Leo Tolstoy, the Russian writer of the famous novel War and Peace, once remarked “Everyone thinks of changing the world, but no one thinks of changing himself.” That may be true of most people, but it certainly isn’t true of the profession of pharmacy. We are changing ourselves. Slowly, and yes somewhat painfully and at times awkwardly, the profession of pharmacy is moving from a merely dispensing function to a full-blown healthcare providing status. And we’re not done yet. As one of the nation’s most accessible healthcare providers, pharmacists are taking their training and passion for patient health and applying it in a variety of ways to meet the needs of our culture and time.
Amongst those needs which are prevalent in our culture today is the need for solid information and professionally managed programs to tackle the issue of obesity and maintaining a healthy weight a lifestyle. Amongst the leaders in this area is my friend and pharmacist Terry Forshee, who has not only found a way to deliver healthy lifestyle services to his own patients, but has developed a program that others can use in their pharmacies too. The program is called Take Charge. It is a real pleasure to chat with him today here on The Honest Apothecary.
1. Terry thanks for taking the time to chat with us here at The Honest Apothecary. Would you share with us just a little about your own career as a pharmacist first?
I have been exclusively an independent pharmacist my entire career and even as a student. I was able to buy an independent pharmacy right out of pharmacy school…obviously things were different then. I had worked for independent pharmacies since I was 13 when I got my first job making milkshakes at Tunnel Hill Pharmacy in Tunnel Hill, GA. I bought my pharmacy in 1978 and have owned all or part of about 12 different pharmacies in the last 35 years. I have done pretty much everything in pharmacy during my time. We have a DME, uniform shop, coffee shop, LTC pharmacy all under one roof in my main location in Cleveland, TN. I also am majority owner in a second store 25 miles away in Dalton, GA.
2. When did the idea of developing a nutritional program for weight loss occur to you, and how did you develop it?
I first learned about Take Charge from a compounding pharmacist friend of mine in Chattanooga, TN in 1998. I immediately was enamored with the concept of helping educate a patient on how to get healthy and lose weight. At the time we had just enacted TennCare here in TN, which was the nation’s first managed care (oxymoron) Medicaid program in the nation. I saw the proverbial writing on the wall and knew that pharmacy as I knew it was on the way out. In late 2007 Tom Breslin, who had created the Take Charge program passed away suddenly due to cardiac arrest. Out of self-preservation, I purchased the company because I had been doing so well with the program in my own pharmacy. I had no intention at that time of reintroducing it to the marketplace BUT after much soul searching I decided that if the program was so successful in my own pharmacy why couldn’t it change the face of modern pharmacy like it did my practice? So I began a 3 year process of re-engineering Take Charge exclusively for the independent pharmacy market. The main issue that I had to confront was the production of outcomes. So, the key piece of the puzzle that came into place was the development with a local internet company of one of the first “cloud based” software programs in order to assimilate data from pharmacies all over the country to prove what I already knew…that pharmacists could have a significant impact on our nation’s obesity crisis. In addition, the curriculum was re-written specifically in order to highlight the community pharmacist as a health coach. Our advanced meal replacement shakes were re-formulated to meet current nutritional standards and Take Charge was re-introduced to the independent pharmacy market in early 2010.
3. Could you share with us a little bit about how the program actually works in your own pharmacy? When a patient wants to enroll, what happens?
Our main source of referrals is now physicians in our area. Through our physician marketing program we have developed a systematic approach in order to show a physician how the pharmacist can assist them in caring for their obese patients. The physicians in my town write a prescription for an initial lifestyle consult with me which their patient presents in the pharmacy. Once the patient determines that the program is right for them they began a 90 day hands on process that enables them to break current bad habits and begin the process of creating a new lifestyle that the can live with. The program is successful because the PATIENT actually creates their new lifestyle by incorporating common sense changes that they choose to live with. This is the key to our success…we don’t tell the patient what to do, we allow them, under the guidance and encouragement of the pharmacist, to actually create a lifestyle that they like and can live with. As they see the weekly results they begin to buy in to what we are teaching them. By the end of 90 days they have a blueprint that they can work from to continue to transform their life until they reach their ultimate goal. On a final note, the average patient stays with the program almost 9 months in order to cement their changes and feel confident that they will ultimately reach their goal of good health for life.
