American Druggist, January 1998

Cover Story
SEEING GREEN IN A NATURAL APPROACH

DAN WAGNER HAS BUILT A NEW KIND OF PHARMACY FOCUSING ON HERBAL PRODUCTS AND OTHER NATURAL REMEDIES. WHY?
By Michael Slezak

Dan Wagner was sitting on a beach in Costa Rica, contemplating the direction of his life. It was the summer of 1996, and Wagner was debating whether to sell his independent retail pharmacy to Revco in favor of opening a new "natural" pharmacy. Then, it happened.

Wagner looked up into the sky and saw a sign -- the clouds above him seemed to magically come together and spell out "S-E-L-L." As Wagner recalls it, that's when he made his decision.

By January 1997, Wagner had sold his retail practice (located in a Pittsburgh suburb) and began laying the groundwork for Nutri-Farmacy, Wildwood, PA, a business he founded last April which forsakes traditional Rx dispensing in favor of vitamins, herbs and nutritional supplements. (Wagner still operates a traditional institutional pharmacy, Med-Pharm, from Nutri-Farmacy's basement.) The new concept has been well received by patients, reports Wagner. He estimates his first year gross sales for Nutri-Farmacy will be around $250,000 to $300,000. "I'm still concerned about profitability," he says. "But the amount of repeat business is encouraging. Each month business is up 7% to 8%." Many customers spend $50 to $100 per visit buying herbal and nutritional products. Wagner adds Nutri-Farmacy has drawn customers from all over Pittsburgh and even from parts of Ohio.

Even more surprising to Wagner, half of his patients are age 50 or over, whereas he anticipated attracting a high percentage of younger baby boomers. "Older patients are very much open to herbal and natural remedies," he says. "They're sick of taking meds and upset with managed care policies that restrict them from going to the pharmacy of their choice."

That Wagner received his "sign" to proceed with Nutri-Farmacy during a visit to the rain forests of Costa Rica seems fitting. A lifelong environmentalist, Wagner first visited the rain forest with the group Pharmacy From the Rain Forest in 1994, and has made a number of visits since, both with the group and independently. On those trips, Wagner met with Central and South American shamans and studied the medicinal value of indigenous plants, turning his passing interest in natural remedies into an exciting new practice focus.

Wagner's discovery of natural remedies coincided with his increasing frustration with growing managed care pressures on his traditional retail pharmacy practice. "I knew it was time to move on. I felt that opening a natural pharmacy was the right thing to do, and my experiences in the third-world and the rain forest convinced me," he explains.

Wagner's final decision wasn't based solely on cursive cumulous clouds. He also began building his knowledge base reading books about herbs and natural remedies, travelling to seminars and conferences on complementary medicines and working with the American Botanical Council. Wagner says the growing body of evidence supporting herbal therapies convinced him that for many conditions, these natural products can be safer than-and at least as effective as pharmaceuticals.

Today, Wagner is using his practice at his 1,100-square-foot Nutri-Farmacy to fill what he calls an information void for patients seeking to incorporate complementary therapies with Western medicine. "People are going into the health food stores, buying herbs and related products with no professional intervention. They're not getting their questions answered. They may be on prescription medications that can interact with herbs," says Wagner.

"Pharmacists and doctors aren't taught about vitamins, herbs and nutrition in school. Chiropractors and other alternative practitioners don't know [Western] pharmaceuticals that well. As a pharmacist who educated myself in the area of natural pharmacy, I'm in a perfect position to fill this role," Wagner says.

A computerized database of herbal information is essential, too, says Wagner. "No one can know about every single herb, how they are used and every interaction. But with that knowledge right there on the computer, pharmacists can weigh the benefits of herbs versus the dangers," he says. Wagner has two herbal databases: Health Notes, Seattle, and SDI Systems, Dallas, TX.

