Behind-the-scenes of Pharmacists United for Truth and Transparency | Scott Newman, President of PUTT

This transcript was generated automatically. Its accuracy may vary.

[00:00:15] Scott Newman, PharmD: Well, hello, Scott. Hey, how's it going, Mike? Good. 

[00:00:18] Mike Koelzer, Host: Thanks for joining us. 

[00:00:19] Scott Newman, PharmD: Glad to be here. Glad to be here, Scott, 

[00:00:22] Mike Koelzer, Host: for those that haven't come across you online. Give us your name and tell our listeners why we're talking today. 

[00:00:31] Scott Newman, PharmD: Sure. Um, I'm Scott Newman. I own a small independent pharmacy in Chesapeake, Virginia, um, Newman, family pharmacy.

I'm also the president of pharmacists United for truth and transparency. 

[00:00:44] Mike Koelzer, Host: What's the acronym? P U T T mm-hmm . So pharmacists United for truth and transparency. 

[00:00:52] Scott Newman, PharmD: Yep. Um, the history of the organization is about 10 years old now. Um, I've been with it for the last, probably about five years or so. Um, mostly in the background for a couple of years.

And then, um, obviously, you know, on the board, um, about a year and a half ago, uh, Actually it's been a little longer than that. Um, two August ago I joined the board and then in January of last year I became president of the organization. Um, it was originally established when Lipitor went generic and the group was kind of, uh, the original founding, uh, members were really just trying to figure out why you could buy brand Lipitor with a $4 coupon, um, and get around using what would've been a cost saving generic.

And of course we've morphed into the, uh, to the current state where we're basically a patient and independent pharmacy and pharmacy profession advocates fighting against the pharmacy benefit manager problem. 

[00:01:56] Mike Koelzer, Host: That's interesting. Let's start there. Let's start with that exact example that you're talking about.

So the Lipitor, the $4 coupon tells the listeners and most of the listeners. A good portion, our pharmacist, but some are maybe just listening in. So explain that in terms of what exactly happened in that. And why did that raise people awareness 

up? 

[00:02:24] Scott Newman, PharmD: Well, we raised independent pharmacy awareness because I believe it was one of the first coupons where you could actually buy directly from the manufacturer online.

And that was what, the, one of the bigger issues with the independence guys that, that, um, started the group, I believe. Um, I haven't spoken to them individually, but that's kind of the story that we hear. And it makes sense if you think about it, because all of a sudden the drug manufacturers are directly marketing to consumers with a coupon to keep their brand product prominent and their income not lost from that blockbuster drug.

So ultimately it came down to, uh, you know, just form an organization to try to expose some of the shenanigans that happened in the background in general. And of course, you know, pharma. Uh, you know, up until the last few years and even currently still get blamed for a lot of the reason why drugs cost so high, but are so much, but, you know, we all know that there's another storyline there.

They certainly have, uh, a little bit of culpability, but ultimately I think that they're kind of at the mercy of public opinion, legislators and ultimately are, you know, kind of slaved to the PBM like we 

[00:03:34] Mike Koelzer, Host: are. Um, and when you say pharma, you're talking for the listeners, that's the manufacturers mainly.

Yeah, man drug 

[00:03:39] Scott Newman, PharmD: manufacturers. 

[00:03:40] Mike Koelzer, Host: All right. So take me back to this $4 thing. You mentioned this would've been that the brand name Lipitor had a coupon out that people could get it for $4. 

[00:03:50] Scott Newman, PharmD: Yeah. So, you know, anytime a drug loses its patent, there's generic competition. You know, manufacturers have employed many, many tactics, a lot that aren't legal any longer and a lot that still are that they're trying to correct to keep their market share.

And one of the things that they did at that time was you have a, a, a drug that's lost patent, which is atorvastatin. And now you've got generic manufacturers, um, coming out after the six month exclusivity period releasing, you know, multi-source generic products. Yeah. That is a, you know, ultimately like kind and quality and released it at a discounted rate, obviously, cuz that's what generics are supposed to do is reduce costs and make things more, more affordable.

Right? Well, that's a big hit too. A drug manufacturer's bottom line to lose that type of income. So, um, in order to pad their stats a little bit, they, they may offer a coupon and either it's a copay coupon, and a lot of times they'll offer up to a certain amount, but usually maybe a hundred bucks, you know, 50 bucks, a hundred bucks, and most people's copays, at least at that time allowed for us, for allowed for us to bill.

The branded drug with a patient specific requested DAW code, and then ultimately bill a card secondary so that they only had a $4 coupon instead of like a second or third tier 30 or $40 copay. And ultimately that kind of came down to keeping, you know, why are we purposefully doing this to add, you know, numbers for the drug company, but we're billing the insurance company for the majority of that brand product.

You know, that that might be upwards of, you know, three to four times more expensive than the new generics that were on the market. So how do you justify that in healthcare you're contributing to, to the rising healthcare costs because of this marketing tactic, basically. And ultimately these guys just had a little bit more of a moral compass and wanted to expose that they were keeping costs of.

This medication high deliberately 

[00:05:56] Mike Koelzer, Host: for profit. That is really interesting. And so it wasn't so much like, Hey, we want truth and transparency. So we can be the one group of independent pharmacists out of the whole nation of healthcare providers to make sure that we're okay. It was actually coming at it like, wait a minute, this isn't a.

It's maybe sort of affecting us, but something's not right here. Well, 

[00:06:31] Scott Newman, PharmD: You also, yeah, you also have to remember though that like, you know, pharmacies do have a financial interest as well. I don't think that the motivation is the same for everybody as it is for some of the larger corporations, but you know, the motivation is this, why am I still spending this much on a branded product?

Yeah. Ultimately the patient gets, you know, a reduced copay, right. That may be close to their generic product, but I'm spending more money buying the branded drug. Right. And I'm also not getting paid as well, because you may have, you know, a couple bucks that you might make on the branded drug, but ultimately your gotcha.

Your, your margin's gonna be better dispensing at generic 

[00:07:10] Mike Koelzer, Host: in theory. Yes, I see. So the pharmacists are looking to. Something's not, something's just seems odd here. We're making a couple of bucks on this. We're buying it for hundreds of dollars. There's something cheaper out there. They're getting a coupon and only paying $4 from it.

There's some transparency here that we're not seeing. And there's. Yeah. And there's a truth going on, even though it's a, uh, malevolent truth. There's a truth going on somewhere that we don't know about that we as pharmacists wanna get together and expose all of this. Correct. So that's the beginning of put mm-hmm

All right. So then you come in, how long have you owned your pharmacy, Scott? Um, I opened, 

[00:07:53] Scott Newman, PharmD: I opened in, um, uh, around March of 2013. So I'm just in my seventh year now. All right. 

[00:08:01] Mike Koelzer, Host: You're in your seventh year and after a couple years of that, you, you said you've been with for about five years. Yeah. So when I first 

[00:08:10] Scott Newman, PharmD: opened, you know, I had a lot of time on my hands other than, you know, trying to grow the RX volume.

So I became kind of active on, you know, owner websites at the time. Yeah. Cause there really wasn't a whole lot of social media groups like we have now, which have kind of that's right. Rung up, you know, in the last two or three years. Right. So I came across, um, you know, PDs had an open forum and I joined the talking forum there, which is where I also met my vice president, Don, um, who's down in Coca, Florida.

Um, she and I connected cuz she opened, I guess about a month or two around the time I did. Okay. And um, you know, she, you know, she ultimately. Wow. We reached out to each other anyway. So I joined, I joined put, um, around the same time that the, I, this is kind of in deep, but like the punch lawsuit that Mark Cooper is actually getting around to filing right now, back then, you know, five or six years ago.

Um, you know, a lot of the put members at the time were kind of posting on PDs about this punch lawsuit. So I ended up joining put then, um, I think probably around 2015 ish or so, just as a gotcha. Just as a donating member. Yeah. Right. And, um, ultimately just, you know, Dawn and I had stayed in touch cuz we were growing around the same time and looking for opportunities.

And then of course the reimbursement model changed significantly about four or five years ago. But yeah, I kind of get involved because I like to complain. I certainly like to, you know, I don't like to, to just kind of. I guess, like I said, bitching my own without, right, exactly. Really without, you know, having yeah.

Earned the right to do so. So I, you know, I was a member of NCPA already. I was a member of V PHA, a PHA. I was a member of pretty much any organization I get, but I was also, you know, on, and I still currently do sit on the government affairs committee for V PHA. And so as I'm going through these processes, I'm, I'm just getting crushed on, you know, what I consider to be a not fair playing field.

Like I want an opportunity, but yet my opportunities are becoming smaller and smaller. And then my reimbursements get to the point where I can't depend on consistency. You know, for, let's say 14% margin on cost of goods. All of a sudden it goes from 14 or 15% down to seven. Well, my operating expenses are not high, but they're still around 8%.

Yeah. If you're paying me an average of 7% below acquisition, I can't pay the light bill. I can't pay the lease bill. Right. So I, I started trying to, you know, just connect with other people to see everybody else was having the same problems and, um, connecting with local media and needing resources, which is how I got, um, introduced to Monique Whitney.

Um, my executive director put, uh, she has a background in marketing communications and she was able to help reach out to a local reporter here. Um, and we did, uh, a story or so it was not an easy process to try to bring a reporter up to speed, to. Be able to, you know, to be able to tell the story correctly.

