Wendy 00:00

Hello, everyone. I'm Wendy Liebmann, CEO and Chief Shopper at WSL Strategic Retail. And this is Future Shop. This is where I talk to innovators, disruptors and iconoclasts about the future of retail. My guest today is Michael, also Mike Wysong. He is the Chief Executive Officer for Care Pharmacies with 140 locations around the US, 13th largest drug chain in the United States that you may not have heard of, but you will soon. Mike has lots of experience in the health and healthcare space… Cardinal Health, Amerisource Bergen, BaxterHealthcare. He recently served as Chairman of the Board of NACDS, where he and I first met and he has a very unique point of view on the store on the corner, as I call it, and what all that means to us in this new age. So welcome Mike to Future Shop.

Michael 01:06

Thank you, Wendy. It's a pleasure to be here with you. I can tell you, when you and I met all the way back in 2020 it was always a goal of mine to spend an afternoon with you here on your podcast. So I guess I can cross that one off my list. Thank you for having me.

Wendy 01:21

No, I'm delighted. You know, one of the things that struck me over the last in our continuing conversations is when I think about healthcare and healthcare retail, and I think about lots of the conversations that are going on about pharmacies and the challenges around profitability and healthcare delivery, and how many stores are too many stores, and all of these sort of big, massive issues, I think a lot about your point of view, and this reflection of independent pharmacies, the work you do at Care, which is part of the reason I want to have you on here as we think about What the future of retail really looks like. So tell us a bit about Care and what that is, and what you do there, and then we'll just keep jumping into this conversation.

Michael 02:11

Yeah, and I it's, it's really interesting. So care will be 65 years old this year. It's kind of hard to believe that, and I always laugh, because it's when I, when I travel around, people have either heard of it or they haven't. It's kind of what you alluded to earlier. It's kind of a great kept secret. But when I took over in Care back in 2010 one of the things I wanted to do was to do a deep dive into the history of the organization and really understand it. When I dug into the history of care, what I realized is it started back in Maryland and the Virginia corridor, there were a handful of independent community pharmacies that got together and decided that there was commonality in their purpose, but they would be best served by working in good faith together in the service of something larger than themselves. And so they looked at that and said, “We have expertise clinically. If we build out upon that by creating economies of scale, then we might be able to procure our drugs better, and we might ultimately be able to serve our customers better”. And so over a period of time, Care began to scale the owners decided that a pharmacy franchise would be best served in terms of having the continuity of care. And so really, that was the first genesis of, hey, we want to have an organization that is structured like a drug chain, but has the intimacy of care that resides within community based care providers. So when I came in, that's really what I wanted to build upon.

Wendy 03:43

It's interesting what you say there, because, you know, growing up in the bush in Australia, that's what I grew up with, right? I grew up with the independent local pharmacy, Learmonts on the corner of Commissioner Street, very much focused around knowing the local community, their lives, their families, their dogs, their cats, when I think about independent pharmacies at large, in the US. I think about that intimacy that people and we see in all our How America Shops® research, that people continue to look for in any kind of retail so that that, that notion of intimacy that you raised, I think, is very powerful, you so. So when you look at Care today, 25 states, 140 locations, do they look like each other, or they’re individual pharmacies that just behind the scenes are like each other?

Michael 04:40

Yeah, yeah. So the 140 pharmacies are all inherently and uniquely different. They are operating in every single class of trade, from traditional retail pharmacies to, you know, specialty light, mail order, specialty home infusion, hospice. There's a growing hospice business, rare orphan drug. And so I say, you know, one of the uniquenesses of the organization is how different the providers, providers are that comprise Care. The challenge of that is to your point, and you and I share a lot of similarities in this. You have to make sure that you really understand what each of those entities needs in terms of being able to service their individual customers, and I think we've done a pretty good job of that so, but you can't lose that. I think that's like I said. I think that's what makes Care special in the spaces that it's operating as the ability to stay connected to its customers, understand what they need, so that they, in turn, can provide the same level of connection and authenticity to their customers.

