Are Pharmacist Associations Effective? | Scott Newman, PharmD, Pharmacists United for Truth and Transparency (PUTT) President

Speech to text:

Mike Koelzer, Host: [00:00:00] Scott for those who haven't come across you online, introduce yourself and let our listeners know what we're talking about 

Scott Newman, PharmD: today. I'm Scott Newman. I am a previous retail pharmacy owner, and I'm also, uh, currently the president of Pharmacist United For Truth And Transparency. And I think that, uh, we played on talking a little bit about put today.

Mike Koelzer, Host: Now that you are no longer a pharmacy owner, we've gotta lay down some ground rules for our conversation. And if we start getting into the weeds, you can't just say, well, Mike, that sucks to be you. 

Scott Newman, PharmD: There's a strong urge.

a very strong urge, but I think I can, I think I can manage, 

Mike Koelzer, Host: I know that when you're in the pharmacy as an owner, still, you might think this fight's gonna be a life forever in me because I know what these pharmacy owners had gone through and are going through and I'm gonna keep powering on. Was that your thought?

And has that been true? 

Scott Newman, PharmD: I'm still pissed. I mean from a personal standpoint, I'm, I'm angry. And, and I don't know when that might resolve it. It could be like that man in Bruce Lane, I could literally just take this for the rest of my livelihood as a revenge, who knows? 

Mike Koelzer, Host: It seems like your stress would be a little bit less, which would maybe take some of that off, but do you see that continuing to be lesser?

Do you think it might even get worse because you have more time to get 

Scott Newman, PharmD: pissed? You know, I've always been a reader. So one of the things that helps me to communicate, especially in this role is I read. Anything I can get my hands on that comes across, you know, about the industry and such. And, um, all I've done since I've stopped, you know, running a pharmacy is I found more resources to read.

So I haven't really delved back into social media as much as I had been prior, just as things change and, and, you know, the ebbs and flows start to even out of what my new normal is, but I'm still reading a lot. And so I think that I have a healthy acknowledgement of what I still find just, or unjust.

And this is still a very unjust type 

Mike Koelzer, Host: situation. We all know that when we're talking to somebody and supposed to be listening, whatever the subject is, you start thinking about, well, how's that affecting me now? You know, so you hear their story, you acknowledge it. One of my friends calls me the, uh, The world's best active non listener.

something like that. 

Scott Newman, PharmD: I get it. Hey, with ADHD that I have, like people, people are actually pretty amazed. Like they, they, they swear, at least when they first get to know me that I don't listen. Like I'm not paying attention, but truthfully, that's kind of how I do pay attention. I distract myself by doing something else while I'm listening and they bring it up all the time.

Scott's really listening. Even though he doesn't look like he is, 

Mike Koelzer, Host: I'm the opposite though. Cuz I've had years, you know, of practice of, and I'm not proud while I'm, I guess I'm proud of I'm gonna be first in something. Well, that's something to be first in, but just to own it, I should own it. But yeah, for years, you know, customers come in and they tell you stuff and your mind is somewhere else and you have to pretend like you're listening.

And unfortunately I do that for my family too. So I'm the, I'm the most active non listener. But here's what I'm getting at when you're doing that. When you're listening to people and you have your own story going on, you're getting into what they're doing, but you're also thinking, well, how does that compare to me and so on, but I can see maybe not having that now, as you start reading more, you can get pretty deep into people's problems and, and their emotions.

If you don't have your own emotion furnace in your own pharmacy, just firing up all the time. 

Scott Newman, PharmD: I, I jokingly say that I make it about me, but truthfully no one when their right mind would do what they have done the last nine years and this, both these roles, um, if it was just about me, but yeah, I've always tried to make myself available to others based on my experiences and, and what I've.

Witnessed in my pharmacy. So my big fear is actually not being the guy that comes to the table with the new example or the new, you know, issue that, that I would've found as, you know, a pharmacy owner, I don't want to fall out. Like, so if I start falling out of touch from things and that's a whole different thing for me, I, I, I think that there's that possibility because now I'm not, you know, living the moment and a lot of our ideas and, and experiences [00:05:00] and things that we've come across, come from our board members because you know, most of us are pharmacy owners and, and not being one anymore.

I'm afraid that maybe I won't contribute to that conversation as effectively. 

Mike Koelzer, Host: Yeah. I guess, because we're all kind of in the same boat, as someone tells a story, because we're all getting screwed equally. Mm-hmm . As someone tells a story, you can say, yeah, I get that. Here's my side of it. And I'm fully agreeing with you guys because we all have this same story going on.

It's not like you were bringing a story like, um, yeah. This sub shop down the street closed. And so my big issue is, you know, lunch, lunch here, whatever, you know, you're all bringing the same story. So yeah. You're not able to bring that example perhaps, or 

Scott Newman, PharmD: to say, Hey, wait a second. Is that happening to me too?

Let me go check. Yeah. So I'll be missing out on that a little bit. 

Mike Koelzer, Host: That's gotta feel good though. Sometimes 

Scott Newman, PharmD: it's actually, you know, thinking about for a, so, you know, I've had to run those reports or I've had to call the PS a O or, you know, to verify or to double check or, or run, you know, Phantom claims on things we're trying to verify cost and pricing on and is trying to fit that into an already too busy day as a real pain in the butt.

Sometimes. 

Mike Koelzer, Host: When would you ever think that you weren't bringing enough to the organization anymore based on something that happened because of your sale? I 

Scott Newman, PharmD: don't really know that I know the answer to that. I mean, I live for the most part, pretty vicariously through other owners. I imagine that'll still happen.

Um, it depends on to what degree the industry changes going forward. Cuz obviously things change and that's okay. It's just that I will now no longer change with it. 