So we worked on that together that's and after that, um, you know, just with my presence on social media, cuz that's really what I thought was the best platform for sharing information and ideas and, and you know, that's one good, good thing that we've done well at putt is that we've really have a strong social media presence.

So that's kind of how I, I became intertwined 

[00:11:42] Mike Koelzer, Host: with that. What's that lawsuit? You mentioned the punch lawsuit. Yeah. Punch lawsuit. What, what was that again? I remember, I recall that, but so it's been, what is it I should 

[00:11:52] Scott Newman, PharmD: say? Yeah, it's been a couple of years. Um, Mark Cooker's a, a, a, a lawyer in Philadelphia and, um, became interested in this.

I think he was a friend of, one of the original, um, Um, uh, establishers and, um, excuse me, he, uh, he is good at reviewing state legislation and contracts with the PBMs and laws and such. And, um, they came across the issue with, you know, catamaran at the time, which ended up getting bought out, getting bought out by OptumRx with United healthcare, you know, and ultimately that's, um, uh, it is been going on for quite a while.

Uh it's it's, it's still, you know, it's gonna be going on for, it took a long time in discovery because of the transition and all that kind of good stuff. Sure. Can't really talk a whole lot more about that, but, um, hopefully that's going to be, um, you know, coming up soon 

[00:12:47] Mike Koelzer, Host: and that had to do with the, 

[00:12:49] Scott Newman, PharmD: this is Mac pricing and them breaking their own contracts on Mac pricing.

[00:12:53] Mike Koelzer, Host: Gotcha. Gotcha. So Scott, I've been on a lot of. Boards where I've gotta be careful to show up to all the meetings, because if I don't, they're gonna make me president or vice president or something like that. Mm-hmm . So in the case of put right now, was this something as president of this, was this something that you were moving up towards and looking forward to?

Is it something that you got put in because you didn't show up to the meeting? Well, or, or tell me about 

[00:13:36] Scott Newman, PharmD: that. Yeah. I make a joke out of that too. Just like anybody else would, um, you know, I, I wanted, I, I crave information and so I wanted to be when, when I was, uh, inducted to the board, you know, we have once monthly board, um, you know, board of director calls, uh, that, you know, are pretty much.

You know, outlined and there's some open discussion stuff, but we also, um, the executive, um, executive board will also have twice, uh, twice weekly meetings on Tuesdays and Fridays, just conference calls. And I just BA 

[00:14:16] Mike Koelzer, Host: video two or just 

[00:14:17] Scott Newman, PharmD: conference. Yeah, just, just audio. We just gotcha. Um, we either use a platform or if it's just a couple of us, then we.

Uh, merge calls, but gotcha. Anyway, we do that, you know, that's regular, I mean that we, there's only very few times where we don't have those calls and usually it's because one of us is traveling somewhere, um, and can't get on. But, um, anyway, so I just, I wanted to be a part of that call and they were glad to have me cuz one of the things that people don't realize is that even with our massive, you know, what I would consider a pretty phenomenal engagement profile on social media and the information that we get ahold of.

And, um, we can talk about that in information. I think that's probably a good topic as well. How things get released and how things are, are. You know, kind of been exposed over the last few years, you can trace just about every one of those things back to a handful of our members. Um, who've gotten it into the right person's hands, um, which is kind of cool.

So we, um, I, I just basically wanted to be more involved. I wanted to help to bring, we, we, we are small. So, we've, you know, there's really only about three to five of us that are actively working, you know, 40 plus hours a week on running the organization. And that kind of blows people away. Cuz we get pulled in a lot of different directions and sometimes I have to tell people, look, there's like three of us right now that are working on about 17 different things.

Um, and we don't have the funding to hire a whole lot of people to do it for us. 

[00:15:48] Mike Koelzer, Host: So break that down. If, if there's three to five of you and you say 40 hours, you're all like putting in five to 10 hours a week on this outside of your regular jobs. And so on. 

[00:16:00] Scott Newman, PharmD: To weeks is more than others, but you know, it, it's, it's gotten to a point where we've had to, you know, kind of, instead of trying to tackle everything that comes across our face was we, you know, we, we ultimately get, uh, uh, have to prioritize whatever is most important, what we're working on.

Right. Or if there's something crazy that's happening and we have to 

[00:16:21] Mike Koelzer, Host: redirect, you gotta drop it and then redirect 

[00:16:23] Scott Newman, PharmD: it. Yeah. I tell people that, you know, when it comes time to, to, you know, change leadership at the, at the organization, you know, it, by the way, we're a nonprofit 5 0 1 C three. Okay. Um, we aren't, um, uh, We donate only basically.

And, you know, it's membership driven and, um, we do have tax status for a little bit of politicking and such. So yeah. Um, there's all that, but, um, I, I basically tell the story like this, that I'm just the full bit on the phone when they said, Hey, shouldn't you be, you know, Scott will be the president and I'm like, yeah, okay, sure.

S gotta do it. But you know, our previous president there, um, had just had a baby and, or was going to have a baby and she was trying to step back a little bit and ultimately, um, there was gonna be a void and, and, you know, maybe Don would've been a better option, but I think that Dawn and I had talked about it and she, um, you know, she said, look, I, I will do everything in the world in the background, but you've got way better.

You've got way better people skills. So maybe you should just yeah. Uh, handle that portion of it. And that's kind of how this worked well 

[00:17:33] Mike Koelzer, Host: does put, use. Any paid staff at all? Any paid position? Well, 

[00:17:39] Scott Newman, PharmD: yeah, well, none of the board members based on our bylaws receive any type of compensation, but we do have Monique who's our executive director.

Oh, nice. And then she's had she's the last year, just because out of necessity has been able to hire, um, Shannon, who is our, her, uh, executive assistant. And they both are just incredible. Yeah. Uh, you just can't, I can't say enough good things about those two. They, they really have. A good grip on what we're dealing with as independence.

Um, you know, a lot of people can't really relate to our plight because they don't live it every day. Right. So it's hard to find people who are as passionate about it as we are. Yeah. But they've been down that rabbit hole and they're stuck. So yeah. You know, their passion is, you know, very, very high.

So yeah, 

[00:18:25] Mike Koelzer, Host: I remember in the old days, like my dad he'd be on, well, I'm just guessing, but he'd be on the school board. Okay. So this is before fax machines and before email and all that. So when you're on the school board, you'd meet once a month. And in my estimation, it was a true meeting once a month, you'd meet and then a month would go by mm-hmm nowadays with email, you could be on a monthly board and you could be doing something every single day.

So you guys are on. Two calls a week, but you're probably firing stuff back and forth like all day. Oh yeah. 

[00:18:59] Scott Newman, PharmD: It's, we've got the board on, you know, on group texts and group emails and, you know, the information that we are exposed to, and most of the people on the board are pretty good. Um, and kind of why, why we have certain individuals or, I guess personality or, or character types we look for because of their engagement.

Um, I'm really good at finding obscure information. And I'll, I'll tell kind of a funny story about that if you want me to, but absolutely. So back last year with the CVS Aetna merger, going through that process, I just happened to read a really obscure, you know, article because I, I, I was up late and that's what I do when I'm up late and I just read as much as I can.

And. Uh, you know, we're on a Friday call and, uh, it was about the judge getting, uh, judge Leon, getting upset with the department of justice and CVS for basically trying to make him rubber stamp this merger without going through the appropriate process. And, you know, at the end of our calls, you know, Monika always says, well, you know, you were honored, is there anything else that you wanna share?

And I'm like, Hey, did you guys see an article where the judge just like raped over the department of justice? And they basically were trying to say that the merger was finalized, but yet the, uh, the public comment period, won't even close until like the middle of December. And this was in November and they're like, no, So I, you know, found the article and I sent it to them.

And next thing you know, we were, you know, splitting the cost of hiring a, a, a lawyer to file a Toni act, uh, lawsuit against the merger on behalf of putt and PI. Who helped us pay for that? Because it was quite expensive. Yeah. But we were there from day one, you know, even back in the early spring, causing some issues with other organizations because you know, our, our head organizations hadn't really even come out and spoken against it.

Yeah. Right, right. You know, here we are shouting at our lungs. Don't let this happen. Don't let this happen. This is not going to be good. Every promise that they're gonna make, they're gonna break it. We already know that don't make the deal with the devil because it'll bite you in the end. Yeah. Right.

[00:21:07] Mike Koelzer, Host: Scott, how careful should, if at all, how careful should. And independent pharmacy owner B with either on social media or through out, or through writing a blog or through a podcast, how careful should somebody be as far as getting their hand slapped or getting their contract removed from one of the PBMs that got ticked off or a lawsuit, 

[00:21:44] Scott Newman, PharmD: very, very careful.

And, uh, you know, 

[00:21:46] Mike Koelzer, Host: You do have to be careful. It, it's also 

[00:21:48] Scott Newman, PharmD: a function of how, I guess, where your mind is in the whole idea of it. You know, I, a long time ago, um, I, I, I would usually use a bad word to describe it, but I have no. Like no, nothing left to give in that instance where I don't, I don't care. You know?

Um, you don't. Yeah. Personally. So like, I, you know, one, one of the things that, um, like NCPA hates about us is that we don't, we, we, we, we teach people how to create anonymous Twitter accounts, um, and they can not like it all they want to, but the problem is is that we can't share information openly. Because it puts a target on us, right?

