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AAP: Pharmacists Must Band Together and Advocate for a Seat at the Table

In today’s practice landscape, Dingman’s advice for independent pharmacists is simple: “Get involved.”

At the conclusion of American Associated Pharmacies (AAP) Annual Meeting, chairman of the board David Dingman, RPh, joined Drug Topics® to discuss the importance of pharmacy advocacy work, the biggest issues facing independent pharmacists today, and his top takeaways from the recent meeting.

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David Dingman, RPh: Thanks for joining today. My name is Dave Dingman. I’m currently serving as chairman of the board for American Associated Pharmacies Cooperative Group. I’m a graduate of Albany College of Pharmacy, 1993, and that date gets farther back every time I do one of these. Thanks for having me.

Drug Topics®: Why is it important for pharmacists to get involved in legislative advocacy work?

Dingman: Traditionally, over the years, pharmacists have not done a good job of grouping themselves together as 1 professional entity, and we've been left grabbing what's left over from the other the other [health care] professions, both in services and in compensation.

Now more than ever, with reimbursements shrinking and the cost of medications going up, our margins are just evaporating; many of [us are] actually losing money on prescriptions. Who would have thought that that would even be possible? I know my accountants scratching their head wondering how this business model works. But now more than ever, it's important to get involved, be active, and have a voice at that table saying, “Hey, enough is enough. We need to be viable; we need to be compensated to continue to do what we do.”

What kind of advocacy work is AAP supporting to improve the practice of independent community pharmacy?

AAP does support advocacy groups and organizations as far as legislation. We don't do it on our own, but a perfect example would be [the National Community Pharmacy Association] NCPA. We support NCPA, we continue to donate, we do membership drives for them in order to advocate their agenda, rather than create one of our own. We're good at what we do, but as far as supporting the profession in general, we support the groups that are good at what they do.

What is the biggest challenge that you think independent pharmacists and pharmacy owners are facing today?

The biggest challenge that pharmacy owners are facing today… That's a big barrel to choose from.

Right off the top of the head, [the answer] is reimbursement. We have these shrinking margins and these big, huge [pharmacy benefit managers] PBMs just kind of push in, bullying us around, with take-it-or-leave-it contracts. Traditionally, pharmacists are pleasers. Everybody who walks through the door, we want to help them out—regardless of what their insurance is, or their background is, or anything like that; we're here to help and we're here to serve our communities. Over the last few years, as a business owner, you have to make some decisions… [such as], “Look, if you take this insurance, every customer that comes walking through the door is a liability to your business and you cannot afford to continue to fill their prescriptions.” It's absurd that it's come to this, and we need to advocate to fix it, sooner rather than later, because more and more of us independents are going by the wayside. [Many of the] seniors in our group are just throwing up their hands and saying “enough is enough.” We don't have any place to turn; It's getting desperate out there.

Pharmacists have been integral to the COVID-19 vaccination effort, and the recent test-to-treat initiative includes pharmacies as a part of the strategy. Are you hopeful that this expanded practice will become standard for pharmacists?

COVID has, without a doubt, expanded the horizons of what the community pharmacy can do for their communities. I think we've been tremendous with the access, the speed with which we can deliver the care, and the affordability of the care. This is this has been a big bailout for pharmacies that have participated in both testing and in [providing] COVID-19 shots. I think it's a shot in the arm; we're all scrambling through the middle of a pandemic to get this thing up on its feet.

Unfortunately, community pharmacies and the independent pharmacist were kind of left out of the first wave in most parts of the country. Once we got involved, we really shined, and I'm super proud of my peers for doing that.

Now, depending on the state you're in, that has a drastic effect on what you can do and how expansive the rules are. I'm excited about the prospects of the future—new revenue streams, obviously—but it's just 1 more step where we can benefit our communities individually, [and for example,] take some of the what the [physician’s] offices would consider to be a menial task and streamline them into our tasks. I think if we if we work together, as opposed struggling with this turf war, our communities will benefit, ultimately.

This year’s AAP Annual Meeting took place at the end of April in Tampa, Florida. Are there any high-level takeaways that you’d like to share?

The AAP [Annual Conference, held this year in Tampa, Florida from April 21 to April 23], it's a very intimate thing to me, being chairman of the board [and being as] involved and as engrossed with AAP as I am. I'm excited to showcase what the executive staff and the board have come up with for the year. I'm excited to see our members; I get much more out of [the meeting] than I can ever bring to those [meetings], just talking to the other owners and operators and [learning] what they're doing and find out what their solutions to the problems have been. It's been tremendous.

The speakers were high energy, very engaging. It wasn't just number crunching [CE sessions] where you’re kind of half nodding off; it was exciting, it was uplifting. I really praise the AAP executive staff for putting such a great program together.

We do things the way we do, whether it's your ordering, how you fill a prescription, the smart sync program… It's not changing the way the business is done, it's just tweaking a little to accommodate how to become more profitable. It’s taking shipping dollars and putting them into health care dollars. Those are the kinds of things that I've taken away [from the meeting].

As far as the conference personally, I've been exposed to it all year long. So, there wasn't really [much that was] new to me, but I got fired up listening to new our members get fired up—they're like, “Oh my lord, you guys found a fantastic solution to this problem.” Or maybe they didn't understand the problem, but in standing around and having a discussion with them, and explaining it to them, [now they do].

It's great to interact; it's been a few years since we've been able to, and we're looking forward to kind of hitting the ground running and moving forward together.

Do you have any final thoughts you’d like to leave with our audience today?

At the conference, we got to meet a couple of gentlemen who are running for office that are some of our own members. One is a local assembly candidate for Florida. Florida is in a big hotbed battle legislatively to help our members down there. We also have a couple of congressional candidates who are pharmacists. I would encourage you to listen to their platform. Obviously, they have very similar interests being pharmacy owners like yourself, and seriously consider supporting them, or at least hearing their platform.

Get involved: call your local guys, call your local legislators at both the state and federal level, and get involved. It's simple to send an email; if you just ping them once a month, it's not hard to do. In New York, I’m a member of PSSNY, the Pharmacists Society of the State of New York. They give you a cookie cutter [template that you can use to] ping your legislators and just let them know you're there. I think the majority of the problem that we're facing as independent pharmacies today is our problems are so complex, and we're going up [against] such a behemoth of an opponent with these PBMs, and there's so much money coming from the other side, that they don't know how to fix it. And that's mainly because they don't know what the problems are; they don't understand the problems. We have to do a better job of explaining our problems, addressing our problems, and getting legislation through to level the playing field and ultimately take care of the customer.

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