PharmacyProud.com | Dave Ruth

This transcript was generated automatically. Its accuracy may vary.

[00:00:12] Mike Koelzer, Host: You're listening to the business of pharmacy podcast with me, your host, Mike Koelzer

Dave Ruth is a pharmacy owner in Kentucky. He's worked in chain pharmacy most of his career, but became an independent owner just over a year ago. He is also a founder and partner in pharmacy, proud.com in listening to Dave, it's easy to hear the pride in his voice when talking about caring for his customers.

When I asked Dave what he missed most about leaving the chain pharmacy, Dave said, if you don't miss your patients, you've been doing it wrong. Enjoy the show.

Dave is very patient with me. I had a glitch or two earlier and, uh, he's hung in there joining us now. And I guess that's what we do as, uh, business owners. We find out how to make everything work. We don't have a choice. 

[00:01:21] Dave Ruth, Pharmacist: Well, you know, uh, it, it helps whenever you have an opportunity to rub elbows with such luminaries as yourself, uh, with, with the whole patient thing.

I, I believe, 

[00:01:31] Mike Koelzer, Host: you know, my wife, my, my wife, uh, she doesn't like, you know, computer issues and, and, uh, she just, you know, she'll do 'em for a little bit and she'll kind of say, that's enough, they'll give up. And, um, I will, nobody else pats me on the shoulder except me, but I always find a way to. Get things figured out.

And if, in my dreams, if somebody came to me and said, oh, Mike, you're so good at that, it would be like, well, you don't have a choice, you know, when you're in the pharmacy. And if you can't get something up and running, those are dollar signs behind that. If you're not, if you, if you haven't figured it out.

So in my little dreams, I'm kinda like the family hero. 

[00:02:15] Dave Ruth, Pharmacist: Well, you know, um, um, perception sometimes is reality, right? Yeah. That, that really is, uh, the way that we have to operate things. I was on the phone with an internet service provider for two hours, because they were saying that they wouldn't be out to, uh, to get the internet back up and running until Monday.

And I'm like, well, you know, we're actually a healthcare provider. Yeah. I think that I probably need to be a fuzz, uh, above the food chain then. Yeah. Then, then, then, then billy@homesurfingespn.com. Yes. And, and there's, uh, you know, sick people kind of, sort of need medicine and we need the internet to be able to do everything that we need to do.

So, uh, get out there and after two hours, it finally worked, but I quite literally was on the phone with them for two hours. They didn't appreciate me very much by the end of the time. I don't believe well, you don't, but it 

[00:03:04] Mike Koelzer, Host: fixed. You don't have a choice. You don't have a choice. You have to do it. Well, Dave, you, you have done.

Really cool things, um, with your, with your profession, but let's start, I know you have an association back, you had started an independent pharmacy and now you've actually become an owner. Bring us up to speed on that. 

[00:03:28] Dave Ruth, Pharmacist: So, you know, I graduated from a, from a UK, uh, university of Kentucky in 2007. And at that point in time, even during pharmacy school, I was a, I, I was a chain guy.

I was an intern for, uh, one, one of the, one of the big chains. Um, And, uh, you know, they're based outta Arkansas, if that tells you anything. And, and I, for the most part, I really did enjoy my time there, at least with some of the people there. And I was there for, uh, accountant pharmacy school, 11 years. And, um, then I got an opportunity to get into the independent game, um, uh, a few years ago.

And. I decided it was time to make a leap because with, with the, um, with the, the change, and I'm gonna try to be as diplomatic. Uh, Mike it's possible. Whenever I say things like this, uh, with the chains, uh, sometimes I was told or with my particular one that, um, you focus too much on the individual patient and.

Focus enough on, uh, doing all these corporate metrics and all these things that we're asking you to do. And I said, yeah. And I had Frank discussions with people, you know, uh, if that's the way you want this business run, or if that's the way you want this practice run, that's, uh, that's all well and good, but I'm really not your guy.

Like me, I'm not going to do it. That's before I worry about patient care. And so the opportunity to move into the independent game, really, uh, it, it came at a good time for me and, and I did it and I moved over and then I, um, actually wound up going, uh, uh, taking a ownership opportunity with, uh, and it was a little bit messy in the great scheme of things.

Uh, the, my, my, uh, boss, I guess, uh, my, my employer, the owner of the pharmacy that I worked at, wasn't in the market for a partner. But one of our competitors was, and you know, I'm at the end of the day, um, as much as I enjoy working in a certain place, um, my. My duty is to my wife and my kid and the kid that I didn't know that I had on the way at the time, but nobody else knew that we had on the way at the time, either turns out.

So, you know, I got a wife and two kids at home now, and, and those are the people that I work for. Like, those are my true employers. So, uh, the opportunity was right for my family and it was time to, uh, make a, make a change. And I wound up going about a three quarter of a mile down the. To, to, to run a competitor as a, as a minority shareholder.

And, uh, as we sit here today, about 14 months afterward, uh, instead I'm, I would say senior partner, but I'm the co senior partner. Uh, we, we have a coup uh, we have a handful of shareholders, uh, The guy that owned the store of 100% in full, uh, whenever I came over and I are now a co senior partners there, and I'm a minority partner at, uh, in four other stores.

So we've done remarkably well over the last 14 months, but a lot of that is, uh, it is due to. My partner and, uh, my partners, uh, putting me in a position where I could really succeed and they, then they set me up in a great, in a great situation. So we, we all benefited and everything's going pretty well right now.

[00:06:46] Mike Koelzer, Host: Now, Dave, when you say, when you say you had left the chain, were you saying that you went to somebody else that was kind of, of a, a competitor of where you wanted to go or just a competitor of the chain? 

