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While most small pharmacies are struggling, the Lucas family embraces its motto, ‘Our Family Helping Yours’ to thrive.
When the Lucas family mentions “pharmacy,” it is often spelled “Pharmily.” It could not be otherwise, since Mom, Dad and two of their four children are directly involved from a career standpoint and the other two occasionally work at the family’s DownHome Pharmacy in Botetourt County.
It all began in college at what is now Virginia Commonwealth University when Tim and Allison Lucas met in 1990, fell in love, and married in 1994. They then pursued what would become the family career. Recently, 24-year-old daughter, Kayla, finished pharmacy school at—where else? —VCU and the family is working out a partnership deal for her. Ultimately, she wants to own her own pharmacy.
Younger brother Keaton, 16, is strongly considering a pharmacy career, says Allison, “but he hasn’t started working here yet. He will, once he can drive.” Kendall, 21, and Kylee, 17, are tech trainees at DownHome, but “they want to help out, not make a career” in pharmacy, Allison says.
The kids, she says, represent “a plan for our retirement.” She smiles.
Initially, Tim went to work for a big box retailer with a pharmacy, says Allison, “but he became frustrated, wanting to do new and innovative things.” So, “we ventured out on our own in October of 2001,” founding DownHome Pharmacy.
Allison takes part in filling prescriptions, but also is the bookkeeper, “bill chaser and insurance” chief. “I need control over it.”
Insurance and billing, at any pharmacy, have become the largest headache, says Tim. He has been president of the Virginia Pharmacists Association and is now the president of the Roanoke Valley Pharmacists Association, so he knows the issues inside-out. He says that often the demise of small pharmacies can be traced to those two issues and they cause major headaches even for the big box pharmacies.
But those are only two of the challenges facing the industry in the time of COVID, when pharmacists have been especially active—and in short supply. “Pharmacists are the most accessible health care professionals at a time of growing health care needs,” says Tim. “We fill prescriptions, administer vaccines, but we also offer advice—sometimes to physicians— and bills in the General Assembly will help us to increase our activity. It is great for patients if they have access to a professional in less intense forms of care.”
Physicians have not always been fully accepting of pharmacists’ help, says Tim, but that has changed in recent years, especially now that pharmacists are required to have doctorates in pharmacy. “Newer [physicians] often do rounds with pharmacists and doctors ask our advice about medicines,” he says.
But sometimes the pressure and stress “can be overwhelming” because pharmacists “are stepping into aging populations, but we don’t get paid for our advice. Doctors turn in insurance bills for their time and are paid for medication review, but pharmacists are not. We are continuing to fight for provider status.”
The number of independent pharmacies “is dwindling,” says Tim, “and the ones left are struggling with arbitrary fees from insurance companies, responding to government guidelines and seeing poor reimbursement rates and ‘lack of performance’ fees on standards that are impossible to reach 100% [compliance].”
Small, independent pharmacies—like small, independent hardware stores—have buying cooperatives that allow them to be competitive in pricing with the CVSes, Walgreens, Krogers and Walmarts, says Tim. But insurance companies continue to steer prescriptions to the chains or mail order pharmacies
But at DownHome, it is not just counting and dispensing pills. Sometimes, it is creating them. Kayla “literally grew up” behind the counter at DownHome, she says. It started with compounding prescriptions, something very few pharmacies of any size still do, but representing the creative part of the business. “When Dad gets interns, he always starts with compounding; it is time-consuming but also very rewarding to meet a patient’s need,” she says.
There is a real family feel at DownHome Pharmacy, which recently moved into a new building of its own. Watching the Lucases in action for 30 minutes or so tells you all you need to know: This is a family business in the strictest sense.
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