Diary of a Neighborhood Pharmacist, Entry #13

I think I mentioned that I was pushed into the job without adequate training. On-the-job training doesn't work as well when you're working alone.

Last night I spent a couple of hours with one of the other nighthawks, someone who has been on the job for years. He came from a different background than I did. My concerns in past jobs were drug information and counseling, and I never gave much thought to the business aspects of running a pharmacy. If I thought about it at all, it was to make sure that we had adequate supplies of everything, even drugs that we never used – like snakebite antivenin. As far as I know, there are no black mambas in the New York sewer system (presumably they were eaten by the alligators), but if there were, I would have been ready.

Ned*, on the other hand, had his own store before the chain bought him out. He gave me lectures on the importance of low inventory, turnover, and leverage. The Retail Owners Institute says that pharmacies should have a turnover rate of nine (meaning that they should sell out their entire inventory every 40 days or so) but Ned had a goal of 12, which meant not more than a 30-day supply. In a staff job, I would imagine wanting a large inventory, so that there's never any outages, never the need to apologize for not having the drug. But Ned had been a businessman, evidently a very good one, and still thought like one.

Actually, I was in charge of pharmacy inventory at a hospital many years ago, but I didn't learn the lessons that Ned did – in fact I learned just the opposite. This was Vietnam era, and I was a low-level enlisted man at an army hospital. My job wasn't to reduce expenses, but rather to maintain them, because if we ever spent less than we had the year before, the people in charge would cut our budget. If I didn't spend enough, I would get a call from the captain in charge of supply, telling me how much to spend and how soon. This didn't strike me as the right way to run an army, but I didn't feel like risking stockade time for disobeying an order.

This was decades ago, before drugs got super-expensive, so that I learned which drugs had high prices and small bottles. The last thing I wanted was $17,000 worth of mineral oil or magnesium-aluminum hydroxides filling the aisles. My favorite drug was nitrofurantoin, for treatment of urinary tract infections. At $140 a bottle, it was what passed for an expensive drug in its time. Whenever I had to spend money, I would always start with what we really needed, and then top it off with a few bottles of nitrofurantoin.

One day, a shipment arrived, but the bill was for thousands of dollars less than I had anticipated. It seems that elsewhere, somebody had been negotiating a new contract for nitrofurantoin that cost only $40 a bottle, and not the $140 I had relied on for so long. After that, I never found anything with quite the same cost/size ratio, but I did learn to look for drugs with short expiration dates.

For a while, the army was doing recruiting by claiming that they would teach skills that could be carried over into civilian life. Somehow, I don't think that what they taught me about inventory control would have helped much if I had opened my own store.

*not his real name

See the previous installment, Diary of a Neighborhood Pharmacist, Entry #12, or the next installment, Diary of a Neighborhood Pharmacist, Entry #14.

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