Q&A with pharmacist Michael Altman of Greenleaf Pharmacy in Hastings-on-Hudson.
How do you read doctors’ notoriously bad handwriting all day? You get used to it. And if not sure, you call. We fill more than two-thousand prescriptions a week, and we have to call a doctor only about three or four times a week.
What’s the most challenging part of your job? Dealing with the insurance companies. They’re refusing medications for patients not based on medical needs but on their company’s financial well-being. At least three times a day I have to call a patient to say that his insurance company won’t authorize the drug prescribed for him.
How much can you save, on average, choosing the generic instead of the brand name? Depending on the drug, forty to seventy percent. And the usual co-pay for a brand-name drug is forty to fifty dollars and for a generic, only five to ten dollars.
What are some other ways to save on the cost of medicine? Natural products are cheaper than brand names and just as effective. For instance, Singulair, a drug that reduces inflammation throughout the pulmonary tract, costs one-hundred thirty-eight dollars for a month’s supply. Perimine, a perilla-seed extract, is just as effective for only twenty-three dollars a month.
How do your prices compare to those of the bigger chains? The bigger chains may be buying their drugs cheaper, but they don’t pass their savings on to their customers. For people not on insurance, we are cheaper because we don’t charge a big mark-up. And for the ninety percent of our customers who are on insurance plans, they pay the same amount of co-pay wherever they buy their medication.
Because you’re a pharmacist, do you find yourself less or more prone to take medicine yourself? I don’t take anything. My mother used to get mad at my father because we didn’t have any Tylenol in the house—and now my wife gets mad at me for the same reason. I don’t remember my parents ever being sick, and I only missed school once, because of chicken pox.
What one thing would you like all of your customers to know? A drug is a poison, not candy. Before you put anything in your body, educate yourself about any possible side effects.
What’s the best part of your job?
I really feel like I am making a real difference in people’s lives on a day-to-day basis.
What first sparked your interest in becoming a pharmacist?
My father; I was very close to him and I saw how customers responded to him and how he really made an impact on generations of people’s lives. He owned the Liggett Rexall in Ardsley. I started helping out when I was about four, and went on to work holidays. I did everything: stocking shelves, filing, etc. And later during pharmacy school I did my internships there.
But then you made a detour, career-wise. Tell us a bit about that.
After I passed the pharmacy boards, I decided to work as trader on Wall Street for eight years. Things changed for me after September 11. I had a couple of friends who were there, and I was really stressed out, so my wife said you should buy a pharmacy and get out of city. I knew the owner of Greenleaf; one day called me out of the blue and asked if I still had my license and could I cover him on a Saturday so he could play golf. Over the next six months, I would sub in pharmacy. Finally asked if I could work fulltime and said had never had a boss. But I would buy it if he sold it to me. That was five years ago and I’ve never been happier.
If you weren’t a pharmacist, what would you be?
I’ve done everything I’ve ever wanted to do I’ve ever wanted to do and succeeded at it and I’ve never been more fulfilled and happier than I am now I wouldn’t change a thing about what I am doing—except dealing with the insurance companies.
Many people are getting their drugs online from Canada. Good idea?
To me, it’s a bad idea. A year-and-a-half ago, I would have said go ahead and do it, even though of course it was bad for my business. But it’s not a safe practice anymore because you really don’t know if you’re getting the real thing. That’s because lobbyists for the big chains like CVS and Duane Reed who were getting hurt by this practice convinced the government to put pressure on the American drug companies to stop selling to Canada. So most of their sources from American suppliers got shut off and they had to go to other countries like India and China and I now question the quality and legitimacy of the drugs you get from these new sources—are the medicines from these sources the real thing?
What are some common misconceptions others have about your job?
Some people say that all we do is open a bottle, pour it into a vial, and throw a label on it and that’s it—or that we just count pills all day. If that was all we did, a lot more people would die because pharmacists provide a key level of oversight. Now people can go to five different specialists and the left hand doesn’t know what the right one is doing with regard to interactions between the different medications they may be taking.
What are some of the most common mistakes people make when it comes to taking over-the-counter medicines?
Especially with children, parents are overdosing the kids. They think if a little is good, a lot is even better. Or they’re not following the recommended dosages printed on the package. And for little kids below six, those dosages are often not clear. Parents should ask their pharmacist or doctor for guidance because the correct dosage is determined by weight, not age.
Adults overdose themselves, too, because they don’t think its medicine because it’s sold over the counter; they think they can take more because it’s not going to hurt me.
Have you ever made a mistake dispensing medication?
No, not that I am aware of. I have made mistakes prior to the medicine actually being dispensed but they have been caught before they leave the store. I set up three layers of protection at the store to make sure nothing goes out incorrectly.
How to you ensure that no prescription is dispensed incorrectly?
