Pharmacy U

Apple Hills Pharmacy opens doors to services that boost business

0045_Gray_PB Jan 2015_Scope of Practice

John Girgis enjoys clinical care and appreciates technology. Both interests have led him to new opportunities in the four pharmacies he owns in the Greater Toronto Area, one in a retirement home and three in medical clinics (including Apple Hills Medical Centre in Mississauga). The four locations are served by a total of 20 employees.


By Phillipa Rispin

Photography by Brandon Gray

About 10 years ago, Girgis was invited to join a McMaster University study which involved incorporating insulin therapy for Type II diabetics. It became his responsibility to do mentoring and education for new insulin starts. The experience opened his eyes to something he was already becoming aware of: a need for education, teaching and awareness about various diseases.

Nearly four years ago, Girgis became a certified diabetes educator (CDE). “I focus the majority of my time on teaching, education and mentoring, working closely with physicians in all of our locations in managing complicated diabetic cases,” he says. “We can implement new insulin starts and titrate dosing. I’ve also gone to the community and given lectures to different seniors groups regarding diabetes awareness.”

Although Girgis’s emphasis on diabetes has not significantly increased client volume, it has increased the number of patients with diabetes.

Girgis was offering enhanced services even before he became a CDE. Another service being offered in all of his locations is smoking cessation. All his pharmacists are certified in smoking cessation, and Girgis and his associates can coach and monitor clients who wish to stop smoking, and they can prescribe Champix (varenicline) and Zyban (bupropion).

“We’re getting increasing numbers of people from the community asking about the services,” he says. “Having pharmacists offering varied professional services in the community creates better patient care and outcomes — a win-win situation.”

The four Girgis pharmacies are also focusing on immunizations now that they have legal authority to provide flu vaccinations, and it seems likely that other types will be allowed. Girgis plans to include travel, shingles, and hepatitis series vaccinations.

Employing technology

All this increased activity does not necessarily mean a heavier workload for Girgis and his employees. He hires registered technicians who have the authority to sign off on the technical aspects of prescriptions, so pharmacists can focus more time on clinical and therapeutic issues. He also puts technology to good use.

“At Apple Hills we have a robot that fills prescriptions,” he says. “It doesn’t help me directly as the pharmacist, but it does help take the load off my technicians. They then have more time to do other tasks which complement the pharmacist’s ability to deliver enhanced patient care services, for example, looking at demographic info or calling up clients and reminding them to make an appointment for a follow-up diabetic MedsCheck.

“I was one of the first independent pharmacists in Ontario to install a robot in my pharmacy. I’ve found that technology, if you leverage it correctly, will help create the environment to make you more efficient in delivering clinical services to your clients.”

Girgis’s pharmacies also have interactive voice recognition (IVR) systems, installed in the late ’90s, one of the first independent pharmacists to install such a system. And, he notes, he’s had a website for years.

A healthy bottom line

Girgis is happy to provide enhanced patient care professional services, and they’re also benefiting gross profits, which he estimates have risen between five and 10 per cent. He’s not surprised.

“When we focus on the care of the patient, we don’t have to really worry about the business side,” he says. “People see that you care for them.

“Pharmacists have slowly transitioned from the product-focused to the patient-focused. The pharmacists who are now fully transitioned will be successful, because when you lose sight of the person in favour of the product, then your client will also lose sight of the genuineness of your care. It’s about wellness. We focus on wellness and keeping our clients on a healthy track.”