sign off on whatever prescriptions we need. So it takes a little while to build this, you know, Rome was not built in a day, but once you do it, it took us about two years to really get through the process of learning what we needed to do and how to do it to get to the level we are doing it now. But you know, we sell a ton of supplements and we, you know, do a lot of consults.

Bonnie: Hmm.

Kendell: That is awesome that you are sharing that knowledge. I have some pharmacies that I hear all the time saying, yeah, I talked to TW about doing this and that. You are really helping. It is not, you just built it just to hoard it. You have built it and now you are allowing other people, other communities to benefit from it also.

Bonnie: Yeah, yeah.

TW: You know Kendell, that is a terrific point because to explain why this is so important, if we learn to be the wellness center where we actually treat you to be healthy and healthier and healthiest, if we can do that, then we can change how pharmacists are practiced, they become a real value that I have a relationship between me and my customer or me and an employer and they are paying me for that value, and I have no middlemen between me, no PBMs, no insurance companies because this is all cash and they are getting the value for the money they are paying us, and that is a win for pharmacy because we now are practicing at a whole new level that nobody can take it away from us. The only way I can screw that up is if I screw up the relationship with the customer.

Scotty: You got a patient for life there.

TW: Yes, yes.

Scotty: Forever.

TW: And we end up doing Zooms, we are doing Zooms with patients, like a lady’s sister lives in Texas or Washington state, and so we are actually sending the kits to do the testing and setting it up for them, and then we do the Zoom with them, and there is a lot of basic stuff like I threw up on the screen here, you can do little things like pH, nitric oxide, a BCA, a body composition analysis. You know, you can do uric acid levels. You can do all these things in your pharmacy. These are real quick. So we have developed a little program that you know, we will charge $20 a month and you can come in, get all these tests and then we will give you the supplements and then you can come back and we will retest you each month and then you can show the person that the time, money and the effort they are spending is worth it and you are getting them healthy. Again, a healthy retirement plan.

Bonnie: Love it.

TW: You know, and how do you optimize people’s health? Well, you know, you do nutraceutical and supplements and testing and compound prescriptions and consults and lifestyle diet changes, but really it is always a combination of those things, and sometimes you do need prescriptions and sometimes you do need to compound prescriptions, but you need to start out with the basics where you are actually fixing the underlying root causes rather than masking it. I mean, how many people get a blood pressure medicine and they never do any root causes? We have had a number of patients that we treated their inflammation, their CRP levels and it has gotten rid of their blood pressure problems, just because the inflammation went down. So, you know, my job is to optimize my patients’ health, not just to fill prescriptions.

Bonnie: And so I like this point you have up here about age. Just out of curiosity, what is the youngest patient you have worked with and what is the oldest one you have worked with, TW?

TW: We have had, I think a 96-year-old, and we are not afraid to give hormones, biomedical hormones to, you know, a 90-year-old either. I mean, you have got to give people, their bodies the tools they need. And we have had some kids as young as four that are already showing up with all kinds of, you know, these wide ranging symptoms that are kind of, do not really make sense, and they go to the doctor, everything is fine. When you start digging down, it is the same old things. You know, they have, you know, a gluten problem, a dairy problem, you know, so you just got to figure what the root causes are. They are already deficient in things, and so once you start figuring it out, they start feeling better.

Scotty: TW, what about those who have the mindset that I want to get into, you know, expanding my horizons with the, my license and get into something like this, what would be your advice on getting started? What would be the first, you know, two or three things to get started once they have that mindset that, hey, this is something I want to do for my patients?

TW: Yeah, yeah. Just do something. Just pick one thing and do that. You know, just do nitric oxide. That is a great one to start with. You know, most everybody is going to be zinc-, vitamin D-, fish oil-deficient. Fish oil is a terrific one to use. I recommend Parasol. We like that one a lot. It is got the right DHA, EPA content. And again, we can do blood spots for fish oil, for vitamin D in your store. So you can do the bush, the blood spot form or give them the kit to take home, you can send it in, you will get the results back as the pharmacist. And so again, this is something simple and easy you can do. These tests are 30, 40 bucks, and the person can get a level that you are treating too.

Kendell: And I know like for example, compounding is a big barrier to entry because you have to have the right equipment and things of that nature, but for just kind of being the wellness center, as you put it, are there any major barriers to entry, major things that keeps someone from being able to get into kind of shaping their practice to be more focused on health that you know of, or is this something that the average pharmacist, if they decide tomorrow I am going to start doing it, that they can kind of just get started?

TW: They absolutely can get started tomorrow. They can get started today. The only barrier is themselves, and you know, we are all our own worst enemies, but the only real barrier is yourself and your comfort level. So like I said, start with one thing, and let’s get one thing going that you are successful with and then build upon that, and pretty soon you will be selling, you know, $10,000 a month in supplements at a 50% gross profit margin. And if you, and I am working on some things right now to help us develop private label that does not cost you an arm and a leg, so it would be high quality, third party tested, the correct stuff. At the same time, it will be at a good price where you can make a good profit margin and private label it. And so that is one of the projects I am working on there because I feel, and this is not all altruistic, if we could get to where we had 30 or 40,000 independents nationwide, we would look like we are a green and growing group, not a brown and dying group, and that would give us the touchpoints we need where Microsoft and Amazon and Ford and Chevrolet, all those people, GM, they would pay us to keep their patients healthy. Now, that is the model I like for us to find.

Kendell: That is amazing.