Wendy 05:28

When I think about that and what you just said, I think a lot about, within that context, the difference in things like the big box chains the Walmarts, the Targets, the Krogers, versus the regional retailers, whether it's in drug or food or, that opportunity that a local retailer, a more regional retailer, has in building the connection and understanding in the community. And I see some of the big boxes really trying to become more localized, but that is a challenge right on both sides of that.

Michael 06:05

Yeah, I think so. I mean to me, you know, I know you know this. I have seven kids. Many of them are in college and grad school and in different places around the country, and they all gravitate to different colleges for different reasons. Some go to big colleges. Some go to liberal art college, all colleges. So I think each of the providers that comprise our space, the national chains, the regional chains, crossover organizations like Care Pharmacies, that you could argue are a bit of both of those things, right? A regional chain and a community based, you know, more community based pharmacy group. They all have uniquenesses. They all have strengths that they can bring to bear in the service of their customers. You know, the question just is, is, how do you do that? How do you apply that? You knew, you know that from your from the work you do at WSL, with all the suppliers that you work with, all the consumer product groups, they're different products with different visions on round how they want to bring those products to market. And your job is to help them make sure that they build an authentic, trusting relationship with the consumer, so that the consumer wants to continue to vote for them, you know, in bigger and better ways. And so I say it's not so much what you are, but why you what you do, and how you apply that and the strategy to that, and how do you do that in a way that's really beneficial for the people that you're doing that on behalf of

Wendy 07:24

Yeah, that's that's one of the things you raised, this issue of trust, or this topic of trust, one of the things that we've been seeing a lot in our research over the last several years, particularly as it relates to the pharmacy, is not that people don't trust the pharmacist to deliver prescriptions. Deliver, you know, vaccinations make, you know, call the healthcare company whatever it is to sort out medical bills stuff. But where there's this massive gap is in being trusted to deliver information, health information that I need as a consumer, patient, shoppe. r, caregiver, fill in the blanks, to take care of me and my family, and I often have that conversation. You can see retailers go, What do you mean? The pharmacist isn't trusted? Look at our ratings, and we say, no, no, no, it's not that they don't trust them to deliver the care. What they're not they're what they are saying is they don't trust them because they don't have, you know, they don't have time to give the kind of information I want to guide my some trips to the pharmacy, right? Not all of them. So how do you see that within the context of of the Care the diverse care network, is, is it easier? Is it harder?

Michael 08:44

So I think, I think you bring up a great point, which is, okay, you know, where operating pharmacy is just one stakeholder in healthcare. From my position, having lived through Covid and some of these other things, the pharmacy really is the backbone of the healthcare system, right? And that's not meant to denigrate or disparage physicians or manufacturers or wholesalers, or, you know, anybody else. But you know, I think when you add on the complexity and how non-synchronous the system is today, and how dynamic it is, and then you throw on politics on top of it, man, it makes finding the truth is pretty hard. I think one of the innate gifts of pharmacy is that it is inherently a trusted profession. People will come in and seek counsel from their pharmacists, whether it's at a Walgreens or a Care. I think intrinsically that trust resides, and so that's why I say I think the pharmacist really is the quarterback of the process. When I look at Care, I'm probably a little more myopic and deliberate. I'm trying to make sure that my stores understand the role that Care plays on their behalf by making sure that. That the products are accessible at a reasonable price, that the back-end programs and services are meaningful for them in terms of helping them concentrate and focus on the things that matter most, which is taking care of their customers and their patients. So I think you're able to establish that authenticity across a drug chain of many different classes of trade I think are growth over a long period of time, is a testament to that being a fact.

