1) because retail pharmacy chains with greater name recognition are encroaching on independent pharmacists' territory in increasing numbers,
2) because so-called "pharmacy benefit managers" or PBMs, companies that have adopted the role of middleman between employers and pharmacies, have taken over deciding how reimbursements will be offered to pharmacists; in turn, this has negatively impacted the independent pharmacist's profits, as well.
It's not necessarily true that the independent pharmacist is soon to be extinct, though, and in fact it can actually be true that independent pharmacists will be an invaluable part of the healthcare system indefinitely. There are steps independent pharmacists can take to cement their future in healthcare despite these new challenges. Specifically, they can do so by:
Clinical pharmacy is a relatively new development in pharmacy that is fulfilling a dire need for the healthcare industry at large. Independent pharmacists establish clinics within their own pharmacies that treat patients with non-urgent healthcare needs. This is more cost-effective and affordable to patients than traditional treatment venues, and provides a much more convenient way to attain this type of medical attention than visiting a doctor's office, urgent care center, or emergency room can.
In addition, clinical pharmacies help "take the load off" already overwhelmed emergency rooms and urgent care centers by shunting non-emergency cases away from these establishments. Placing patients instead in the clinical pharmacy, where they can be given the care and attention they need – but without the wait time and expense, and without putting patients who have truly urgent medical needs at risk of not getting the medical attention they need. By doing so, independent pharmacists ensure that they have a place and a future in healthcare that is broader than has been true traditionally.
Medication therapy management, also known as MTM, is an area that independent pharmacists can truly excel in, unlike their retail pharmacy competitors. Why? Because retail pharmacies don't handle filling their own prescriptions and instead have them shipped out. Retail pharmacies can't hope to get to know their customers and patients as well as the independent pharmacist can, because they don't provide the kind of personalized attention to their patients that effective MTM requires. By contrast, independent pharmacists fill their own prescriptions and get to know their patients well; they therefore have the ability to provide truly personalized medications counseling. They can also provide patients with injectable medications that would normally only be administered by a nurse or doctor, and this in turn will also increase patient compliance, an important function that will drive down costs and ensure a future in healthcare.
Because independent pharmacists know their patients/customers firsthand and are not simply "administrative boards," they are much better equipped to handle information sharing; they can also ensure that that information will be accurate and that patient privacy will be protected at the same time. With independent pharmacists stepping into the role of data collector and information provider for others in the healthcare system who need to receive data and information, the "care continuum" is less likely to be interrupted and mistakes are less likely to be made; the information independent pharmacists can provide to others is received firsthand, thus ensuring its accuracy.