Mike Koelzer, Host: When you guys talk, you're bored. How many on the 

Scott Newman, PharmD: board? I think we have, uh, nine right now. All right. So 

Mike Koelzer, Host: When you guys talk, is it ever your job or someone's job to say, all right, guys, let's reign it in enough.

Bitching. Let's go. 

Scott Newman, PharmD: Yeah. Yeah. That's Monique's job. . Being the only one who didn't have any sweat equity, mostly into the game, we can get rather negative. And you know, there's always that fear that that's just your culture of the board, but, you know, it's a hard thing to gauge when you're constantly being crapped on, um, and frightfully.

So we vent it's either that or drink more and we don't wanna do that, but, but yeah, Mon Monique wants to try to keep some things positive and try to keep things cuz you know, in leadership, that's what you do. You try to maintain positivity. But I think that you have to have a healthy dose of reality with that.

And so we balance each other out well and I'm not 

Mike Koelzer, Host: talking so much on long term, but even like a meeting, like when you guys are all on video or something like that, do the meetings, the board meetings, let's say, yeah. Are they focused enough for 

Scott Newman, PharmD: you too. Oh, no, no, they're, they're very focused. Yeah, we, yeah, they're very focused.

We, we, you know, we like to joke and say that we do the, the best Robert's rules of, of etiquette that we, that we know how to, um, you know, we have minutes and we have, uh, an agenda and Monique and I discuss that usually day before we have our board meeting. Um, you know, we can add or change things. We do save the last, um, maybe 15 minutes just for, you know, board members to bring anything that they wanna talk about to everybody's attention.

Um, and those discussions are usually based off, off of somebody's, you know, uh, schedule coming up with a legislator or, or somebody's experience with, you know, getting, um, you know, excessive fees taken out at the point of sale, or, you know, it's usually something new, you know, new, new business from, from a board member's perspective 

Mike Koelzer, Host: when you've got, let's say nine people.

Spending an hour or two on the computer. That's like half of a work week. You know, you've got like 20 work hours there. And so you're all bringing your gripes and complaints. That's what gets you onto the board, but she then is able to focus that 20 hours and say, let's go 

Scott Newman, PharmD: formally. We have a board meeting once a month, but informally we have, uh, phone calls or zoom meetings twice a week, Tuesdays and Fridays, Tuesdays is usually reserved for me and Monique and you know, maybe my vice president, Don or, um, Deb, Kevin out of Minnesota, she's more active in.

The, the, the workings of the organization. So, you know, three or four of us are on a Tuesday [00:10:00] call that discusses Monique's schedule for the week. And anything that we need to talk about that we're planning or we're dealing with. It's mostly business business discussions. The Friday call is open for any of our board members, if they wanna Ajo or if they have time or if they're not swamped.

And the Friday call is kind of a non guided conversation that may recap things that we've already texted each other about, or, um, you know, we usually take a few minutes and complain. Uh, sometimes it's half of the conversation, but that's Fridays for complaining. Yeah. Once we get that off our chest, we can have a good weekend.

But, um, there, there does have, you know, in such a, in such a frustrating and. And obviously our listeners and yourself know this better than anything, you know, when you get kicked in the nuts every single day, there's not a whole lot of good things to talk about. Yeah. Sometimes that makes the pain go away.

Yeah. So, you know, I have found self-deprecating humor to be a very therapeutic thing for me. Yeah. So, you know, a lot of times I will just drag myself around. Um, and, and, you know, I try to be careful about it cause I know it bothers Monique, uh, but for a good amount of time, there's really no outlet for the frustrations, except for amongst people who know what you're dealing with.

Yeah. So that's where you are. 

Mike Koelzer, Host: I'm in the middle of reading Victor Frankel's man search for meaning. And he was a psychiatrist in Auschwitz. And that's one of the things he's saying in there. It's like, even in the midst of the concentration camp, he said to his buddies there, he said, we gotta think about one thing to laugh about every day or to go crazy, the value of humor.

And I'm not putting pharmacists by any means into the category of concentration camps, but the value of humor under stress, especially with comrades, it's like, oh yeah, there's a huge value to that. Yeah. 

Scott Newman, PharmD: And, and sometimes all you have is to make fun of yourselves. 

Mike Koelzer, Host: I often have a feeling of embarrassment being a pharmacist, being in this position, you know, especially when I complain about the contracts we've signed.

And I know that you and I spoke last time about contracts of adhesion and things like that, but I'm often embarrassed in my mind, if I'm part of it, then I'm part of the problem. And there's a lot of emotions for me that go along with needing that humor. There's rage, there's disgust, there's embarrassment, there's sorrow.

There's a lot of things. Disbelief, 

Scott Newman, PharmD: disbelief like seriously, how can this be? Like, it's almost to the point where it's so ridiculous that like, what else can you do to make fun of it? 

Mike Koelzer, Host: We're talking about nine people on this board, in this organization that share something in common. What is this board?

Scott, is it made up of pharmacy 

Scott Newman, PharmD: owners. Yeah. Doers people, people who we've, we've made connections with, uh, either in, within our own membership or different functions who we recognize as a, somebody who we would like to have amongst our ranks, since we don't have, you know, a whole lot of paid staff in order, do we have the budget for it?

Then we want to find people who are doers, people who can handle, oh, you know, pharmacy and still work, you know, 20 hours a week get put for free. You know? So it's, it's, it's people who are trying to make things happen and not just, you know, ride the tail coats of everybody around them. When 

Mike Koelzer, Host: you say doer and you say 20 hours, give me an example of that.

Scott Newman, PharmD: Well, a lot of our graphics, uh, are rooted in a lot of research in data analysis. You know, Dawn down in Florida has crunched hours upon us probably. I mean, I can't, you know, quantify it takes so many hours crunching data so that we can make a nice graphic out of that data. There's people who have. Made personal connections with very important people in either the state there in legislature wise, Deb Kevin, up in, in Minnesota, she formed an independent pharmacy association called the Minnesota Indies or Mindy, and she's got a hundred and some odd people organized and together with one mission as independent owners now.

