he'd actually wrote the regulations for a pharmacy in pennsylvania haven so he was truly an amazing man and i worked for him for about five years bought the store up his widow and she actually worked with me and then ten ten little typical small hometown drugstore gerard acquired it and i watched it over the years grow and grow and grow and recently you just moved to a new location where you really are and you gratifying work is we do a lot of work for hospice patients people in the last days of their lives we we helped to to allow them to transfer change to die in without pain and in and at home that's what hospice is all about so so we make several things that you know help those people you know and that's true pharmacy this through chemistry yes and as opposed to having pre manufactured pills and you make sure the no no we were biggest yeah the first and now there are some more but but actually companies coming out of fire because of the place and others place in new england that they did manufacturing and they called it compound ing and several people died and bad sterile techniques bad things and so so what we do is individual lives per patient we're not you know we don't do it on a manufacturing top style basis and you're one of the only pharmacies in the run here to my understanding that is taking this new that the dry syndrome actually went away and post traumatic surgery sometimes caused a lot of problems and it actually actually your own blood cells actually heal scarring  it's really a neat process and i want to take a step back in time gerard and i were in the same chemistry class in high school and he loved chemistry i did anyway so as you expanded geoffrey's drugstore and it's it's a pretty huge now a new facility you over the years even before this latest move have gone to the home health care field and tina is part of that department out of our own stores and eventually it just came became too much so we created our own entity we created our own company called washington medical team that works for washington medical and she's our rep she goes around and talks to people  decorative cane there we we are sorry we personalize it for you yes well well the nice thing is you keep you keep that hometown approach to things and that being personalized and personal care you're not you're not at your pace the patients that come to you are not a number went when i call in and i say something and they know who i am when i call an as opposed to going to some of the big chain places or or the big providers that what's your what's your number and ron here in western pennsylvania i think that's that's paramount people want that here and then i think people have to understand that if you spend money locally it stays local and we pay taxes we buy the groceries we do this we do that if you go to chain a big chain that money doesn't stay about what goes to wherever their corporate headquarters are are and you're not helping your community really so just to talk to stay local shop local you know is an advantage to everybody including yoursel and i'll be willing to bet that you started out because somebody came to you and said i need a hospital bed or i need this or i need that and you said while see what i can do and then you started doing it because i know jerry i think the first hospital bed i ever did i worked from nine to nine in the early days because i had to and then at nine o'clock i left that struck the hospital bed but went to my back and climbed up the steps and put together in a guy's house and like wow this is good i could do that and yet i don't know i can do that t so i know you're jerry's cousin and that's always a wonderful thing which he has a lot of his friends and relatives that work with him and you walk in there you get the sense of family i mean a lot of these places have pharmacists that come in to work and they're there for a year or two when they're gone and  brian's been there as long as i can remember yes you know and so people stay for a reason and it's not just i got a job making money it's because it's a nice place to work and nice environment and that's the that's the big thing because all that goes out to the client because that's that's the philosophy and again it comes from jerry so i'm sure he's a good guy to work for that so so tell us what you do within this washington  marketing here and there and then as far as we do a little bit of everything we do health fairs you know also and that's an education and i program direct and try to educate them on you know their needs of what they would want what they need we also saw a diabetic shoes so we sell diabetic supplies there also and you just kind of get to know the patient and see exactly what you know what they're looking for so do you do you go out homes and so forth yes and market market to them show them you know give them brochures and booklets on what we haven't and what we have to offer them and so if i was in need in the hospital for a hospital bed in my home what is my procedure well we would get you set up how do i even call you what's what's the first step that i need to make to get a hospital bed in my home you would just contact us at the i would i need a script for my physician would is there anything like that required for insurance companies do insurance companies pay for this stuff you know yes some of it and some of the equipment is paid for and there's a general criteria list so if you need a hospital bed you have to be you know there has to be certain criteria that you fit and generally the reason this business this business is mostly referral business so so if you need a hospital bed you're usually coming out of the hospital right or coming out of some type of surgery  coming out of some situation and there are there were fraud in caesar that usually the actual home care nurses which will make a lot of referrals for the social workers from the hospital or from the doctors offices or or the  managers of the doctor's practice so generally those who are for a source that you know and then you have where where we fit in is is you have freedom of choice so you get to say they give you a list may say you want to get it from you and you hopefully you choose us because we sometimes is best you know that started a long time ago even with physicians practices the hospitals kenyan practices the physicians employees and now they're on the clock and now they have to see so many patients with a certain amount of time and if they're not meeting quota there are other spend too much time for their patients they get yelled at and i'm getting this from my personal friend who's an internist and he said he had to leave the place he couldn't take it anymore he was allowed to practice medicine he can spend time with his patients and it had to find an alternative so that filters through with everything when you're dealing with with your corporate medicine yes you know it becomes a problem so so they make the  ok so so you come with a truck and you bring it into the house and if you set it up in the room you have to put in and then when there's no need for the hospital bed again you come in we we are a power wheelchair specialist so we have the we actually have the medicare bid for power wheelchair so we do power well chairs for a lot of people in western pennsylvania and we repair them and we actually put the we can things pain relief yeah antibiotics that the biggest problem in pharmacy and the biggest one of the