A Glimpse of Rural Pharmacy Practice

Wow, what a week it’s been!  Our days have been filled with travel and meetings all over southern Minnesota.  Monday and Tuesday were spent in Worthington, Adrian, and Fairmont touring Sterling Drug stores and the towns.  Thursday brought us to Comfrey to speak with Jim Schneider about the recent closure of Schneider Drug.  This week provided an informative glimpse into rural pharmacy, which I had never seen before.

Perhaps one of my more surprising revelations was that these towns in rural Minnesota are not as small as people from the Cities might think.  Worthington and Fairmont both have populations of 10,000-12,000 and boast large towns with a variety of services and opportunities.  Even Adrian, with a population of 1200, had a beautiful golf course and new assisted living facilities.  These towns do not seem as “rural” as I had expected.  Comfrey fit my expectations a bit more, but I was shocked to see how beautiful the buildings and homes are, since everything was rebuilt after the 1998 tornado.

Along the lines of pharmacy, I again had a few surprising revelations.  After visiting several independent pharmacies in the metro area and hearing about the challenges they face, I had assumed that most rural pharmacies had the same problems.  And I also assumed that rural pharmacies would have problems finding enough patients to sustain the business.  But after visiting southern Minnesota, it seems that rural independent pharmacies are generally thriving.  One of the largest factors causing their closure is not slow business, but finding a new pharmacist to replace the retiring owner.  Rural pharmacies are able to thrive for a few reasons.  There are fewer chain pharmacies as competition, and while there is certainly competition between the several independent pharmacies in the community, pharmacies are able to find their niche and somehow everyone can survive. These rural pharmacies offer countless services that enhance their business, from large DME sections to diabetic shoe fittings to MTM visits.  For some pharmacies, their niche includes a large gift section.  I was surprised at how important these gift sections are to the communities, because many times they don’t have other local options when searching for items like home decorations, for instance. 

Another interesting find regarding rural pharmacy is that pharmacists in these communities are really recognized as health professionals.  Pharmacists are trusted and respected, and communities seem to truly understand and appreciate the services that pharmacists offer.  Pharmacists also generally are very involved in other aspects of the town, whether it is the economic development association or running for the school board.  Rural communities view their pharmacies and pharmacists in a much different light than anything I’ve ever experienced here in the metro area.

Lastly, I should mention the unique and exciting setup that Sterling Drug has started in the cities of Adrian and Worthington.  Adrian lost its pharmacy a couple years ago and they were not able to recruit a new pharmacist to take over the store.  Sterling Drug recognized this opportunity and put a telepharmacy in place about a year ago.  Karen, the lone tech at the Adrian location, fills prescriptions and takes pictures of the process.  These pictures are electronically sent to the pharmacists at the Worthington store, who then perform quality assurance checks and verify the accuracy of the prescription.  When a patient arrives in Adrian to pick up medications, Karen again calls the Worthington pharmacist and a patient-pharmacist consultation takes place over video and telephone.  Only a small handful of telepharmacies exist in Minnesota, but I’d guess that their number will rise over the next few years as aging rural pharmacists close up shop.  Telepharmacy is a fantastic way to serve communities that otherwise would have to travel to meet their pharmacy needs.

I went into this week with an open mind and some excitement, and I can safely say that I am now strongly considering rural pharmacy as a career path.  I am so very thankful to have had this opportunity.  I really wish that somehow all Minnesota pharmacy students had the chance to see firsthand the great opportunities that rural pharmacy practice can offer!