And that's within the last two years, uh, you know, Dawn facilitated, organizing spar in, in, uh, Florida, you know, and at one point they had, you know, a hundred or [00:15:00] so members for that organization. And even though it's not a pot organization, you know, we help to market and, and make connections with.

Lobbyists and such for their mission. And granted it's not been successful, but it is Florida. But, you know, just to organize a group of independent owners like that takes a lot, and these are the kind of people that we have on our board. 

Mike Koelzer, Host: It's interesting when I'm hearing that, because it reminds me of being on a parochial school board years ago.

And I learned the hard way, I guess, that our board was a recommending board. In other words, we would get together for like three months in a row, you know, talking about something. And then, the leader of the parish who would come in and say, no, , you know, it's like, why all do we do that for? But what I'm hearing is your stuff.

It sounds to me like there's enough freedom. And maybe it's even encouraged for people not to get the approval of all the way up through the almighty head of, but to be able to do something. 

Scott Newman, PharmD: Well, I mean, obviously we're more concerned about facilitating change. Um, I often interviewed my previous bosses without them knowing.

And so I would ask him questions like, you know, how come they micromanage his, his people and, and then you, you just let your people do their job. And he basically said to me, if I wanted to micromanage people then I would hire. People who needed to be micromanaged. And he said, but that's not what I want.

I don't hire people. I have to micromanage mm-hmm . And so it was kind of like, we don't put people on the board that we have to micromanage. Uh, we don't have time for that. We need people who are gonna go out and facilitate change, bring the ideas back to us so that we can roll it to other places or share the information.

Um, if it's successful, if it's not, and we can learn from that too. But you know, people who, um, if we do have to delegate some work, or if there's some things that need to get accomplished quickly, or even large scale project wise, you can't really hand that off to somebody who is not even a self motivating person usually.

So it's just a good idea to have people who are doers, people who are self-motivated and don't require to mic, you know, micromanagement that if you do have a project, you know, it's gonna get it done because they already take initiative to do things that they need, they need to do. How do you 

Mike Koelzer, Host: know that a lot of boards take warm bodies?

How do you know with put, do you have a flexible board where some years you might have five people and some years you might have 15? Or how do you know that you're not getting non-doers on your board? Let's 

Scott Newman, PharmD: say, well, you don't and occasionally you get surprised. but we ask for at least a three year commitment.

Mm-hmm that doesn't always work out. If you wanna do a 10 year commitment, there's no reason you can't, you know, it's just up to you. We just ask for a minimum of three year commitment, but it's a long interview process. And I say that facetiously, cuz it's not really a formal interview, but just like you and I know each other and every time we interact, we learn a little bit more about each other, right?

Same, same with the people who we eventually nominate or are asked to join our board. They're people that we've interacted with or we've, we've worked on something with, and you know, that's a, that's a very informal process, but it's probably the best way to interview somebody is to just work and interact with them over the course of time.

When you have an opening on the board and you offer it to the best candidate based on who, you know, and worked with. 

Mike Koelzer, Host: What is the supply and demand? Do you have enough people that want on and you're denying summer? Would your board grow if you found the right people? Yeah. 

Scott Newman, PharmD: Well, our bylaws are written, so I think that we can have up to 11.

Yeah. Um, we rarely, rarely have carried 11. We've gotten close and that's only because we would rather run with less people, waiting for somebody who we know will participate and be engaged than just ask anybody to be there. Cause otherwise you end up carrying other people and we've got enough to do, to not have to do that.

So it's one of those scenarios. We can have up to 11, we probably average nine. Um, and it's only a priority to fill those spots. When we have a candidate who we want to approach to offer the position to. And not [00:20:00] everybody says, yes, you know, uh, some people have too much going on or maybe they don't mind supporting the mission, but they don't want to contribute to the mission.

Uh, from a time standpoint, maybe they don't get along with some of the other board members. Obviously some personalities are stronger than others, so there's different reasons why. Um, but for the most part, I think that at least I did. I'd hope that the people that we do bring into this particular role, uh, feel honored to do it.

I, I know I was, I, I felt like it was a huge. You know, acknowledgement of my skill set, to be invited. Do you turn people down? It's not like we announce that we're looking for a board member. You know, it's not something that we, we really publicize. It's one of those situations where I think that I don't know who want to do this, if, I mean, like, as, as a, I mean, don't me wrong.

I think that you would be honored to yeah. I was honored to be invited and was excited to do so, but I'm not sure that I would've gone looking for that role. 

Mike Koelzer, Host: What holds is put filling that the other, let's say three to six national organizations aren't filling, aren't able to fill don't wanna fill whatever.

Scott Newman, PharmD: So I, let me just state for the record of prior what I was about to say, we encourage every organization or every person that we engage with membership wise, or non-membership wise to join, you know, their local state and national organizations. We're not trying to use C membership anywhere. Um, in fact, you know, our, our quote, unquote membership as Monique likes to call us, or actually donors, we were a donation driven organization and we just call them memberships.

If you, if you donate to the organization regularly, um, it does give you a little bit of access to some things that maybe that people who aren't donating don't have, but mm-hmm we always require, I mean, I say require it's highly encouraged that, you know, my board members are. You know, members of the large national organizations like NCPA and a PHA and such.

Um, and at, at this point, I believe that they are all that we all are, um, unless someone who's just not told us, told us that they got to that point. Um, I mean, I, you know, I'm very active with V PHA here in Virginia. I've been on the legislative, um, government affairs committee for five years, six years now.