So, you know, the anonymity helps people to hide at least with putt, as members hide behind the shield of putt so that it doesn't come back to them when they share information. And let's be real, the chains aren't gonna share the information. The only reason why we have any of the only reason why we're even here today, where we're at, where there's states all over the country, and there's a national conversation and there's news articles written out of Ohio.

And there's, you know, a whole industry of data analysis that's developed out of this is because we, as independents need were able to contrary to what contracts tell us that we can't share information shared it because we could do it without fear of repercussion, because we do have examples of pharmacy owners that didn't take those, uh, uh, precautions to be anonymous and.

Were threatened or were audited out of business basically, um, in retaliatory type tactics. So they're very real. So what I say to the people who don't think that we should, you know, have anonymous Twitter profiles is, I don't have one because I'm not throwing a bunch of stuff out there that I shouldn't anymore, that I don't do anything wrong in my billing processes.

And I stay very squeaky clean, so you can audit me all you want to, um, if you play fairly, you're not gonna find anything, but you know, there is that risk still being the, the president of an organization or a board member of an organization like this, that would open you up to a, a pretty sketchy or egregious audit practice.

So anonymity is very important. People need to be very careful when they're out there on social media, what they're posting. If it gets back to them, they absolutely can be retaliated against and they absolutely will get threatened and they absolutely will get a call from their PSA. They'll get a call from the PBM and they will ultimately get an audit or be kicked out of the network.

[00:24:37] Mike Koelzer, Host: And would those be, of course, those are not fun things to happen. Is there also the threat of a, a li suit or a anything like 

[00:24:47] Scott Newman, PharmD: that? I think that that's probably like, you know, I think in a normal way. You know, a contract situation that's, uh, really one of your only options, but we're not in a normal contract.

I mean, we're dictated these rules. We're dictated what we can and cannot do. And they have so much power that why waste the time they can just audit you out of business. It only takes one or two. 

[00:25:10] Mike Koelzer, Host: They don't have to threaten with liable suits because they're not gonna get a lot of money from someone. If they win a libel suit, they're just better off just kicking you out.

If they want to, how much anonymity does. Put provide, because it seems like if they get mad at put, they can just look up and say, okay, well Scott's the president and, and Dawn's this. So let's find out where they work and remove their contract because they're part of the place that did that.

So it sounds like it's a, a, a filter, but you have to be careful still, it, it, 

[00:25:44] Scott Newman, PharmD: it would be very difficult for a PBM to come in and audit one of, or all of our board members egregiously because of our prominence. I mean, we would have that student all over everything and, and our legislative contacts would, I think I, at that point would probably step in, um, I've worked with dozens of lawyers that call me for information.

I could easily find someone that could undo a lot of that. It would be hard for them to effectively do it? Absolutely. I don't think they could do it without repercussions. 

[00:26:19] Mike Koelzer, Host: Then you guys can go to the press or whatever and say, Say look, they're all of a sudden auditing the top, you know, brass of putt.

It's like, we must be saying something. We must be saying something right. If they're coming after 

[00:26:35] Scott Newman, PharmD: all of us, well, it's less about contracts and more about self preservation for them at that point. But just to be clear, I don't like to sit around and pull data out of my system. I rarely would ever even look at a lot of that stuff.

I don't have to, our membership and our, you know, potential membership share that with us relentlessly and half the time of the stuff that we put out, I don't even see it. That's done, you know, through our, our, you know, our leadership, our, uh, executive director's office. And, um, you know, most of it is.

We might help to interpret it or, you know, help functionally show how to best present it in simpler terms for people. But other than that, like we don't, like, I know that my board, for instance, it's rare that data actually ever comes from us for that reason. We don't share our own. And a lot of the, 

[00:27:26] Mike Koelzer, Host: yeah, and a lot of times you're not even stepping out with your own comments, you're saying, correct.

Put says this. So that's kind of the, kind of the corporate veil or the, the non, you know, the, the nonprofit, the, the group veil you might 

[00:27:39] Scott Newman, PharmD: say. Yeah. I mean, data comes to us now. We used to kind of seek it out, but we don't have to really do that anymore. I, if I come across stuff that people are posting that I think opens them up for, you know, possible retaliatory stuff, I.

I will share stories with them or ask 'em to remove it and then provide it to us so that we can put it behind, you know, the group, the organization's, um, you know, strategy. So I don't know, you wouldn't see, we wouldn't be where we are with, with PBM exposure and education. If it wasn't for that, that.

particular way of 

[00:28:13] Mike Koelzer, Host: doing things, at least some level of protection. 

[00:28:16] Scott Newman, PharmD: Yeah. Like, like gag clauses, you know, the, the, the, the gentleman out of Louisiana, uh, who basically helped spring the whole gag clause issue in full, you know, coverage from state and federal level, even now that wouldn't have ever happened.

If it wasn't for one of, you know, one of our members talking about it openly enough to get some attention to it and showing this is what they're doing with callbacks, and this is why they don't want us to say anything as a gag clause. Right. 

[00:28:45] Mike Koelzer, Host: If he, if he had to do it all by himself, he'd be shut down somehow way, way before that.

And maybe even who knows, who knows when you're playing with that kind of power mm-hmm, what kind of things he can do. Mm-hmm Scott, what if you could, if you could capture what you say. But's mission is I know it's, uh, pharmacists United for truth and transparency. Who is that for? Is that for the legislatures to see, is that for the public to see what is the goal?

I know that I personally love having the information out, but what is the goal of getting out truth and transparency? Who is going to run with that then to help the pharmacy? 

[00:29:38] Scott Newman, PharmD: So there's a couple of things. The first thing our bylaws are written now, or have been, um, uh, changed to basically say that, you know, our number one mission right now is the elimination of PBMs.

And until the PBM issue goes away, If it ever does, then we dissolve, we go away. Um, it's written in a way, so that PBMs are our main focus right now. And, um, you know, our mission is basically to get them out of the middle. Gotcha. But that's a singular mission, but the truth and transparency portion is very important because that's how you get to that end game.

We all see the egregious stuff that they do every day. Um, we all see the way it affects our patients and our businesses and our ability to take care of our patients and our businesses, um, and our communities ultimately, and, you know, truth is a way of shedding light on that black hole of a process. Um, you know, we don't release data or we don't release visuals or graphics or white papers or any of the stuff that we produce without making sure that it is a hundred percent true.

That it can be verified or validated. And we're very careful about that. So, you know, if you ever hear anybody say that, oh yeah, well, that's not true. Or this isn't the complete truth. That's bull we, that's what we focus on. And that's how we make sure that our, our, uh, information is, um, useful for everybody so that it can be.

Um, so that it can't come back. They can't come back and say, oh yeah, yeah. Well, they're making this up. The other thing apart, the transparency thing, this is a really important topic. And I think most people would agree as fellow owners that might be listening to this. I think that every single independent in the country right now would open their books and their contracts and everything that they do from the top down, if it were required, um, by legislation or if there was an avenue to do so without having, you know, a PBM pull of contract, we, we are open and transparent because we are on the moral right side of what's going on.

We have nothing to hide. Right? You can see any rebates that I get. You can see any deals. I get any drugs I buy for what I've bought. You can see it, all my finances. You can see every bit of it. I don't care because of nothing to hide from a transparency standpoint, the PBMs have, are really good at grabbing buzz words and.

Running with a, um, trying to control that conversation and redefining what that word means. And I'll give you a good background of that. You know, CVS, uh, has been touting the firewall for decades. Firewall does not now does not mean the same thing that we all fought. It means because of that, they've taken that topic and transformed it into what the idea of firewall was that they, you know, want it to be, and firewall doesn't mean that you can't get information back and forth, or the one umbrella portion of the company.

Can't see what's on the other side. What they mean is that they've set up mechanisms so that people within the company can't see through it, but upper level management absolutely can, um, you know, just an example. I mean, you know, if, if, if CVS, the pharmacy. Has an exclusionary contract, which they do through steering with Caremark, how convenient of them to be able to get that?

Well, you can't have that with a true firewall. Right. You know it, but, but it exists. So how, how lucky of them that they got the contract to be exclusionary? How did that 

[00:33:32] Mike Koelzer, Host: What happened? Just a small example. Every, every three to five years, I'm piercing my pharmacy to see where I am in the market and see, see if I'm worth anything still.

But I was talking to, I won't give the name, but I was talking to this one chain about pricing us. And then I was also talking to this guy that supposedly used to work at this chain like five years ago. We signed this nondisclosure thing with, with both and so on. And, and, you know, we went to both of them separately to try to see where the difference was and all this before you know it, these guys are giving us some malarkey about, yeah, we were just, it just happened that.

Your city came up and, you know, it's like, I mean, they're like, they're like in bed together and, and here they are telling me that it just happened to come up. So there's no, there's no fricking 

[00:34:27] Scott Newman, PharmD: firewall. There's no firewall. And so they've, they've managed to convince, you know, the powers that be regulator legislators, and you know that there's this, this firewall and it's a sham of a firewall.

Well, they're trying to do the same thing now with the definition of transparency. And so when we talk about transparency, we want transparency across the entire supply chain. We want it for manufacturers. Um, in fact, there was a bill that came up in, um, Virginia in the house, uh, subcommittee about two weeks ago.

And you know, our executive director with V PHA, Christina, be. Spoke for it because we want transparency. Well, Christina spoke for this bill and got a text message. You know, 10 minutes after that, there were some upper level pharma execs in the room, and they were very upset that she testified for this bill.

