Balancing retailing and education, USC's Rudolph drives pharmacy care

Drug Store News, August 18, 2003 by James Frederick

LOS ANGELES -- Retail pharmacy practice doesn't have to be drudgery or a constant source of stress. Just ask Mike Rudolph.

Rudolph is an affable, bearded pharmacy practitioner whose persona is equal parts breezy Southern California entrepreneur, highly focused educator and clinician and enthusiastic guru to a new generation of up-and-coming pharmacists energized by new possibilities in community pharmacy. Given his obvious zeal for breaking new ground in pharmacy care, his nose for business and his ability to juggle numerous roles as retailer and professional mentor, he could serve as a walking pharmacy recruitment poster.

"We hear a lot from pharmacists about how terrible this profession is. It doesn't have to be," asserted Rudolph, who has gained a reputation for innovation both as a successful independent pharmacy owner and as director of community pharmacy practice at the University of Southern California School of Pharmacy. "Pharmacy is fun again. You can have a passion for it."

Those are heady and even inspiring assertions, given the challenges facing the profession. But Rudolph has the credentials to back them up.

Besides owning and operating eight drug stores serviced by AmerisourceBergen's Good Neighbor Pharmacy program--with two more under construction--he also runs USC's two campus drug stores. Those stores generally are thronged with students and faculty, and hum with activity as doctorate of pharmacy candidates staff a busy dispensing area and counsel students in semi private cubicles.

Rudolph is bridging the gap between academia and retailing. He described USC's drug stores as an incubator and proving ground for pharmacy care initiatives. "It's a university setting, but it's a real-world pharmacy, where we're doing new disease management programs," Rudolph noted.

He and a team of faculty members, students, residents and clinically oriented pharmacists have developed disease management models in asthma, diabetes, hypertension, emergency contraception and even tuberculosis.

Some of those programs are funded by state or other agency health care budgets and operate as collaborative practice networks with physicians and clinics.

"This is where we see the future of pharmacy," Rudolph said. Most of the TB programs out there really don't work on getting patients through the compliance issues; they go off their medications. We've developed a program that's 95 percent compliance-effective."

Getting paid for patient care

Rudolph was named Bergen Brunswig's 2001 GNP Pharmacist of the Year--just prior to the merger of Bergen and AmeriSource--for his innovations and leadership in expanding the role of pharmacists in disease management. He and a colleague, Kathleen Johnson, Ph.D., an associate professor of pharmacy at USC, have spoken to numerous professional and business groups, including the National Association of Chain Drug Stores, about the role of pharmacists and new business opportunities inpatient care.

At USC, We have a team of people involved in community pharmacy activities," Johnson explained. "We're trying to change the practice, one student at a time."

Rudolph is putting that message to work by encouraging USC students to become clinical specialists and by drawing on their skills to turn his drug stores into clinical-care sites. He says his ability to attract pharmacy .residents and graduates to his stores has been a crucial factor in his success.

"I built my small chain of eight stores on relationship I developed from the school, he explained. Most of our pharmacists were either schoolmates or students of mine."

Rudolph's pharmacy model also works because the company has partnered effectively with state and local health initiatives and insurers to manage patient outcomes. "There is a place for disease management. You can do these things in community practice and make money," he asserted at his flagship store in Whittier, Calif. "We do it in all our stores, and we're starting to see some dollars come in from carriers for specific programs."

For instance, he said, "We get paid for emergency contraception services. Some of our stores do flu vaccinations fur a fee, and we also do asthma and diabetes management."

Thus, four of Rudolph's stores participated in a pharmacy care demonstration project with USC, Vons and Ralphs Supermarkets. The project, supported by AmerisourceBergen and Glaxo-SmithKline, involved 125,000 patients insured by Pacificare. Those patients were "compared to a control group to see the effect of pharmacists' interactions for asthma, diabetes and hypertension," Rudolph said. "We're publishing the results through USC."

Rudolph and Johnson also helped design a project and train several hundred California pharmacists to manage asthma patients on Medicaid for Blue Cross/Blue Shield. In a pilot test, that project reduced overall health costs a stunning 48 percent for patients in Fresno, Calif., Rudolph noted.

Rudolph credits his daughter Dana Porter for his pharmacists ability to juggle dispensing and clinical care. Porter, who recently joined her father as an adjunct assistant professor of pharmacy practice at USC, envisioned a system that ties pharmacy automation and POS procedures with back-end accounting and billing functions. The system also allows pharmacists to be out front with the patients, doing disease management and overseeing the operations," he said.