Wendy 10:28

I sometimes like to disagree with you on things, but I certainly would not disagree with you on that notion of the of the value of the pharmacist as a trusted purveyor of keeping people's keeping people's family healthy. And I absolutely agree that, with all the challenges of Covid and all the things we're learning on an ongoing basis, that you know, where do I go? I go to the place on the corner where I can be served. There we were just presenting some of our latest How America Shops® research on health. And again, this it was, it was this combination of the gap, again, healthy information. But the other piece was all the places people today will go for information on health, the doctor, the nurse, the pharmacist, the dentist, dermatologist, whatever. Then we have all the alternatives, you know, the the acupuncturist, the physical therapist, and then we got all the the other places, everything from Reddit to Tiktok, right? or it's a it's an urgency, or whatever it is, but people who we say, have no time, and we're all living under these incredibly stressed conditions, are still on that journey to find better, more appropriate information on our health and wellness, which seems to be like a massive opportunity to solve for. So I don't know, what do you see in that space now?,

Michael 11:57

It’s an interesting dichotomy to say the least, right? When we haven't. We just kind of talked about some of the foundational elements there, but we didn't talk about the innovation and what's happening there. You know, some of the digital things that are happening, artificial intelligence. I mean, it's, it's, it's pretty impressive. What you're seeing there, my sense of it is, is that we're really at a kicking off point and an expansion of that. And what do I really mean by that? What I mean is, is that when you look at consumers and you look at patients, some of them are very tech savvy, some of them are eager and anxious to connect in that way. It's like my kids, you know, will sit on the couch and they'll text me two feet away, instead of, like, talking today. So I think you have to be able to serve all of the patients and all of the consumers based on how they want to communicate and where they're struggling to reside. And I think that spectrum is getting wider and broader as the technology just continues to take off at the lightning pace. What I don't think is going to change is back to the intimacy component of that. Can you connect with your customer in the places that they want to connect and then communicate with them in a manner in which they want to communicate? We've had some success at that because of the diversity that resides within our drug chain. We're not perfect at it, we've gotten better at that, because the needs of a traditional pharmacy are going to be inherently different than than somebody that's practicing in oncology. So I think, I think it's just putting the the spectrum. It's widening that out at a blistering speed, and you have to be able to account for that, otherwise you run the risk of not being able to connect or communicate with happy customers.

Wendy 13:46

I mean, that's just good basic know who the customer is, right? I mean, we know there are the people who walk in. They take their script, they want to leave, they don't care. Don't bother me. Yes, I sign the thing. I'm fine. Maybe that same person comes in with some totally unrelated question about so that ability to know both who is that customer at that time, and what trip are they on, and who are those other people who are in line waiting to, you know, get their script filled or ask quick, whatever. Does AI and all of these new digital tools, is that helping already? Does that support some of the work that the Care Pharmacies are doing? or you're doing as an organization to support them?

Michael 14:32

I think it's helping us in places, we have one of our pharmacies, it's called Carry RX, two very talented and bright owners down there that are heavily engaged in artificial intelligence, and, you know, entrepreneurs really focused in on the digitalization of healthcare. I think that's likely where we're going to see this, really, on the back end, in terms of some of the clinical benefits of that. And I think that will mature. And again. My earlier point, I continue to take off at a rate that it's probably even tough for me to put my arms around in time, in terms, you know, in terms of where that's really going to go, or what the, what the true impact of that will be over the next, you know, over the next decade. Um, there's definitely a place for it. I think you've got major retailers today that have invested heavily in that, because it's going to make everybody more efficient and more effective as these new, you know, models of care take place, and they're definitely in the process of taking place. My brain is interesting in this regard, because, as it is, as advanced as everything gets in this huge taking off, it's almost like it's not up and down, it's round and round again. And the things that, even the new things that innovation will bring, will bring you back to that intimacy and authenticity that's reside with connecting with customers in places that make it easier for them to connect and communicate. So I think the more advanced it gets, the more elementary the focus gets. Yeah,

Wendy 15:58

I do think about a lot of the latest technological innovations in general, and in healthcare. You know, in terms of use of AI, on the one hand, it's, it can save me money as a company, if I, you know, if I can robotize the things I'm doing, the processes, I'm doing, the analytics, I'm doing all of that, and theoretically, to free me up, or as long as I don't lose sight of who I'm ultimately trying to sell stuff to that or build a relationship with, to be not so crass. So those two pieces to it. I mean, sometimes there is that tendency, if I'm being my cynical self, to say, Oh, great, we can save a lot of money there, and so what? But if you to your point, come back the full circle and keep that level of intimacy in mind, who am I trying to serve and how better am I trying to serve them? I think that's a very interesting, I mean, to think about that for those people who don't know Mike as a painter. So now I'm already thinking in these virtual an artist, not a paint. He's not painting houses. Well, he might do that too, but he he's an artist. So I do think in visual context. So the other thing that intrigues me about the diversity of Care the Care organization is, is there opportunity to learn from the different because you have different formats, you know, specialty medicine, is there an opportunity to share that learning across the organization, formally or informally? Is that how that works?

