To become more efficient, independents are moving away from paper billing and adopting new systems such as automated phone prescription systems. // Photo by Eric Näslund
Today, the independent pharmacist, like the health care system itself, is at a crossroads. On the one hand, more people are buying more prescriptions. Balo, for example, is filling more prescriptions than in previous years, an increase he attributes to an aging population and the tendency for doctors to prescribe multiple medications for a single condition, such as high blood pressure. And at a time when many doctors spend less than 10 minutes with patients, Balo says his clients appreciate the personal service and medical advice. Portland’s neighborhood-based buy-local ethos also bolsters his business, Balo says. But Portland’s buy-local sensibility didn’t help the iconic neighborhood drugstores that have closed in the past 10 years: Dickson’s in Montavilla, Phoenix on Foster, and NW Portland’s Nob Hill, featured in the Gus Van Sant movie Drugstore Cowboy.
These retail and demographic trends are up against what Coulter describes as “a health care system we can’t afford.” And to reduce health care costs, many businesses will have to make less money, be it doctors, mail-order conglomerates or independent pharmacists.
What distinguishes the independent drugstore is that its fate intersects with other key issues of our time: how to balance big-box affordability with the values of neighborhood enterprise, and how to preserve rural America. Of course, all of these debates have been unfolding for a long time. Amid the latest wave of closures, Oregon’s surviving pharmacies remain upbeat — perhaps out of necessity. “People have been predicting our demise for 50 years,” says Courtney. “But 50 years later, we’re still here.”