Seeking Refills: Aging Pharmacists Leave Drugstores Vacant in Rural America By Tim Markian Hawryluk Courtesy of Kaiser Health News Ted Billinger Jr. liked to joke that he would work until he died. That turned out to be prophetic. When Billinger died of a heart attack in 2019 at age 71, he was still running Teddy B’s, the pharmacy his father had started more than 65 years earlier in Cheyenne Wells, Colorado. With no other pharmacist to work at the store, prescriptions already counted out and sealed in bottles were suddenly locked away in a pharmacy that no one could enter. And Cheyenne Wells’ fewer than 800 residents were abruptly left without a drugstore. Pharmacies
were
once
routinely
bequeathed from one generation to the next, but, in interviews with more than a dozen pharmacists, many said the pressure of running an independent drugstore
Tom Davis, pharmacist and co-owner of Kiowa Drug, outside his store in Eads, Colorado. (Rachel Woolf for KHN)
has them pushing their offspring toward
the remaining drugs. Customers who had
might tell a patient, ‘We don’t have that
other careers. And when they search for a
dropped off their prescriptions before
in stock,’ or ‘Why don’t you go down the
buyer, they often find that attracting new
Billinger died were able to pick up their
street to the chain?’ But down here, we just
pharmacists, especially to rural settings, is
medications.
take care of our patients, and we just eat
difficult. With a large group of pharmacists
Davis
then
bought
the
pharmacy
it.”
nearing retirement age, more communities
from Billinger’s estate. He runs it as a
He can survive, he said, because, after
may lose their only drugstore.
convenience store and six days a week
48 years, he no longer has any business
delivers prescriptions to it from Eads, 44
debt.
“It’s going to be harder to attract people and to pay them,” said David Kreling, a
“I look at my bottom line,” Davis said.
miles away.
professor emeritus at the University of
“By the time you paid a pharmacist, the
“With the amount of profit that I had at the
Wisconsin-Madison School of Pharmacy.
location there was borderline unprofitable,”
end of the year, that would not have been
“If there’s not a generational thing where
Davis said.
enough if I was having to pay a mortgage.”
someone can sit down with their son or
He has received numerous requests to
Studies have found the number of
daughter and say that they could take
open pharmacies in other eastern Colorado
pharmacists nationally to be sufficient,
the store over, there’s a good chance that
towns, but making that work financially
even more than enough, to meet current
pharmacy will evaporate.”
would be difficult. Reimbursements from
needs, although supply and demand don’t
insurance
always line up. Finding pharmacists is more
Tom Davis, Billinger’s friend and co-
plans
have
dwindled,
and
owner of Kiowa Drug in Eads, Colorado,
customer bases have eroded as health
stepped in to sort out the mess in
insurers push patients toward mail-order
Cheyenne Wells. With permission from the
deliveries.
difficult in rural areas. “Once they get a taste of the big city,” Kreling said, “it’s hard to get them back to the farm.”
State Board of Pharmacy, the county sheriff
“I fill prescriptions every day where my
let Davis into Teddy B’s in the eastern
reimbursement is less than the cost of the
Workforce data also shows worrisome
Colorado town to take an inventory of
drug,” Davis said. “In other settings, you
trends. Concerns about a shortage of
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