Uh, I believe that's about right. Um, and I've had other roles, you know, here as well. Um, so, you know, we, if we're gonna work in a state, we want them to be members of this. We'd rather work with the state organization through them because the resources and their structures already facilitate what, you know, we're trying to accomplish as it is.

Sure. U usually, um, in some states are better than others with that. 

Mike Koelzer, Host: No sense going in, out of pride and reinventing the wheel? No, 

Scott Newman, PharmD: no, no. We're not trying to reinvent the wheel. We're just trying to, we don't always agree with some of the directions that the larger organizations go or take. Um, we're a little bit too angry for that.

Hmm. We think that there is a lot to be said about how dirty PBMs fight and how nice we play as a community, which we don't really agree too much with. We want to be a little bit more aggressive because I think that's the only way you can fight them. That being said, not everybody agrees with that, but I can tell you that the whole good cop bad cop thing is a thing for a reason.

I wish that we would get utilized for that more often than not, but there's a level of. Nicety that is maintained, that all I can assign to it is the reason why we've been getting our asses kicked for so long. Hmm. Uh, I think that we have an edge. We're not really afraid to say the hard things. Um, it doesn't always get received well by our colleagues, but I think that it's effective to the degree with which we're recognizing who we're at war against 

Mike Koelzer, Host: these bigger organizations being the good cops.

You've got a mass murderer in the PBMs. Done their crime. And you've [00:25:00] got the good cops in the organization saying, here's how we're going to respond to that. You wish that the good cops would call in the bad cops once in a while and use you actually as a bad cop, because you can say the dirty things and maybe not as politically correct as some of the good cops say it, you wish they would use you more almost as a warning.

Like if you don't listen to us as a good cop, you're gonna see a lot more of the bad cop. Yeah. 

Scott Newman, PharmD: I see it more as of a released hounds, you know, when you, when you're not, when you're not getting the, what you need out of the process and you need, you know, membership of an organization like this to flood the social media with, you know, let's just call it.

What it is, you know, being direct, I guess it's, you know, we have a tendency in our organization, in our membership, by the way, I, I do remind the other organizations that my membership is their membership. It just happens to be that this particular sector is a little bit more pissed off and aggressive and willing to make a little bit more noise than the rest of the get along gang.

So I, I tell you, you know, that kind of social media presence that we have allows for us to be very vocal and get a lot of attention. And, and I hope that it's the right kind. And sometimes I disagree too. I'm sorry, but like, you know, if you have somebody who is in a position of power that can change or fix our issues, I don't believe that you cut any slack because of that.

Mike Koelzer, Host: Have there been organizations that have publicly admonished? You saying you saw what put us there? 

Scott Newman, PharmD: I don't think we've gotten anything like that. Most of our admonishment comes, you know, privately on the back end. Um, we get yelled at, by somebody who thinks that we're, you know, causing problems or not cooperating, they send you 

Mike Koelzer, Host: a letter or what if 

Scott Newman, PharmD: it's not public, we've received an email or two really, uh, directed at leadership.

Sure. Yeah. Or, or in a meeting, cuz we do have meetings with these organizations and, and sometimes they don't go so great. I'm more in the role of, I, I want to work with these organizations. I know they don't necessarily want to work with us. Yeah. So I'll give a summation. If there is a general disagreement over the way something should be done or handled, then depending on how strongly they feel about it will either get ignored or they will say something if they feel like it's egregious enough, but.

I've also said our piece to them as well, and that isn't always received well, but it's obvious that no one else is saying these things to them who should 

Mike Koelzer, Host: be, and you'll let them know. And you think maybe your voice of letting them know might be a little louder than just the average pharmacist in a store saying, I don't agree with that, but you can bring that message.

Scott Newman, PharmD: I think they surround themselves with too many people who just agree and say yes to 'em and enjoy being part of the 

Mike Koelzer, Host: club devil's advocate. You don't need to tell them that they should think differently. That should come from the constituents and from the membership and so on. But you think that your voice is maybe a healthy voice of dissent that maybe is a little bit louder than the average member's voice alone.

Well, we've 

Scott Newman, PharmD: put ourselves in the position of not being ignored easily. Will you push your way to the big kids table? Yeah. It's harder for them to ignore you. 

Mike Koelzer, Host: What's a current hole that the major organizations with all their good values, but maybe some shortcomings, but individuals with all of their value, but maybe some shortcomings.

What's a current hole that PUTT seems to slide into just nicely. 

Scott Newman, PharmD: The states 

and their state organizations need more support and our national organizations. Don't really have the resources to fight nationally and individually in the states. 

Mike Koelzer, Host: Oh, that's interesting. 

Scott Newman, PharmD: Now they usually do have people who are assigned to that, but it's not enough.

It's not enough. They're spread too thin. Um, you know, it's oftentimes when we request information that we know that they keep or they have available, it's sometimes it, it may come to us [00:30:00] faster than, you know, a average Joe, but it still sometimes is a process to get, because they're obviously, you know, spread thin, couple people handling all 50 states.

And we work very closely with the, the, the larger organization's, you know, council and such, and, and we all have great working relationships, um, you know, with, amongst the, the lawyers and such that happen to represent either state or national levels. And they have been very available to us. There's no complaints there.

Um, they're wonderful people. Um, I think that, uh, the states just don't have enough support from the state organizations. And most of that is just due to the fact that most of those organizations are not just independent pharmacists, there's academics. Right. You know, there's hospitals, a lot of the legislative.

Priorities get either divided or ignore it together or get diluted by other aspects of the profession to be fair. You know? So unless you're truly an independent pharmacy organization in that state, you're likely not getting a good legislative, legislative push or, or, or policy pushed and you need help.

That focuses more on independence. That's really interesting. 

Mike Koelzer, Host: You have, let's say a major organization that really cares about independence and you got a lot of independence joining in focusing and pushing, but. That strength, maybe at a national level, but as soon as you break out to the 50 states, you've kind of diluted again.

