Carrboro Family Pharmacy Celebrates 25 Years

Dr. Keiko Bury answered questions about Carrboro Family Pharmacy (CFP), located in Carrboro Plaza and celebrating 25 years serving this community. Hear more about CFP in her WCOM 103.5 interview on The Carrborean Radio Hour.

CFP was the first independent pharmacy in Carrboro. What was the original vision for it in 2001? 

Ben Cutrell (everyone calls him Benny) was the original owner and he first opened the pharmacy as an alternative to get away from Kerr Drug where he was working at the time. He was working 12 hours shifts, saw a lack of customer service and didn’t like the pressure to upsell front end merchandise. He simply wanted a career that would allow him to be at home more with his family yet still be able to take care of patients and provide top notch customer service.    

How has it changed in the past 25 years? What hurdles has it overcome?

Pharmacy practice has changed SO MUCH since that time! In 2001, times were much simpler and pharmacies were able to operate with a predictable budget based on dispensing prescriptions alone: A prescription would come in, we would bill insurance for the medication and be paid the cost of the medication plus a reasonable dispensing fee that would cover the cost of supplies/labor/utilities/etc.

That model quickly went away around 2006 with the creation of Medicare Part D plans and the creation of Direct and Indirect Remuneration (DIR) Fees. These were hidden fees that we couldn’t see at the point of sale and “clawed back” in an unpredictable manner at the end of each quarter by pharmacy benefit managers (PBM). It was at this point retail pharmacies (independently owned and corporate chains) started disappearing. Since that time, we’ve been able to “crack the code” on tracking those fees and found a way to incorporate additional services to supplement our income outside of dispensing. The fact that we’ve been able to pivot and reinvent ourselves in a way that keeps our doors open to our community has been the biggest mountain we’ve been scaling (I wouldn’t say we’ve cleared it just yet!)

Independent pharmacies are becoming a rarity. To what do you attribute your longevity when so many small pharmacies have been absorbed by national chains?

I think Benny seeing the changes in the industry and having the trust in me as a newer generation of Pharmacist to have the energy to keep the business alive was the biggest thing. He just also happen to be at a point where he was ready to retire so the timing worked out perfectly for us making the transition. Unfortunately, I’ve known a lot of independent pharmacy owners over the years who have made the decision to close up and sell their files to a corporate chain and for them, they’ve just reached the point where they’re tired of the constant stress and dead ends from the initiatives they have tried.

New Pharmacist graduates don’t have the insight to take on the challenges of pharmacy ownership in this new landscape and furthermore, a lot of them don’t even have an interest in pursuing a career in community pharmacy anymore because of all the negative press.

I think part of our success is our location—we have a good mix of insured to uninsured/underinsured populations that helps us be able to provide care to most everyone who walks through our doors. Even more important than that was me having the courage to make a huge overhaul in the who we were conducting our pharmacy operations with. Just after COVID I decided to change our primary wholesaler and all of our third party contracts—even opting out of signing contracts with certain insurers because they were offering us unsustainable terms. It was risky and I stressed about it for months before I actually pulled the trigger, but it was by far the biggest positive impact on our bottom line.

How has the role of the pharmacist evolved in the last two decades? Are you doing more 'consulting' or 'wellness coaching' now than you were 20 years ago?

Pharmacists are able to do so much more today than we did 20 years ago and I think COVID taught everyone across the nation as well as here in North Carolina how important pharmacists are in the healthcare team. A lot of the clinics were closed during COVID and the hospitals were bombarded with critically ill patients, but our doors were still open for business. People found their way to us and didn’t need to make an appointment or pay a copay to talk to our pharmacists for first-line treatment options. People still had their baseline conditions that needed maintenance therapy during that time: hypertension, diabetes, epilepsy, etc. Those didn’t go away so we found ourselves offering blood pressure and blood glucose monitoring—essentially seeing patients in clinic and communicating therapy changes to their providers or refills.

Once we were able to acquire COVID vaccine, we were able to prescribe and administer vaccinations to everyone in our community as well as the treatment courses. Pharmacists stepped up to the plate and showed everyone that we can help our community and our provider colleagues in the name of patient care.

Today, I’m able to offer long acting injectable medication administration to people living in our community, prescribe hormonal contraceptives, prep, smoking cessation agents, epinephrine, prenatal vitamins, glucagon rescue therapies and Narcan as well as provide a wide array of vaccinations in addition to traditional prescription dispensing. In the works is designing our workflow to be able to offer test and treat services for flu so patients will be able to come to us to get tested and receive treatment for me and their family members with us instead of having to wait at an urgent care.      