[00:07:00] Dave Ruth, Pharmacist: Well, um, I, I left, uh, the chain pharmacy, uh, you know, I was running a. Uh, I was managing a, um, a, a pharmacy in Lexington in the big city where I worked.

Sure. And I wound up going to a, um, going, going to a more rural area. It was about an hour commute, really, but it was, uh, working with a, with a guy that I had a, um, A previous relationship with, and it was his store. And, you know, I had done some relief work there, which I probably wasn't supposed to do in the chain lexicon, but, you know, uh, uh, sale lave said the old folks, it goes to show, you never can tell, I guess.

Right. But, um, but uh, you, I, I wound up taking a position there and I was there for a couple of years and, and then this new, this new opportunity came along and gotcha. And, uh, and, and did, um, honestly, uh, uh, truth of a matter, uh, stated I signed, uh, when I came over, I, I was willing to sign a three year contract and I didn't quite work there for three years, but, you know, whenever, uh, whenever it turned out.

That we, uh, that we found this opportunity, what's he gonna do? Is he gonna have me, uh, working there for another couple of months saying, Hey, I'm, I'm actually gonna leave and go work for that's a business thing. Yeah. Right. And, and, and, and we could get into all that, but it's not really, uh, necessary for it, it doesn't really further our discussion.

No, that's at the end. But at the end of the day, he can't have me working there as a lamb duck when I'm going down the street. So he had, uh, he didn't want me to finish that contract, so, but. I did not. And that's okay. And that's fine. 

[00:08:36] Mike Koelzer, Host: What did, what did you miss about the chains? If anything, after you made that leap, what, what did you long for, in your memory of working at the chain store?

[00:08:52] Dave Ruth, Pharmacist: Well, um, I think that's a double edged sword on, on one hand. Uh, if, uh, the first thing you miss about a practice, where you ate, where, where you were for several years is not your patients. You've been doing it wrong. Yeah. And, and certainly I, to this day, uh, I'll occasionally run into one of them out and about somewhere or, uh, one.

The people like, you know, I had several interns at that company that are still, um, managing stores that were like you, I guess, part of my, uh, in, in a sports lexicon, they they'd say they were part of my coaching tree or whatever, but, um, you know, they're, they're still there. So I still hear from them about somebody saying, Hey, what's Dave into these days.

And sure. They're, they're certainly first and foremost of what I would say. I. From there from everything else. Um, you know, in the great scheme of things, for the most part, they were pretty good to me for, uh, a long time. And they, they, uh, helped support me, get me through school and they, they, they paid me actually, uh, uh, Which, uh, in 2019, maybe not so much, there's plenty in the news about, uh, particularly that corporation, but several others, uh, getting rid of fairly tenured pharmacists and hiring new grads at a lower rate and all that stuff.

But, um, But for the most part, they treated me pretty well. And, and, um, you know, I'll, I'll say, uh, my first, uh, district manager, whatever for that company was also my landlord when I was in pharmacy school. So we had, we had solid relationships. Sure. It's just that, uh, you know, in the great scheme of things, I'm, um, I'm a down home country boy.

Uh, it was in Kentucky in a fairly Sizeable city. You know, Lexton has a quarter million people. It's the second biggest, uh, town in the state. But, uh, you know, in the great scheme of things, a quarter million people, isn't a huge city or anything. I, but, but I'm a, I'm a country boy, and I. And being able to get into a rural practice where you know everybody by name and they don't treat you like a fast food restaurant, just, uh, well, this one's closer.

So I'll go here and that appealed 

[00:11:02] Mike Koelzer, Host: to us. Yeah. What, what, um, wh when GI give us a snapshot and, and this will be mainly pharmacists listening to this, give us a, a snapshot of, of where you're spending your day in terms of the, the square feet of your store and, and your general product mix and things like.

Well, okay. 

[00:11:26] Dave Ruth, Pharmacist: So, um, like, like I say, I'm a, I I'm the senior or a senior partner in, in one location. I'm a minority shareholder in a, for additional stores. Now, some of my other partners, like a, I guess my cos senior partner in my primary practice location, he has. 20, uh, 18 in Kentucky, either, as the senior partner or the junior partner and two in Florida, uh, recently, uh, acquired.

Uh, so, so we're branching out a little bit, uh, all minor in Kentucky, but, um, so I'm administrating. um, for those stores, but I'm also administering a couple additional stores that are in similar, uh, similar or, uh, loosely similar geographic areas. I'm essentially east of Lexington in Kentucky. So I administer for, you know, seven or eight, um, depending on how we wanna look at it, I guess.

But my primary practice location is in a, uh, is in a small town. What I would call kindly on the border of central two Eastern Kentucky. Okay. And we have, um, a, it, it, it. Uh, years and years ago, the building was an old diner and, uh, it it's, uh, it doesn't have a whole lot of the retro diner, uh, benches or anything like that, that you, that you think of when you hear old diner, but it's a small space.

Uh, I do not have an office per se there, you know, it's, it's a, it's a front end and a back end and we're done. And, and, you know, it's a low overhead, like, you know, my rent, there are three figures, right? Uh, Yeah, high three figures, but three figures monthly. Um, and, and you know, not a lot of people listening to this will, uh, will have a similar experience.

That's at the low end of the spectrum and that's fine. You know, some of the rent at the other places is certainly correspondingly higher, but, but this place is, you know, really, really it's essentially, uh, no more than. I think, I would say a thousand square feet all told it's a, it's a small area.

Uh, but we, uh, and, and we do a correspondingly fairly small, um, uh, front end or over the counter trait. We do some honestly, uh, Mike, I probably give away as much Tylenol as I sell. Sure. A great scheme of things. Uh, we do, we, we do have, uh, some, uh, some, um, We do, uh, trade and CBD oil as well. Um, we're pretty exclusive as far as that goes, uh, for what we carry, we're strictly in an and pharmacy and, and that's, uh, that's due in a lot of ways, uh, to, uh, and, and I don't know, uh, whether it's appropriate to use that name or not, but I'm happy to use it cuz I'm proud of the products we care.

