coverstory Pharmacy prospers in the Buckeye State Bryan Coehrs, PharmD, takes the Pharmacy Counter's MTM to new heights Coehrs, PharmD, recently told Pharmacy Today. "I think we've sat on the perimeter of health care too long, and we now need to establish ourselves as primetime players." In the midsized city of Toledo, OH, Coehrs is Director of Clinical Pharmacy at the Pharmacy Counter, a three-branch, 44-year-old independent pharmacy. Medication therapy management (MTM) may not be a catch phrase in every household yet. Toledo may be, however, an ideal place for pharmacists with big plans for the future of the profession to ply their trade. Coehrs spoke with Today from his cell while vacationing on Cape Cod, MA; vacations aside, there's no place like home. It's the small-town feel of Toledo where Coehrs was born and raised that appeals to the young pharmacist. "Everybody's got a little swatch of land that belongs to them," he explained. "There's always enough to keep you busy [in Toledo], but not so much that you can't sit back and relax once in a while." Coehrs certainly has enough to keep him busy, as the pace of his work has picked up recently. Still, his MTM patients seek him out by name, no matter how swamped he gets. As a floating pharmacist for the company during his first year--he began with the Pharmacy Counter right after graduation--Coehrs found himself "bouncing around, depending on MTM needs, or if a pharmacist was off." He added, "I really had a hard time grabbing an identity until the last 2 years. I've been at my current location for just over 2 years now, and I've developed a pretty good rapport with my patients." "Pharmacists need to be involved," Bryan to a patient who may be taking multiple medications without understanding why. "I think the educated person is far more likely to be the adherent person," Coehrs said. "It's neat how pharmacists can help people. ... MTM is much more than just a trumped-up brown bag." Far from it; the Pharmacy Counter has made a name for itself among employers looking to get the most bang out of their health care buck, including Lucas County and the City of Toledo. "Program-wide, we have roughly 500 patients receiving MTM services," Coehrs said. After an intensive application process, the City of Toledo Diabetes-Related Medication Therapy Management Program, a partnership of the Pharmacy Counter, the University of Toledo (UT) College of Pharmacy, and the FrontPath HealthCare Coalition, recently received a $25,000 grant from the National Coalition of Business on Healthcare to jumpstart the program. This grant, and the local relationships and partnerships that fostered it, have placed the firm on the cusp of the MTM revolution. "Employers realize that they're spending hundreds of thousands of dollars a month in drug costs," Coehrs explained, "[yet] they don't know what happens to the drugs once they [buy] them [for] the people. Do they throw them out? Do they take them? Do they give them to their neighbor? Is there a therapeutic benefit and good outcome?" He chuckled as he recounted the words of one company consultant: "He always says, `I'm sure your mailman is a nice guy, but he should not be giving you drug therapy advice.'" Changes in the structure Although the Pharmacy Counter had always been a clinically minded organization, about 6 years ago, business founder Martin R. Davis, BPharm, determined that a complete update in facilities, products, technologies, clinical staff, and business model was needed to separate his business from the dozens of new drug stores in the area. "We got rid of the greeting cards, candy, and all the other things typically found in a community pharmacy and went strictly medical," Coehrs stated. That meant making a major commitment to medical supplies, providing a full line of home medical equipment service, and hiring the on-site professional staff to support it. The pharmacists were joined on www.pharmacytoday.org `The light bulb moment' Customer service and problem solving initially attracted Coehrs to the lab coat. Working in a grocery store as a high school student, he "serendipitously fell into it," attracted at the time by a dollar-per-hour pay raise and a general interest in the field of medicine. "I started listening to the pharmacists speak," he told Today. "I listened to them talking about medications with each other, educating patients. I've always liked being a problem solver." Education would become an overriding passion for Coehrs, who thrills in the "light bulb moment" of getting through 32 PHARMACY TODAY SEPTEMBER 2008 04_Cover_story.indd 32 8/25/08 9:26:23 AM PHOTO CREDIT: JOHN GREEN OF GSI PHOTOGRAPHY