Mm-hmm so then you say, well, who's sticking up for independence at the state level. Well, let's look to the state organization. The problem is you don't have a real beefy, independent pharmacy state organization, or a big slice of that pie in the state. That's where you guys come in. That's really cool.

Yeah. And most states 

Scott Newman, PharmD: don't, um, several of them do, I mean, Louisiana has a really strong. Obviously independent pharmacy association. And we end up working with them more than probably anybody else, but we do that because it's such a learning experience with how they do things and how they get things accomplished and the resources that we can share with them, with what they're trying.

We wanna support them to make sure that they stay viable and successful. But we also want to take back with us and share with other states that may be able to benefit from how they accomplish what they accomplish. So we will obvi a lot of times bridge information amongst the different groups. You know, it's one of those.

Learning without having to reinvent the wheel type things like, like we talked about before. So I think that when you have an organization that represents all aspects of the profession, unless you've got an executive director, like we have at VPH, a, in Christina Burelli, um, who has taken the whole independent, you know, plight to heart, like a lot of people do that, that didn't have any, you know, any, any skin in the game until they were introduced to it.

Uh, we still have to divide some of our. Attention to the profession and the academic side, but we're lucky cuz we get to focus primarily. Let's just say, if we're gonna drop six bills, four of 'em will be PBM bills. Two will be, you know, professional services bills or something like that. Um, but that's not like in every state, you know, they could divide it up as 2, 2, 2, and two or something like that.

And so those states are organizations representing the whole profession. And so maybe the independent flight, maybe they have an academy of independent pharmacies that meets on Sunday of the weekend of their annual meeting, you know, nothing really strong. So when I say we work in the states, you know what our board members do like with what Dawn and Deb and um, O others have done as well.

And that's forming. A strong, independent group in that state to help represent the interest of independent pharmacy where the, the, the state pharmacist association may not necessarily, um, have as much passion for that side of the profession as we are, or as we have as owners. And that happens a lot. So, yeah, that's where we kind of, we, we are finding that we have legislative successes when we're able to not necessarily break away, but organize within that state organization to [00:35:00] independence, to focus on going out on their own and, and attempting to, to facilitate change.

And that's where we kind of give them the, the, the guidance. 

Mike Koelzer, Host: When you say guidance, is that slang for. Bringing our pitchforks. you know, what is guidance is that slang 

Scott Newman, PharmD: guidance could be anything from encouragement to, um, sharing bills. Hmm. You know, if we've got a successful bill, like pot will sign 

Mike Koelzer, Host: its name to a bill.

Scott Newman, PharmD: No, but we can help get it. The draft of it. Sent from one email to another, in another state and changed the wording to gotcha. That state, you know, you don't wanna write 17 pages of legislation, brand new. If it's already been written, there's no plagiarism issues there. So, you know, you just, you know, a lot of, a lot of, as states are introducing and, and passing larger PBM bills, they're functionally conglomerates of different states, PBM bills put together the best parts that are effective.

And we like, and we help with that. A little bit NCPA does that too. But like I said, sometimes the resources are a little thin, so yeah, we have really good input from, um, people who have been successful. Like Greg and Georgia, we work very closely with him. Um, he's no longer in Georgia. Uh he's with, um, uh, AP C I, I think it is.

Yeah. And then of course, Randall down at Lipa in Louisiana and. These are where they're winning mm-hmm and why they're winning. And, you know, sometimes it's situational, you know, sometimes the legislators, uh, let the legislative makeup politically is just right. That's what kind of happened in Virginia a few years ago.

Um, sometimes it's that they've started the process five years ago and are now finally starting to break through and, and now we need to guide them on, you know, bringing it home. And that is everything from facilitating, you know, um, what we look for in a good lobbyist, that could be how you organize your.

Independent ownership and, and you know, this model of an independent pharmacy group and how we structured ones in the past. Um, and it could be that we help with billboards or marketing or providing, you know, the papers that we take to our legislators, or if we're in a committee, we often will see our graphics on the table of a legislator.

That's, that's talking about a bill or in a committee. Those came from one of our members that was provided to that legislator. 

Mike Koelzer, Host: When you say lobbyists, what do you mean by that? Put doesn't have lobbyists per se, 

Scott Newman, PharmD: right? No, no. And we don't lobby and we don't actually, but we can help. We can help screen potential lobbyists that, that, that independent group might 

Mike Koelzer, Host: hire you at a state level.

And these are pharmacies that might. B being helped by the state association. You come in and add more power. Like we just talked about where the lobbyists come in? Are they actually hired by like these, you know, 50 independent pharmacies? And what group is that then who signs 

Scott Newman, PharmD: their paycheck? However, the group structure is organized.

Like we talked 

Mike Koelzer, Host: about earlier. There's different ways that these are organized. 

Scott Newman, PharmD: Yeah. Um, you know, we have an ideal way, but, but that's not important specific wise. It really is based on the situation and who steps up to help do that. Mm-hmm but could be that, um, Somebody's passionate about doing it and they find it important.

Um, and they just step up and do it. We don't, we don't endorse these and they're not affiliated with us specifically. Um, we kind of let them go out on, you know, do this. This is how we've seen people do it. This is how we've done it in the past. We don't want a bunch of putts around the country. I mean, it was an idea that was tossed around, but we just found that there's, um, there's too much to guard when it comes to who says they're representing us.

Yeah. Right. So we do encourage states that don't have strong, independent representation to form their own business groups. Mm-hmm , uh, organizations like, you know, to, to, to have their voice and to have their agenda, um, or the things that need to be accomplished front and center for 

Mike Koelzer, Host: them. What's an example of a lobbyist?

