When you have been in the pharmacy business for nearly four decades, serving the same area of rural America, you have seen a lot.

“But this is the first time we’ve had to lock our doors and not let people come inside,” said Charlie Moore – owner of Charlie’s U-Save Pharmacy in York, Neb. with his wife Charlene, since 1984. “We have been here through all kinds of blizzards and everything else, but not this.”

Charlie, his wife Charlene, and daughter Connie (who is also a pharmacist like her father), took a moment to sit in a circle at the appropriate social-distance, to be interviewed about their family-owned pharmacy and how it has been impacted by change through the years and the recent COVID-19 outbreak.

Charlene has worked in nearly every aspect of the business, from clerking, dealing with insurance, to home deliveries – a service they have offered from the pharmacy’s fruition that has become even more important with the COVID-19 outbreak, “You really build a relationship with people. I notice now that people are even more appreciative than they always have been. We have become that familiar face to them when they are stuck at home.”

Connie said treating people the same in such a complex system began to grow more difficult, especially when Medicare Part D began in 2006. According to the Center for Medicare Advocacy, Medicare did not cover outpatient prescription drugs until January 1, 2006 when Congress authorized the Medicare Prescription Drug, Improvement and Modernization Act. The act, its implications and how it plays out in the day-to-day efforts of pharmacists is complicated.

While there are challenges, Connie noted the CARES Act – the aid package recently passed by Congress that is meant to keep businesses and individuals somewhat solvent during the COVID-19 challenge, does have a piece within it that may help independent, family-owned pharmacies, “Sadly, it has taken a healthcare crisis to get it into legislation. The piece that went through the CARES Act, may include recognition for pharmacists as providers under Medicare. As pharmacists, we have always considered ourselves to be healthcare professionals and have done the same schooling or more so than many others in the healthcare industry. Currently under Medicare we are not considered healthcare providers, so we don’t really have a status. We can counsel patients about their medication, do a comprehensive medication review and Medicare in the past wouldn’t pay us to do that. We hope this legislation changes that.”

This type of additional payment and comprehensive care becomes even more vitally important in rural areas, Connie added, where some towns may have a pharmacy and no doctor or where medical personnel are already stretched to the limit, “If we get through this crisis and pharmacy gets its recognition as a valuable member of the healthcare team, some really good things could happen. Pharmacists being able to do immunizations for patients and have sit-down conversations that they may not have time for at the doctor’s office, really provides better healthcare overall.”

While they try to keep an optimistic outlook, Connie admits COVID-19 has been a sobering experience. Her husband serves as the Lab Director at York General Hospital and there has been far more debriefing at home as of late, “Sometimes I do have to say to Bill, ‘Okay, what is really going on? I need a reality check. Is it this bad or isn’t it? Are we in-between?’ It’s really hard to think about how to balance all of this.”

Charlene has felt the short-term impact of the reduced services already, “I was prepping for cataract surgery and went to my appointment and it was all locked up. No one called me. It’s going to be a nightmare rescheduling all of this. One patient told us their heart doctor called them at 10 p.m. one night and said they were not going to be coming in for a couple of months.”

Right now, despite the challenges and the unknowns, this father, mother, daughter, and the team at their pharmacy plan to give service with confidence and care out their drive-thru window and home deliveries.

“It’s pretty humbling when you can bring someone to tears when you have enough alcohol pads for a diabetic or toilet paper for an elderly person,” Connie admitted.

“When we came here, there were five independent pharmacies in York, now we are the only one operating independently,” Charlie said. “We have told patients for years – if you need something, call us. What we can do now is to continue answering the call.”

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