Startup Lessons Learned | Kristin Tallent, PharmD, Collaborative Therapeutics

Valuable Lessons Learned | Dr. Kristin Tallent, PharmD

Mike: [00:00:00] Kristin, for those that haven't come across you online, introduce yourself and tell our listeners what we're talking about today.

Kristin: I am Dr. Kristin Tallent and we are going to be talking about the ups and downs along the way that I've experienced as a pharmacist. Um, we spoke about eight months ago, so it's great to be back on the show again, to share kind of my journey.

Mike: Something that sticks out to me from when we spoke last time is the dirty rat that stole information from you and you wish you would've done a better job of copywriting and stuff like that. Now it's always easy to sit back and throw stones at yourself. Did you learn from that? Is that practical? The stuff that you were thinking you should have done? Have you done it now? And has that worked better for you or has it been a pain in the ass? And, you would've done it the same way the first time?

Kristin: Um, no. It's definitely been a pain [00:01:00] in the ass, but it's also something that I have. Definitely learned from and have been more diligent with since that experience. And so now when I'm entering into different agreements with people, I am a lot more cautious and a lot more thorough when I'm reviewing contracts or bringing a contract into place that may not necessarily have, uh, been initiated by the other.

Mike: I have a friend in the plastic business and he invents different things, bird feeders and um, equipment hooks for the garage and things like that. And it seems more important to me than the actual copyright. is the threat of that, because I really don't think if I steal something from you, Kristen, I really don't think you're gonna sue me for it.

I don't think you're gonna come after me with this huge lawsuit, but from the start I'm gonna look at it and say, Oh, she at [00:02:00] least mentioned it, so I'm not gonna go there. , 

Kristin: prior to this experience, I thought that it was more than that. If you signed a contract, You had to abide by everything that was in there or something bad was going to happen to you. Right? But something bad only happens to you if that other person comes after you with an attorney in hand, right? But the likelihood of that happening, I'm not sure, is very high due to the expenses of all of that. So it's like we put all these contracts in, it's like a double edged sword.

It's kind of, honestly, the whole thing is silly in my mind. The fact that somebody learned from me and took my stuff, that's silly. The fact that I'm now kind of. Gun shy a little bit to enter into agreements with other people or pass along information that I have without having somebody sign a contract is silly.

The fact that I spend, or we all kind of should be spending money to have attorneys write up these contracts. It's all just nonsense.

Mike: [00:03:00] I'm not patting myself on the back, I think most people do this when I sign a contract, it's kind of a moral obligation to me, like, I don't wanna do what's against the contract because then I've broken, you know, who I am. I guess some people look at it as like, yeah, we're gonna sign the contract and that's all part of the deal. And if you can get around the contract some way or scoot around things as long as you don't get sued and so on. That's the important part about it.

Kristin: Don't you feel like there should be this moral obligation though, with or without a contract?

Mike: Yes. It's almost like an expectation document. Even if both sides meant the best for each other, sometimes that stuff gets garbled. What's the best for each party?

Kristin: My view on life has always been a curiosity of why we can't all just get along. Like we're all doing [00:04:00] this thing called life and trying to make it in whatever way that looks for each individual person. And I just have never been able to understand why we. Can't just do our own thing without stepping on other people's toes or being rude to other people or inconsiderate and all of these, these types of things.

So now in an era, here we are in 2022, where everything is digital, everything is internet based, especially with things like these courses and learning and whatever. Even in that space, I still feel the same way. If you're learning something from somebody, why would you then twist it around and then teach it to somebody else in that same exact market?

I don't know. I mean, I know a lot of people still kind of do that, but I think the way that it was done to me explicitly was just [00:05:00] very, like you were saying, just morally inept. It's like, why would you do something like that? So, I don't know. That's kind of where I get stuck with it because honestly, I hate contracts.

I just wish we could all kind of like play well in the sandbox together and drive pharmacy forward and create this in an incredible, um, industry that everybody loves. And we all love what we're doing, but

it's just not realistic. 

Mike: Do you steal a lot?

Kristin: Do I what?

Mike: Do you steal? Very much.

Kristin: No, I can't say that I do

Mike: I never thought I stole very much either, but years ago. I was in the seminary for one year in St. Louis. It was a long time ago, and we had this kind of commons room where there was cassette tapes and things like that.

 And this was before even CDs. And there was this tape by Chuck Mangione. Do you know him at all? [00:06:00] You probably don't. He's instrumental, feels so good. Was a pretty big song in the seventies. That was before your parents were probably born. 

Kristin: That is not true,

Mike: You're 29.

Kristin: We can go with that.

Mike: So I'm listening to it and I said, I really enjoy this. And my mind is thinking nobody else really enjoys this. And in fact, it's taking up quite a bit of room here in this cassette. Tape holder, so I'm gonna bring it to my room and play with it. So I played this Chuck, me and Joani live at the Hollywood Bowl tape come the end of the year.

In my mind, that was mine. You know, it's like nobody wants it. I don't know what it was doing there. I enjoy it. I'm gonna do this place a favor and take it off their hands. I brought it home. I didn't go back to this seminary. I'm at home then like two or three years later, and I'm putting this cassette tape in, and it dawned on me that I stole it.