Is that like it? Some young person that's hired and then they're going to [00:40:00] email and call and visit offices. How wrong am I on that? You 

Scott Newman, PharmD: have to understand that these usually effective lobbyists have their relationship builders either through their previous professions or careers or industry connections.

And so, I mean, anybody could, you know, study and be a lobbyist. You know, it's just something that you are more effective if you're, let's just say the ex Lieutenant governor. 

Mike Koelzer, Host: So it's an old fart. A lot of times, a lot 

Scott Newman, PharmD: of times it's people who are still wandering the halls of their state legislatures, but no longer in the capacity of an actual delegate representative.

Or legislative or executive. 

Mike Koelzer, Host: So if someone who already has connections, they might do this over a coffee or visiting. What are some examples that maybe of how they would lobby that? 

Scott Newman, PharmD: Generally speaking lobbyists are going to help to make connections with legislators and are gonna help write bills. They're, you know, traditionally they're.

In, you know, maybe a lawyer by professional trade there that's handy to have, doesn't have to be, but it's handy. They make contact to talk about issues with the legislators. They, you know, will set up times to meet. They'll meet with, uh, you know, different players that make decisions and certain things like bills that have been passed and maybe they need, you know, somebody to enforce it.

A lot of times they'll facilitate meetings with the people that are responsible for enforcement. Um, they really are just the people who you hire to push your agenda with your legislators. 

Mike Koelzer, Host: At a state level, are there any independent groups that have formed and they hire like a full-time person to lobby or are these lobbyists, they might be a third pharmacy and a third dental and a third something else, or they usually like full-time for pharmacy at a state 

Scott Newman, PharmD: level.

Yeah, it just depends on, I mean, that can be expensive if you've got a well funded group. Right. Um, you certainly can. Um, or if you , it's not unheard of for, you know, someone who has made their living and they're just looking for something to repair or, or make their soul happy and may take you on as a, as a, a charity case.

And, you know, maybe you don't pay them as much front until there are some successes, but, um, either way. Lobbyists are still pretty expensive. And yeah, you know, they're either going to be with a firm that represents other, you know, groups mm-hmm and so you have to be real careful cause you certainly don't want to, and for some reason they aren't really that worried about it.

I think that because by nature, they, they just, whoever they're kind of like mercenaries, they just, they, they, they go to battle to pay 'em the most. Yeah. Um, and, and so you can have a conflict of interest where let's just say your, the lobbying firm, maybe not that particular lobbyist is, you know, working for.

You know, maybe the wholesalers, you know, and, and there's going to be an issue at some point that you're a wholesaler and you aren't gonna agree on. Right. And your lobbyist is all of a sudden the person who's, you know, who, who are they going to represent? I can tell you it'll be the one that pays the most money.

So 

Mike Koelzer, Host: you, you be careful and it might be a part-time thing. Right? Well, it depends on 

Scott Newman, PharmD: the legislatures too. I mean, California is, you know, year round. That's true. You know, whereas, you know, you know, Texas for instance is every other year and we in Virginia are, you know, three months out of the year usually.

But I don't 

Mike Koelzer, Host: mean part-time through the year. I mean, like it might be a 15 hour, a week thing. You're paying someone to make some connections. When you hire a 

Scott Newman, PharmD: lobbyist, you typically are hiring them based on their formula for. Doing several things for you. One is to find sponsor bill sponsors and drop legislation.

Hmm. You know, there's a specific charge for how many of those you want to do in a, in a session. Oh, I see. And then there's a charge for, do you want us to just follow and communicate what's going on with things that you would, you would have a stake in. Gotcha. Um, it's cheaper to do that than it is drop legislation, but, um, when you drop legislation, that number is bigger because you're not only writing and meeting and amending and trying to negotiate bills, but you're also following other things that are going on with that bill either in one side or both sides of the, of the assembly.

So it's a lot more involved. It becomes probably more than a full time job for them [00:45:00] at that point. 

Mike Koelzer, Host: You know, I ain't no genius. And I know states can be sued, but it seems like in pharmacy, you got two things going for you at a state level. One is, and this is where a state can get sued, but it seems like states can more easily write in their rules.

If you don't follow a PBM or lessen that if you don't follow what we're doing as a state, you're not gonna get a business license to be a business in this state. That's number one. Number two is the legislators are in these areas. It's like, oh, you know, Scott's former pharmacy was in this area or I'm a neighbor of So And So or my grandma's in the nursing home by Joe's pharmacy.

That kind of thing. It seems to be like this. Yard more of legislators than at a federal level. And for those two reasons, it seems to me like, unless there's a huge national law sent down, it seems like states are at a pretty cool level to fight the inadequacies that are going on in the industry. 

Scott Newman, PharmD: It's definitely easier.

Uh, we're talking about a bipartisan issue that shouldn't be. Ignored by either party for the simple fact that everybody can agree that PBMs are a problem. And they're also probably the primary reason why drugs cost, what they do. So if you are looking to be fiscally responsible, we're looking to help people out with drug costs.

Then obviously this is a bipartisan issue. It's easy, it's an easy target, you know, those are the best kind, the feds, there's some fishy crap going on there. I don't know where quite what it is other than the fact that politics is politics. And, you know, you're, you're, you're, we're low on the totem pole when it comes to what's right.

And what's wrong. And obviously, so are our senior citizens, uh, you know, you're second class citizens at that point, when it comes to representation there from, you know, what's hurting you and what's not, um, but at the state level, you've got what you mentioned. You know, we serve our legislators in our own practices.

A lot of the time, um, there, it's not unheard of though, to be honest with you, for states to lead, um, on legislative issues to begin with, and then nationally it gets, you know, the feds pick it up at some point. Um, they're usually slow when it comes to that the states will address it faster and more efficiently.