And, um, and, um, you know, we, um, we, we do a fairly sizable trade, uh, in that as far as, uh, for, uh, a rural, uh, area that's, um, if not the buckle on the Bible belt, it's certainly one of the notches, you know, it's, uh, there's a whole lot of, um, Ethical, um, or moral, um, worries, I guess, for some patients, whenever we're talking about using a, a CBD type product, but we, um, so for, for that type of area, we, we try to do our best to educate and, uh, yeah, that's a big part of it.

And explain to PE and it's a big part of all of it, I suppose, is making sure that you have an opportunity to spend time with your patient base and educate. 'em like, you know, cuz you, you, um, you, you obtained your degree by, by spending a great deal of time, effort, and money to learn all this stuff. And so did I, so taking time to.

Uh, use that degree is always something that, especially a guy that's a rehabilitated chain pharmacist that felt like he was a robot. Sometimes just pumping out the number after number like it, it, it's a, it's a nice, uh, opportunity. And it's a nice, uh, reminder of, uh, why we love what we do 

[00:15:27] Mike Koelzer, Host: so much. Dave, something that caught my ear.

It's the great equalizer now about, you know, office space and you're, and you're, uh, the administrator of, you know, a half dozen, uh, other pharmacies. How, what are you, what are you, um, doing? What's your communication, uh, slash organization? Um, With these other pharmacies, is it a lot of calls? Is it a lot of emails or a lot of in person visits?

What's your, um, what, what's your favorite mode of, um, you know, getting your thoughts to them and, and, and feedback from them. And so on. Well, 

[00:16:11] Dave Ruth, Pharmacist: um, a little bit of all the above, I suppose, Mike, uh, we have a, um, B because, um, you know, we, we have, um, be between my, my own, uh, uh, personal shareholder stakes and, um, The other partners, you know, we, we have a fair, we cast a fairly widen net.

Um, the, uh, the first store that I guess is a senior senior partner, if you want to think of it that way, the guy that's the majority shareholder at the, the majority of these stores, um, he, uh, you know, his first store. Just happens to be fairly centrally located to all of them, at least in Kentucky.

Gotcha. And, and it happens to be the one that's the closest to, uh, where I live. So it's easy to get out to, to the primary store, which also has the, uh, management group, uh, per SES. Um, gotcha. All this gotcha is attached. So we, we, we. Office manager, but to refer to her simply as an office manager is just a, a wide and grievous, um, , uh, underestimation of her actual, uh, role and, uh, skill.

Sure. And, and, and for that matter, she's also a partner in a couple of the stores that I'm a shareholder in as well to include my primary. Practice location. And she, uh, and, and, and she's, uh, what, what she is, is she's the, uh, the, the, the generator that keeps the lights on for us. Oh yeah. In a metaphorical sense.

So, so we rely on her pretty heavily to help get some of these administrative tasks out, but I'll, um, I'll spend, uh, probably three quarters of my practice, uh, time, uh, onsite in a location being the, uh, I guess, uh, quote unquote, the pharmacist on the bench. Gotcha. And, and that'll be, uh, I try to get to each and every one of 'em at least once or twice a month, uh, as the guy that's there running the operation and, and then, you know, I'll have some days where I try to hit two, three or four, um, At once and, and just pop by and say, Hey, listen, I'm a, I'm not bad at what I do, but, but I'm blessed.

And I'm fortunate to have several people working with me that are probably better at what I do than I am. I 

[00:18:32] Mike Koelzer, Host: I know a lot of us maybe don't have the, um, the, you know, enough, enough, uh, lack of pride to do that. But that's what. That's what they say, uh, you know, get things 

[00:18:43] Dave Ruth, Pharmacist: done. And like I say, that there are people that are better at, uh, running the business side than I am.

And there are people that are better at the clinical side than I am. And, and honestly, you know, when we, when we're talking about 20 stores, you know, I hope I'm nothing. If not a self-aware man, I'm probably middle of the road at both of those for 'em, but. Uh, I just happened to have maybe a luck into an opportunity or two, and I hope I, I grabbed it whenever I did, but when I'm administrating or when I'm traveling out and going to, to tour and visit some of the pharmacists that are on site working these stores, I hope that what they see me as and what I try for them to see me as is just the tool that they can utilize to help them, uh, continue to run their business in a smooth fashion.

And we, and we've got. We got a whole lot of talented people. I'm really, really lucky to be where I'm at. 

[00:19:37] Mike Koelzer, Host: Yeah. And that's, you know, we've always said that in, in our, in my pharmacy, we've always said that, um, you know, we always wanna have good people, but even, you know, even, even greater procedures and in ways we do business versus, you know, and that's how McDonald's made their money, you know, they don't have, um, rocket scientists.

In, in the, um, you know, in the food prep and there's, and, and you don't, you know, that's not where a rocket scientist belongs, but trying to get, um, good people in a, in a great system is, is probably the smarter way to go than always having great people in a, in just a decent system. Because of those great people.

Take their vacations or, or, you know, through attrition, move on. Um, it's, it's hard to re 

[00:20:27] Dave Ruth, Pharmacist: yeah, absolutely. I think that's, uh, I think you hit the nail right on the head with that and we, uh, it takes, um, it, no, uh, if you wanna punch, uh, Punch higher than, uh, having, having a store and running a store and, and plenty of people, uh, do that and are fulfilled by that and are very, very, very successful at it.

Uh, both, uh, you know, personally and financially, but also as being a really, really good steward for the community, which is what I hope all of ours, uh, want to be, because I know that's one of my, the chief and, uh, overarching goals. But, um, if, if you wanna punch higher than that, You best believe the first order business is you need to have a good, uh, if you need to have some good bones in place for that.