I was in the damn seminary. It never crossed my mind that [00:07:00] I had stolen that. And I did. I think a lot of people, when they do stuff that we think is wrong. I think a lot of people don't think it's wrong in a way.

Kristin: So it's so funny that you're talking about this and being in the seminary, cuz I was at church on Sunday and do you know what the topic was about

Mike: stealing Chuck Manjii tapes. a,

What a coincidence. 

Kristin: Okay, so they mentioned that. They did mention that, but then it was all about forgiveness. And so I think that really we have to just appreciate, I think maybe a little bit to your point is that not everything is done intentionally and we don't know where the other person is in their journey or what their intentions were, to begin with. And so I think forgiveness is really important.

Mike: Yeah, I say forgiveness ness. [00:08:00] 

Kristin: maybe that's why you were only in the seminary for one

year. 

Mike: They kicked me out. I think the moral of that is 

 if you think you need a contract with somebody because you think they're shifty, don't even go into it with them. If you don't think you need a contract, definitely get the contract. That's the kind of person you wanna be in an agreement with. Definitely get the contract, but it's gotta feel like you don't need the contract if you think you really needed it, cuz they were shifty, don't start with them.

Kristin: Right, Right.

Mike: This person you trusted and you trusted them so much you did not get a contract with

Kristin: I know I did not get a contract and I didn't get a contract with several people. Um, and honestly, I probably wouldn't do it any differently if I could go back because it just wasn't realistic at that point in time.

Mike: to get one. 

Kristin: to get one, yeah, the cost of me having to get an attorney to write up a contract and all the back and forth, it [00:09:00] just didn't really make very much

sense. But regardless, Um, I think my main message to share with other people, pharmacists especially, is that we don't really know this world of contracts very well

and it's just good whenever you're entering into some type of agreement, whether it's a business agreement or some type of collaborative agreement, it's good to get them so that, like you had mentioned both people are on the same page and have the same expectations cuz you could then start to put other things in there outside of, don't steal my stuff or don't deal, duplicate my information that I'm giving you.

Outside of that, like some of the things I've learned throughout, some of the different things I've done are setting meeting expectations in a contract because if you don't have those meeting expectations in the contract to begin with, person A might be expecting to meet with the other person every other week and the other person B is not really expecting to have [00:10:00] to communicate with this person at all.

So it's important to kind of. Iron. Iron out some of those little details at the beginning so that the relationship can unfold well.

Mike: One thing I learned and it probably costs more money, but hire an attorney that you know will take you to the worst case that they're prepared to do that.

We had a family attorney, kind of a friend of the family kind of thing, and something was contested and it got to the point where I'm pretty sure the other side threatened this attorney. And this attorney was so afraid that they acquiesced to the demands of the threatening party.

 If that was a big enough law firm, I don't think you'd have somebody that was able to be threatened because they know that there's legal things there to back them up. But that gets into it because here we are saying you almost don't need a contract.

And now we're saying get the biggest law firm you can [00:11:00] afford. That's why you don't go into business with your family if you can help it.

Kristin: I was just about to say that exact thing. I do not like doing, um, business related things with family or close friends because there's just too much risk of it going sour, and I've experienced those situations and so I just try to avoid it at all cost.

Mike: Because you don't separate it. People say, Well, you separated his business. Like, no. I've got family members that, uh, someone in the family, not my direct family, but extended family, their sibling was very thankful that I took this. Sibling of them on this payroll because they know that this person had some idiosyncrasies of, nervous about certain things and not being able to do everything, maybe a little slow here and too much detail, O c d, that kind of stuff.

So I'm the hero for a while, but [00:12:00] then through different reasons, this person ends up being fired and now I'm the bad guy. And I feel like going over there saying, You knew your sibling was crazy. I was a good guy and now you're on me for firing them. It's not a social justice pharmacy,

Kristin: Exactly. . Exactly.

Mike: But that's why you don't have a family.

Kristin: That's exactly why you do not hire family and you don't hire close friends or you know,

children of close friends,

Mike: Why did this topic come up for you? Why did you think about that? You were just saying, I'm, I'm gonna think about everything that could go wrong? Or did you have a situation,

Kristin: no, not personally, but in pharmacies that I've worked at, I've seen it unfold. And then you can't let go of that person because they're family. And this reason and that reason where if you had a Joe Schmo off the street come in and do exactly what that family member was doing, they would've been fired years ago.

[00:13:00] I think running a business with your spouse is really challenging, I say it is really challenging because my husband and I, um, we're pretty new to the entrepreneurship arena and so we try to support each other with our businesses. We essentially have two or three businesses together and we just try to support each other where we can. But it does get a little, it adds another layer. Having to navigate communication.

Mike: I think a lot of it probably has to do with what kind of business you're in, I know one thing that I wouldn't do is I would never wanna be with someone real close to me when things get stressful. I remember at the pharmacy years ago when we were busier and you'd have some times where you're just like crazy busy.

And I still remember some things my dad might have said to me in the moment, you know, that he probably wished he could have taken back. And I probably do the same thing to my kids or [00:14:00] something, or other employees and you kinda wish you had 'em back. But, you can only take so much stress at once. So I think that'd be one area I can see growing, like having fun, dreaming about a business with a spouse, but when things get tough with the stress, that would be hard.