Uh, you know, even with the political discourse that's there right now. There's still a lot of stuff getting done at the state level. Not as much gridlock. I, I guess you would say the idea that you have better access to your state representatives and. you don't have any excuse for not being able to meet or at least trying to get a meeting with them because they're all available.

Mm. In fact, in Virginia, we organize every year, bring your legislator to work day and, you know, Christina facilitates it with V PHA, but we literally get our legislators to come in and walk our pharmacy. And listen to us, talk about the deals, the issues that we're having as small business owners and our patients, what, how it affects them so that they can start to be educated.

And that's been very, very 

Mike Koelzer, Host: effective. I like to bitch a lot about what's being done to us in the pharmacy. Sure. Me too. That's more fun. And you don't have to take the blame. Where are pharmacists currently to blame? In other words right now, if a pharmacist is not doing A, B and C there is to blame, or are we past that?

And it's like, no, we're not gonna blame you. You guys are so beaten down, but there are pharmacists to blame anywhere right now. Yeah. 

Scott Newman, PharmD: But not in the way you would think we didn't do this to ourselves. Okay. However, we have a very poor track record of involvement. Hmm. You know, as a, as a profession, or even as a, an industry in our profession as independent owners, it's still a very small percentage of us who are actively fighting the fight either financially or with our sweat equity.

It's a very small percentage. [00:50:00] Even the organizations that have. The best engagement. , it's not close to a hundred percent. I mean, Louisiana, for instance, they've probably got the best engagement and it's set up for them that way, because they get things. When they join, you know, Lipa, they get audit representation paid for by the organization.

They get counsel, you know, when, when those audits come through, there's a, a, a very good value in joining them. There's a benefit for them to do so. it's almost detrimental not to. And you've got to be a very special organization to get to a point where it's obviously detrimental not to join. Like it hurts you financially directly, if you don't.

Whereas most organizations aren't, you know, it's detrimental that you don't participate and join, but you're not gonna be able to show a direct correlation between those things. Uh, so you have to, it's our fault that we've been passive on being involved in pushing legislation and, and staying active, like Louisiana has pharmacies.

Yeah. 

Mike Koelzer, Host: Where are organizations to blame? If an organization says we don't have the participation that we would like to have. and you alluded to it. Uh, maybe they don't see a direct value. And so unless you can put a price on it right away, or do the potential members, is it up to them to throw financial trust into the organization?

Hoping that it's gonna pay off? 

Scott Newman, PharmD: I don't know what motivates people to stay out of the fight. I've heard many, many, many excuses. Hmm. Um, anything from, what has the organization done for me when I was a member to, you know, um, they never did anything at all, you know, or they, you know, I didn't benefit from it.

Or, and, and I think that, that those they're missing the boat at that point, because. if you're not part of the conversation, directing what the organization does and you sit back and let the organization happen around you, then yeah. There's a good chance that they may do something that you don't agree with.

Well, that's because you didn't speak up or you didn't participate. That's your fault. 

Mike Koelzer, Host: Someone's listening to this right now, a pharmacy, and let's say an organization came to them and they said, we want, I mean, because there is a price, if an organization came and they said, we want $10,000 for you to join.

It's like, where do you go with that? Now someone else comes and says, we want $10. All right. Well, what does that mean? How do you decide on a value when you're joining something? Yeah, because I know put, will take a donation as a membership and that's pretty cool. Because someone can put some in, get involved, put some time in, 

Scott Newman, PharmD: I mean, we've literally had one time donations of $10, you know, you're kind of a member, but we ask for, you know, a $50 a month donation commitment because that's kind of where we've calculated.

We need to be, to do what we do. Um, certainly the roster is as valuable to us as the money. The represent the, the, the roster of who we represent number wise is important. Yeah. Just like any organization value is an individual's idea, you know, and, and what I find of value, you may not find a value, but I will say this, we will waste money on some nonsense and a heartbeat that would quickly add up to a membership of three or four organizations together.

Hmm, where it would be in our better interest to, you know, not buy pizza for everybody three times a week. Yeah. Versus twice a week. Um, you know, or, you know, we give a lot of independence and I was guilty. This too is known for giving away a lot of stuff, you know, to, to patients in need or whatnot. I'm not saying take away from them, but you know, maybe there is someone who's taken advantage of you there, you could save a couple bucks there that's happened to every one of us.

Yeah. Um, and so I think that if you're not doing it because of the financial difficulties and I get it, I'm, I'm well aware of the financial difficulties. Believe me, if you've listened to a single word I've said, yeah. You know, I, I am aware of it, but I've always found a way to stay, to keep my memberships [00:55:00] active.

Sometimes it was six months later, but they didn't really kick me off the roster, but I always have renewed my membership, even if I missed the frigging renewal date, somehow I made it eventually. And if you can't, sometimes if you just communicate with the organization, they'll still let you play and, and take it out slower.

Or, or, you know, if you can promise in six months that you can pay it, they'll work with you. Um, they don't wanna lose you, cuz like I said, that roster, your name on that roster is pretty valuable too. Um, but if you're not prioritizing it, then your priorities aren't correct. Your, your priorities should be the viability of your business and, and what these organizations like ours and, and the other ones do for the profession as a whole.

Is invaluable, but what does it do for you? Well, indirectly it saves your business, you know, theoretically, um, directly, no, we're not gonna, you know, unless you're in Louisiana and you're getting, you know, free audit counseling, it's there's, you know, or if you, if you're going on our website and going into the, the, the member only section where there's resources that no one else has, um, there's a value to that.

But if you don't, if you're not interested in doing that, then obviously there's no value for you. There, 

Mike Koelzer, Host: someone's a struggling independent pharmacy. That's fed up with everything. And let's say that you could probably join a couple national groups, your state group, and put, and let's put a figure on that.

Of what a thousand dollars total. 

