Talking Shop with John McMullin, owner of John's Pharmacy

In more than 45 years as a pharmacist John McMullin, owner of John's Pharmacy in Cape Girardeau, has carved out a niche for his business by specializing in helping patients with diabetes cope with their disease. Diabetes kills more people each year than breast cancer and AIDS combined, according to the American Diabetes Association, which marks November as American Diabetes Month. Nearly 26 million children and adults in America are living with diabetes and another 79 million at high risk for developing type 2 diabetes.

Q: How did your career evolve to get you to where you are today?

A: I began working as a pharmacist in Sikeston, Mo., in 1965. In 1972, I relocated to Cape Girardeau and began working for Medicare Pharmacy, which was a chain pharmacy in our same location, where I worked as a pharmacist for 18 years before purchasing the business and opening John's Pharmacy in 1990. I have always been interested in diabetes, and as a result of my desire to provide extra special services for diabetics, John's Pharmacy has always specialized in diabetes care. We offer free diabetic counseling, diabetic shoes fit by the area's only certified pedorthist, and special discounts on insulin and other diabetic supplies. We are also evolving to offer more comprehensive pharmacy service for all our customer and have grown to house a separate pharmacy to service long term care facilities, which opened in 1995, and recently expanded and remodeled to accommodate a lab and sterile room for pharmacy compounding.

Q: How has the pharmacy industry changed over the years of your career, particularly where technology is concerned.

A: When I became an RPh in 1965, only about 5 percent of our customers had insurance to cover prescriptions. Today, close to 90 percent of our customers have some kind of insurance. In 1965 only four oral medications were available for diabetes management. Today, there are eight categories of diabetic medications with multiple agents in each category. Not only are more medications available, technology makes it easier for us to research information, side effects and interactions. Information is readily available, which of course makes it easier to find solutions and answer questions, ensuring our customers receive good information they can trust. We have recently automated part of the prescription filling process with new technology in both our retail and long term care pharmacies. The robots make it possible for us to ensure prescriptions are filled accurately and efficiently, eliminating the possibility for human error.

Q: How did you come to specialize in diabetes care and what are some of the unique needs of diabetes patients you work with?

A: I've always enjoyed pharmacology and have had both friends and relatives affected by diabetes. My interest in the disease led me to begin attending continuing education classes in diabetes in the 1980s. Diabetes is a disease that impacts many aspects of a person's health and many of our diabetic customers have needs associated their eyes, feet, kidneys or circulation. When a diabetic is able to control their insulin and glucose levels and improve their overall health, their quality of life is greatly impacted for the better. We ship diabetic testing and insulin pump supplies to our diabetic customers all over the country. We also work personally with local diabetics to address all aspects of health associated with the disease with the hope that we can make a real difference in their lives.

Q: What sets an independently owned pharmacy like yours apart from pharmacy chains?

A: The biggest difference between a chain and independent pharmacy is the quality of service and the variety of services offered. As an independent pharmacy, we offer very personalized care and specialized services that the big stores don't, such as insurance billing for medical equipment, ostomy supplies, and pharmacy compounding. Although pharmacy regulations exist for all of us, it is also helpful that we are not governed by cumbersome policies and procedures that you sometimes find in larger corporations. We have the ability to make decisions and meet unique needs as they arise. We can provide fast service, offer free delivery, and address individual needs on a one-on-one basis. Our pharmacists have personal relationships with our customers, which helps us to understand their unique needs.

Q: How is health care reform impacting your business?

A: The full implications of that law have not affected us yet. Still, we experience increased challenges associated with insurance companies not covering non-formulary medications, having multiple tiers with higher co-payment amounts, and making it more difficult to get the customer what they need, when they need it. The process of billing insurance has become more complicated and it is getting harder to meet more stringent requirements set up by the insurance companies. In addition, pharmacy reimbursement rates from the insurance companies are lower than they have ever been.

Q: What are some of the most common mistakes consumers make when it comes to prescription medications?

A: Most mistakes made by consumers are made because they are not careful or informed about what medications they are taking, how they should be taking them, or what they are taking them for. Many people are hesitant to ask questions, which can lead to misunderstandings and dangerous mistakes. Our pharmacists are readily available in person or on the phone to answer questions. We offer blister packaging and personal assistance for those who need help ensuring that they take the right medication at the right time. Consumers should always check with a pharmacist or physician before taking prescription medications with over the counter medicines, and always order medication refills before you run out so that you never miss a dose. Other problems come from consumers using multiple physicians and/or multiple pharmacies. It is safer when your physician and pharmacist are aware of all the medications you are taking. When you have multiple prescribers or use multiple pharmacies, harmful drug interactions or duplicate therapy may be overlooked. By working with a regular pharmacy, you can trust that you will be alerted to potential problems and feel comfortable asking questions.