Kristin: Yeah, definitely. And luckily we haven't hit those times. Ourselves. But I remember working for um, a couple who owned an independent pharmacy when I was still in school. And I don't even think I realized the dynamic that was going on necessarily at the time because I was just an intern. Like there every so often, you know?

But to be an actual pharmacist there 40 hours a week, whatever, dealing with the, the relationship dynamic

of, you know, owning a pharmacy, I just feel like that would be really challenging cuz you have to deal with two [00:15:00] people, not one. And then you're trying to figure out who's actually in charge.

Mike: And God forbid there's any triangulation going on, how my kids do it with Margaret and me as parents, you know, Well, mom said this and this and that.

Kristin: exactly. My three year old does that, like how do they learn that so

early? 

Mike: good at it. 

Kristin: They are.

It's impressive.

Mike: I've used this saying that, uh, I think I made it up that things look a lot better when they're hidden under a hundred dollar bills.

 Our business, we never had that much animosity going on in the business but when the business finally had financial troubles, five years ago after 70 years, something like that, things got bad in a hurry. When the ship starts taking on water,

Kristin: It really does. I like that saying what did you say? It's buried under a hundred dollars

Mike: things look better when they're buried under a 

hundred dollar bills. I think I made that up. I like that.

Kristin: I like that 

[00:16:00] too. I like that too.

Mike: So, Kristen, as you start going through the business now, here, you have to start making more agreements with people and. I think when we talked before, you maybe had some people that were doing some things for you and so on.

It's hard to commit to a full-time job. You look at that person and you say, I gotta be with this person for 2000 hours a year. They're not part-time, so I can't put them on sometimes when I feel like it and move them around certain days, like I can, most of my part-time staff, but a full-time person, that's quite a commitment just 

emotionally. 

Kristin: Yeah, it is such a commitment and I have not figured this part out at all. I, I'll be honest with you, I'm in the thick of that. I am really realizing that as business owners, especially as pharmacists who are business owners, we are really not equipped to be doing this. Not [00:17:00] naturally anyway. You know, I mean, if you're, like, you probably had some exposure to that given, did you say your dad owned the

Mike: Yeah. From a kid, business was in my back pocket. 

Kristin: Yeah. So unless you had actual, familial exposure to something like that or whatever, if you had some type of experience, that's a different story, but just somebody who went to pharmacy school became a pharmacist. We are not equipped to be business owners. Naturally. There's a huge learning curve.

These contracts and agreements we're talking about. Hiring people. I mean, let's back up writing a job description. Then you have to interview them, hire them. I mean, all of these things. Figure out the benefits, so on and so forth. And so you don't realize going into it, that you are entering into a space that is like one learning opportunity or obstacle after another.

Mike: 10 years ago I had to do [00:18:00] inventory really quickly. Like I had to get it done in four hours because of some tax thing or something. Anyway, I probably had like five or six employees stay after work.

October: They would take inventory for a while then every so often take a 10 minute break as a group.

Mike: What I found out was it was hard to get them off of their break Pretty soon I felt like I had to get my tool belt outta my car, you know, put my hard head on and like, come, you, you and they're like moping back to work 

Here's the thing, you don't get that in a pharmacy when you've got patients staring at you. People automatically know their job. If they naturally should be there at all, they respond to customers wanting things from them.

You don't have to crack the whip when there's customers around, but I found that when the place was closed, now I'm like a job foreman or something with your stuff. Kristen, if you haven't, I imagine you're gonna get to the point [00:19:00] where you're hiring people that there's no customer staring back at them all the time to give them the impulse to work.

I'm imagining you're getting people that got to, motivated through different metrics and things like that, that it's not just the customer pushing them along.

Kristin: Yeah, that's true. And I also, I also like to hire people who are good at certain tasks instead of having like a jack of all trades. And so then that kind of becomes a little bit challenging too, because then you're having to hire somebody for sometimes a minuscule

number of hours. So you're sometimes almost better off hiring a contractor or like a freelancer of sorts for certain activities.

Mike: Unless you've got like five locations and you can, take the person and divide it up 20% each. You're better off [00:20:00] getting, contracting either someone who's there or some national business or something like that. 

Kristin: exactly, when you own a physical pharmacy, that's a totally different story. You need to be able to, you know, hire bodies to be in there to do it, you know, to do the job and to do it well. And to your point, um, I, I learned that there's all these types of personalities that mesh well together.

And when you're hiring people, it should be done kind of strategically based on the types of personalities you already have on staff and kind of what you need and what you're looking to hire. So anyway, it's just another, another piece of like all these things that as pharmacists, we don't naturally know.

Mike: I remember I hired one of Margaret's a long time ago. This was 20 years ago. He was just like a clerk. We called him, I dunno if that's derogatory now, but just a clerk, you know, he rang up stuff. You didn't have a job description. Your job description was, do whatever the hell I tell you to do.

That was a job description, you know, [00:21:00] So about a year in or something. I'm like so and so, can you do this? He's like, Well that's not part of my job description . I'm like, Well, maybe being fired is part of your job description. And I kind of felt bad because it's like I probably should have had a job description, but I never had anybody tell me that before.