And I looked at Christina, cuz I was up there with her and I said, you don't owe them anything. They haven't gotten up and spoken for our PBM bill. Maybe they haven't spoken against it, but there's a political interest there. You know, we don't owe them in. So if we're gonna be transparent, transparency is not a buzzword that only applies to certain business practices or certain businesses transparency.

It should be, it should be across the board from step one all the way to step 10. And so we are open to it. Our members are open to it. PBMs, obviously aren't because everything is, oh, well that's proprietary, you know, that's such a bullshit argument. Yeah. Um, you know, transparency is not what we can't allow them to define what transparency is and that's kind of what they're trying to do right 

[00:36:11] Mike Koelzer, Host: now.

Everybody's willing to be transparent on err, on stuff that doesn't matter. But when it comes to the, if it's a one piece of DNA or the one link in the chain or the one ingredient in, uh, Kentucky fried chicken or something that makes it, and if you're hiding that one thing, well, then you're not. You can be transparent in 99% of the stuff, but if it's at 1%, exactly, you're not transparent on the whole hundred doesn't 

[00:36:39] Scott Newman, PharmD: matter, doesn't matter.

Not a bit, you know, and that, so that's kind of where we're at with the transparency thing and part of that mission. So, you know, we are for transparency. I mean, I'm for transparency from the medical side, the hospital side, the entire supply chain from, from a to Z is it's, it needs to be opened because I, if it's not, if there's, like you said, one portion that's missing, then that's the one portion that will take up.

90% of, you know, if you're trying to be transparent on where the money is, 90% of that shady stuff will happen in that 1%. That's not 

[00:37:14] Mike Koelzer, Host: transparent. That's right. Let me ask this, Scott. So if we break the term down pharmacists truth and transparency, or we're, we've talked about that, are there any issues as far as the second word United and let me ask this.

[00:37:30] Scott Newman, PharmD: Oh yeah. Mm-hmm 

[00:37:31] Mike Koelzer, Host: when you say United, for me, that sounds like a great term it's United, but as I'm thinking about it, here, are there troubles ever with the United where even the people don't join put because they don't want to be United in a certain front. And is there any, uh, discussion inside of put, to say we're United and, and I'm not implying that you're not the question.

Is there any? Challenges to what United 

[00:38:05] Scott Newman, PharmD: means. Oh, yeah. And I think that even if we didn't use it in our, you know, in our, our name as a profession, as a whole, this has been one of my biggest complaints is that we, we, there's so many different avenues of opinions and let's face it. We've all got large egos.

We all think we're doing things the best way. Yeah. We're all independent. So many, I've seen so many conversations where, oh yeah. My way is the best. Yeah. My way is the best. And you know, to come to a consensus on that for us is difficult, but participation is, um, in general to unite and even amongst the organizations, I mean, you know, I say this all the time.

If, if, if our leadership and our national organizations have been successful, the last 25 years then probably wouldn't exist. So, yeah. So I, from a standpoint of. The national organizations, um, you know, put is more of a, kind of a gorilla warfare type group that exists because playing nice, hasn't worked.

And the reason why is because playing nice, you know, doesn't consider the fact that the enemy is playing dirty and that's exactly why we exist. And we want to be loud. These are, you know, our members are loud. They're, they're, they're angry. They're, you know, losing relationships. They're divorcing.

You know, sometimes we've talked people down from, you know, potential suicide because of this it's ruining their lives. So, you know, when we have interactions with other groups, um, you know, either on the state or national level, you know what those organizations are, right? Um, we don't have a great reputation.

And even after the fact of me coming into office as president and reaching out and trying to form those relationships to be functional, um, I can offer them something that. you know, that should be appealing and that's that we don't mind playing dirty in the background. We don't need to take credit for anything.

You can take all the credit. There's many, many, uh, situations where that's happened in the last even year or two, um, where some big things happened. And we were very much in the background, supplying the information for it to ever happen or help organizing and, and uniting the different organizations to functionally release SU such information.

And we won't show up on any talking point that in, in a, you know, a talk or a, a conference, or, you know, how did that happen? You know, we rarely will get thanked, but we don't, we're not there for that. We just want this stuff exposed. So, you know, keep playing nice at the national level, keep playing nice at the state organizations and the state national organizations.

We don't mind being the ones that. Do you know, we don't, we don't wanna play. We wanna, we wanna fight in the trenches and, and that's okay. That I think that that's a necessary thing to do 

[00:41:07] Mike Koelzer, Host: because from the beginning, it has always been that they've been more of the gorilla warfare. If somebody was looking at it, besides just the information coming out is that, and I love what you said about your mission, that you guys would be done.

Once PBMs went away, you'd be done. I mean, if that's not a good way to narrow down a mission, I don't know what is, if someone were to look at your guy's website or at the mission statement and so on, do you have anything in there? I know you don't use it, I don't imagine you'd use the word gorilla in there, but is there anything in there that lets you?

People know that you're, you are going to be the front. You're gonna be the fighters and so on. Or how, how would you say people first come across that knowing that you guys are willing to lay a lot of that, the line, 

[00:42:11] Scott Newman, PharmD: um, Ironically originally, it would've been very easy because there were a handful of us either running the group or closely affiliated.

Um, we even have some state chapters that have developed out of it. Okay. Um, and you know, it's not something we just set up a state chapter anywhere. There's gotta be the desire for independence and, uh, push or some, you know, they reach out to us and ask for help, but right. Ultimately the social media engagement is how most of them find out about us.

Gotcha. Um, and, and, you know, uh, from a, yeah, we're not, I don't, we don't put, I mean, our, our, our tr let me just plug the organization website. If you go to truth rx.org, you know, we have a very professional website. It doesn't say we're gorilla warfare fighters. Right. But, you know, ultimately, you know, uh, the, the front page of our, our website says our name and then says nonprofit advocacy organization founded by independent pharmacies.

Yeah. Pharmacists to expose the truth. PBM anti-competitive tactic. Yeah. And, and that's kind of the, the, in a nutshell of what it is, um, you know, in CPA has a very similar mission, but they go about it a little bit more, you know? Yeah. P politically, right. Um, you know, our members are actively engaging with the powers, it be on social media to a point where you.

They get a little bit upset sometimes with us for the way our members act. But I do remind them on occasion that every one of my board members are active members with those organizations as well. So if you're accusing our members of being a little bit over the top, they're your members too. They're just a little bit beyond patient now.

Yeah. Because they realize how they realize how, uh, uh, is Sentinel. This moment is right. I've heard, I've heard and I'm sure you've probably heard it too, where industry experts have said that there's a good chance that we lose, you know, 4,000 independence in 2020. Yeah. Right. And in the next five years we could lose half of the 21,000 or so that we have, yeah.

Is that when we have to try to fix it legislatively or that someone wakes up and says that there's a problem. Cause it's gonna cost a whole lot more money to do it then than it would now. Yeah. But ultimately we all feel that. So, you know, Ironically as loud as we are, we only have about 330 members. Yeah.

Um, we have, uh, obviously some well funded members or some that aren't, you know, right. We, we, we have some that are a little bit, um, more successful than others when it comes to store quantity ownership. And yeah, we've recently partnered with a couple of other, uh, groups. Um, one in particular is, uh, one of the, uh, uh, one of the, um, oncology associations that has a large, like dispensing portion in, in their pharmacy.

But they're being paid at the same crappy contracted rates. Yeah. Right. For that, or steered the specialty. And, you know, those guys have kind of joined in the fight. They're also fighting they're a little bit, well, better funded than we are, but we're glad to have 'em as members, you know, as 

[00:45:21] Mike Koelzer, Host: I see it, it plays out.

Pretty well, because we all, we've all heard of good cop, bad cop, and we've all heard of, you know, there's people that come in with their, uh, figurative pitch forks, but there's also people that have to go in with, you know, pens and write stuff out and sign things in that. And it's probably hard for groups to do both.

I mean, it's hard to be, it's hard to have both set of tactics and I think you put it well where maybe on the surface, some of the groups say they don't wanna maybe associate with the other groups, but in, in the background, I think they're thankful that, that you guys are playing possibly the, you know, that you guys are playing the bad cop side.

I think it needs it from all different angles. 

[00:46:11] Scott Newman, PharmD: Yeah. And you know, don't get me wrong. We have discussions within our board and within our membership and there's people that want us to be way more, you know, Aggressive. Oh, more aggressive. Um, yeah. And then there's people that don't want us to be as aggressive.

Right. We try to find the middle ground of representing our core membership, which are more aggressive types. Um, you know, we, you know, you talk back about the uni unity question, you know, um, we have members that are obviously members of the independent pharmacy associations in those states are commonwealths, and then those other organizations that work with us and some like in Florida, You know, they've had issues with the state organiza national organization at the state level there.

And, you know, the independents didn't feel like they were getting a representative voice. So they formed their own organization. Yeah. Um, you know, and that's not a put organization, but we work very closely with that organization obviously. And there's, um, people that have influence in the, you know, at those state chapters who think that they shouldn't be working with us or a rogue organization.

Um, and ultimately it comes down to, you know, we're not saying anything that's not true. We're not putting information out there. That's inaccurate. There is nothing that you can discredit in any of the stuff that we do. We are a unifying group. And that's really what the mission is, is to unify organizations because we're all over the place.