And, um, and some good ideas. Yeah. And some good, uh, I hate to use the word policy because it sounds so corporate, but you, you have to have some good standards of practices, I guess. 

[00:21:21] Mike Koelzer, Host: Yeah, you do. And I, and then someone told me the, um, you know, it's kind of like policies. it'd be like, you know, me driving down from Michigan down to your parts and you know, not having everybody wants their freedom, but it'd be like not having.

Yellow lines dividing the highway. I mean, to get where you need to go, you have to have enough structure to give people the freedom to, to move in the right direction. 

[00:21:47] Dave Ruth, Pharmacist: Yeah, absolutely. Uh, the 100% agree with that and, and we've got good. And, uh, like I say, a lot of that has. Absolutely nothing Mike to do with me.

And, you know, like I say, I, you know, we, we've got, uh, several partners on board. Um, a and you know, I've got, uh, in a lot of ways, I still sort of feel, uh, look at myself because I've only been around for such a brief period of time in the great scheme of things as a, as more of middle management. But, you know, my, my partners and, and like I say, are, are a couple senior partners really don't think of me.

That. And they don't treat me like that. They treat me as an equal, which is, you know, uh, it it's a good feeling, but, you know, I, I sometimes, um, just like anybody else, uh, struggle to, I, I guess kind of, sort of comprehend exactly, uh, what kind of an impact and what kind of headway we've made over the last 14 months.

It's been a bit of a whirlwind. 

[00:22:46] Mike Koelzer, Host: Sure. Yeah, exactly. Exactly. Dave. Tell me about it all right. We've talked about you've, um, you've talked about wanting to help the customer and, and it's it's, it goes deeper than, than just a, a transaction. And a lot of times. Pharmacists are stuck with that, with that transaction saying, you know, I wish I could do more.

You've actually done something more down in, uh, in Lexington on Saturday. Tell, tell me, uh, tell, tell the audience a little bit more about that. 

[00:23:22] Dave Ruth, Pharmacist: So, um, you know, even when I was in pharmacy school, you know, just, just like, I'm sure, uh, you had. When, when you were in school as well, uh, one of the things that the administration wanted to, uh, wanted to.

Uh, make sure that everybody understood is that community service, uh, wasn't just a requirement for your degree, but, uh, for you to, uh, be a good pharmacist, uh, in your profession and a good steward for your profession, moving forward for the next, uh, 20, 30, 40 years, you needed to continue. And, there was a, you know, a community service requirement with, uh, with school in the UK.

And one of the opportunities that they provided was an opportunity to go volunteer at the, uh, free pharmacy in downtown Lexington. And, um, and, and I did it a couple of times, and then whenever I graduated and, and I move moved on and started running, I've run in stores, uh, for, uh, a co in a couple different, uh, areas for, um, For, for my, for my employer, uh, for my, for my chain, um, you get so busy and everybody calls you on your day off.

Hey, can you do this? Hey, can you do that? Can you go work these extra S well, I got student loans. I'll go to work. Sure. But, um, but so I fell outta the habit. And then, a few years later I got back into the habit and I went, uh, and I started volunteering there again for the first time in, uh, quite some time actually.

And it turns out that I really appreciated getting back out there. And I did it a couple of more times, and then we switched operating systems like pharmacy software to what I just happened to also run in my day job. And, uh, when that happened, I, I was kind of, sort of volunteered to be the pharmacist in charge there.

And I was already the pharmacist in charge elsewhere. So I had to, you know, get, uh, permission from the board, the Kentucky state board of pharmacy in writing to be able to be P C in multiple locations. But because we're, we're literally only open for three hours a. From nine to noon on Saturdays. And even though lately it's closer to one or one 30, most of the time, because you know, we've got, uh, uh, politics aside, uh, healthcare environment in 2018, 2019 is probably a little bit different than it was, um, several years ago.

And, uh, we've got more people that I I think have slipped through cracks recently. And, and the original thing, uh, has always been you. Uninsured. And then with, uh, the advent of Medicare part D or everything in the donut hole, UN uninsured and underinsured, uh, uh, became a thing. So we, uh, you know, we're busier now than we were several years ago, but that's a, I mean, it, it, it's a double edged sword.

Again, it's a good problem to have in, in as much as the words, getting out to people that need it. And it's a bad problem to have because people need it. But when. But be yeah, right. We run strictly on, um, either donations or, uh, the, the majority of our operating budget comes from a grant from the good Samaritan foundation, which is, you know, associated with a university of Kentucky and, and their hospital system.

So, yeah. You know, we, we have a budget that we adhere to and, you know, we're E everything's free. We do not have a switchboard where we can bill insurance. It's all, uh, some sometimes, you know, somebody comes in, they have insurance and they can't afford their copay. And it becomes an opportunity for, well, do we, uh, do we spend $450 on this, uh, on, on this, uh, a B a, um, uh, slash steroid inhaler.

We, uh, Come up with 40 bucks to help 'me pay their copay, or do we send them to the, to, to the health department who has a three 40 B cash, uh, program that, that, that they're able to do since? Uh it's um, you know, like I say, it's, I'm quite unquote, the P I'm there about once a month in the great scheme of things.

And we've got, we've got a wonderful staff of several, uh, rotating, uh, in and out volunteer pharmacists. And we have also a, and, and we have a, uh, I I'm the P C but the pharmacy in and of itself also has a CEO. And I'd be remiss if I didn't mention that he absolutely has a, probably a heavier hand in it than I do.