Some teenagers say it's not part of their job description. I could have done better, but I fired him.

Kristin: Well, I mean, just a simple statement that's not part of my job. Says a lot about a person, don't 

Mike: Yeah. Yes it does. Certainly. But I had someone come up a couple years ago, one of my employees, and said he wanted to know when a smoke break would be. I just wasn't used to that in the pharmacy. One of my people is taking a smoke break. When I was working someplace and I wanted to take a Snickers break and I'm like, that's fair. If someone can sit there and smoke for 10 minutes outside, I gotta be able to go outside and have a snicker bar.

Kristin: That's always been a running joke in any place that I've worked [00:22:00] with smokers, especially in the hospital, it's like they get like two smoke breaks plus their lunch break. So they get two smoke breaks during their shift, plus their lunch break and it's like, during an eight hour shift, you work what, six, seven hours?

Where are all my breaks?

Mike: they really have that

Kristin: Uh, I mean, I don't think that it was 

actually part of the, 

Mike: but they 

Kristin: job 

description. ,but 

Mike: They got it.

Kristin: yeah.

Mike: That doesn't seem like something you wanna promote. 

Kristin: No, 

No, I don't think so.

Mike: You get two times a day to go out and smack your kid around or something like that. You know? It doesn't seem like it's something you wanna like to promote. 

Kristen, what positions now as you're growing, what positions have you had to bring on and, how did that decision go about maybe making someone full-time and part-time contract and so on?

Kristin: Oh boy. I've made a lot of mistakes this year. 

Mike: Oh, let's hear 'em[00:23:00] 

Kristin: 2022 has been a year of learning. Oh my goodness. It's been a year of learning. So I own a wellness center in my local community where we do integrative wellness consultations, so trying to help people find the root cause of their illnesses and heal from the inside out and an integrative approach.

I like to try and blend traditional medicine with a more holistic approach. And so in doing that, I wanted to scale and bring in a mid-level practitioner who could prescribe so that I was giving people the full. Service that I knew that they needed and also that I feel like patients deserve.

But I did it all wrong. I hired a physician assistant. It wasn't the person. Maybe there were some attributes about the person that could have been better, but [00:24:00] really, all in all, she was great. The problems really came into play with the fact that she was a physician assistant. And in the state of Maryland, in most states, I think all states actually physician's assistants need and overseeing medical

doctor. And so not only was I paying to have the physician assistant staffed, but I was then paying a fee to have the overseeing provider. I did it all myself. And that's also another thing I learned is I probably shouldn't have been doing all of that, so, So I don't even know how to put these in order of lessons learned, but I would say that first lesson learned was that I probably wasn't ready to scale

is number one. I probably shouldn't have been thinking about hiring another practitioner in the first place.

Second thing I learned was that I should have hired a mid-level practitioner or a physician who maybe saw [00:25:00] the vision and wanted to do this, who did not need an overseeing provider. 

Mike: Let's say it wasn't a physician, you would have someone in who could do things, but maybe more narrow scope of practice 

Kristin: not necessarily but, but to your point, they would be prescribing things like thyroid supplementation or bioidentical hormone replacement therapy or low dose naltrexone, maybe some com custom compounding type things.

Mike: That would only be a physician, right? Everybody else 

is gonna need somebody.

Kristin: no. There are some states where nurse practitioners. Can they practice on their own?

Mike: Oh, so you would've gotten an NP instead of a pa?

Kristin: Yes.

 And so that would've taken the expense of the overseeing provider out of the.

Mike: Did you consider that ahead of time or you didn't think so?

Kristin: I didn't think about it. That's why I'm saying I learned way too many mistakes and I've been learning them the hard way. So maybe somebody can gain something from this

Mike: [00:26:00] So I think you mentioned her kind of in the past tense. Is she no longer around the pa?

Kristin: No, I ended up letting her go unfortunately, because the business just wasn't growing 

as quickly as I had anticipated. Again, I shouldn't have hired her in the first place because I realize now that my business wasn't busy enough to justify not only the expense of her, but also it wasn't busy enough to guarantee her the volume of patients that she was able to handle and, and, um, financially wanted to get, cuz we were doing a bit of a fee for service, so to speak.

Mike: And that could be solved. I ain't no expert, but that could be solved by maybe having then a nurse practitioner who wants to do some part-time stuff and start 'em on Tuesday and Thursday kind of thing.

Kristin: Yes. And so actually at this point, it took me several months cuz she was done at the very end of [00:27:00] June. And just within the last couple weeks I've been talking to a nurse practitioner who is willing to just kind of see a patient here and there for prescriptive reasons. And it's been so far working out a lot better.

But I did learn a lot of expensive mistakes. The other one I kind of wanna share, is that, These mid-level practitioners are used to the larger entities that they tend to work for paying for their liability insurance,

which tends to be, give or take about $5,000 a year. And so it's important for people going down this road to realize that that's probably going to be something that comes up in conversation and be ready to answer how you're gonna handle that.

Mike: That's an example where one side, you both have good intentions. One side might think, Well, of course this is covered. And then the other side's saying, of course, is not covered. You don't even think about it.