Bonnie: Yeah.

Kendell: And one other question. I am always thinking about the pharmacist who is, spends the majority of their time at the bench, so they are the independent who’s not able to hire several pharmacists to cover the whole schedule. What is some, what is the time commitment? So you said financial barriers, there aren’t any. What is the time commitment, and if someone is serious but they do not have, they are not as profitable as they will want to be currently, how would you encourage them to get started with taking the necessary steps to dedicate the time needed to get something started like this?

TW: Well, I mean, you know, what are you going to give up for the gain? You know, you got to give up something, so you know, maybe instead of having a whole day off, take a half a day off and then for another half, you know, that you have scheduled patients to see and start building the income that way. But immediately, you can start in between patients. Hey, like I have a lady come in and she said that she is having trouble sleeping at night, and she is having some leg…I asked her is she having leg cramps or muscle twitches, and she said she did. I said, and this lady’s like 80 years old, and I said, hey, you want to have some fun? She says sure, starts smiling. So I said, hey, lick this. So I gave her a pH strip to lick. Her pH was like five, 5.5. I mean, it was real low. So you know they are mineral deficient, so give them some magnesium, so I gave her some magnesium. This was on a Saturday. She comes back on Tuesday going, I am sleeping all night and my leg cramps are gone. What else can you do for me? I mean, those are real simple wins you can do and start today. I mean magnesium, vitamin D, fish oil. You have people with eye problems, they have eye dryness and stuff, give them some fish oil, and in six weeks it will be fixed.

Bonnie: So TW, when we do these, we like to end with a bottom line, which is the name of the podcast. We all kind of go through and give our bottom line kind of from what we have talked about today. I am going to go first.

TW: Go for it, Bonnie, go for it.

Bonnie: I have like six. I have actually been making notes. But I think understanding what I have taken away from this, we have talked about this a lot so I, you know, I kind of already had a, kind of a background, but really, as an independent pharmacy to me is really understanding the importance of making this, it is again, not just filling scripts, it is a wellness center, it is helping the patient, whatever that might look like. But it is a win-win too, so it is a win for that patient because you are going to help them in all different aspects of whatever they have got going on, but then it can be a win for the pharmacy as well. It is just kind of a byproduct of the situation is this may be, you know, more profitable for you as well, and you know, being able to offer this, the guidance, the advice and just more of a caring nature to me about the situation is what I am taking away.

TW: That was inspiring, Bonnie. TW’s got Bonnie inspired.

Bonnie: It does, I am so impressed.

Scotty: I think TW did a great job. He has got you ready to roll, Bonnie.

Bonnie: I got to sign up, man. I keep saying it every time we talk about this. I am going to pull the plug. I want to see.

Scotty: I think my bottom line is, I like just pharmacists out there practicing at the top of their license, and this seems like that is, there is a lot of reward, it seems like, coming out of this for the pharmacist and the patient. So, practicing at the top of your license is key, and that that really is the future pharmacies need to go down towards, because filling prescriptions is not going to get you to the top.

Bonnie: Yeah.

Kendell: Yeah, and I will say for me, the wellness center aspect of it, the biggest barrier from what you said, TW, is someone’s own mind, and the biggest tool and asset to building it is their mind, just being able to see the connections and make the connections that they have the educational background to already make. So it is just amazing that, just in their own mindset, in between patients, they can build something that is collectively becomes a wellness center, and that is all it takes, so that was a big takeaway for me.

Bonnie: And I would just like to say that I am so excited about this that I am willing to do a podcast episode in the future where we can test my stuff and we can read the results and then talk about what we can do to help me.

Kendell: That is pretty, that is a good idea, Bonnie. That is a good idea.

Scotty: That is such a good idea, Bonnie. We do not want to know what you got going on.

Bonnie: I mean, I have not talking about extreme details, but I mean the basic stuff, I am not shy.

Scotty: TW, what is your bottom line today?

TW: You know, I think we said it before, it is really us pharmacists have a new paradigm to practice pharmacy. This is an opportunity for us. It is actually a gift from the current medical system to us is what it is. They are practicing sickness and people are dying to have the chance to have wellness, and that is why they are going to Dr. Google all day and they should be coming to us, and so it is a real gift to us to change the way we practice pharmacy and step up to be where we really should be. And this is practicing, you know, the clinical stuff that pharmacy schools have been talking about forever, but cannot get any traction, and this is how you get the traction. And for us, it is really rewarding as a business owner, because now I am more insulated than I was before, because if Caremark dumps me for whatever crazy reason, I am still in business.

Bonnie: You are good.

TW: And so it protects my, all the people, my teammates here, and that is what is important to me, because down the road it is all about the team you build to accomplish great things, and that is what I find rewarding. And so if it was 40,000 of us pharmacists, we could double the number we have. It would be rewarding in the long run for all of us.

Scotty: Well said.

Bonnie: Absolutely.

Scotty: Well said. Well TW, we certainly appreciate your expertise, your time today. It has been, as always, it has been fantastic to have you on here talking with you, and we hope to do it again soon, because you got a lot of knowledge up there and we love to have you on here, so…

Kendell: Yes.

Bonnie: Lots of different topics we can touch on, that is for sure.

Scotty: Oh yeah, oh yeah. I will be sure to email Jaime and say, hey, I need a probiotic when I get off this thing, but, yeah, thank you, TW and we will sign off on “The Sykes Bottom Line Pharmacy Podcast.” Until next time, thank you all for listening.



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