Advancing The Profession of Pharmacy

Professor-turned-Pharmacy Owner Saves Payer MILLION$

by | Feb 24, 2016 | Big Picture Ideas

I want to thank Randy McDonough for sharing his thoughts on the future of MTM and clinical retail pharmacy.  He and his business partner Mike Deninger are on a quest to re-create the idea of good community pharmacy.

Randy McDonough is co-owner of Towncrest, Solon Towncrest, and Towncrest Compounding Pharmacies.  He is also co-founder/co-owner of Innovative Pharmacy Solutions.  He oversees Towncrest Pharmacy’s clinical services including MTM services, wellness screenings, immunizations, and adherence services.  He is responsible for development, implementation, and quality assurance for all aspects of the clinic and services.  He is board certified in geriatrics and as a pharmacotherapy specialist.

Randy has published and presented extensively on the subject of pharmaceutical care and MTM in the community pharmacy setting.  He currently writes a column for Pharmacy Today titled “MTM Pearls” Randy is a member of the American Pharmaceutical Association, National Community Pharmacists Association, American Society of Consultant Pharmacists, American College of Clinical Pharmacy, and the Iowa Pharmacists Association.

His areas of interest include community-based outcomes research, pharmaceutical education, diabetes education, disease state management, student development, and the development of patient care initiatives in the community pharmacy setting.  Recently Towncrest was studied by a large insurance payer and their data showed that over the course of a year their clinical interventions saved the payer $2.4 million dollars in healthcare costs.

Q: Hi Randy, thanks so much for agreeing to share your story with the Pharmapreneur Community.  So exactly how did you become so business savvy?

(Laughs) Well I wouldn’t really consider myself all that savvy, but I have been fortunate to work in many different areas.  The first opportunity came while I was a professor and I worked on developing practice models for community pharmacies.  We develop sustainable clinical services and practice models.

With that being said, my business partner, Mike Deninger, and I understand the importance of keeping our practice financially viable.  This means that we closely monitor our payroll, inventory, COGS, and revenue streams.  When we develop and implement a new clinical service, we determine all of our costs and come up with a price that is competitive yet profitable and calculate a breakeven analysis.  We truly believe that the future of community pharmacy practice is about patient clinical services and being fairly reimbursed for providing a higher level of care.

There are 5 key areas that contribute to our pharmacy’s success

  1. dispensing
  2. two clinical appointment style offices with pharmacy resident programs
  3. the sale of certain durable medical equipment and staff specific to the area
  4. group home contracts
  5. compounding

Q: How can we make clinical decisions cost effective?

As we discussed previously, any clinical service that we have developed and implemented has passed the profitability test (revenues surpass our costs).  But we also understand the importance of integrating our clinical services into our daily workflow.  We created a process called continuous medication monitoring (CMM) in which the pharmacists provides the prospective DUR services, identifies and resolves any drug therapy problems (on-the-run), and document their activities.  We do this for each and every patient encounter (new prescriptions, refills, drug information requests, etc.).  We also promote our services to patients during our encounter with them.

We have made this system work because we utilize our technicians to perform all of our technical activities, technology such as robots to fill medications, and workflow solutions to improve efficiencies in the dispensing process.  All of these efforts have freed up our pharmacists to provide clinical services for our patients and routinely make clinical interventions.

Q: What advice would you give pharmacists who want to innovate and become entrepreneurs?

Be patient, believe in yourself and what you want to accomplish and follow your dream.  Many people will not want you to challenge the “status-quo”, so you have to have a clear idea of the pharmacy you want to practice.  “Start at the end in mind” is great advice.  Essentially it means, come up with your ideal pharmacy practice then work backwards.  Find your niches and free up pharmacists to do more important work.

Q: Who inspires you?

Eugene White.  He was a pharmacist way ahead of his time.  Back in the 1960s he began experimenting with an office-based model in his community pharmacy.  He inspired me to challenge the system and create a new model for community pharmacists.

Again, I want to thank Randy for his work and for inspiring other pharmapreneurs as well.  I encourage you to check out his work on the APhA MTM Pearls column and follow Mike at The Thriving Pharmacist.

If you found this interview inspiring and would like to continue receiving posts from us, we invite you to join the Pharmapreneur Community Newsletter to receive helpful tips and ideas on how you can build a pharmacy consulting business in your area!

About the Author

Blair Thielemier, PharmD, is a business development consultant specializing in pharmacist-led billing models. She has set the industry standard for virtual pharmacy conferences with the Elevate Pharmacy Virtual Summit in 2017. She has consulted with national pharmacy organizations, drug wholesalers, point of sale companies, and Fortune 5 health insurers. She has books and online courses available for individuals looking to leverage their pharmacy knowledge into monetized clinical programs at She speaks internationally about trends in leveraging pharmacists to improve value-based care.


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