Kristin: Yeah. You [00:28:00] don't even think about it. But I think that's what happens whenever we start doing things that are kind of outside of the box. And you're starting to see that more and more in the pharmacy industry because of all the changes kind of going on, these pharmacists stepping out like myself and practicing in a more non-traditional fashion.

We're still doing things that were fully educated on how to do, when it comes to clinical things, but all these other pieces, uh, not so much

Mike: Then at some point you say that you're gonna take these things you learned. Both as a manager and clinical wise, and you're gonna build it in a way to teach some other pharmacies. You kind of made that move in the last six months or so. And how is that going, and what horror stories can you share with us from that? 

Now, when people go to [00:29:00] the link in the notes, they're gonna see this beautiful business you have.

But that's not fun to listen to from people on the inside. We want the scoop.

Kristin: That's so fair because everybody polishes everything. And I know, I'm always saying social media pulls the wool over

everyone's eyes 

Mike: We don't need that

Kristin: It's not fair. And so I try to be pretty. Transparent about where I really am and what I'm really doing. Um, and so yes, I do, I I like to help other pharmacists.

I have a soft spot specifically for independent pharmacies. I like to help them implement their point of care testing services. and so that hasn't come without its own growing pains at all. because I've, I've realized that I have to spend the time not only trying to get the sales. I mean, I'm a business, right?

I need to get independent pharmacies to [00:30:00] purchase this product, but I also need to maintain the product. and then there's this third layer of having to continue to optimize the product so that you as the customer are getting everything from it that you're

expecting. And so it really, in and of itself is its own business.

Can be my full-time job,

Mike: No doubt, right? I mean, this is a different business, right?

Kristin: It is.

Mike: So you have two full-time jobs.

Kristin: Yes. Pretty much.

Mike: Which one do you start paying back a little bit? the one where you are the actual caregiver giver, right?

Kristin: We should talk about this in eight months,

Mike: I pick the one that allows me to sit on my ass more. That's the one I would pick, that I can sit in front of a computer and make decisions. So for me, that's gonna be doing something like that. But you don't know right now you've got two full-time jobs basically going on. Which one do [00:31:00] you daydream about?

Which one do you picture a couple years from now saying this was cool because this happened? Is it that side with the consulting or is it this other side the medical side.

Kristin: So I kind of call it my patients and my pharmacists that's how I kind of block them off in my mind. And to be honest with you, I don't know cuz I love them both. So here's the way I look. I serve my local community and my patients because I've seen how much this integrative approach can change people's lives and how quickly it happens.

If people are willing to take the recommendations that I make, 99.9% of the time they're feeling better. By the second time I saw them within 30 days. It's incredible. 

Mike: Give me 15 seconds cuz we don't like to talk about medical stuff here. I ain't smart enough and it doesn't interest me. Give me 15 seconds of what you're talking about with those people. Vaccinations. What else?

Kristin: So I get a [00:32:00] full past medical history. I have them fill out a symptom questionnaire. These are very comprehensive forms. And then I also ask them to upload the last one to two years worth of labs that they've had done. And I do a whole assessment. I look at all of that before we even meet for the first appointment.

So I have a really good idea of who this person is gonna be sitting in front of then after our first 45 minute appointment, I make a plan and recommendations for you to put in place that typically consists of things like lifestyle modifications, supplement support, stress reduction techniques, nutritional optimization, things along those lines.

And there's al, there's this delicate balance of doing it right so that you're giving them enough to have them see results, but not giving them too much where they're overwhelmed by the situation and just say, Eh, I'm not gonna do that.

Mike: Are you directly getting revenue for that?

Kristin: Yes,

Mike: You are. You're charging them for that service.

Kristin: Yes. It's a cash

Mike: Gotcha. [00:33:00] Your pharmacist, are you teaching all of that? Is it more on testing or vaccinations or something? the whole batch that you're teaching pharmacists to repeat what you have done?

Kristin: Yeah. So the course that I have right now it's just to help pharmacists implement point of care testing. So it's pretty much a point of care testing on a silver platter. I tell you what and how to do it from A to Z, and I don't really leave anything 

unturned. 

Mike: Do you mean by testing? That's part of what you do for the customers, but they give you their blood test for the last two years or something like that. What testing are you doing for the customers?

Kristin: So we do c flu, strep, and a1c.

Mike: Not testing, but vaccinations.

Kristin: No, these are all [00:34:00] tests. I started my testing facility because of C.

Mike: gotcha. These are tests. 

Kristin: these are 

tests. Yep. And then as soon as I started, I realized that other pharmacists need to be doing the same exact thing. So I created the course to help them learn how to do that. And since then I've been trying to continually tweak and optimize the course.

And now it's starting to evolve. Into a more comprehensive approach to kind of all testing services It's mainly point of care testing, but there will be

some more

information about additional testing like your regular lab work

and stool tests and hormone panels and food sensitivity tests and all kinds of different things like that.

Mike: And they're just learning that testing stuff, not so much. All the other stuff that you were talking about in your care plan, cuz you mentioned other stuff. [00:35:00] Right.

Kristin: Yes.

Right. They're just learning about

the testing. 

Mike: Why? Just the testing first. Is that because it's more black and white? Why don't you take it vertical? And why did you go wider on the testing?

Kristin: You know, that's a really good question and my honest answer is because I'm only one person.

