Taking Care of Every Patient in Every Pharmacy

In 2020, I interviewed for another position that aligned closely with my professional aspirations. Over the course of my 44-year career in community pharmacy, I have consistently sought opportunities that suit my personality and values. My approach has been straightforward: I have primarily worked with family-owned independent pharmacies, having discovered early in my career that chain pharmacy environments did not provide the fulfillment I sought. Since leaving Rite Aid in November 1981, I have found greater satisfaction and professional growth within family-owned independent pharmacy settings.

My daughter Gretchen Garofoli, PharmD, BCACP, CTTS, FAPhA, a clinical professor at West Virginia University, called one evening and said, “Dad, you always mention wanting to move closer to our 4-year-old son, Luke, and I’ve found an opportunity for you.”

She said Nickman’s Drug in Lemont Furnace, Pennsylvania, was looking for an experienced clinician, and it sounded like a great fit. Since my wife’s family originally came from Uniontown, Pennsylvania, we were definitely intrigued. At the time, I had an excellent position with Thompson Pharmacy in Altoona, Pennsylvania, and was also teaching in the physician assistant program at St Francis College in Brooklyn, New York.

As a 62-year-old pharmacist, I was interviewed by Jim Nickman Jr, a businessman in his early 40s. Jim began the conversation by expressing his desire for me to provide health care support for the people in Fayette County, Pennsylvania, stating that there were 5 stores, and the patients had shown tremendous loyalty to the Nickman family. Their business was established in 1974 by Jim’s parents, both pharmacists, and Jim Jr, though not a pharmacist himself, is successfully expanding the enterprise.

Fayette County is among the 5 most economically disadvantaged counties in the state and ranks as the second least healthy. The majority of coal mines have ceased operations, much of the local industry has relocated, and the region faces significant challenges with drug abuse.

The initial step undertaken was the dispensing of naloxone (Narcan) pursuant to standing orders authorized by Pennsylvania’s physician general. To date, this initiative has contributed to saving at least 13 lives by delivering this critical medication to individuals at greatest risk.

When COVID-19 vaccines became available in 2021, we identified a need for home vaccination services. At that time, we received requests from a local agency regarding the possibility of administering vaccines in patients’ homes. Recognizing this, Jim Jr initiated a program to provide home-based vaccinations for homebound individuals in Fayette County. To date, I have administered over 135 vaccines to our patients at no additional cost. This effort reflects Jim Jr’s commitment to serving the Fayette County community by “taking care of my people in Fayette County.”

Among the 135 immunizations administered, 1 recipient was an 80-year-old patient with Parkinson disease who has been bedridden for 3 years; both his wife and daughter expressed their gratitude. I also provided vaccinations for 2 seasons to a patient with multiple sclerosis, whose parents continue to express appreciation following her passing by sending a holiday card and a contribution for staff meals. My work has taken me to some of the most remote areas of the county, where each patient has shown deep appreciation. I make it a point to let patients know that this service is made possible through the support of Jim Nickman, as part of his commitment to giving back to the community.

We are currently in the midst of another flu and COVID-19 immunization season. There is no question that vaccinations can be challenging, time-consuming, and sometimes disruptive to workflow for our bench pharmacists. I would like to express my appreciation for all pharmacists who prioritize patient care by providing these essential, lifesaving vaccines. Every dose of COVID-19; respiratory syncytial virus; flu; pneumonia; shingles; tetanus, diphtheria, and pertussis; and other vaccines administered reflects each pharmacist’s commitment to serving their communities, regardless of practice setting.