And when we come into a state to help bridge those gaps, it works very, very well. We've. Proof of it in places that've been successful where we've, you know, ultimately we're not out to try to usurp any state group. We've never even talked about doing that. We're not trying to replace anybody. We're not trying to replace, you know, right.

Uh, the national organization. We're not trying to do anything to stop what they've already, in fact, it's to our behest to work with them because they already got the infrastructure there. So yeah. When, when we've had successful support, um, of, of a state organization, you know, that's the ultimate goal. If we work with Illinois, we wanna work with the Illinois pharmacist association.

If they're, if they're engaged with us, then we've got very successful models where that's been affected. Yeah. Right. If they're not willing to work with us, then it is a contentious situation because we, if, if we see that there's work to be done, or if there's urgency in a state and we are involved in it, we're not going to cow to that organization and allow them to, you know, screw the process up when it's that critical.

Um, we will certainly input our opinions and our membership will scream as loud as they need to, to make sure that it's done correctly. Yeah. So. You know, there's a lot of, once again, a lot of egos and a lot of people who think they do things the right way. But ultimately the question is, if on this topic of the PBM debate and PBM legislature is your state organization representing the independent pharmacy owners where most of their money comes from appropriately, right?

Or are they not really into it or not reaching at least a, a, a semblance of the passion and understanding of what it is that we're dealing with, right. If, if they have that and it's disconnected, then there is absolutely a contentedness between them. 

[00:49:39] Mike Koelzer, Host: Well, I've watched some of those Netflix shows, I think it's called broken and they go through each edition, going through a different part of the food industry.

And I think it was either the chicken farmers or I think it was the chicken. Farmers clean that one. Yep. Where, where these guys, I mean, they'd put on, they'd put on hood masks and they'd go out in their pickup with baseball bats and pipe bombs and things like that. Yeah. And they would, they would do physical violence to these places.

And so my point on that is that if anybody thinks a group like put who's under the threat of getting your own stores, taken the contracts taken away and all that kind of stuff, if they wanna see someone who's gone far, , they've gotta watch that show mm-hmm and then realize that there is, there does seem to be room between.

You know, pipe bombs and larger national associations that somehow seem to be sleeping with the PBMs a little bit, because they don't seem to be fighting hard enough. And so those, those chicken farmers look like make you guys look like a, a dance, you know, a dance class or something from what they were doing.

[00:51:10] Scott Newman, PharmD: Yeah. And honestly, it's probably because it costs too much to pay people to be at our stores while we go out and do that. So, yeah. Right. That's true. We can't get off to do it. So we gotta be, we gotta be at work. That's true. 

[00:51:23] Mike Koelzer, Host: Well, Hey there there's but, but you're, you guys, aren't open, you guys aren't open 24 hours though.

You could get a, you could get a pickup at, you know, 10:00 PM or something like that, but, uh, yeah. You know, 

[00:51:35] Scott Newman, PharmD: I don't know, I don't sleep a whole lot, but I do a lot of work after hours. So yeah. Stuff I can't get done during the day, but most of us are just tired. We, you know, we are working hard. We're not being reimbursed properly for what we do for sure.

And so, yeah, you'd have to have the energy to do that as well. You gotta, you 

[00:51:52] Mike Koelzer, Host: gotta, you gotta have the energy, maybe some of the tools too. I think when you're a chicken farmer, you have the, you've got the, you already got the pitchforks and all those kinds of stuff. If you had to do your own organization, let's say that someone says, uh, Scott you've, there is no put or, you know, whatever you're in this, you're in this mythical world where put doesn't exist.

If you had every say to form your own organization like this, what would you personally change? If anything 

[00:52:29] Scott Newman, PharmD: change from which standpoint, from like the current status of our organization or the current 

[00:52:33] Mike Koelzer, Host: setup of put, if you could go in there and say, all right, guys, this is good. I'm the president, you know, this is working fine, but let's say you could write your own script for an organization.

And let's say it's still in the same atmosphere of every, all the challenges that we independence are facing. Would you change anything about an organization if you had. Every way you wanted it. 

[00:52:57] Scott Newman, PharmD: Well, I mean, yeah, if it had every way I wanted it, we would have unlimited funding and we could actually put boots on the ground in every state to do the fight.

I mean, ultimately that's what our biggest challenge is, is membership cause actually membership numbers with, if there's, you know, let's just say 21,000 independence, right. And considering multiple store ownership, you know, there's quite a bit of pharmacists that are still out there that either haven't heard of us.

Right. Which is not surprising when you've still got pharmacists who don't know what DIR fees are, that own stores. Yeah. Um, that happens, um, and you know, membership numbers. So when we show up to a, a, a state, you know, and let's just talk about from a, like, we're working with the state organization, we encourage membership at the state level or, or organize with your state, you know, national.

Like V PHA or, or NCAP, or, you know, every state has one of those organizations, um, start there obviously, and get us involved when you need the support. Cause you know, we, we know what. Needs to be shown or, or given to the legislators, but we need to be able to show up and say, well, we have 30 members in Virginia, or we have a hundred members in Virginia.

Um, you know, I think that Florida, we might have the largest bit of membership, maybe Arkansas. Um, but they're a very powerful group when they go to speak to legislators because there's so many of them. And we can use that as an influential tactic. When talking with legislatures, we're here representing 12,000 independent pharmacists instead of 300.

Right. But with that, obviously, comes the membership amount cuz you know, we, we do fly all over the country. In fact, I think Monique in Wisconsin, Speaking today. Um, you know, we, we go and talk to different places and we spend time with, uh, state organizations in some cases to work like, like, um, LIFA down in Louisiana, they have a very strong, independent pharmacy association that we provide a lot of support to.

Um, and so there's some travel involved and there's some expenses involved with that. And 

[00:55:00] Mike Koelzer, Host: What do boots on the ground look like? Is it having people actually pharmacists actually able to go to the state capital for example? 

[00:55:11] Scott Newman, PharmD: Yeah, absolutely. And, and, but even more so just to have a presence like our organization to have a presence, I mean, it, it, it's, it's one of those things that were absolutely necessary for the, you know, for exposing the information.

And then to be rep to help, I guess, to support our membership there. Um, for us to show up for me to show up for Monique, to show up for Dawn, to show up for Owen Sullivan in Illinois, for Amy Rogers in Arkansas, you know, for Lauren in, uh, Illinois, in Missouri in, um, you know, it's one of those things that we want to be able to say, Hey, we're here.

And this is what your membership gets. And we, if you look at a lot of the videos in the past two years of Senate subcommittees, or how subcommittee hearings, where we've had either our members or their organizational leadership testifying look on top of that desk and you'll see, put graphics all over it and people that's what comes with the membership is that type of support and those graphics aren't free.

You know that we have to pay for those things and, or, or hire, or get a really talented board member. I'm hoping that we, we got one here real recently, but that'll be later down the road, but it's one of those things that it costs money to run an organization. And, and we are very good about not spending where we shouldn't and spending where we should, but ultimately it's, it's a costly endeavor in general to be that engaged.

So 

[00:56:48] Mike Koelzer, Host: we're talking financial, when it comes back to your first point, though, of boots on the ground, that's actually faces showing up at things mm-hmm right. Oh yeah. And then in your magical world of, of Scott , you know, if, if you had your thing, it would be more members. Yes. Let's come out of that fantasy world.

What does it take to be a member? 

[00:57:16] Scott Newman, PharmD: uh, the desire to end PBMs in their current existence financially. We, you know, we are just a donation membership, so we don't really have members. We have donations, you know, for, for the most part, our donating or our contributing membership. Um, you know, we ask for 50 a month, um, certainly.

3000 members versus 300. It wouldn't need to be that much. And we're only going to write. We're only going to spend what we need to do the job and nothing more. Um, yeah. You know, certainly there's, I mean, we have, it's a suggested amount. I've got people who are monthly members. They, they, you know, they give us a credit card and they say, well, I could do 25 a month.

They're members. You know, if I've got several that are multi store owners that do 200 months, they're a member, you know, there's, there's people that will make a large one lump sum donation. They're members. You know what I mean? So. Gotcha. Ultimately, ultimately just, just putting, look my biggest thing with people I speak to, and I've, I've got some, um, folks that I've literally had to say, I can't have this conversation with you anymore.

Cuz I've got stuff to do. You've either got to put in your sweat equity or your financial equity, but you can't do either. And that's one of the things. Yeah. So I mean, we, if we've got people who are actively wanting to engage in getting work done, but can't really afford to join, you know, put the sweat equity in.

I've been there. I am still there. I don't have the money to go throwing out anywhere. Willy Nilly if I don't see a good return on that investment, but I do have my sweat equity. Yeah. And that, and that doesn't have to necessarily be with, put that's across the board. I don't, you know, do I care if you join, put or not?

Absolutely. Ultimately get involved. 

[00:59:05] Mike Koelzer, Host: Yeah. Because the first thing you said is it almost sounds like the money follows first. You have to have a commitment to, to reforming or getting rid of the, getting rid of the 

PBMs. 

[00:59:15] Scott Newman, PharmD: Yeah. So, you know, there's too many of us sitting. You know, waiting for our businesses to collapse still, right?

I mean, if that's not a catalyst to get involved, I don't know what is, and we have been obviously more involved as, as, you know, pharmacists that own independent pharmacies than we ever have been. But the states that are really successful right now, never lost engagement, you know, Georgia. Yeah. You know, Louisiana, right.