Mike: So you might do this here and then maybe the next one's a little bit more intricate and you teach that so it 

Kristin: Yes, it's still Microvertical. Um, but I don't really wanna get too much into the clinical piece of functional medicine cuz that's really what I'm doing is functional medicine. And so I don't necessarily think, at least right now, I mean that could change, but I don't really wanna get into the functional medicine clinical education because there's so many other, like, incredible resources out there.

I don't even want to dive into that. I'm more so trying to teach pharmacists how they can very easily use testing as a revenue stream and then [00:36:00] honestly use it as a springboard into other services. that can simply be dependent on what they're interested in. So if you're not interested in functional medicine, then number one, don't call it that. 

Or number two, don't do that.

Mike: It's almost like if you can teach a pharmacist to charge for something and you can teach a patient to open up their wallet, 

Kristin: Yes. 

Mike: 80% of the way there.

Kristin: And you just said exactly what it is that I'm trying to do, because we've been backed into a corner as an industry. We're not getting reimbursed the money that we used to on prescription medications. You know, same song, different day. But the point is, we have this opportunity right now to start charging for a service, and C O V allowed that to be pretty easy.

Like just start offering COVID testing. People want it, right? I mean, maybe they don't want it as much right now 

as they did a year or two

years 

ago. 

Mike: here in the winter,

Kristin: Exactly. [00:37:00] But number one, don't you wanna be prepared If it does come back here in the winter, and number two, you don't stop there. That's the biggest 

message is 

there's the flu strep.

Those have been around for how long and they're not gonna go away. A one Cs for diabetics, lipid panels for people who are on statins. Like the list goes on and on and on of the point of care tests that you can do, but then you've trained your community that you're a place where they can get tests.

Why do you have to stop at those types of tests? Why don't you start to offer some of these cool panels that they probably aren't able to purchase anywhere else, or they're having to try to search for? I, I think that especially the younger generations don't look at physicians the same way as.

The older generations do. And so I think the younger generations tend to be [00:38:00] more hands on with their health and also more willing to purchase things online to try to solve their own problem, get their own answer, solve their own problem. So why not as a pharmacy or even a pharmacist like myself, why not position yourself in your local community to be that point person where people can get answers?

I'm not diagnosing anything. I'm just helping them get rid of their symptoms that they're dealing with and hopefully putting them on a healthier path.

Mike: Yeah, I think that's a good point about them going maybe into their own hands and the, accompanying statement to that is not going through the gatekeeper so much. And you're seeing that with a lot of things. People that are writing short stories, they go on, you know, certain sites and share those with their people, or this podcast, you know, doesn't need a middle man.

I don't have sleep with one of those fat Hollywood guys to get my show to the [00:39:00] masses, 

Kristin: You wouldn't sleep with one of those Hollywood guys.

Mike: I'm not saying I wouldn't, I just don't have to. The choice is mine. but that whole thing so think of the middle man for this podcast. Think of a middle man for health. As the doctor, you have to wait for them to say you need the test and all that kind of stuff. And I think that is, going into people's hands a lot more. I 

Kristin: agree, and also our attention span is getting shorter and shorter and shorter. So the days of going into a doctor's office and sitting there and waiting and waiting and waiting and then being willing to do that again and again and again are pretty slim. Like if I go to a doctor's office, unless they're really going to, I don't know, be some kind of incredible specialist for me, I'm not going to sit 

there and wait for two hours for a physician.

I have a dental implant. I've had it forever. I waited in that oral surgeon's office for hours every single [00:40:00] time I went there.

And luckily, I think I only had maybe two or three appointments but I don't think we're willing to really do that outside of certain circumstances like that.

Mike: In the old days we would turn our film in, you know, you'd wait for three days and get your film back. You know, you'd look through 'em and think like that. Once you see something in an instant, you don't want to go back to that.

You know, talking about waiting in the doctor's office. My first child, we took him into the pediatrician's office and my wife and I were there and our little guy is not so little anymore. He's 30, but at the time he's lying on the table. They're naked. We waited for probably 20 minutes or something like that. I cringe at who I was back then. I come out and I basically yell to the whole office. I'm like, 

my son's in there naked and this is early in the morning. We should not have had this, Wait, you're doing this for [00:41:00] financial reasons because you'd rather have us wait than you wait and this and that. I cringe at that. I can't even believe I'm sharing this. That was who I was more back then, but I even know why I told that story.

I think I just like telling how I went out Rambo and post Office.

Kristin: Waiting. It was waiting. People don't wanna wait anymore. 

No. 

Mike: Wait for that.

Kristin: No, and I mean, add a child to it in the pediatrician's office. I mean, oh God, it's painful. It is so painful. But to the point of actually dealing with adults and these testing opportunities, it is just that it's an opportunity not only for you to serve your local community and provide them with a service that more than likely nobody else is offering them.

But it's also an opportunity for you to do something maybe that you love more 

than what it is that you're currently doing, or to, you know, offer another [00:42:00] service in your independent pharmacy for, you know, business purposes and revenue purposes and profitability purposes.

Mike: I think it's cracking open that wallet. That's what it is. I think it's charging, having someone, the first thing is charging, then it's cracking the wallet open.

