Not your typical pharmacy

Mortar & Pesto in Red Deer, AB., is not your traditional pharmacy.  That’s because owner Jennifer Fookes is not your typical pharmacist.

The living wall of plants, which is made up primarily of herbs (that are custom blended into formulations), gives you a clue to what this place is really about.  So does the large and comfy client consultation room, which always has a fresh box of tissues for those times when things get emotional, as people open up to Jennifer about their health journey.

Missing from the shelves are OTC products normally found in a pharmacy, replaced by natural supplements, medicinal teas, essential oils, gluten-free baked goods, and elderberry syrup.  

Yes, there’s a big Pharmachoice banner on the exterior sign.  But don’t let that fool you.  Unlike many pharmacists, Jennifer is a proponent of natural remedies.  She spends a major portion of her time explaining the benefits of natural health solutions, while doing her best to gently steer people away from unnecessary use of pharma-based products.

A passion for natural products

Jennifer is a pharmacist with a passion for including natural health solutions as much as possible.  “I guess you could call me a holistic pharmacist,  but I most commonly call myself a functional medicine pharmacist.  This title is a good fit for what I do, because it is the discipline of improving the health of the body from a strong scientific position.”

Becoming a holistic pharmacist

How does one become a holistic pharmacist, a person with one foot in the pharma world, the other firmly in the natural realm?  Jennifer explains it was not an accident: it was always the plan.  

“My mother had pancreatic cancer when I was a teenager.  When we were told that conventional medicine could no longer help her, our family began a search for anything that could make a positive impact.   I learned a great deal about the power of natural medicine, and how it had been used by civilizations around the world for thousands of years.  And it inspired me to pursue a career in a related field.  

“With all I had learned, I wanted to put it into practice, in the most effective way possible.  I wanted to help people with their health, by incorporating natural options.  After considering everything, I thought the best way to do that was to become a pharmacist.  Initially, I considered becoming a medical doctor, but I thought being part of the current medical system might hamper my efforts and hinder what I wanted to accomplish.  The medical system is like an institution and includes at least 90 percent of all doctors and nurses.  It just felt to constrictive to me, for what I wanted to do.

 “And I also looked at being a naturopathic doctor.  However, I feel that to be a good naturopathic doctor, you should first become a medical doctor. This would have taken too long to accomplish.  As the mother of a young daughter, I needed to be in a position to get into the workforce and support her as quickly as possible.   It turns out becoming a pharmacist was the quickest route, plus – to me – it put me in the best position possible to help people.”

Owning her own pharmacy

Becoming a pharmacist gave her a legal standing to focus on natural health, but from a scientific position and point-of-view.  “Owning a pharmacy offered me that sound scientific foundation to go to a higher level as a trusted natural health advisor.”  Also, becoming a pharmacist opened the door for Jennifer’s entrepreneurial side.   “I believe in choice. Pharmacists can be entrepreneurs.  This gave me the freedom to try the things I wanted to try.  I wanted to be accessible to the public.”

In the store

Being the only pharmacist on staff pulls Jennifer in multiple directions, so she greatly relies on her staff.  “It’s important to be able to trust and invest in your staff.  It’s good for me, because pharmacy technicians can do roughly 80 per cent of what I do regarding prescription re-fills.  But it’s also good for them, so they can realize their potential and reach their full scope.”  

Jennifer’s system

Jennifer has a system in place to get off on the right foot and put clients at ease.  “From the start, I moved to what can best be described as a ‘client’ model rather than the ‘patient’ model most people are accustomed to.  From my experience, most of the people who come to our store have been in what I call ‘the medical system’  for a long time. They go see their doctor, they do everything they are told, and they really don’t question anything.  They’re not aware of the options available to them.  They get into the cycle of being on prescriptions.  The ‘patient’ model can really undermine them.  It takes away their autonomy. It implies dependency on the practitioner.”

With the ‘client’ model, she explains, they decide what they want.  “It’s a collaborative care model.  They access the knowledge base of the practitioner, but they choose what they are comfortable with.  This is an integrative practice.  They can see both sides of it.  I’ll use everything in my power to help them.”

Every client is different, says Jennifer.  “After explaining everything to them, some clients want all natural health solutions, but they may be required to still be on some meds.  With some clients, it’s the other way around: they prefer meds, but are willing to try natural.  We tell them, ‘Here are your options,’ we explain the best of both, and give them their choice.”

Most people aren’t used to this method of health care, she says.  “If they work with another pharmacist, they are a bit surprised with how we do it.  I guess it is a very rare type of practice.”

Referrals

The majority of Mortar & Pesto’s clients are referrals, often from current or previous clients.  But many come from family doctors and specialists, “because they know what we do here, and they know it’s the right path for many.   Our business is growing annually by between five and 10 per cent, based solely on these recommendations,  plus returning clients who we maybe haven’t seen in a while.

“It is rare for a kidney specialist to recommend one of their patients to go visit a health food store or even a natural health practitioner.   My advantage is doctors very much understand what pharmacists do.  We, of course, have the same medical ethic of ‘do no harm.’

“I’m not here to replace anyone:  I’m here to be a complementary component to care; to be a coach, to encourage people to take control of their own health and teach them to use things that will not run them into debt or misuse the wrong natural products.”

New client consults

For new clients, Jennifer says the first meetings are often about breaking down old beliefs and establishing trust with her.  “I would say that two-thirds of the people I see are almost too trusting.  They have been in the medical system for so long, they are used to giving up the power of decision.  They try and give me the power.  My number one job is to give them their power back, help them identify the questions they could be asking, and encouraging them to be a participant in their health again.  

