Prescription for success

Don't expect to find garbage cans, toasters, garden supplies or many over-the-counter medications at East Marietta Drug Co.

You can find greeting cards, but cosmetic products are kept to a minimum. This isn't Walgreens, CVS or Eckerd, where film-developing centers and beauty counters can take up as much space as the prescription counters.

It's tough to run an independent pharmacy like East Marietta Drug Co. these days. To compete with the big chains, you have to fill a niche they don't fill.

"My prescription prices are the same as or lower than our competitors,' but we focus on personal service, accuracy and patient safety. That gives us an edge," said Jonathan Marquess, Pharm.D., CDE, who with his pharmacist wife, Pam, runs independent stores in Marietta, Woodstock, Stone Mountain and near Lake Oconee.

Free delivery and education about health problems like high cholesterol and osteoporosis come with your prescription.

Georgia has one of the highest rates of diabetes in the nation. In 1993, when Marquess noticed more customers needed prescriptions for diabetes medication and asked a lot of questions, he saw a need he could fill.

"Diabetes is a disease state where you can make a difference quickly," Marquess said. "If patients control it with medication and take care of themselves, they can lead a basically normal life. If they don't, it can be a killer."

Marquess became a certified diabetes educator so he could provide in-store, one-on-one and group counseling to patients who are referred to him by physicians. He also helps local companies educate employees, improve their overall health and keep insurance costs down.

Accredited by Medicare/Medicaid, he teaches customers how to monitor their blood-glucose levels, eat right, stay active and take their medications.

"I love talking to people and helping them," Marquess said. "They'll try something I suggested and come back a few weeks later to say that they feel better."

Because Marquess knows many of his customers and what prescriptions they need, there's less chance of negative drug interactions. He also is a compounding pharmacist, which means he can formulate medicines specific to patients' needs.

"My store isn't a household name. Most people find us by word-of-mouth, but, once I get them in the door, hardly anyone ever leaves," Marquess said.

Before chain stores sprang up on every corner, the community pharmacy was a hub of health care information.

"The pharmacist is the most accessible health care person," said Steven Wilson, Pharm.D., owner of Carter's Pharmacy in Smyrna. "He's working most days, and anyone can walk in and get free advice. Sometimes it's a minor issue, but it can also be the kind of knowledge that keeps patients out of emergency rooms."

Wilson works six days a week, and his longtime customers know that they can find him at home on Sundays. He grew up in Smyrna and used to ride his bicycle to get ice cream at the Carter's fountain.

After he graduated from Mercer University and became the director at Brawner Psychiatric Institute, Wilson worked at Carter's on weekends. In 1989, he bought the place, and his wife, Karen, added a gift corner to increase business. The "corner" has grown to a 5,000-square-foot store, Karen's Gifts, next door.

Wilson, who has served as president of the Georgia Pharmacy Association and was recently appointed by Gov. Sonny Perdue to the Georgia State Board of Pharmacy, likes owning a community pharmacy that serves four generations of his friends and neighbors. But in today's competitive climate, Wilson calls on every ounce of business savvy he acquired when he was studying for an MBA at Mercer University.

He knows where to get drugs at the best prices and how to bid for contracts at nursing homes and prisons to increase prescription volume. Still, the slow and low reimbursements from Medicare and insurance companies challenge the profitability of independent stores, which rely heavily on sales of prescription drugs. Small margins could be crunched further by recent government proposals to slash reimbursement rates for generic drugs.

The rise of mail-order drug companies is another pressure on small pharmacies. Many employers reward employees who use mail-order houses with low overhead and low prices, but customer service can be lacking. Wilson often gets calls from mail-order customers who have questions about their medications.

"If they aren't in my computer, I don't know what else they are taking, so it's hard to give answers," he said.

Despite the challenges and increasing competition, neither pharmacist would trade his store or profession.

"It's rewarding to come into contact with so many people and know that you are serving your community," Wilson said.