Pharmacists: Expanding Clinical Services to Meet the Needs of the Community


There isn’t a single primary care physician in Baxter Springs, Kansas. In these rural medical deserts, quality medical care could be over an hour’s drive away. Without a reliable public transportation system, a personal vehicle, or a willing friend or family member to drive, marginalized patients often fall into the care gaps created by these transportation barriers.
Thankfully, the residents of Baxter Springs can rely on their local pharmacy to address their unmet healthcare needs and much more. Ever since Wolkar Drug embarked on the Flip the Pharmacy program in 2020, the pharmacy has drastically expanded its offerings of clinical services to better serve the patients in its community.

“Flip the Pharmacy was the teaching tool that helped us transform our traditional dispensing workflow,” shares owner Brian Caswell, RPh, who spearheaded the campaign. In addition to Wolkar Drug, Brian owns three other Flip the Pharmacy participants: Four States Pharmacy in Galena, Kansas, Cherryvale Pharmacy in Cherryvale, Kansas, and CJ Pharmacy Carl Junction, Missouri.

Brian Caswell

Brian Caswell

As a part of Flip the Pharmacy, pharmacy teams work to transform their community-based pharmacy practice beyond point-in-time, prescription-level transactional models toward longitudinal, patient-level care processes and value-based models.

Brian recalls, “Before Flip the Pharmacy, our pharmacy ran like a well-oiled machine, processing over 500 prescriptions a day. At first, we struggled to deviate from our product-focused workflow, but the monthly change packages and coaching support have kept us accountable.”
Using monthly change packages, Flip the Pharmacy coaches work with local pharmacy teams to implement the six key transformation domains for four progressions: Hypertension, Opioid Management, Immunizations, and Diabetes/Social Determinants of Health. Change packages are loaded with best practices and workflow innovations that support practice transformation.

In October 2021, Brian concluded his two-year term as president of the National Community Pharmacists Association, leading 21,000 independent community pharmacies through COVID-19. Despite the many tragedies of the pandemic, Brian acknowledges that it has accelerated community pharmacy practice transformation on a national scale. Thanks to Flip the Pharmacy, Brian’s pharmacies have transformed their immunization programs, leveraging the appointment-based model to host numerous mass vaccine clinics and implement COVID-19 testing.

Patients will travel from near and far to receive this care, but these pharmacies have also developed robust home delivery programs. “It’s more than simply dropping off a prescription at patients’ front doors,” Brian offers. “Home delivery affords us the opportunity to become the eyes and ears in patients’ homes and assess the social determinants of health at play.” Wolkar Drug’s delivery driver, Brad, is revered by his patients for always going the extra mile. He’ll often offer to drive a patient to a medical appointment, pick up their groceries, or simply sit down with them to pray.

Brian attributes his pharmacies’ success in the Flip the Pharmacy program to the support of coach Sandie Kueker, RPh, whose bubbly energy inspires the whole team even on their lowest days. “Not only do coaches provide resources and keep us on track, but they also give us the hope and encouragement that motivate us to continue,” Brian shares. “Sandie is truly a gifted teacher and mentor.” Coaches like Sandie are funded by the Community Pharmacy Foundation and national and local team sponsors. Team Kansas is funded, in part, by a team sponsorship donation from Transaction Data Systems (TDS). TDS has two pharmacy management systems, Rx30 and Computer-Rx, that are capable of documenting Pharmacist eCare Plans.

In the future, Brian knows that clinical community pharmacies will become the new norm. As the most accessible healthcare providers, community pharmacists have an opportunity to continue the dialogue surrounding social determinants of health and forge deeper patient relationships. He believes that pharmacists have a duty to serve as a voice and advocate for their patients.

“When I was in pharmacy school, I had this dream of transforming pharmacy,” Brian reflects. “33 years later, it has been incredibly rewarding to watch that vision unfold with Flip the Pharmacy.”

The Flip the Pharmacy program has over 1,000 community pharmacies actively engaged in practice transformation, which are supported by over 450 pharmacy coaches from 63 local Flip the Pharmacy teams and ten Technology Solutions Partners. Learn more at and access the publicly available change packages and supporting resources.

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