“The other one third, they’ve done the same thing forever and they are skeptical about going outside their comfort level.  I have to build trust with them.  I say, yes… it can be confusing, but I want what’s best for you.  In my position, I can be both inside the system and outside of it.  I will say, ‘I sense that you feel the system has failed you…tell me about it,’  and that’s where the health journey really begins for many.

“If we follow the functional medicine process, we can have about three intensive consultations, and from that point, they will be able to make their own health decisions and not need me as much.”  

Jennifer has some clients who have seen her for the entire 10 years of her pharmacy career, and many come back after not having seen her for years.  

Natural as much as possible

When asked if she tries to incorporate as much natural as possible, Jennifer answers in an instant.  “Absolutely.  It’s a good thing.  During scheduled consults, some people get frustrated because I always loop back to lifestyle.  Even with over the counter pop-ins, I will give them a quick lesson on managing inflammation, and how it’s easy to fall into the habit of using OTC meds.  I will always recommend natural first, so they can try for themselves."

She reports her success ratio for switching people from meds to natural products is “very high.  Pretty much every person who leaves will at least change the fats in their diet and begin to question ingredients.  I always try and have them leave with a website to check out or a recipe to try.”    

There have even been cases where Jennifer has steered people completely off meds and totally onto natural products.  “I have had very good success in people with hypothyroid, menopause symptoms, insomnia, anxiety and depression, as well as autoimmune issues.  Autoimmune is huge, so I teach people about natural alternatives and help reduce and sometimes eliminate meds.”

In her first two years of operating the natural pharmacy, she has only had one client who was not receptive to the idea of holistic options being presented along side standard non-prescription drugs.  “It was a nurse.  She came in and wanted some Tylenol for minor pain.  I spoke with her about alternatives, but she was having none of it.  She seemed nervous to try something from a different format store. The sense was that natural medicine raised suspicion about our authenticity in the health sphere; it quickly was obvious she thought I was trying to sell her some snake oil.  But it’s extrememly rare to meet someone who isn't curious, if not already actively seeking a natural route.”

Product balance

Mortar & Pesto’s product balance proves it is not your traditional pharmacy.  “A traditional or typical pharmacy model is based on roughly 80 per cent pharmaceutical products, and 20 per cent ‘front store’ items, with natural products representing about one per cent of that 20.  At our store, we are 50 per cent pharmaceutical with the other 50 per cent of our offering as holistic and natural products.”

Pharmachoice

How does Pharmachoice feel about her focus on natural health solutions?  “One Pharmachoice executive came out to see the store, I think mostly out of curiosity.  After seeing what we are doing, he was blown away and left happy.  I think he realizes – as I do – that pharmacies have to diversify.  They need to be different.  It can’t always be about cutting margin.  The days of making lots of money by just dispensing drugs are gone.  You need to fill hundreds of prescriptions a day to make money, leaving your pharmacists run ragged and clients feeling that they just weren't given enough face to face time. A wellness based practice is actually better for everyone."

Pharmachoice is a banner or membership made up of independent pharmacists and pharmacies.  Jennifer says the best way to describe this is as a buying group.  “To me, the benefit of belonging is about getting price breaks while maintaining my full choice over the variety of products to carry. We don't have to carry any specific products.  However, you need to have a group to get fair prices on a variety of common items.   Pharmachoice negotiates the best prices and thus our clients and their insurance plans receive value. I could go out and negotiate on my own with the over the counter brands, but it wouldn’t help me.  I couldn’t get the same pricing on my own.  For me, it’s about buying pills at the same price big chains buy them for, so we can be competitive. In this economy and with the increasing competition, we must maintain fair prices.

“We have full control over what we carry; our product range is vast because of independent response to what our community wants for products and services."

Promotion

Even though the business grows each quarter, primarily based on referrals and former clients, Mortar & Pesto does promote itself.  The store sponsors the recipe page in a local community magazine.  Social media is a good forum, with the store utilizing conversational posts.  There is a lot of cross-promotion with local physiotherapists, chiropractors and dentists.  And that works.  “They send us people.  They see the effects of the meds on their clients and patients, and they send them to me primarily to help get them off meds.  So, I guess we have created a bit of a niche for ourselves.”

Speaking attracts customers

One of the most effective forms of promotion is when Jennifer gets out to speak.   “I get asked to speak regularly for banks, local businesses and organizations such as Central Alberta Lyme Society, Scotiabank and Proverus Chartered Accountants.  These health talks help promote wellness in the workplace and also to promote our business.

If I speak to a group of 10 people, you can count on three or four coming to our store and they often end up leaving with something, like tea and supplements. They may even request that their prescriptions be transferred to us.”

Store plans

Jennifer has short and long term plans for the store.  “We did want to expand and add more clinical people. We recently added a registered nurse with a broad background in healthcare in Canada and the US.  I could see opening more hybrid stores like this, or maybe partnering with health food stores that might be struggling as I think this model might do well in other communities.

“ I’d like to get our aquaponics going as well, as I want to have a sustainable way to offer fresh sprouts. It is in the plans to expand our lab facilities to create custom herbal tinctures as well.  A larger ambition is to attain B Corp status so while we strive to meet strict pharmacy guidelines, we’ll keep looking at how we can reduce our environmental footprint.

The old ‘medication for everything’ paradigm is running up against a population that is increasingly aware of alternatives and their preference for such, says Jennifer. “Medications are – in some cases – not as effective as they used to be.  For instance, we are running out of antibiotic solutions.  We don't even have drugs that will fight certain bacteria. You may have heard of "superbugs" for example. But natural products can often do things the pharmaceutical products can’t.  We’ve overused antibiotics and we can’t keep up with the mutations of bacteria that threaten human health. From resistant staph infections to the dreaded C. difficile, healthcare is becoming desperate for new, creative and effective treatments. 

“Pharmacies have to rethink their role, and I think what we are doing is headed in one possible right direction. At least our clients think so!”