South Carolina, you know, those, you know, New York, they've all had strong organizations that maintained the status quo the entire time, you know? Um, and that was based on some very good involvement, 10, 20 years ago. 

[00:59:59] Mike Koelzer, Host: Right. Someone's listening to this now in their, in their car, as soon as they stop. What's the very first thing they should do as far as at least touching the organization.

Would it be hitting your website? 

[01:00:14] Scott Newman, PharmD: Yeah, absolutely. There's so much information there. There's a little bit more resources when you're, uh, you know, when you're signed up on the website and a contributing member. Yeah. But if you're not, most of our stuff is still there for people to go under the resources tab.

[01:00:29] Mike Koelzer, Host: Give us that, uh, website again. 

[01:00:31] Scott Newman, PharmD: Uh, truth. RXT R UT H R x.org. 

[01:00:36] Mike Koelzer, Host: That's easy truth rx.org. Mm-hmm Scott, what do you do? If someone says right now, Hey, Scott, we're gonna stop time. We're gonna stop putting in time. We're gonna stop your pharmacy in time. You're not allowed to do anything Ry related, but we're gonna give you a year just to do whatever you wanna do.

You've got the money to do it. What are you doing for a year outside of. Your profession. , 

[01:01:06] Scott Newman, PharmD: uh, I will teach myself anything with a YouTube video and a tool that I would need. I'd flip houses or learn to weld or fix something I love to do. Uh, I love to do something with your hands. Oh yeah. I love being outside.

You know, I, it's kind of ironic that I'm in a job where I'm inside 12 hours a day, but I crave this sunlight. I love to do yard work, all the digging. I mean, stuff like that. That's cool. I love to do rec. I love to recondition and make stuff new again. That's broken. Like, I, I know, take a lawn mower small engine apart, put it back together, make it work again, paint it, you know?

Yeah. Rest restorative stuff. I love 

[01:01:45] Mike Koelzer, Host: doing that. One of my favorite things I did was shoot. This is now like, golly, this is 25 years ago. It was redoing my basement at my first house that I had. And I would just go down there at night and just stand there and look at the work that I did. And when I finally finished it and I'm talking about some drywall and old carpeting and Fe stuff like that, when I was finally done that gave me so much joy and satisfaction.

Oh yeah. And a friend told me one time, I said, I said, I don't know why that is. And he said, well, I like to do it. And he was a pharmacist. He said, I think it's because in pharmacy, when you come in in the morning and you leave at night, you've done a good job, but your store looks exactly the same. Yep. And with fixing stuff and creating stuff, you're able to see that progress, which you believe it's there in pharmacy, but you don't always see it happening.

Right. 

[01:02:45] Scott Newman, PharmD: Yeah. And it's for me, you know, I, I had a, I have a 15 year old craftsman riding lawn tractor that, you know, I I've always kept running well, and it looks brand new because I, you know, two years ago I sand blasted the, the lawnmower deck, took it all apart, you know, redid the carburetor and wow fuel lines and repainted it.

Um, you know, the base base coat, clear coat and everything. Wow. Um, it looks like it came right off the factory line at this point and runs like it's brand new, but it's just enjoyable to do that. Like, it was a fun project. How 

[01:03:22] Mike Koelzer, Host: Did you get into pharmacy? 

[01:03:25] Scott Newman, PharmD: Uh, by kind of on purpose, but by accident, I had, uh, my father is a retired pharmacist, um, and he had kind of a miserable sob, but he was also in the military and, uh, Navy pharmacy.

And so they just did things a little differently. And so, you know, my dad as a, a person who I didn't think enjoyed what he did, I figured I, I, you know, as a younger person, I blamed it on pharmacy, but it was just him being miserable. And then I got married and had a child really young, and I had a degree in chemistry.

Um, uh, I have a BS in chemistry from Randolph, Macon college, and I was like, Well, I wanna take care of my family and, you know, I wanna make decent money. And I knew my father made decent money in retail pharmacy. So I applied and got in and mostly went to pharmacy school for the money because I thought that it was, I was prepared to be miserable for the rest of my life.

And while I was in pharmacy school, I worked for 

R 

[01:04:22] Mike Koelzer, Host: aid. You were prepared to say, I'm gonna be a pharmacist and I'm gonna be M. 

[01:04:28] Scott Newman, PharmD: Well, I was prepared to be an unhappy person. Like my father traditionally had been even in pharmacy in spite of it because of the money. Gotcha. So when I was in pharmacy school, uh, I took on a job cause I had a family and I still had to make a little bit of money with Rite aid.

And I was put into a store with two fantastic pharmacists who loved what they did every day. And I basically said to myself, well, obviously my father's just kind of a miserable person. These guys love what they do. And that's when I found my passion. You know, I loved playing baseball. I was, uh, decent at sports in high school, but I wasn't meant to be a professional baseball player.

I was meant to be a pharmacist. And it's just what I'm good at. 

[01:05:09] Mike Koelzer, Host: When you went to Rite aid and met these couple guys, you were already a pharmacist. 

[01:05:16] Scott Newman, PharmD: I was a student. I was 

[01:05:17] Mike Koelzer, Host: in pharmacy school. You were a student, but, but if you didn't find those guys, you would've just been, you would've gone to the pharmacy and said, it's worth the money.

I wanna be miserable. But because you found these guys, you were able to say I'm able to find some passion in pharmacy. 

[01:05:29] Scott Newman, PharmD: Well, that's when I was aware of the fact that there's some passion there. I would've found it regardless. Yeah. But it was just good to actually have some confirmation that what I was doing was not just because of that.

[01:05:40] Mike Koelzer, Host: Yeah. You just realized your dad was miserable, but he would've been miserable. He would've been miserable doing whatever. Yeah. 

[01:05:46] Scott Newman, PharmD: And I, you know, I got a kind of personality. I could be happy being a Trashman as long as the day is fair. as long as the day is what 

[01:05:53] Mike Koelzer, Host: fair. What does that mean? 

[01:05:55] Scott Newman, PharmD: No, that I'm not, I'm not that I can do my job to the best of my ability without having to worry about if the other players in the scenario, aren't trying to put me out of business, undercut me, abuse me, or possibly 

[01:06:10] Mike Koelzer, Host: steal from me.

So you'd be trash. You'd be a, a, a tr a sanitation worker. I have to call him. You'd be a Trashman as long as everything seemed fair right now, though, you're in a profession where it's the opposite of that. 

[01:06:23] Scott Newman, PharmD: Well, so I would be happy being a trashman. I don't think I would really want to be, but I could make the most of it.

If 

[01:06:30] Mike Koelzer, Host: people were playing fairly, but now you're in a profession where that's not happening, right? 

[01:06:37] Scott Newman, PharmD: Yeah. So I found a second passion in advocacy. So, I mean, You know, I am not traditionally a negative person. Right. I, I, I try to remain positive. I'm not a conspiracy theorist, but I can say that I've seen a lot of things that somebody said that this is too crazy to believe that's been true.

Um, I've seen, you know, overall, I'm not really, there's a lot of positivity amongst, um, I guess, leadership of our profession in general, when it comes to, you know, survival and how the profession's going. I'm not that optimistic about it right now. Right. And it's because of the things that I'm exposed to and see, and yeah, I just don't see.

I don't see, um, I don't see how we're gonna make it too much longer. Right. Right now, you know, I am a member of CPS, N I. I'm traditionally called cha-uh, excuse me, I'm traditionally trained as a clinical pharmacist. That's the way I was taught and brought up in pharmacy school. And I'm all for it. I was probably, if not the first, one of the first vaccinators in Rite aid, I helped develop that protocol.

And that plan when I was just outta school, I've been engaged with doing that since day one of my career. And I just don't see the structure or the payment model built well enough yet for the timeframe that we're working. Yeah. When it comes to survival, it's just not there. Yeah. 

[01:08:14] Mike Koelzer, Host: I, I don't disagree.

[01:08:15] Scott Newman, PharmD: We, if we don't, if we don't figure out how to fix the reimbursement model and its current. Construct. I just, we, we don't, we're all borrowed time right now. And a lot of us are literally borrowing money to, 

[01:08:26] Mike Koelzer, Host: to borrow, to buy time I'm in that situation. You know, I'm in that situation as I sit here in the pharmacy, there's very few 

[01:08:33] Scott Newman, PharmD: of us who don't believe me.

And if they aren't it's because they've got pre deep pockets. 

[01:08:40] Mike Koelzer, Host: Scott, you said that you were prepared to be miserable in pharmacy yet you say right now, and I can see that despite this topic that you're a positive person, would, would you say there was a, a time in your life where you switched from negative to positive or were you always pretty positive?

You were just prepared to be in a miserable situation. 

[01:09:08] Scott Newman, PharmD: I'm always pretty positive. I mean, it's not really the story's way, much better when you embellish stuff like that. So , it could just be part of the story. I 

[01:09:17] Mike Koelzer, Host: mean, wait, what's part of the story, 

[01:09:18] Scott Newman, PharmD: the part where my father was miserable. I figured that that was his cause when I was young, but you know, my dad used to be a positive person.

Pharmacy took it away from him in my 

mind, 

[01:09:30] Mike Koelzer, Host: you know? Yeah. Well, that's the thing. I mean, people have you, you talked earlier about people that can be suicidal, losing families, divorce and all that stuff. And, and, and, when you're living constantly in a situation that is not, you know, fair, you pick up even some, you know, post-traumatic stress or complex post-traumatic stress.