Uh, and, but, but he'd say that, uh, I'm the boss, I'll say that he's the boss, uh, in, in any effect, we work pretty well together, but, 

[00:27:54] Mike Koelzer, Host: uh, That's right. And plus you're gonna both avoid responsibility when, when something hits a fan too. I like that theory to, 

[00:28:02] Dave Ruth, Pharmacist: to a point. Sure. But unfortunately when it all boils down to it, my name's on the wall.

So,

[00:28:10] Mike Koelzer, Host: You know, we had, uh, forgot where I was. It must have been when I was in pharmacy school, we had a place called Matthew 25. So it was in the Bible where. You know, Jesus talks about clothing, the naked and that kind of thing. And so it was from that and we would go down there and we'd. I, I don't know how we did it.

I wasn't in charge of it though. I was, I was, I don't think I was using a pharmacist yet, but we'd actually get free medicine, not free. We'd have used medicine from people that dropped off their medicine, you know, before the incinerator and the drug collection things. And, uh, I, um, I'm glad my name wasn't on that because we had.

You know, you had medicine coming that was in someone's house for, you know, two years and you would take it and Bo Bo it up and give it to the next person. And you know, maybe in maybe third world countries that you can still get by with that, but not with all the. Um, the, the, the legal and, you know, rightfully so in, in today's day and age, 

[00:29:13] Dave Ruth, Pharmacist: we, we, we still have plenty of people that are willing to, uh, that, that, that inquire, uh, weekly.

Uh, want to know, can they donate, uh, this medication for a family, for, from a family member that is unfortunately passed on or will I'm not taking this anymore. And, and yeah, we, we do have, uh, some constraints, uh, or, or not some constraints, but some, um, some, some leeway to be, uh, Able to take in, like, you know, if it's in a, if it's an inhaler in a sealed container it's in date or something.

Sure. We, we, we've got a donation form. We can do that. Gotcha. You know, if it's pills in, if it's pills in your mail order, pharmacy bottle or something, and, and, and that, that, you know, we can't do, unfortunately, but. 

[00:29:59] Mike Koelzer, Host: Yeah, we kinda dump 'em out and, you know, and, uh, and you know, just kinda do our thing. So they, so you've got, um, ability to do that with some, like you say, sealed in the foil thing in that you guys have some leeway there, that 

[00:30:13] Dave Ruth, Pharmacist: samples, because you know, we're, we're, we're, again, we're not, uh, we're not, uh, dispensing them or we're not billing an insurance.

We're not, we're not gaining any sort of financial benefit. From it. So we do have a, like, you know, we, we can have a relationship with a physician. That's got a sample closet that we can get into also. And, and because, well, that's great. It helps. But you know, like I say, we, uh, uh, our, our, the majority of, uh, the drugs that come in and go out the door do come from a.

From, from the good people, the good Samaritan foundation that, that have a, that, that have a founded, um, found it to everybody's benefit to, to help us out with some money. And we, we, we're certainly very, very appreciative of them and everything they do for us. And, and the, I'd be remiss if I didn't mention that we're a part of a, um, Uh, under, I guess, an umbrella organization, we're, we're essentially one room in, in an entire free clinic.

Uh, it's called Mission Lexington and they, um, so we've got a free, uh, uh, a free, uh, medical clinic, uh, that runs on volunteer help as well, a free dental clinic that runs on volunteer help as well. And there's also a free optometry clinic. That has, uh, opened in the last year, year and a half or so.

And, and they, uh, they're, they're a great support staff and, and they're, uh, they're wonderful people that take care of, uh, take care of us at faith pharmacies as well. Uh, but, um, but it, it, it's just a really neat operation and I, I'm very, very, just monumentally blessed, uh, to be a part of it, even a 

[00:31:45] Mike Koelzer, Host: small part with.

Career, and you're obviously love of pharmacy, your love of people. Tell me how you've branched out from regarding your, um, your pharmacy proud, 

[00:31:54] Dave Ruth, Pharmacist: uh, site pharmacy proud thing, um, is, uh, it's ever evolving. Uh, if, uh, anybody has seen the videos, you know, I, I, I'm a partner in that site, uh, with, with a guy by the name of John who is, um, who's actually, uh, one of the, uh, when, when I referenced two senior partners, uh, he's the other one, uh, with the organization as a whole.

And, and he's actually the guy that, uh, got me the opportunity to, to become an owner in the first place we happened to be out of, in. For, uh, state capital, uh, a couple Februarys ago, lobbying for a, you know, Senate bill for, you know, fair and transparent, uh, Medicaid reimbursement, uh, across, uh, both independence and, you know, chain pharmacies.

But, uh, He, uh, he, he brought me along, uh, with this pharmacy proud of the venture originally. I think the plan was kind of a subscription model, but we wanted to, we wanted to use it just like a lot of other people are wanting to do things right now, which is to unify, uh, the independent pharmacists across the nation.

And, and to realize that, you know, if. Dave's pharmacy's on one block and Mike's, pharmacy's, uh, two blocks down the street. You know, we're not competitors. We shouldn't think of ourselves as competitors. We should think of ourselves as allies that are both trying to, uh, uh, try trying to do what we all need to be doing, which is, uh, at the point in time, in the day, whenever you, uh, turn off the lights, set the alarm and lock the front.

Uh, your community's a little bit healthier, uh, than it was before you opened the door and turned on the lights and turned off the alarm, uh, that morning. And, uh, you, you get, you, you, you can be right. You can be a partner, you can be a, you can have positive relationships with those independent pharmacies in, in your area.

And that's what we want to foster kind of nationwide. And we've, uh, we, we've kind of tried to. Realize now over the last, uh, couple months that what we need is more. Viable online social presence to really on social media start interacting more. And that's one of the reasons that that is one, one of the ulterior motives I had in coming on today is, uh, I is to, to come up with some more content, uh, with you that, that we can also with your permission, share on the pharmacy proud website as well.