Kristin: Yeah, there's a statistic, and I wish I knew it off the top of my head right now, but somebody who spends even just $1 with you

Mike: Yeah.

Kristin: is statistically so much more likely to purchase from you again because you already had them pull out that

card 

Mike: Exactly.

Kristin: their wallet or whatever it is. 

But as soon as they do that, once they, I wanna say it's either like 50 or 75%, it was

a very large number. They are much more likely to spend time with you again. And so like you're saying, we need to start as pharmacists in the pharmacy industry, we need to [00:43:00] start realizing that it's okay to ask people to pay us for a service.

Mike: Yeah.

Kristin: Start where you're comfortable. I remember whenever I started doing consultations, I was working at an independent pharmacy.

We also did compounding. I loved all of that. And so I went to a um, B H R T certificate program and I started doing hormone replacement therapy consults for patients. So they would purchase a test kit. When their hormone results came back, I would meet with them and would go over their results and I'd write up recommendations and send 'em to the doctor's office.

This is nothing new. Many, many, many other pharmacists are doing this across the country. And I think I started at like $75 an hour. Like that's what I started at. And I think sometimes people get hung up with what to charge or what's everyone else [00:44:00] charging. And yes, although that's important, I think it's also important to. Ask yourself with your, what you're comfortable charging,

Mike: Yeah.

Kristin: because if you can't have a conversation about it and sell it to the person standing in front of you, 

then it's pretty much worthless. Right.

Mike: Yeah. You have to believe in it

yourself. 

Kristin: Absolutely. You definitely have to believe in it. and then I just slowly started increasing it.

You know, the more people that irritated me, the higher the

Mike: There you go. There

Kristin: The higher the price went.

Mike: There you go. 

Kristin: I am not doing this for $75. It is now $125, and then it was $150 

Mike: I think the current building situation, at least in Michigan, it's hard to find, kinda like handymen and at least my wife tells me, she looks at me here and says she can't find one. It's hard to find handymen and things like that. And when you find them, you know what? I think they do? I think they all set their price to say, Okay, it's this much labor, this much this and that. I think they do it [00:45:00] now and they just double it. You know? They just double it. And if someone takes 'em up on it, well then they wanted it, 

Kristen, if someone's listening right now and they own their pharmacy,

 What's your best idea to crack that wallet open of the patients and giving pharmacists something of confidence to sell service 

Kristin: If

Should it be pharmacy related?

Mike: Well, let's start with it being legal. , something off the top of my head is, I'd say I can help you lose weight.

You know, for 30 bucks or I can help you quit smoking, you know, something without a product. but something to get them to open up their wallet. Probably the cheaper, the better.

Kristin: This is a fantastic question because you prove a really good point in that people.

Associate pharmacies and pharmacists with a product. So how do we get them to associate us with a service?

 Can I do a [00:46:00] bundle?

Mike: yes, you can bundle 

Kristin: That was easy. That 

was 

easy. It was the bundle. That's exactly where I started, is to buy a hormone test and then we will do a consultation for an additional fee. Now if you're trying to differentiate between the two, like, Hey, patient, customer, you're buying a test for $199. Then my consultation fee is $75.

In addition to that, to go over the results. Then that way in the patient's mind, you're kind of training them, this is what the test is worth, this is what their time is worth, and they're doing me a service, not 

Mike: necessarily, 

Kristin: selling me something that they're now reading to me for free,

Mike: Yes.

Kristin: No other healthcare professional is doing that.

And that's another one of my biggest things that I would love to try to get out into the pharmacy world is that we're worth a [00:47:00] consultation fee

Mike: Yeah.

Kristin: and no other healthcare practitioner is providing knowledge for.

Mike: No.

Kristin: We need to stop. I'm not saying that in the OTC aisle, you know, you need to nickel and dime every single person that you talk to.

But to answer your question, I think pairing a consultation with a product is the easiest way to start offering these services for you. Probably to kind of get your own mind wrapped around it, but also for the customer who's so used to buying a product from you, you can kind of pair the two together, and that's what I would start everybody out with.

Mike: I think that's right, and I think that, I'm being a little bit facetious here, but you know, it's almost like, you can buy this bottle of acetaminophen for, $5, or you can buy this bottle of acetaminophen for [00:48:00] $1, but it does have a $3 consultation fee with the pharmacist to talk about your OTC status.

 So now the customer 

says, Well, that's five. That's one. Okay. I'm paying three for a consultation. Obviously it's less than five. Yeah, I'll go with it. I'm being facetious, but it's splitting it so they can see the split somehow.

Kristin: Yes. And there is somebody out there, I don't know who it is, but there's a pharmacist out there who doesn't do exactly what you just said, but she charges for time. Consultation time. So it might be five minutes or 10 minutes or 15 minutes. But instead of just sitting there and talking to patients about whatever their health concern or question is, she charges them for that conversation.

but like you just said, I think that's great. So I would pair it with whatever product and service you're most comfortable with. Or the product and service [00:49:00] you're most interested in learning

about, because you don't wanna make it painful, right? So if you're interested in hormones or you like helping people with, you know, stomach problems or you know, wherever your soft spot is, maybe you love supplements and you get one of those hand screener things that test your, uh, your nutrient levels, you know, But like we're. Charge for the product and then charge a separate consultation fee, I would say, at that same time as the purchase because of the product. Because then you have them book them, book their appointment right then and there, and that way they're scheduled and they've already paid, 

so they've committed without even leaving your 

facility. 