I mean, it can change people. 

[01:09:58] Scott Newman, PharmD: Well, all of us are here because of our egos in one shape or another, like I've said before. I mean, you know, who, who can open up a business like this and take that risk without having a huge ego. You can't control how much. It's a whole different argument, but we all have relatively big egos.

I think you're right. This situation will tear an ego right out of you and knock it down. So many levels that you start to second guess decisions. You start to second, guess, you know your abilities. You start to second guess everything. And if that ego isn't left intact, you know, it, it, it changes your whole outlook on 

[01:10:38] Mike Koelzer, Host: everything.

All right, let me ask this. I am a third generation pharmacist. So my grandpa started the store mm-hmm or bought the store. Then my dad, they both passed away and now I am here as the owner. I've got a big ego, but I. attribute it, that I would need it to become a third generation owner. Because quite often, even though I am the owner, you get slapped so much by the PBMs.

You almost feel like a manager versus an owner. Now, your dad owned that pharmacy before you came in. 

[01:11:20] Scott Newman, PharmD: No, no, my dad, my dad worked for me for a few years before his health deteriorated a little bit. Well, lemme ask you this, if your grandfather and you, uh, let's see if your grandfather and your father both handed down a successful business to you and left you with the responsibility of possibly handing it down to one of your kids and you lose it.

What's your ego feel about that? 

[01:11:45] Mike Koelzer, Host: Well, you're exactly right, because I'm yep. Facing that right now, where I'm still sitting in the pharmacy. I have no freaking idea what this would do to my Eagle, because I'm still here. And I can imagine it mm-hmm if the day, if it ever comes where I sell or lock the door or someone else buys it and keeps it going or something, I have no idea how that's gonna feel, because right now it's crazy because my ego's down because of getting flat by the PBMs, but it's actually kind of up because it's one of the first times that I feel like it's mine, because I'm really fighting 

[01:12:28] Scott Newman, PharmD: for it.

Yeah. And, and the thing that's kind of two different avenues to look at. I'll tell you what it is, my ego would be left intact if I didn't have to wake up every morning and look up my bank account. Yeah. Right. You know, if I, if I was, you know, my ego would be left intact. If I can say that I ran a successful pharmacy for 20 years.

And then in the last few years, the PBMs have stolen it from me. My ego stays intact. You know, if you're starting a business right now, and you're unaware of how hard it is, your ego is gonna take a beating. Like it's never taken before. You're 

[01:13:03] Mike Koelzer, Host: saying. And I think I agree with that, that I'm like, look, I've kept my ship intact.

My ship still sails. I can't help if there's a hurricane out there. So it has nothing to do with how I've run this ship. Is that what you're saying? That you, if you get taken out now, your ego's okay. Because you know that the outside influences are so strong that it's just not an ego Buster. 

[01:13:33] Scott Newman, PharmD: Exactly. But

That might be the preparation part where we've been already down that path and back to what we're talking about with relationships and destruction of, of, you know, marriages and, and, you know, going down that path. I mean, I'm going to come to terms with it because I've done the best that I could. And I know that I'm capable, you know, not everybody gets to that point before they lose it all or before they're losing everything around them.

Um, there's a certain, you know, war battle that you go through to get to that point internally and externally, obviously. And that's kind of where I'm at with the whole, not really trying to hide behind an anonymous name. I don't have anything else to do. You know, when I first opened, I knew that I could be successful because I understood how a business of pharmacy worked from a, a, a financial side standpoint from, you know, uh, keeping track of, of not overspending dollars where they don't need to go.

Um, you know, even to this day, I spend hours shopping 17 different ways. Secondary wholesalers to make sure I'm not over paying. Right. Um, I maintain a lot of that control. So, you know, I have very low days on hand. It's probably lingering around the 16 area, cuz I use my technology to predictively fill stuff in order when I need it.

You know, all these things that you would do. I don't overstaff. I don't, um, pay too much for my staff, obviously in the market. I, uh, I, I limit my. Expenses to needs and not once. Yeah. And I've done all these things because I know that's the one portion that I can control. And if I've controlled that portion to a certain level of, of what I would consider, and I'm very hard on myself, exceptional.

Yeah. And I'm still failing, so there is nothing in my control beyond that. So, when there's things that I like, I've reconciled that that's the preparation part. I've come to terms with the fact that you've done everything that you can, or at least that you're aware of. Um, there might be some other opinions about that, but to the best of my knowledge and ability things that should traditionally make you very successful in this industry and in the past, would've, uh, I've done all those things and, and I'm still losing.

Control. And that control is because I don't own it. It's on the payment side. 

[01:16:05] Mike Koelzer, Host: I'm really drawn into what you're saying right now. And I think it's because it's really, it's not a happy situation, but it's really speaking to me about saying I've tried everything, but how do you,

how do you get to that comfort level to know that you've tried everything, would it have to be comparing it to what others have done? Or how, how do you know when you've given it your all 

[01:16:44] Scott Newman, PharmD: for me, it's comparing what over time, where I should be versus where I'm at and the peaks and valleys in between.

And I've just been just because of that. Timing of opening and going through. You know, seven years. I know where I got to a point where I said to myself, okay, this is where it should exponentially take off. And that's about the same time that my reimbursements dropped from an average of 21% to seven and a half, nine to 10 11, all over the place.

I was there. I was about on the cusp. I had paid off any debt that I had already. I was starting to theoretically be able to pay myself. I ended up investing more money into product and growth and trying to make more, you know, margins. Yeah. Um, and then it was pulled on August 30. First of that year was 2017.

The very rug gets pulled out from under my feet. I just bought a $40,000 ice and water vending machine cuz the ice and water store next to me closed. And then, the hunting supply, uh, fishing store next to me got rid of their ice machine cuz there was a store next to me and I had this nice $40,000 machine that I bought and it's paid for and it's getting delivered.

Yeah. And all I gotta do is find the money to, you know, four or $5,000 to put it in. It's gonna be 24 hours. It's gonna pay for itself. And boom, I lost $92,000 in cash flow between September 1st of 17 and 12 30, 1 of 17. And that damn machine is still sitting in the crate behind my store. 

[01:18:24] Mike Koelzer, Host: That's the exact time that we are looking at two, we say like April of 17, but it was somewhere right in there on 17.

And so what you're saying is you can look back from what you're doing now and say, I'm doing so much more now. And I'm looking back at where I was and I know what that momentum and that line that graph would've been, and then it dropped. Yeah. You know, what's the hurricane out there and not 

[01:18:51] Scott Newman, PharmD: your.

Yeah. And that's when I, you know, I just about lost it all then, you know? Yeah. I was having trouble paying my primary and, you know, ended up, uh, going from, you know, every two weeks to every other day, you know, terms. Yeah. Right. I had the opportunity a year later to go back to terms and I'm like, you know what?

I don't even want it. Best thing that ever happened was now I don't overspend at all. I just know how much money that I can spend to be able to pay that bill in two days. And that's it. Yeah. So I have a very tight inventory because of that. And you know what? I don't owe McKesson any money because of it.

Right. And it's nice. I hated having that bill come due every two weeks and not having enough money in my account, or at least it cleared me out. So I couldn't make payroll. Now I have some control 

[01:19:36] Mike Koelzer, Host: over it. Yeah. That, that, that sucks. That sucks to see 

[01:19:40] Scott Newman, PharmD: that. Well, I, like I said at the time, that was my measure of ego failure too, because how did I get to a point, like you ask your, you ask your rep, you know, if I basically go on on C O D, which is not really what it is, it's, it's actually pay, pay, hits the account the day after.

But yeah, if I go there, how, what are my chances for rev surviving? And he basically said to me, you won't make it. That was three and a half years ago, 

[01:20:04] Mike Koelzer, Host: When all the trends say, you're done, you're gonna be done in 60 days. That's three years ago, but it's just not, it's just not coming through. No. And that's what shows that this model's not going to and its current model's not gonna stay.

Well, 

[01:20:16] Scott Newman, PharmD: the one thing I've always said is that, you know, we're. Dying a slow burn, crash and burn here because, you know, as a small pharmacy, I still have $2 million in annual sales. That's a lot of cash flow, hardly. Yes it is. And so we live off cash flow and the longer, the more CA the more sales and, and turnover you have, the better your cash flow is.

So, you know, I may lose money. Profit wise, annually, but if that cash flow doesn't keep me in there for a long time to play that game, it isn't improving. I wish it were right. You know, I mean it was doing okay. And you start to settle out and then boom, January 1st express scripts and some contracts.

Now, even though we're. You know, three, two years into a three year contract and they want to renegotiate it and we refuse as a PSA to do so, but all of a sudden they've just redesigned the plans and offered the idea of y'all picking the pharmacy that you want to use for the health plans. And 30% picked us and the other, you know, 70% apparently didn't so, boom, you lose 70% of your, you know, script volume, which is not mentioned.

If you were thinking about selling completely, it takes value outta your store because you get paid based on script count. All of a sudden, I can't bill two thirds of the plans that I was billing. Yeah. You know, just a month later, you know, I've grown every month, over year script volume wise for seven years straight.

Yeah. And some were booming. Some weren't. I'm still making the same gross on cost of goods that I was five years ago, but number wise, and I think everybody's experiencing that, but yeah, ironically, because of the express scripts, you know, a strange thing that just started happening in the first year, right. I lost 280 scripts over the year prior in January.