And, uh, and, and get it out, but absolutely the moral of the story is we do think that we have some knowledge, uh, that we've guarded, uh, in our various practices over the course of our careers. And we want to, you know, share it. And we also want to give, uh, other independent pharmacy owners a, uh, or, or independent pharmacist or anybody that's interested, really an opportunity to kind of, sort of.

Take part in a, uh, in an organic transfer of knowledge, uh, what works, what doesn't work, how can we move forward? How can we unite? How can we realize that we are the, the, uh, together? We, we are the, uh, biggest force in the industry if we would only, uh, recognize each other for that and, and, and bond, and make sure that we're able to kind of, sort of take back control of the profession that has over the last, uh, Uh, 10 or 15 years, uh, kind of, sort of being rested away from us.

[00:35:20] Mike Koelzer, Host: Right? Right. Yeah. You mentioned about independent pharmacists and we're probably, if somebody saw how cozy two independent pharmacies could be, that are even, you know, a mile, you know, half mile a mile away, they think that we are crazy and we'd say, We've we've had some pretty big enemies out there. And so our competitors are probably our best friends, at least they, you know, they, they can empathize with some of the struggles in the business.

Yeah. 

[00:35:50] Dave Ruth, Pharmacist: And, and I think that is, um, certainly a big, uh, key for me is knowing. That there is that level of empathy between one another. Like, Hey, um, you got reimbursed 38 cents for a lisinopril. I got reimbursed 38 cents for a lisinopril. It was insane. Right. And, and, and, oh, oh, good. Not for nothing or nothing, but then they went ahead and decided to take back 10 cents of that.

Uh, three months later, I 

[00:36:20] Mike Koelzer, Host: always try to, I always try to stay close to the. To the ear of the competitor, you know, one to, uh, you know, for all the, all the good reasons. Tongue and cheek, at least it's like, well, if we're, if, if we ever, uh, have to go down with a ship, at least I've got, you know, some other people to pull hands with as we're, as we're going down.

[00:36:41] Dave Ruth, Pharmacist: Like I say, I've only been in my previous independent, um, uh, practice before I started doing, I guess what I do now. Um, the, uh, the. The owners weren't necessarily, um, like, like it was my job to run the building, but it wasn't my job to worry about the bottom line or whatever that's what they wanted to do.

And they didn't, uh, and that's fine that worked for them and that's okay. But to me, I, I. I have a vested interest in knowing that I'm running, uh, the business either for them or for myself now, uh, in a way that's, uh, responsible and financially solvent because, you know, I can say, Hey, I want to turn a nice profit.

So if I need to give away something to a patient that needs a PA and maybe I'll get reimbursed and maybe I won't, but I, I need the, uh, The, the general practitioner, one of the general practitioners that are close by to know that they can rely on me to fix a problem for 'em, uh, you know, that, that you can't, you can't really put a yeah.

A value on moving forward. I'll get that money back eventually. But the darn thing about the power company is if you can't make enough money to pay the bill sooner or later, they stop turning the lights on. And, and, and it's really difficult to practice. Then the board of pharmacy gets upset if you don't have electricity or running water or anything like that.

Most 

[00:38:00] Mike Koelzer, Host: certainly, well, David, as you, as you look back, um, as you look back at your, uh, time at, at the chain and, and, uh, you know, the independent and doing your, your, your, your things downtown and your, uh, website that, that you're, um, uh, moving and, and thinking with, and so on. What things, is there anything that you, and let me, let me phrase it like this, most people who've even been through quite a bit of things in life, you know, they, they say, well, I really don't know if I would change anything.

It kind of made me who I was, as you think back though, are there things, are there things you would've done differently? Are there areas where you said, you know, I, I, I missed this or I should have done that or, or, um, Or is it, or does it all come out in the 

[00:38:56] Dave Ruth, Pharmacist: wash? You could certainly take the, uh, philosophical or the, or the, um, you know, almost metaphysical, uh, Uh, tack on that, which is, well, um, you know, like it's like with time travel, if you go back and change one thing, even if it, uh, E even if it is something very, very simple, if you ordered a Coke instead of a Pepsi, uh, what sort of long arching effects does that have?

Uh, E we're not gonna take that tack, like, we're just gonna be, uh, improved Frank and honest. Um, there are some things that in the moment maybe I would've done differently. Maybe I, maybe I wouldn't have moved to doing the independent thing with this particular person at the time I did, or maybe I would have, or maybe I would've sought it earlier.

Um, uh, the, the take home message is that, um, one thing that, um, mattered to me was I worked a lot. I mean, I still do. Uh, uh, I, I got, uh, a kid that's, uh, 20 months old. I have a kid that's five months old. I've got a, I got a wonderful wife and a wonderful family at my house. Uh, I would like to be able to spend some time coaching league basketball these days.

I would like to be able to spend some time, um, ING, um, talking, teaching my kids to play golf or going to, uh, piano recitals. I don't know what they're gonna want to do. Uh, but, but I'm going to want to have some more flexibility with my schedule than I ever had before. Uh, so the timeline where, uh, doing all these things kind of fell into my lap.

Was pretty, uh, serendipitous, just because it was the right time for me. Uh, so in the great scheme of things, uh, yeah, exactly. Running the chain stores for so long and realizing that I was never a, uh, real good candidate for upper management because I'm, I'm just not a corporate guy and being told that and that's, and that's fine.

It, it is what it is, but, um, Everything kind of, sort of fell into place, even though there were a couple times that it was fairly uncomfortable. Uh, uh, so what would I change? I'd probably, uh, have never, uh, I'd probably carved out time to volunteer at the, uh, at the store downtown, even as soon as I got out of pharmacy school or I would have looked up John.