First, a pharmacist enters a medication into the computer and the computer generates a label. Then a trained pharmacy technician checks that label against the prescription. If there are any doubts, he may question the pharmacist, then the pharmacist confirms the information or calls the doctor to check. If both the pharmacist and tech agree, the labels goes through a bar code reader to check that the bar codes on the big dispensing bottle and the label on the individual vial are the same. Finally, the pharmacist goes back and opens the dispensing bottle and does a visual check to make sure that the appearance of the pills in each is identical.
What vitamins or supplements do you take on a regular basis?
Every day I take Every Man multi-vitamin, 1500 milligrams of fish oil, and two gel caps Zyflamend, a natural anti-inflammatory supplement because I box now and don’t want to be sore; it’s also be found to kill 74 percent of prostate cancer cells. And from October through March, I take two natural Wellness Formula tablets a day to boost my immune system—it’s worked for me for 19 years. And when I feel like I am getting a cold, I take two tablets three times a day for two days. I sell about 1,000 bottles of this every winter.
What do you think should be done about Americans who can’t afford their prescriptions?
I have a wacky plan that I think could save us all millions of dollars. You know, the United States has a contract with the drug companies to supply the VA hospitals and Congress where they provide the medication at a 30 percent below cost—and they still make money. If that pricing was extended to everyone, we overnight would save 30 percent of our drug costs. This will never happen but I think that would be a good way to solve the problem.
As it stands now, there are patients that I give the medicine to without charge because they simply can’t afford it. My old business as a Wall Street trader was all about the money; this isn’t about the money. I really believe that I am making a difference and am happy to be able to give back to the community.
How can I double-check that my pharmacist has not made an error in dispensing my prescription?
If you’re not comfortable, you can always call your pharmacist and ask him to tell you what the markings of the pill you should be taking look like to make sure the pills you received look as they should.
Does the time of day you take a pill and with or without food really make a difference?
Yes, not taking medication as direction can adversely affect their efficacy.
What are the effects of CVS on your business—what do you have to do to compete?
They can’t compete with me. Ten minutes away, there’s a Walgreen in Ardsley. If they moved nearer to me, I would be getting busier and busier; people would walk in and be told that there’s an hour-and-a-half wait and no one would know their name. The big chains can’t compete with the quality of care we provide and the level of service we deliver. We know everyone’s name; we’re like the “Cheers” of pharmacies. I know 95 percent of our customers by their first names and they are usually in and out in 10 minutes, and often five if they are sick. I would fire anyone who told someone who was sick that they had to wait more than 20 minutes—unless it was a very busy Monday. Even then, we’d ask to see how soon they needed it and try to accommodate them.
What five over-the-counter medicines should no household be with out?
Advil or Tylenol, a dry cough suppressant called Delsym, the natural Wellness Formula for general health, and acidophilus for stomach upsets and to stop diarrhea.
What is your top selling over-the-counter medicine?
Advil and Tylenol. A lot of the baby boomers are aging but still active, so we see a lot more pain and arthritis. Their parents took cod liver oil which helped reduce inflammations. We take Advil or Tylenol
What prescription medicine do you dispense most often?
The pain killer Vicodin and Lipitor or Zocor to lower cholesterol. Also the Zoloft, the antidepressant and Ambien, the sleepaid.
Because you’re a pharmacist, do you find yourself less or more prone to take medicine yourself?
I don’t take anything. My mother used to get mad at my father because we didn’t have any Tylenol in the house when I was growing up—and now my wife gets made at me for the same reason. I am very fortunate that I have really good genetics; I don’t remember my parents ever being sick and I only missed school once, because of chicken pox. Now since I’ve gotten older—I’m 41—I try to use natural supplements and products for my family and patients.
What about your kids taking medicines?
I have three little girls; I try not to give them anything but my middle child is allergic and has asthma and so she takes something for that. I’m certainly not going to not give them medicine if they need it and the person who makes that decision is their pediatrician. They also take acidophilus, a natural supplement, as needed; it’s great for stomach upsets and diarrhea.
What’s the best way to treat a common cold?
I like Cold Calm, a homeopathic remedy.
What can I do to prevent a cold or lessen its symptoms if I feel one coming on?
I use natural Wellness Formula tablets; if you feel a cold coming on, take two tablets three times a day for two days. And from October through March, I take two natural Wellness tablets a day to boost my immune system—it’s worked for me for 19 years.
What’s the best way to treat a headache?
For a sinus headache, I recommend a natural nasal spray called Sinus Buster.
For a regular headache, I’d say Tylenol or Advil; it’s a personal choice because they both work but Tylenol is easier on the liver and kidneys.
Pharmacies use to sell cards, chocolate, shampoos, etc. Many now don’t. Why not?
We sell a little bit of everything—except cards, because there’s a card store two doors down from us and I want to support other small businesses—but a lot don’t. The margins stink and they can’t sell enough of it and you can get these things anywhere so there’s no value added to the customer. And you can’t be everything to everybody.