Scott Newman, PharmD: Yeah. Quick math, uh, Close to it, close to a thousand annually worth it. Oh, I mean, based on what you give for that. Yeah, absolutely worth it because you're helping to fund me and Monique and all the efforts that we put into what we do. Um, I would hope that was the same as other organizations.

I know that there's some more bloat in the larger ones. Every dollar that we receive goes directly back into the fight. You know, my board is unpaid, we're all volunteers. You know, Monique has a salary because if we didn't pay her, she. I wouldn't want her to do this for free. It's too much bullshit, but I, she probably would, to be honest with you, she'd have to find another job, but you get your heart into this and it's harder to let go.

You can overlook a lot of things in salary. If you feel like every day you go home and you're fighting on the good side. Um, but yeah, you know, it depends too on, is it worth it to me? Uh, I don't own a pharmacy anymore because I basically got put out of business, but that being said, I also know the efforts that I, and my board and Monique put into the fight.

I think that's worth it because we do all that on our time, our 

Mike Koelzer, Host: dime. Let me ask again, from the owner's point of view. So you were in your last business, you owned your pharmacy for nine years, nine, 10 years. Mm-hmm . So let's say a thousand dollars a year for. nine, 10 years. So you're looking at $10,000 and you know, how you ended, you sold, if you could say to yourself that $10,000, and we know it might be not that much might be more, but let's say an average $10,000 as you look back, would you write that $10,000 check again for the national state and putts efforts and so on, whoever else might be in there was that $10,000 over the last nine, 10 years a good spend.

Scott Newman, PharmD: Oh yeah, absolutely. I mean, we got audit legislation revisited and passed back in 2017. That one audit alone could save you that much. Yeah. Right. You know, these are things that they are no longer able to abuse us audit wise, you know, they're, they're not allowed to take back. For clerical errors, whereas in the past they would nitpick things.

And you know, if, if you know, day supply calculation is, is a clerical error. Now that can be revisited if it's incorrect, you know? So they're not allowed to take the money back for that. So, yeah, absolutely one audit alone could, could, could 

Mike Koelzer, Host: pay for that. I think that's what we have to look at as owners. I think we have to look at the, you know, a span because it's hard to look at one year and say, was it worth $1,000 this year?

Back in my pocket. The other problem 

Scott Newman, PharmD: though, Mike, is that everybody benefits from this only a small percentage of us are actually financing it right. Or putting the time in, [01:00:00] but everybody benefits. And yeah, I know that there's going to be a degree of people out there who are okay. Consciously with that, but I don't know that everybody thinks about it that way, but you should be because imagine what we could do if everybody was yeah.

In the game, PBMs could never, PBMs could never fight us or, or out fund us. If we were all in the game, we would have too many players with them. Ability to influence their immediate surroundings. You know, their local legislators. We have too many boots on the ground at that point. I know you like that phrase that I used.

There's too many soldiers to fight. If it was PCMA, they wouldn't have that many soldiers. 

Mike Koelzer, Host: Wait a minute here. You're telling me that if a hundred percent of pharmacists be it owners, employees, independent owners, independent owners, you're telling me if every independent owner joined this thousand dollars in these four or five different organizations, that there would be a huge difference.

Scott Newman, PharmD: No doubt. Really. I'm not gonna say it's a hundred percent. I bet. If we got to like 80% or even 75%, that would be more effective than PCMA could ever be. Really? Yeah. 

Mike Koelzer, Host: We'd overtake them. 

Scott Newman, PharmD: There's no amount of money at that point that they could outspend us to overcome. Our 

Mike Koelzer, Host: influence. Hmm. That's interesting.

I 

Scott Newman, PharmD: just solved the whole problem. If we did that, this whole thing would go 

Mike Koelzer, Host: away. We wouldn't have you here. If you weren't gonna solve everything. Mm-hmm 

Scott Newman, PharmD: got to the bottom of it. Didn't we? 

Mike Koelzer, Host: You're a three peat now. Yeah. Is 

Scott Newman, PharmD: Ben jolly, still beating me? 

Mike Koelzer, Host: Um, by the time this airs, Ben will already have been on three times.

He's just two so far. Okay. So we're tied. You guys are 

Scott Newman, PharmD: tied. I'm not competitive. when he got the second invite I sarcastically posted. Oh, okay. Great. Ben gets a second invite. How did he do that? I love Ben to death. We talk a lot and he's invaluable. It's 

Mike Koelzer, Host: those that are fighting in the dirt, but also reaching towards the clouds of change and so on that are the most interesting, because it's a little of both and that's an interesting spread.

Scott Newman, PharmD: It is. And, and I'm always fascinated with, um, my peers in these roles, because I, I can't know everything. I know a lot, but I'm not gonna take the time to figure out the things that Ben jolly does. Not my personality. You know, I do share a lot of interest that he does, like when it comes to FTC and, and stuff like that.

I mean, the stuff we've been studying, um, and, and discussing, you know, for years now together, we're just now seeing movement from that standpoint with this administration. But it's interesting that, um, there's so much history. That you really should understand from that standpoint, when it comes to what has been approved and what has been allowed in industry and corporations, um, to even understand where to go from here, you know?

Yeah. And it's very, very fascinating. I recommend that anybody who's interested in this is, subscribe to Matt Staler because his, his, the information that Matt puts out is, is insanely informative. 

Mike Koelzer, Host: By the time this comes out, we will have already aired the show coming out with Luke Lindy and Ben talking about the FTC and Amazon and PBMs.

All right, Scott, thank you very much until next time. Yeah, I really 

Scott Newman, PharmD: appreciate it. And uh, maybe I'll find another, um, interesting topic that we can cover next time. 

Mike Koelzer, Host: Absolutely. All right. All right. Talk to you soon, Scott. Thanks. Thanks Mike byebye.