4. What about paying for this service? Who pays for this and how much does it cost?
This is actually the most exciting part of Take Charge! Because of the savings on their food bill the program costs most patients absolutely nothing additional out of their pocket to do the program other than what they are already spending on food! Our meal replacements retail to the patient for $8 per day, so since the average patient spends more than $20 the program is essentially free to them. Now, the key to our future as community pharmacists depends upon our getting classified as providers so that insurers will pay us directly for obesity counseling. Even though NCPA and APhA have made it their #1 priority to get pharmacists approved as providers, we at Take Charge are also working on a different track to accomplish this. We have developed a dialog with the CDC in Atlanta in order to gain access to Medicare’s already established budget of >$750,000,000 for “intense obesity counseling.” If we are able to accomplish this of course commercial insurers will follow. At that point pharmacists will become the “go to” professional for obesity and will assure community pharmacy’s future under the new health care system. Now, finally, the last piece of the puzzle is the implementation of the Affordable Care Act or ObamaCare. Under these new guidelines health insurers will be REQUIRED to pay for obesity counseling! This information was published in USA Today during the past week and can be found here. http://www.usatoday.com/story/news/nation/2013/07/04/obesity-disease-insurance-coverage/2447217/ .
5. Now, you have developed this so that other pharmacies can utilize the resources you have created. How does it work and what does it cost the pharmacy to do so?
At this point in our history I feel that we have made Take Charge affordable for every independent pharmacy in the nation. At only $349 per month a pharmacist only has to see 5 patients PER YEAR in order to completely cash flow the program. Once ObamaCare is fully implemented OR Medicare determines that pharmacists can help with the obesity epidemic that number falls to less than 2 patients per year. I really believe that Take Charge is the portal through which independent pharmacy can secure our future. Now it is up to pharmacists to seize this opportunity by fully investigating what we have to offer. We can only succeed if independent pharmacists understand that the current model is a pathway for success only for the chains and mail order pharmacies. I believe with everything within me, that if independent pharmacists will take a chance on what we are doing, we will control the market for obesity education and payers will beat a path to our door.
6. Can an individual pharmacist at this point offer this service in his or her own community, without a formal connection with a retail pharmacy? If so, how would that work?
This is a great question! I believe that pharmacist have opportunities in several arenas to provide patients with access to this vital service. I believe there are opportunities working out of physician practices, working the program out of their own office based practice and working in employer facilities to have a successful practice. Remember, if we can seize this reimbursement that Medicare is offering for obesity counseling, a mere 100 patients per year would net the pharmacist more than $250,000! I believe with these numbers a lot of doors will open.
7. Can you share a success story from Take Charge Rx?
I have had more than 700 patients go thru my program in my own pharmacy and many success stories. However, the one that sticks out to me the most is a 69 year old female that came to me on her 69th birthday with a desire to lose 70lbs by her 70th birthday. Now, those of you that work with BHRT know how difficult it is for a 69 year old female to lose weight! With that in mind I asked her “what if it takes 2 years to lose that much weight?” Because what we are doing is not a quick weight loss program but a program that enables to lose weight and keep it off. I will never forget the look she gave me. “That would be OK but I believe I can do it in one year.” I was taken aback but told her that if she did exactly what I taught her maybe she could do it even though I had never had a 69 year old female do that. Long story short, she did the program exactly as I taught it and began a journey that saw her lose 1.5lbs virtually every week! On the Tuesday before she was to turn 70 she came in to weight to be sure she had a chance. She was 0.6lbs away from her goal! She went back home and hit the treadmill with a vengeance and came back in on Friday morning…the day before her birthday. There were shouts of joy and tears as she hit her goal exactly! That was 2.5 years ago. She continued on to lose 87lbs and has kept it off for over 2 years. She was able to stop 7 medications, get off of her C-PAP and change her life.
8. Where should my readers go to contact you if they want more information about offering the Take Charge Rx program themselves?
They can visit our website at www.takechargerx.com or contact myself via email at firstname.lastname@example.org or my national sales director Marvin at email@example.com . Our toll free # is 800-782-3444. All I can promise is that we at Take Charge will do everything in our power to help them move into this very profitable area that can define pharmacy for the next generation.
Well, I want to thank Terry for sharing his passion for patient wellness and the Take Charge program with my readers here at The Honest Apothecary. If you are an owner, please consider contacting Terry about beginning this program in your own pharmacy. And if you are a patient, please ask your local pharmacy about ways they can assist you to achieve a healthy weight and lifestyle.
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