Yeah. Wanna know something, my cost, my net on cost of goods increased by four grand. Now that helps the bottom line. But if I were considering selling. That crushes my value, cuz they don't give a crap if you're profitable or not. They want the numbers. Yeah. So another challenge, you know, now I've lost volume.

I've certainly gotten a little bit better on the payment side because I've purged some brand drugs that were costing me a lot of money that way. Yeah. Um, but ultimately, you know, and I've cashed out a bunch of things that I probably, I ideally might have wanted to do prior to that or not take insurance at all.

That model might still exist to where it's feasible. I don't know if it is for each individual pharmacy, but for me, I don't think it is, but it might be, you know, 

[01:22:58] Mike Koelzer, Host: one of my friends, he always says, well, things only get so bad before the other side, what you thought was bad, looks better than what you're currently doing.

What is your cutoff point? I mean, do you have, do you have a time where you walk away or, I mean, when you're forced. You always might decide to. 

[01:23:21] Scott Newman, PharmD: Yeah. Yeah, absolutely. I mean, don't get me wrong. Every one of us who struggle has had this thought as to what the out looks like, and I think it's situational for each other.

Maybe your lease is coming up. Maybe you've been, you know, yeah. Right. Maybe, maybe you've. You've been really, um, uh, in, uh, pursued by, uh, a drugstore down the street. Yeah. Or whatever the case may be. But I think that, you know, ultimately the timing of it is going to be dependent on the individual situation.

But I think we're all there already in our heads for the most part, unless you're super optimistic. And you found a way to hustle the system. Yeah. I mean, a lot of people are good hustlers. I am not a good hustler. I don't want to be a hustler. No. You know, I, I just want to be able to take care of my clients and, you know, speak with them and, and save a life here and there.

Right. Which I've done in this environment, which you can't do if they can't get paid to do it. My, I guess my, my biggest answer to that question is, is that everybody, the situation's gonna be unique, but I think we've all had the thought. And certainly if, when it comes to timing, You can miss a big opportunity to help mitigate some of the pain of it.

One you can actually be paid halfway decent to, for, you know, basically your hard work and dedication to get to that point or whatever investment you made initially. And hopefully you can recoup some of it by selling with yeah. With your family intact and your relationship intact. Um, and then the other idea is, what are you gonna do next?

I will never go work for a chain pharmacy on a bench ever again. This month, even allowing that cage, you couldn't pay me. And they aren't even paying that well anymore. You couldn't pay me twice. What they paid me when I left to be able to do that. So, you know, I won't go do that. I mean, I could see myself, you know, I could see myself switching careers.

Yeah. I could see myself switching straight up to advocacy if I could ever figure out how to monetize it. Right. You know, the information that I know and the understanding of the system that I have in its current form, it should be marketable. I would think, you know, 

[01:25:28] Mike Koelzer, Host: but you and I are talking about something that's been through the head of every independent pharmacy owner.

Let me ask this, Scott, pretend, pretend you got past the point of selling. All right. Pretend that nobody, nobody wants anything. Just pretend. What would be your, like, what would be the hour you close, like when you run out of inventory or when you, or when it's dark inside your store or what it's too 

[01:25:57] Scott Newman, PharmD: late then?

Um, I, I think that it's, I think that when you start to see the effects of the intentional devaluing and you know, I, I I'm seeing it now. You know, the fact that my business is worth less than it was a month ago because of my script volume being forced outta here. Now, can we pass legislation and hopefully stop it.

You can pass legislation all you want to, if it doesn't have any enforcement, it's not gonna matter. You know, it's still 

[01:26:26] Mike Koelzer, Host: happened, but let's say you can't sell. All right. So this is what I'm, I'm in this situation where all right, maybe I go on forever and I'm successful. Maybe I sell, maybe I say, you know what?

You're past the point of selling at what point? There's a day of the week. Let's pretend that those other options aren't there. There's a day of the week where the door, the door of the store, doesn't open. Why is that? Is it because you can't buy drugs that day or you can't pay your, your payroll 

[01:26:54] Scott Newman, PharmD: or what?

No, I've been in both of those situations. and they didn't close with me. So no, those aren't them. 

[01:27:01] Mike Koelzer, Host: What forces you to lock the door? I, 

[01:27:04] Scott Newman, PharmD: I say accepting the fact that I did everything I could and. I'm going to lose more value in what I could get for it. If I continue down. The 

[01:27:15] Mike Koelzer, Host: same path. Gotcha. So it's like, you're gonna, you'd be better off selling this inventory to someone down the road than selling it to this person, walking in to buy a prescription or something like that.

It's more 

[01:27:28] Scott Newman, PharmD: complicated, I think, then that, you know, I'll be honest with you. There's a whole group of people out there who chastise owners who are looking to sell to a chain or instead of trying to find another independent owner. And I don't understand that mindset other than I get it. Um, nobody really wants to sell it to a chain, but I'll be honest with you.

If you're selling to an individual at this point, all you're doing is ruining another individual's life. Sure. I refuse to do that to my fellow independent owners at this point where I hand them off a big steaming pile of loss and they go, and they're, you know, I've made it seven years because of my skill set.

Yeah. Right. And maybe they don't have it. And they're done in six months and they've lost everything that they have in six months. I couldn't live with myself. 

[01:28:16] Mike Koelzer, Host: Doesn't 

help anybody. 

[01:28:18] Scott Newman, PharmD: No, there are people out there that will argue well, there's better ways to do it. I'm sure there is in your situation, but you don't have your business at 800 battlefield Boulevard itself, suite 1 0 5 dash 1 

[01:28:30] Mike Koelzer, Host: 0 7.

It's all individual. Nobody can judge. 

[01:28:33] Scott Newman, PharmD: There is 

1. Cookie cutter is the right way to do it. There's some guidelines. And look, I've tried the, you know, every, oh, you need to be in CPA. Well, guess what? I'm not big enough for them. Oh, okay. You can't do that. Yeah. Or you need to get away from McKesson. Well, there's two other options and they're just as bad only they wouldn't front me, the inventory on the front end, you know?

Right. It's like everybody's situation is different. And, you know, from a advice standpoint, I only really give it when I'm asked for it, because I know that my opinion is not really advice. It's an opinion. Yeah. And so is everybody else's, you know? Yeah. There's certainly guidelines, but there's no cooking P you know, I joined PDs.

I made most of it didn't help me. Right. Because I wasn't willing to hustle every day. Right. Um, or the repercussions that come with it, uh, you know, people say, well, you know, you need to be more involved in CPS. And I've been with CPS since day one. Yeah. You know, I've been doing the clinical stuff regardless of my affiliation with them, you know?

Right. I'm already there. Right. But my particular situation in general is not going to be the same as yours. And so I don't try to judge. So like, if, if people have advice to give, please understand that don't think that if someone decides to sell their pharmacy to someone other than an individual or they decide to get out, they're doing it with a huge, heavy heart that they've had to come to terms with.

This is my baby. I love being here. If I ever chose to go down that path, the last thing that I need is some judgemental people saying, well, you just didn't know how to be a business 

owner. 

[01:30:11] Mike Koelzer, Host: Yeah. Screw 'em because nobody knows. And is really no one's business. What's on your heart. And they don't know that you are doing something noble by not.

Letting another individual, you know, for example, yeah. If, if you ever are in a situation you're doing something noble by not letting that store continue. I mean, you're, you're, if you got to that situation, you're basically falling on your sword, uh, or, or covering up the hand grenade by not letting someone else buy it in six months, ruining their family.

Yeah. 

[01:30:45] Scott Newman, PharmD: I I've just seen it happen so many times. I mean, even around me, I've seen where, you know, these entrepreneurs go in and open up and six months later, they're like, I don't know why I couldn't make this work. I said, because it's not set up for you to be able to survive 

[01:30:59] Mike Koelzer, Host: period. Right, right. Well, Scott, you got a lot of wisdom.

You're the right person to be president of put at this time. And so thanks for all your efforts. Yeah, absolutely. It's been a real pleasure talking 

[01:31:10] Scott Newman, PharmD: to you. Uh, if I ever do decide to, to get out of the actual ownership part, I'm not gonna step away from advocacy. So don't worry about that. 

[01:31:19] Mike Koelzer, Host: You can't still be in our face somewhere.

That's right. again, truth rx.org. 

[01:31:26] Scott Newman, PharmD: Sign up. We are really doing stuff for people. I mean, you may not feel like your other organizations are, and that may be a realistic viewpoint. It may not be, they're really good about touting what they do for us, but ultimately we want outcomes, but actually it is literally.

And our own self-interest as owners and, and on our board as owners trying to save this, uh, you know, the, the idea of independent 

[01:31:52] Mike Koelzer, Host: pharmacy, we may have a brighter future, but I mean, one of the models, this is probably why you don't want me on your board because one of the models could be for an organization like yours, which, and that's why I love talking to you here could be like misery loves company.

you know what I mean? They are all right. Someone understands someone else and someone cares. And what, what does that phrase mean? They don't, they don't know how much they don't care how much, you know, until they know how much you care or something along those lines. So that 

[01:32:25] Scott Newman, PharmD: that's good. Corny and appropriate. 

[01:32:28] Mike Koelzer, Host: all right, Scott, we'll be watching 

[01:32:30] Scott Newman, PharmD: you.

All right. Thanks, Mike. Good to talk to you. Take care.