biggest problems in health care is compliance you know what we mean by compliance is we have something but it's not benefiting us if it's just sitting on a shelf and sometimes we forget to take our medication sometimes we leave the house without it so yes so that's what jerry speaking only talks about compliance so so most of the hospital readmissions are because people don't take meds they get discharged from most of the time and infection comes back is because somebody has ten days worth of medicine and they feel better after five and they stop taking their medicine so why why is that a problem because it creates increases the health care costs and ing and and the op the chances that it's going to come back worse because because what happens is the medication kills the always tell me if i'm wrong but you have a limited cation kills the older cells and doesn't kill the younger cells because the stronger and that's why prescriptions are for those that a certain dosage and i prescribe for a certain amount of time and when we short changed that or we don't take them on time those newer bacterial a multitude of meds eight nine meds and they get nine bottles intercity and and so they start trying to put them into these little seven day reminders and they you know one falls and they're not sure where they took them or not so we've come up with a system or day spent trying to get their parents take their meds and make sure that everything's fine so this compliance issues are really important thing it's one of the it's one of the best things we do and we we we market the caregivers we marketed to nursing homes and marketed to doctors offices  you know the whole world is revolving around compliance and also reimbursement to physicians are now being based on their ability it's called a star rating system their ability to make sure that the patients are you know make getting to their appointments taking their mad's you know being followed if if in the biggest part of that is compliance with meds so so the doctors have a have an integral and important interest in us to make sure that their patients are taking their meds and sometimes know even with supplements it's thing that they look alike and you know remember you if you talk or not we probably get ten calls a day if i took one and i don't remember i took it should i take another one or should i not if i wait till tomorrow and depending on the drug we we often will tell him to wait for the next day but sometimes we'll tell him the take it anyway because it's it's an anti compulsive we wouldn't want to have a seizure right you know so a little bit more this is better than none at all yeah our people will now use the airborne when they get that first cold is that everybody used to get cold automatically they would they would move to an about ixnay they take vitamin c they take airborne you know we've we've got a we've got it and half my stores filled with and that's a nice thing about drawer r d you would think a pharmacy wouldn't do that but he has walls of it and he has quality stuff in there and his people to know what to tell people to pick up you have a talked with him many times over the years about about natural supplements and so if you're answer this question delicately people think that a physician i don't care what type of position you are now is about medication and i always say we're taught how to write scripts for the most part we're really not and we're taught about pharmacy we have years of pharmaceutical classes and pharmacy agents com reps and talking to us we really don't know about drugs well you know you do the average pharmacist today is a doctor a pharmacy now and they have a six year degree four years of what you just concentrated on pharmacy pharmacology chemistry a physician or a dentist they have some master or two at max of medication and and they depend a lot on the reps that come in for their information  and and in the old days they depended a lot on the interaction between the patients and selves and they got their information from their patients who told them i felt like this or i'm having problem with this and and they would less choose opposed a prescription but nowadays medic  in the old days they were on to medication now they're on twelve or ten and so it becomes more difficult so so we actually have special medication management seminars we have we have we do students i did graduate you came on to canes board and we have students that come through rotations will send students out in the community and we can do what they call brown bags people through all the medicine into a brown bag they bring it to the store and obvious student spent twenty minutes with the patient just talking about what you know what medications app what it does which ones are really important they should never miss you know and if there's a problem maybe there are a problem or two should be together and that happens quite frequently were true enough is it a physician same physician will prescribe two medications  gaiter meaning not you're not supposed taken together right and they still done that way yes and if it wasn't for your watchful eye there could be a problem and a lot of times they say to the patient this replaces this and that and they've got a meds and they say ok it replaces this one and take out the most important meadow half and now they're taken to things that that that that that actually treat the same medicine and then we have a problem and then you go to one doctor once addition and he prescribe something and you go to another physician who prescribe something or she prescribe prescribed they don't know that to do because the patient forgot to say that i'm on this medication i mean and then you have some you can have an issue with that and that's where the skills of the pharmacy come into effect and saying or that now you have high blood pressure now and then you say what do you take any medication no and i said so there aren't any pills that you take whatsoever well i take this pill i take this pill for irregular heartbeat and then you say oh ok well so in a nervous miss the anxiety of coming off as they forget that they have a heart condition and if you don't draw that out then you you could prescribe a pill unknowingly that this co is this issue that happens in medicine and what i like about your facility is you have all these steps in line to help help protect us from that i mean protect the patients protect practitioners that help us with their dispensing to make sure things are correct we have secondary backup plans for double checking and triple checking medications we have computer systems that the double check interactions and so so we have all the technology and sometimes even more than some of the bigger chains and you would drive through and be objective and we deliver here let's talk about delivery that's important we actually have seven cars on the road eight hours a day and i remember when you had one we had one that we spent a lot and it was a little mercury to so seven vehicle seven drivers so from the minute the they all runs up you are and we actually delivered at two o'clock in the morning not a mile and mostly those are nursing  the nursing homes late at night and that's coming because there are some people that are the unable to drive or their condition makes them temporarily unable drive or they're elderly and they're not getting out and you don't charge anything extra for that no that's that's a service of