Mike: I really can't think of too many professions that separate product and service. Now hear me out. You know, maybe a psychologist. You know, [00:50:00] a therapist that's pretty much devoid of product. But if you think about a lot of the professions, it used to be that, you know, people didn't wanna leave a doctor's office until they had the little white prescription, even if it was for a vitamin or something, you know, that was their product.

Or the product is, uh, you know, them tapping on your leg or the cold touch of the, uh, stethoscope on your back or something. That's all the product. There's not a whole lot of places. And even like an attorney, your product is a stamped, you know, embossed, paper, with the, blue marker signature, nice dark black ink.

There's always products. Pretty much. There's not many things that don't have a product 

Kristin: Yeah, and I think we think of things as products, but really they're services because in the business world, If you were trying to sell your business, I think oftentimes the first question is, is are we buying a product or are we buying a [00:51:00] service based business? Because those are two very different things.

But to your point, a lot of things that are services might feel like products, and we can also package them to feel more like a product than a service.

Mike: Pharmacists always say we wish we could separate ourselves from the product we're not products, we're not products. It's like maybe instead of having that goal of separation, maybe be thankful there's some tangible thing, but then make sure you're selling a service with it instead of trying to be only service.

Cuz there's not many companies that do that.

Kristin: I love this. I love this so much because we have used it. The quantity of prescriptions we're filling has been the metric for decades, and we're at a point where that's over. It doesn't matter how many you're filling [00:52:00] anymore, and so while you're shifting away from caring about the number of prescriptions you fill, or really if you fill any, because if you're not making any money, then who cares if you're filling it right? While we're shifting away from that, figuring out how we can start packaging these services 

along with the prescriptions you are filling, because you can use that as a catalyst to these other areas of your business or to these other revenue streams that you might not have yet, but look at it as an opportunity.

every prescription that you fill, even if you might be losing money, It's an opportunity to sell that person who's already going to be coming to your facility. Something else, it's just up to you to figure out what that something else is. People ask me all the time, Well, how do I sell these tests? Like, how do I talk to somebody about a COVID test or flu or strep? And it's, I believe, I truly believe it is as [00:53:00] simple as having a conversation. Plant the seed. If you are running a sink program in your pharmacy, you're calling that person once a month, every single month, unless they're 90 days old.

So, okay, let's, let's say that's four times a year instead of 12, you're calling them about their sync medications. Why not slip in one line 

about a new service that you're offering? And if it's tests, it's as simple as, we just wanna let you know that if you're sick this winter, We do, um, a multitude of different tests.

Things like COVID, flu, strep, make sure you give us a call, we'll give you your results within an hour.

They might say, Oh, my grandma actually, she's sick right now. How do I make an appointment? You just never know what it can turn into. But using that product as an opportunity rather than something that's kind of holding you back, I think is huge because you can spin that client's hell that you already have into a number of other [00:54:00] opportunities that I think a lot of pharmacy owners don't realize.

They're already coming to you. They've already spent money with you, they already trust you, so what else can you help them with? And it doesn't have to be tested. I just happen to like testing. I've used testing very successfully, but it can be anything you want it to be. And sometimes I think more often than not, we need to take time alone as the owner of the business

and start to really think about what it is that we're doing. What are we doing? What are our goals? What do we want our life to look like? What do we want our business to be doing for the community? And work backwards from that, cuz you're not gonna get to that

Mike: No,

Kristin: overnight,

Mike: no, for sure.

Kristin: But that can be created in 1,000,001 different passions. [00:55:00] So however you wanna do it is up to you. But there's so much opportunity out 

there

Mike: Yeah.

Kristin: And I think a lot of it is really outside our tradition. Model and our traditional areas of expertise, like for example, email 

marketing is enormous. People make a ton of money by selling through email. But do pharmacists know about that?

 Not unless you stumbled upon it through your own business endeavors or unless you went searching for it. Or maybe you have a coach or a mentor who has said, you know, you really need to start collecting emails and how 

many 

pharmacy owners have been told that you need to start collecting emails without really understanding why though, and what that could actually do for a business.

And that's just one little example, kind of separate from the, I guess, service.

But anyway, I just feel. What you're saying is huge. Let's use the product [00:56:00] to, to help not only our business stay successful and thrive, but also continue to support the communities that we're serving.

Mike: Kristin, Golly. Good. Having y again. I love talking to you. We cover these little areas and we go so deep.

 but that just means we're gonna have to have you on over and over and over again. In the meantime, we're gonna put a link to your stuff in the show notes where people can go and see what all this is about, boy, keep doing what you're doing and I'm looking forward to having you on next time.

Kristin: Well, thank you so much for having me. You have this. Way of pulling stuff out that maybe I could do 

without, 

Mike: That people feel sorry afterwards.

Kristin: But it's been great as 

always. I'll see you in about 

eight months, 

Mike: All right, sounds good, Kristin. We'll talk to you soon.

Kristin: All right. Thank you.