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August 24, 2010, 2:35 PM
Leaving Your Hometown PharmacistBy JANE GROSS
My insurance plan requires me to fill certain prescriptions by mail order. But I have always preferred to obtain medications from my neighborhood pharmacy in the New York suburbs, even though it means paying for them out of my own pocket.
For me, the expense has been worth it, because I like having a pharmacist who knows every pill I am swallowing and why, and who does many kind and helpful things the mail order companies don’t. A few times, in a pinch, he gave me a couple of tablets while waiting for a doctor to call in or mail a prescription. Once he gave me prescription-strength, rather than over-the-counter, cortisone cream for killer poison ivy on a weekend when I couldn’t find a dermatologist and was an itchy, weeping mess.
He has conferred with my doctors on many occasions when they had doubts that a generic was, indeed, an exact equivalent of a branded drug. Sometimes he assures them the generic is just fine; other times he warns that the additives are different and could explain an undesirable reaction. The doctors, clearly not know-it-alls, prescribe accordingly.
Entrepreneurial and determined to compete with the mail-order business, my pharmacist has spiffed up the store’s décor and added all manner of homeopathic products and all-natural cosmetics to his shelves. He put in an old fashioned ice cream counter, with leatherette stools, and a full menu of smoothies and high quality yogurt. He hand-mixes or “compounds” versions of approved drugs for patients with special needs. And he continues to reach out to patients after hours through a recurring advertisement in the village weekly newspaper that is packed with health information.
Once, my pharmacist circulated a petition warning customers about the dangers of mail-order giants putting people like him out of business. But even if everyone in this village of 5,000 had signed, the tide was against him.
As it turns out, even my own strong feelings of loyalty to him are not enough. Living in semiretirement with no regular paycheck has forced me to rethink some of my profligate spending habits, including my choice to buy all my medications locally. I have scaled back and now bring my pharmacist only my one-shot prescriptions, which are reimbursed by my insurance, and gave in to allowing the recurring ones to be handled by mail order.
Even with this loss of business, my pharmacist has remained involved in my medication regime, educating both me and my doctors along the way. He is adamant that my mail-order pharmacy provide the same generic each time, not a chevron-shaped yellow pill this month and a pink round one the next time. Not only do these different versions of the same drug confuse patients, he tells me, but they also may have different additives, resulting in varying efficacy and side effects.
Because of his guidance, for which he doesn’t make a dime, my doctors now specify which of an array of generics they want, and they specify that my pills remain the same from refill to refill. Sometimes my doctors even call him for advice about other patients, and say they wish there was a similar pharmacist watching out for them.
Jane Gross, a former New York Times reporter, is writing a book about adult children caring for aged parents, to be published next spring by Knopf.