Michael 17:26

When you pull Care apart, you know, Care Pharmacies apart, you look at the overlying or underlying trends, our models are moving to more high touch care, providing models, okay? Specialty Pharmacy, really, coordinated care, more point of care, testing, higher touch points as you move down these models, we're already in that so the people that are venturing down that way, either deliberately or through the transitions of care, we're already there, which means we can coach those folks up, the folks that are already there need the folks that are in the traditional models, because those two things are symbiotic. They have to exist collectively. And so, yes, we were benefited through the entire continuum of care, we can show you how to maneuver through those transitions of care, and to do it without making a lot of mistakes. And when you do that, it's favorable for the customers. We also do that in the relationships that we have with our other drug chain partners. They're operating different models. You know, companies like HEB, they're a wonderful provider, Thrifty White, Kinney Drug, Lewis Drug, I mean, these are companies that have been around for a long time, that are very good at what they do. They're different models, but there's lessons to be learned in terms of how they go to market and how they serve their customers as well. Yeah,

Wendy 18:51

this, this will, dare I say, age me, but I do remember when I first came here and got involved in the industry, it was that shared learning that I found so intriguing, before people became more competitive, or before you had big national change, and that collaboration and learning, I always found so fascinating. You've played an interesting role, and as Chairman of NACDS, where your mandate was across all kinds of retail in that space. It seems to me like the big national chains within their own organizations have the opportunity to learn from themselves, but I often wonder about the need to create a more sort of homogenized whatever it is, you know, one size fits all thingy, that that means they lose out on that learning from the rural opportunity down here to the urban opportunity up there. Do you am I?

Michael 19:52

Yeah, no, I totally understand. I totally understand. And it's the whole, it's back to that, you know, what is your path for? You're a national chain, right? You're going to want to take advantage of the infrastructure that you have, personalize that when people walk in one of your 4500 pharmacies. If your Care pharmacies, and you have 140 pharmacies, you want to scale the intimacy that resides in your 140 pharmacies to 4500 pharmacies, and so it's either a bottom up approach or a top down approach. Both of them are noble, you know, efforts. It's just okay, what, which? What's end of that are you on? And what mandate are you trying to accomplish? So I think we've been fortunate to build that through, you know, a lot of the work we did back in 2010 when I had 40 stores, really focused in on the HIV business here in DC, and we're able to kind of scale the book from there.

Wendy 20:52

And now, as I look at things like a lot of the new products and services that are merging, I mean, the top topic of the moment, you know, something like GLP-1s, and for the the financial challenges that both consumers, patients and the pharmacy has in terms of let reimbursement and things, the cost and then the reimbursement. But that's a that's a massive opportunity in terms of health care. How are you seeing that play out when you look at your 140 partners in this journey.

Michael 21:25:34

So again, the GLP-1drugs are what I call, you know, the specialty problem at retail. So when the specialty business began to really scale with the Hep C drugs, on the heels of the HIV drugs and the RA drugs, they fundamentally changed the book of business, not just in terms of the cost of the medications, but what that did in terms of procurement, the incentives, reimbursement, and so the GLP -1category really has brought that same problem to retail. So we had to accommodate for that many, many years ago, in our own classifications, you're going to see more of this, right? So GLP-1drugs really underscore a number of important topics. So the first is, it's a huge classification. I think I saw somewhere that Ozempic and Humera, that those two branded drugs now account for more sales than all the base generic drugs on the market. The GLP-1 phenomenon isn't going to be an isolated phenomenon. When you look at what's happening, there's going to be another version of that. Can't tell you when, but at some point and in the future, you're going to have, you know, deal with this again. It also underscores the pressure that pharmacy is under today, from a procurement and reimbursement perspective, that is the major challenge confronting our industry today, regardless of whether you're a national chain or a regional chain or an independent buying group. So I think those are things that will all sort themselves out here. I'm very optimistic about that in in the not too distant future. But to me, the GLP-1 drugs are really just emblematic of the dynamic nature of what's happening in pharmacy today, and you can see it therapeutic benefit aside.