Sooner, but because he was an acquaintance, uh, and a friend. Yeah. He was on his way out of pharmacy school as I was on my way in. Um, so like we kind of, sort of ran the same social circle and we knew each other and we had always talked hypothetically where we need to work together one of these days.

And, and then, um, and then whenever the opportunity actually, uh, came to fruition, it turned out that it was a. Pretty it, it was a pretty, uh, synergistic, uh, uh, pairing for the both of us. And, we've both been able to do a little bit more now over the last year and a half. So, uh, so it. Really in the great scheme of things, maybe I would've, uh, looked him up sooner or, or I certainly would've maybe not fallen away from the volunteer gig for a few years after I graduated pharmacy school because it's fulfilling and, and, and not going just like everything else.

Sometimes it's a hassle. Sometimes you'd rather be a. Spending that time with your family on a Saturday afternoon is going out there. And that's why we're trying. We try to keep a fairly steady group of volunteers in and out. So we can be fairly protective of everybody's time commitments, but because uh, life exists and life happens.

Yeah. Right. And, we think we're doing good work. No, I don't know that I've got a whole lot of things that I would really, and truthfully change when, when, when it all boils down to it, like, uh, things are going too well right now. And, uh, we've had too many good opportunities to really, uh, to, to, to look back.

Uh, the next thing is how are we gonna continue to evolve? Yeah. Right, right. 

[00:43:14] Mike Koelzer, Host: You know, and, and yeah, they've always said that. Um, I remember the phrase and I don't know where I heard it, but it's the old one of they say, if you are in a circle with, you know, a dozen people and you all were given a chance to throw your problems in the middle and, and you know, then you got to take someone else's in the end most.

Most times a does, not a dozen times, everybody's just gonna grab their own one back because you know, they, they, they, they at least know the challenges. They, they, they know the unknown, but you know, really it's, it's made, then it's made, 'em got pretty much who they are and, uh, Yeah, everybody's got stuff.

Everybody's got stuff. I read a book last year. It was, um, how not to give a blank. And, um, and, and, and the blank was not a blank, but it just talked about, and I thought it was kind of cool. It said that, um, I said, one of the goals in life is to solve problems. That's what humans are good at.

And they're, and they're, they're built to solve problems. He said, you want to gradually make your problems easier to solve, you know, so eventually I'd like my problems to maybe be, you know, what, uh, what can of, uh, you know, pumpkin. Pie filling. I, I want to use and spend a day maybe figuring that out instead of some of the bigger problems we've had, but you don't wanna stop.

You don't, you don't wanna stop solving problems, just maybe. Just maybe a little bit, just 

[00:44:46] Dave Ruth, Pharmacist: maybe a little bit easier and, and our thing. Uh, and, and I think you'll agree. It's 2019, what worked in your practice in 2009, in 2005? Certainly it doesn't work the same now. And in, and in 2029, what's working really well for, uh, for Dave, uh, today is likely to not work super duper well.

Um, we, we always, we have to realize that, you know, When I talk about competitor, you know, I, I talk about, you know, the, the big change, the, the change that may or may not have also, uh, merged with, uh, pharmacy benefit managers and things like that. And everybody knows who that white often or those white offenses in the room are.

But, uh, I view them as competitors. Sure. But we've already seen, we, you've probably laid eyes on the same, uh, hypothetical 20, 20 contracts that I have that, that already have a contingency for, if we can find a way to outlaw DIR fees Well, instead robbing us from behind blind. They're just gonna rob us in plain sight.

So, they are always going to evolve and they're yeah, exactly. Going to be like this shape-shifting of an entity that we have to find a way to both practice conscientiously with patient outcomes at the forefront, but also find a way to continue to survive. We're gonna have to evolve right along with them.

And if we ever quit doing that well, they'll lock the doors on their own soon. Uh, and, and we won't have a say in the. So, 

[00:46:26] Mike Koelzer, Host: yeah, and I think I agree. And I think that I, I think that one of the, um, one of the benefits that we have. Uh, and, and, and you take any benefit you can get, you know, sometimes it's just the, the, the small edge of someone touching out someone in a, you know, a race or a swim meet.

But the one benefit that we have is speed. You know, we've got, we've got speed. Um, we can make things happen faster in the pharmacy. We can make things happen faster with, um, uh, you know, one, one area that, that we have the speed that, that, um, the big boys haven't figured out yet is, you know, like social media.

I mean, some of that stuff on social media, you know, Facebook ads it's way, way underpriced and, and in two or three years from now, once, once. You know, coats get in there and GM and, and all these other places. I mean, these ads are gonna be extremely high. Well, then we'll go find something else. But that's about it, I don't wanna say that's the only thing we have, but we've got, I think we've got speed and we're able to.

Spin on a dime and, you know, hopefully we get to use that skill in pharmacy, but if, if we get pushed out, um, that will be an advantage that will have, uh, outside of pharmacy in the job market or whatever. And so, um, I, that that's one, I always like to. I always like to concentrate on it, is the speed that we have as being yeah.

And the so-called little guy 

[00:48:06] Dave Ruth, Pharmacist: true. And, and a lot of these other places will, tout their, uh, their, uh, operating system with, uh, all the checks and balances that it has. Uh, and, and the, the way their workflow's set up, uh, As a SA as a patient safety initiative, when, when really all, all it, uh, boils down to is, Hey, while, while you're waiting, why don't you go buy a television or pair of jeans or, uh, go grocery shopping.

And, uh, and, uh, you know, we, we, uh, we have that in spades and, and it is a tool in our arsenal. And, and, and to me, I think the most important thing is, and don't get me wrong. I do know. Have practiced with folks that still practice in, in, in a chain pharmacy setting or, or in a big box store setting, uh, uh, some of the, uh, most, uh, conscientious and, uh, talented and, and ethical and patient care driven, uh, professionals I have ever worked with still work in that setting.

