Stepping outside the box to look for new ideas
Compounding Pharmacy creates opportunity for growth in Cimarron
by Lynne Hewes
If you're looking for someone with a positive outlook on the future of Southwest Kansas, just stand on the corner of Main Street and Highway 50 in Cimarron, where you will be likely to meet Jim Coast, pharmacist and owner of Clark Pharmacy.
Coast, who, with his wife Sandi, has owned and operated the pharmacy, gift shop, and soda fountain since 1975, expanded into creating pharmaceutical compounds in 1998. By broadening his own horizons, he is also promoting a big-town feel in small-town Western Kansas for young people who might want to come back home to live, work, and raise families after graduating from college.
"I guess you could say that we officially got into the compounding business when Mike and Kim (Coast's son and daughter-in-law) came back to Cimarron to live," Coast said. "We attended training in Houston at the Pharmaceutical Compounding Center of America. We'd made some creams and other types of drug delivery systems, but we didn't really do any advertising. I never went out to promote what we could do. For one thing, I didn't have enough staff to take time off from work to do that."
Coast's original Cimarron business was the pharmacy on the first level of the Clark's building. He and Sandi enhanced the space to create a well-stocked, unique gift section, and the old-time soda fountain had always been a customer favorite. Their two sons, Mike and Tony, grew up in the community.
As time went by, they added additional pharmacies in Dodge City and in Minneola. They also expanded into a related business, Coast Health Services, closed to the general public, but which fills prescriptions for nursing homes and assisted living facilities throughout Southwest Kansas.
After training in Houston, Jim and son Mike Coast, like his father, a graduate of the University of Kansas School of Pharmacy, expanded their compounding services, eventually remodeling the top floor of their building to give themselves more room and a quieter atmosphere for producing compounds.
"I remember watching Ralph Clark go into his little cubby hole when Clark Pharmacy was in its original location down the block," Coast said. "I used to wonder why he went into that tight little room. Now I know. It's easier to concentrate now that we've moved things upstairs. In compounding, you need as few interruptions as possible."
Though their compounding business has not done much advertising, Jim and Mike Coast and the two other pharmacists who work there keep busy.
"We do about seven or eight compounded prescriptions per day," Jim Coast said. "It doesn't sound like a lot, but if it takes about 30-45 minutes to create each prescription, then I can spend half or three-quarters of a day up here. In a year's time we do over 2,000 compounds that would not be possible if we weren't here. I'm not downstairs in the regular pharmacy very much anymore."
A big majority of the products they compound are prescriptions for hormone replacement therapy. There are commercial products available, of course, but compounded prescriptions, called bio-identical HRT, can be tailored to each individual patient.
"It's not done on a large scale," Coast said. "We don't manufacture the products; we compound each one for a specific patient. Mass-produced hormone replacements are effective, but patients have to fit with them, whereas we create compounds to fit the patients. Working with their physicians, we can start patients on a standard dose, then adjust that dose according to an individual's needs."
Coast is enjoying his compounding venture.
"I've always liked lab work," he said. "It's challenging and interesting. It keeps me alert. At least once each year I go to a three or four-day seminar, just to keep up on all the changes. In pharmacy school, we were trained to do this, but that was before all the modern technology we can use now. Things are different even from when we started this in l998."
In spite of the technology they're using today, compounding itself is an age-old practice. Before mass production techniques, most pharmacists created their own compounds for patients. In ancient times, compounders created medicinal ointments from plants and animals and even discovered antidotes for poisons.
Coast's compounding area is a far cry from those days. A tour of his up-to-date lab showcases such machines as an electronic balance device, which can weigh something as small as one milligram, essentially something as small as the period at the end of this sentence. There's a powder mixer to blend medications for capsules and a powder hood to make the capsules in. There is also an electronic mortar and pestle, adjustable in speed and time to create a uniform cream or ointment. Everything is overseen and inspected by the Kansas State Board of Pharmacy.
It all seems pretty high technology for an area where the old Odd Fellows Club used to meet above the drugstore.
That modern, high-tech atmosphere is also becoming an asset to promoting the community of Cimarron.
"We want to promote our area to college graduates, people who grew up in the area and enjoyed living here, maybe wanted to come back someday to live," Coast said.
Mike Coast and his wife Kim both grew up in Cimarron, and they're raising their family in the town. After studying business and English, Tony Coast has returned to help work with the group's IT challenges. He also gives presentations at area schools, encouraging careers in science.
The business employs about 12 people full-time and four or five high school students who work at the soda fountain part time. Additionally, as pharmacy school students do their summer internships at Clark Pharmacy, Jim Coast looks for students who were raised in Southwest Kansas.
"You like to see people who, both the husband and wife, have grown up in a small town," he said. "Maybe they'll both want to settle here."
That's all part of Coast's idea to promote not simply his business, but also his hometown.
"Dodge City, Garden City, and Liberal are all growing," he said. "We're in the middle and we can't help but grow too. Things are starting to happen here, what with the wind generators and the oil and gas leases. We're growing, and it's going to take more young people with an education to help that growth continue. We all have to encourage that education. Then we need to see that the community makes opportunities available for kids who go off to college and want to come back. You have to step outside the box and turn over a few stones to get new ideas. Every adventure requires more staff and an opportunity for us to encourage more people to come live in Western Kansas."