What is one thing an independent pharmacy can provide that a big-box store simply can't?

CUSTOMER SERVICE! If you ask our huge influx of new patients, they would even tell you that we simply answer the phone when they call. It’s really sad!

Going further than that you get better continuity of care—we don’t have a huge turnover in staff and we don’t have a backup float pool, so if you talk to my technician manager one day, it’s likely you’ll see her in the store next several times you come in. With more frequent visits, we’ll probably get to know your face and learn about your family and have your order ready to go before you even say your last name. If your provider practices in our area, it’s likely we already have a great relationship with them and their staff and can get insurance issues resolved quickly or your medications changed to something more affordable/available if there is a shortage. All of our staff truly care about patient care and will go above and beyond to the depth they would for their own family. We have a really motivated, intelligent staff who are encouraged to put patients first. 

Are there specific local health trends or needs you've noticed emerging in Orange County over the last few years?

There’s been a big shift focusing on wellness and high end supplements so we’ve started carrying more practitioner-grade supplements to recommend and screen with prescription medications. With our staff being mostly female and having 3 female pharmacists on staff, I felt we were in a unique position to get the word out to local organizations about us carrying an affordable version of emergency contraception or even being able to prescribe maintenance contraceptive options to girls in our area who needed help or advice from a healthcare provider.

Unfortunately we’ve also seen the effects of the opioid epidemic in Orange County and noticed a need to be able to provide solutions to members of our community who have the courage to even walk in our doors to ask for help so we started a syringe service program initiative last summer with the help of our state level pharmacy association (North Carolina Association of Pharmacists or NCAP). We’re now able to provide an array of products free of charge and put people in touch with members of our local community through our state’s opioid settlement funding.     

As you celebrate 25 years, what are you most excited about for the next decade of the pharmacy?

I’m excited to see what our pharmacy will look like over the next decade. We’ve already experienced a bunch of growth over the last 7 years—our volume has doubled, our services have grown, we’ve added more staff and workstations behind the scenes. With every passing year, we find another influx of customers who are discovering us as an option outside of the corporate chain pharmacies and even mail order pharmacies! People now more than ever are yearning for a trustworthy source of information. There’s so much misinformation and social media influencers out there with questionable credentials, but our customers see our staff’s licenses and certifications on the wall right at the front register and can feel confident the person they’re talking to is in fact a licensed pharmacist.

I’m optimistic to see legislative changes that will help preserve independent pharmacies like ours and protect us from pharmacy benefit managers. I also see more opportunity for collaborations with other healthcare providers and health systems to provide the highest level of care for our community.   

If you could give one piece of health advice to the Carrboro community to carry them through the next 25 years, what would it be?

Learn to listen to your body and make time to do what makes you happy—whether that’s spending time with the people you love, devoting time to a hobby or simply taking a walk outside. I see so many ailments and chronic conditions that develop over time that all stem from a lack of prioritizing these 2 simple things. Yes, medications exist to help treat conditions and improve health outcomes, but they also have side effects that can be dangerous in combination with other medications, supplements and vitamins without supervision by a Pharmacist. People think Pharmacist’s are the ones pushing unnecessary prescriptions, but I personally celebrate being able to deprescribe medications!

Do you carry any local products on your shelves?

Yes! We partner with Frick’s Apiaries and sell honey from their Chapel Hill-based farm. Dogwood Acres used to be right down the road from us, but they’re now based out of Archer Lodge, NC and sell their honey when it’s in season. We just started carrying Chapel Hill Toffee products and have been offering Raleigh-based 1 in 6 snacks brand Carolina Kettle chips and snacks. Our front-end merchandiser also just discovered a Raleigh-based shop that makes custom stickers, they just created a new “Carr Bro” design just for us that’s been a big hit. I also buy a couple locally made pharmacist compounded products: Carolina Crud Crusher cough syrup out of Shallotte, NC and EndIt cream out of Chapel Hill, NC.  

Do you have "By the Numbers" stats, such as the number of prescriptions filled since 2001, number of staff members who have been there 10+ years (for example), etc.?

Oh wow! I don’t know an exact number of prescriptions filled, but if I had to guess based on a rough estimate of our usual fill volume, I’d say at least 1,200,000 prescriptions from 2001-2025.

Brennan Ragan, is our technician manager and the longest employee on staff. She’s been there since 2001 when Benny first opened the store. I’ve been there for 19 years, and Susan, our part time pharmacist has been there for about 10 years. The other staff were hired after I took over the pharmacy in 2019.