But, the majority of the people are a hundred percent that are really, uh, wired and, and designed. And, and for that matter more importantly, probably Mike has the professional ability and carte blanche to, um, utilize their empathetic skill set for. Caring for their patients. You go to Mike's pharmacy for that mad, you go to Dave's pharmacy for that.

You don't go to the three letter chain for that. And, and it's, uh, that, that's the one advantage that we're always going to have. And, and that's, it's what I, what we're gonna try to keep hanging out a onto, I 

[00:49:48] Mike Koelzer, Host: I believe there's a ton of conscientious pharmacists there. The problem is they don't have, you know, they're, they're trying to be conscientious with.

You know, I mean, yeah, we, we have our arms tied behind our back sometimes, but at least ours maybe are just from the, uh, PBMs where they're, they get their arms tied behind their back from, you know, the one or two up in the same organization and that, and that's, and that's hard to, it's hard to do when you're trying to, when you're trying to be em, Empathetic.

And, and you got the, the guy above you feeling like 

[00:50:26] Dave Ruth, Pharmacist: they don't give a, they don't give a, they've got, uh, the one thing about, uh, corporate policy and corporate rules and corporate rubrics and all that infrastructure that they have is if you're gonna put on paper, they they're pretty well required to invoice it.

And, uh, that's not that that's not a, uh, grumble or a complaint or an argument. That's a, that's a mere statement effect, but. But what it does is it does not allow for a case by case management of what might be the best for Dave, if he walks into your pharmacy the best way for you to take care of him.

And the one thing that we're always gonna do in our practices. Yeah. And, and I'm, I'm sure yours as well is. How is it that I can most appropriately take care of Mike when he walks in my door? That's the problem. Number one for me and numbers, two, three, and four. Really aren't even two, three and four they're six, seven, and eight.

And problem, number one is actually problem 1, 2, 3, 4, and five. And everything else is, is after that, when you look at the 

[00:51:36] Mike Koelzer, Host: supply and demand of this world, that if we think of yourself as being in the healthcare field, and you look at all of the, um, all of the, the, you know, the, the news, the news focuses on the, you know, the terrorist and shark attacks and things.

But if you look at the numbers, you. You know, it's like you see the whole third top of a graph is, you know, heart disease, those kinds of things. It's not, it's not the attractive news stuff, but if, if, if we put yourself in the position of being healthcare workers with a third of the people dying, and then you throw in things like, um, You know, some, some pretty, pretty big lives are taking know Steve jobs.

I mean, you know, because of his cancer, you know, the only thing he didn't have was time, you know? And so if, if, if you put, if you look at it in that regard, there's a big, a big, uh, uh, you know, supply and demand. I mean, we're, we are. We are in demand. I think we just have to use that speed to, to pivot and find out how 

[00:52:41] Dave Ruth, Pharmacist: we can do it, how we get paid for it.

That's the big bug booth. This is a pharmacy podcast. This is a business podcast and, and running in the black matters too. And. And it's, uh, it's gonna matter tomorrow can, like I say, I, I I've used the word shareholder, uh, multiple times, uh, but you know, that's, uh, I am a shareholder in, in several practices, but guess what?

Those practices that I'm in charge of administering have other shareholders, and that matters too. Like, you know, they, they've trusted me to, to, to do a professional job. That is a. Caring and empathetic, and that is my primary goal, but it's go, go. One probably does is deal with, let's make sure we can keep the lights on and let's see black ink and not ready.

Yeah. One of, one 

[00:53:32] Mike Koelzer, Host: of my goals is, is with, um, with social media, you know, you kind of thought for a while there you'd think, well, we'll reach out. We'll reach out and, and get to know people, but, but through, um, you know, as the numbers, as the numbers get bigger with, with LinkedIn and, and this and that pretty soon, you're you and on Facebook, you know, you're looking at someone you say, I don't know how I know this person and I don't, I don't know why I'm reading about their, you know, their, their wedding.

I don't even remember who this is. So that's where I like this long form of the, um, of the podcast, because we can, we can, uh, have, have. Have an in depth conversation and, uh, it, it puts some, puts some meat on the bones of. Of of meeting, meeting people and enjoying these, these new, uh, stories that I think these, uh, just swiping up the screen won't, won't be able to, to do as 

[00:54:29] Dave Ruth, Pharmacist: well.

When you say is a dead spot on and, and, uh, I, we are in the business, uh, at least, uh, I think you are too, like we're in the business of one of the most important things we can do. Uh, when we go out, uh, into practice for the day we form a positive relationship. And, um, and this is an opportunity to, to know now that I've got a, I've got a friend up north, one of these days, pick up a phone and you're gonna shoot me a text or holler at me, and I can do the same for you.

And, uh, but, but more importantly, maybe somebody else that's listening might, might, might wanna learn a little bit more about what you do and how you do it or what I do and how I. And this is like, we're, we're all on the same team and that's, that's my, that, that's my main, uh, thing that I want out in the atmosphere is, Hey, listen, you're you guys.

Aren't our competitors. Uh, we're not your competitors. We're uh, we're on the same team and we're, uh, we're, we're, we're all, uh, we all need to unite and allow ourselves with one another to, to, to achieve a. Our, our common goal, which is, uh, greater healthcare access and outcomes for our patients and fair and equal treatment.

[00:55:41] Mike Koelzer, Host: Yeah. To be able to be around, to, uh, to be around, to do that, to help with the, you know, the golden, the golden goose, I guess doesn't have to be golden, but at least has to be, has to be alive. Still. Thank you very much, David. We'll 

[00:55:54] Dave Ruth, Pharmacist: talk again. Thank you.

[00:59:17] Mike Koelzer, Host: This was the business of pharmacy podcasts with me, your host, Mike Keer. Please subscribe for future episodes.