Wendy 23:14

The other thing that I know you have been involved in, and we've had some discussions around, is, is opportunities with segments of shoppers, however patients, however we think about them, and the work you've done with AARP and testing models around Care caregivers, and that opportunity we've just seen in our latest research again, you know this sort of notion of people who help people out, don't want to be called caregivers, but are giving care. They're picking up prescriptions. They're helping people with their visits to the doctor, their, you know, groceries, all of those kinds of things. And then there are the people who literally are caregivers. And the solutions that either retailers not providing beyond, yeah, here's the prescription or here, use this with this. But the solutions, in terms of her, are all the things you might want or need, or whatever. I find that really intriguing in the in the Care model, because for us, we have one of our virtual Safaris® that we're doing where we're sharing some of these new online services that are coming through companies, organizations like Carewell and things. So anyway, the long and long to that question is that segment of shoppers, growing segment of shoppers who are helping take care of other people, how do you see that play out? Yeah. How do you see that play out? Yeah, how do you see that play out in the in the in the work you do at Care, with the Care Pharmacies.

Michael 24:41

I think it's when, when I first met the folks from AARP, and we were sitting there, and I learned more about what their main mandate was and what they were trying to accomplish. I went in, the caregiving population at home is a booming population like I had no appreciation for. That until I started to dig into it, and then I went, you know, “food is medicine” is a noble is a noble initiative. Want to address some of these systemic issues driving these unrelated, you know, these unsustainable costs. But we have a growing number of people from the baby boom generation that are going to need care, and many of them either don't have access or can't afford the medications between somebody he's going to be taking care of these folks at home. I thought, man, there was ever a high touch care model, that's it, and it is literally trying to meet a consumer or a customer where they reside, which is at home. So we've partnered with AARP to begin to pilot some programs, mostly educational at this point around trying to make sure that the caregivers are at home, have the have the information that they need to appropriately care for the people that they're overseeing, and then to begin to put together some product offerings and to work with manufacturers to help make sure that those products are accessible and affordable and effective In helping the caregiver, you know, provide that care. So, like I said, I'm very excited about that. I think that's one of these kind of, like, unrecognized opportunities. And I don't think that'll probably be the case much longer, but it really is going to be an emerging need.

Wendy 26:16

Yeah, it is interesting, right? when we're when so many are talking about, oh, we need to think about, you know, more volume, not just dollar volume, but more trips, more items, you know, all of those things. And I sometimes look around and I think there is this massive opportunity sitting right there. And it is, you know, caregivers, who are younger caregivers, who are older caregivers, who are squeezed in the middle, affordability, accessibility, all of those things. And sometimes, I think, takes us a bit and a lot of nagging on the part of people like me and you, to say, who you who you, who is an opportunity, right for support?

Michael 26:52

Well, it's there. It's almost so obvious you don't even know that it's there. It's there in plain sight. And I, and candidly, I didn't know, I didn't fully appreciate it, until I, you know, started talking to to the folks at AARP, and Reema [Jweied-Guegel] and really got a better understanding. I mean, I know she was a guest on your podcast. It was informative. And so I think it's a great opportunity for us, and not just care, but other providers like here, to jump in and help address that, that issue. Yeah,