At Nutri-Farmacy, Wagner conducts 12 to 15 patient consultations per week, averaging 15 to 20 minutes each, using information from his databases. Wagner documents his interventions and advice and keeps a file on his patients. Before patients come in for consultations, Wagner asks them to write down what prescription drugs they're on, any supplements or OTCs they're taking and any diseases they want him to address. "I have them sign a waiver that I'm not dosing or prescribing. I'm giving them education and information and helping them with product selection."

Before Wagner even approaches the subject of vitamins or herbs, he discusses each patient's diet and nutrition. "That's even more important than supplementation," he says.

Wagner will take his next step in the Nutri-Farmacy concept sometime early this year by offering community education classes in four subject areas: vitamins/herbs, nutrition, stress management and yoga. Wagner anticipates charging $35 for four once-weekly classes of about 15 people.

Wagner's goal, however, extends beyond selling herbs and educating the public. This spring, he plans to expand Nutri-Farmacy into an adjacent office space, using the expanded area as a clinical pharmacy setting. He plans to hire a naturopath and a massage therapist and to do more laboratory work, including cholesterol monitoring.

Once his clinic setting is opened, Wagner says he will start charging patients for services, if not before. "The only reason I haven't charged patients yet is because I wanted to see how people would accept this type of practice," Wagner continues. "Now I see they've embraced it with open arms."

Wagner is also considering merging some of Nutri-Farmacy's sensibilities with his institutional pharmacy business. "We can do a lot of non-pharmaceutical interventions for nursing home patients," says Wagner, noting an Oct. 22 article in the Journal of the American Medical Association, which reported positive results in using ginkgo biloba in Alzheimer's disease patients. "I'd like to do some controlled studies on using herbs" in elderly, nursing home populations, he says. "Get them off the hypnotics, the strong sleep drugs, put them on valerian or melatonin. It won't make them so groggy," plus it's safer and less expensive, he argues.

Despite his herbal recommendations, Wagner says he is not trying to steer patients away from prescription and OTC medications. "I encourage my patients to discuss my recommendations with their physicians. I'm not here to supersede the physician's orders. I don't try to switch anyone off of a drug. But if a person eats right, exercises more and takes the right supplements, and their cholesterol level drops, can they reduce their medications? I would hope so."

Thus far, local physicians have responded well to the Nutri-Farmacy concept. "I'm on the advisory boards of two of the biggest hospitals in the Pittsburgh area -- Shadyside Hospital and Allegheny General Hospital. They're both building complementary care clinics and want to educate physicians, pharmacists and nurses in this field. I've also had psychiatrists call me about St. John's wort. And there are at least three or four physicians who are referring patients to me for information about nutritional supplements and herbs."

With one foot in Western medicine and the other in complementary, Wagner strongly rejects the idea that only pharmaceuticals and surgery are valid forms of medicine. "Modern pharmaceuticals and surgery have done wonderful things, but they don't have all the answers. It's arrogant to think they do," Wagner argues. "Look at the incredible increase in resistance to antibiotics due to overuse. How do we solve it? We can use certain herbs and vitamins that have some antibiotic qualities and boost the immune system," he says. "Then, we'll be using fewer antibiotics.

"From what I've seen in the third world and in my practice," Wagner continues, "people want a choice of using herbs, massage, aromatics, acupuncture, even prayer. Actually, every shaman I've seen has used prayer before trying anything else. If people want to use these therapies, we shouldn't discourage it."

Now, less than a year into his NutriFarmacy adventure, Wagner is glad he defied the conventional wisdom and listened to that message from the skies and from within. "There's definitely been a spiritual aspect to all of this," he says, then pauses. "I knew I could help more people in this capacity. And it's true. I have."



Home
Copyright © 1999-2006 Danaura Enterprises, Inc. All rights reserved.
2506 Wildwood Road, P.O. Box 238, Wildwood, PA 15091
Phone: 412-486-8595 or toll free 1-877-289-7478
Fax: 412-486-4898
Email: info@nutrifarmacy.com