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Greg McKenna has already outgrown the Moodus location of the Nutmeg Pharmacy he opened in February 2020. Now he’s seeking approval to build a brand new Nutmeg Pharmacy down the road — a location he hopes will not only continue to serve the East Haddam community but will help expand the role of pharmacists across Connecticut.
The proposed pharmacy at the corner of Rae Palmer and William F. Palmer Roads would have a drive-thru pickup window – an important feature that McKenna said he hoped would make it easier for older patients with limited mobility to get their medications.
But McKenna said he envisions the new pharmacy bringing more than convenience – describing plans of a “highly-accessible outpost” to an often imposing healthcare system, where customers could receive routine tests from their pharmacists to help them work more effectively with their doctors to manage long-term conditions like diabetes and hypertension.
Independent pharmacies like Nutmeg were part of the backbone of the healthcare system during the worst of the COVID-19 pandemic, McKenna said. Early on, they were still seeing customers 12 hours a day, when access to doctors’ offices was limited, and were key to the COVID testing network. This year, they’ve distributed tens of thousands of COVID vaccines.
McKenna said the role pharmacists played in the pandemic showed they could play a bigger, long-term role in the healthcare system — and he is designing his new pharmacy in East Haddam to fit the role he envisions.
In his planned new building, the key to that new role is two consultation rooms, where the pharmacist would be able to sit with a patient and evaluate how their treatment is going. McKenna has one consultation room in the Nutmeg Pharmacy location in Higganum, which gives the pharmacist a space to talk with a patient about how they’re feeling or how their medication is working.
“I’m not going to give them one word of how they’re going to go about treatment,” McKenna said. “But I would sit there and talk to them about diet, I would sit there and talk about what they’re doing for exercise, and how they can improve that. That’s stuff I do every day of the week.”
McKenna envisions the pharmacy as the first point of contact between the patient and the healthcare system. Pharmacies are more accessible and reach more people, he said, as the patients can walk in and speak to someone immediately, instead of setting an appointment in advance.
The plan for the new location includes a blood test lab on site, so customers could come in for cholesterol or blood sugar checks, which McKenna said he could refer to a doctor if the results were higher than normal. He also wants to set up x-ray in the store, as well as offering x-ray house calls to home-bound patients.
McKenna said being able to check his blood sugar levels has helped him personally. If pharmacists could run these kinds of blood tests on site, he said he believes it could help people get quicker and better treatment for conditions like diabetes and hypertension.
In McKenna’s case, a doctor prescribed him metformin because his blood sugar levels were going up, and he has a history of diabetes in his family. From checking his blood sugar levels at the pharmacy, McKenna said he saw that his levels were not going down after a few days of treatment. He called his physician, who recommended increasing the dose. In a few more days, McKenna said his blood sugar was down to the levels where it was supposed to be.
“So, in three days, I got my blood sugar under control rather than waiting three months [to see the physician again],” McKenna said. “And what happens if during those three months, my appointment gets cancelled or I can’t make it, then I have to wait even longer. And having my blood sugar under control in three days is huge, because it helps make sure I’m not clogging my arteries.”
McKenna said the idea isn’t to have pharmacists replace physicians, just to give patients a more accessible person to talk to about their treatment and make sure it’s on track. It could also result in finding medical issues sooner. If a patient came in and received a blood test that showed their cholesterol was high, they could bring that up as a concern the next time they see their physician, he said.
“It’s about identifying and finding those people who maybe don’t want to go to the doctor because they don’t have the best insurance to go, and they’re not sure they’re having a problem, but they’re wondering,” McKenna said. “A pharmacist can do these tests at a much more reasonable rate, and can help the doctor identify who they then have to treat. So the pharmacist can be the canary in the coal mine, and say, ‘I think it’s time for you to go see your doctor.’”
McKenna said he will still offer the same services as he has at the other Nutmeg Pharmacy locations – filling prescriptions, managing medications and packaging them in ways that make it easier for people to remember to take them. But he wants to add more testing because he said he will be able to reach more people and charge a lower rate than doctors’ offices because pharmacists are paid lower rates.
“Our location now [in Moodus] is small and cramped,” McKenna said. “We tried doing as much as we can in the area we have, but we just can’t do all the services I described, because we don’t have room. That’s why we’re getting ready to branch out.”
Aside from space, the main hurdle for McKenna’s vision is the fact that Connecticut pharmacists aren’t considered “providers” in state statute, meaning they can’t bill patients or insurance for these kinds of services – something other states have allowed to varying degrees.
McKenna said the push to get pharmacists provider status in Connecticut started just before COVID, but it came to a halt when the legislature adjourned in early 2020 as a COVID precaution. He said the role pharmacists played during COVID highlighted the importance of allowing them to have provider status.
“I can’t even think about the number of COVID tests that have been done in the pharmacies,” McKenna said. “Now I want to test glucose, I want to test cholesterol. I don’t want to read the results and make therapy changes – that’s the doctor.”
“But we know there’s millions of people who are walking around who have high cholesterol or are hyperglycemic who aren’t seeing the doctor,” he said. “That’s where the pharmacists can have value, because the average customer walks into a store three times a week.”