Wendy 27:18

I was really struck a number of years ago. We did a in person, live focus group for one of our retail clients, and we brought real people into the into the conference room, and one of them always reminded me of this. She was, you know, maybe 20. She was studying at a community college. She was actually then taking care of her grandmother in terms of getting prescriptions, picking those things up for her, making sure she had a medic, you know, her associated products. And it was the first time she was talking about really using digital, using her phone, you know, getting, ordering the prescription in advance, all of the information she got for her grandmother. And you realize that this was not, you know, an older person taking care of their parent. This was a younger person taking care of their grandparent, and the tools she was using were very different from all the others. So where, where technology and innovation bring something different to this opportunity. So when you were talking about digital and technology, I was that reminded me of that example too. So just as a last, what you and I could talk forever, as we often do, but you know, what do you. What do you see coming up the road? What do you see as the opportunities for both healthcare, but also smaller format retailers on the corner. What do you what do you see there? What are you excited about in the in the space? So,

Michael 28:45

So so my my optimism is really around knowing where the model is today and where it's likely going to go. Like I said, we have the benefit, I have the good fortune of presiding over a drug chain of community pharmacies practicing in every aspect of pharmacy. I have the benefit of working at NACDS, which is a lovely organization comprised of national drug chains, regional chains and small four store chains. We have the benefit of working alongside NCPA, which comprises all of the independent community pharmacies and so and our proximity to DC means that we're benefited by our ability to lobby and legislate and know what's going on in the halls of our government at all levels, because it gives you a comprehensive understanding of where things are and where things are likely going to move. My sense is, is that the reimbursement challenges that are confronting pharmacy will likely subside in the near term. That's my hope. You're beginning to see the impact on that, on some of these smaller providers and independent pharmacies and places of high need. My hope is, is that the legislation required to keep that from happening, we. Happen in due time. The fragmentation you mentioned before, my hope is, is that all of these pieces, at some point, will be harmoniously put together. The incentives will be aligned between doctors and pharmacies and insurance companies and manufacturers and wholesalers. Enough. It won't be perfect, but it can be better than it is today. Can be better orchestrated today, and if it's that way, then the real beneficiary of that is the patient, which is what all that was set up for in the first place. So I'm optimistic. I think that's what is likely going to happen.

Wendy 30:41

I must say, I think a lot about keeping the customer, patient, shopper, in the center of things, and taking all the new technologies that come that will help us serve better because clearly that's a massive opportunity. So I love your optimism around all of this. Thank you about your vision of the future.

Michael 31:01

As always, I appreciate that, and I just want to let you know I remember back to 2020 It was February of 2020 the first time I had a chance to meet you and spend some time with you. I had recently found out I was going to chair the Regional Chain Conference for NACDS, and when I inquired about who I was going to be speaking with, they told me it was you, and so I went online to get your background, and I picked up an article, and they described you. Do you know how they described you? They described you as having an Australian earthiness, a fantastic storyteller and an a visionary in retail, and I will tell you, after the four and a half years that I've known you, that is a statement of fact and not an accusation Wendy.

Wendy 31:52

That's very kind and a lovely way to end this and force me to think about the future continuously.

Michael 31:58

Thank you for having me. It was a pleasure to spend the time with you.

Wendy 00:00

So here's the thing, I know we talked a lot about, sort of the some of the big issues impacting pharmacy, things like reimbursement, all of that, but, but the essence of what Mike really talked about was the essence of good retail, right? It is learning from the diversity. It is the ability to keep the, dare I say, the shopper, the patient, the customer in the center of it all, it is using technology to enhance that relationship, not just enhance your efficiency and profitability. That whole focus around, how do we create in our retail relationships a level of intimacy so that we understand not only who we are serving as brands and retailers, but also that in all the new technologies, innovations, products, that we remember that as we go, not wanting to play mother to all of this, but that whole notion of transitioning into the next 2,3,4,5, years with a level of optimism. As Mike said, sometimes, you know, when things get more and more complex, we have to get narrower and narrower and deeper and deeper. And I think the clue to all of that is that ability to stay very engaged with who we are serving, whether we're a grocery retailer, a big box, a fashion retailer, a healthcare retailer and beauty retailer, any other kind, because within all that complexity, that's the ability to maintain our true north. So with all that said, the future is at hand. Look forward to seeing you again in the future. Cheers for now.