Do I understand correctly that, if I lived in the northeast corner of that map, and I had a prescription to be refilled, I would have to return the 40 blocks to "E" each time? Mr. FEDDER. This is true if there is no vendor program whatsoever, or if the original prescription had been filled in the hospital. Under the vendor program system as currently structured, a prescription can only be refilled by the filler of the original prescription. In other words, you cannot originate a refill prescription in that "A" if it was origi nally filled at "E." They cannot transfer the prescriptions back and. forth. If the original prescription was filled by a patient in the center. and he lived at the farthest extremity from there, in order to get a refill, he would have to come back to the center to get that prescription. at a great inconvenience to that patient, too. Mr. WILLIAMS. Thank you, Mr. Chairman. Mr. ADDABBO. Does each individual pharmacy have any large cost in bookkeeping? Mr. FEDDER. The cost in bookkeeping as such has been minimal. We have an effective program in the State right now. This would really be an adjunct to the State program. It is an effective existing program-that has proven very successful. It has been in existence for some 20 years or more. Mr. POTVIN. Mr. Chairman, might I ask one more question? Mr. Fedder, I am sorry to come back. I should have asked this before. I am not personally familiar with your area. I fear that the members of the subcommittee, in addition to the staff, share this handicap. It is my impression that we are talking here, when we speak of your members in that area, of a relatively fragile group of economic entities that is to say the number has been decreasing over recent years Mr. FEDDER. That is correct. Mr. POTVIN. And their annual net income would not be large! Mr. FEDDER. That is also correct. Mr. POTVIN. Would it be possible, sir, without causing you unde inconvenience, to obtain some data on-as an example-could we from you, after you return to Baltimore, the average gross and net f the pharmacies in that area. Or if that is too much trouble Mr. FEDDER. I can give you the average gross now. I do not have the average net. Mr. PoTVIN. That would be very helpful, sir. Mr. FEDDER. The average gross-I will give you a composite and the total. The average gross is $210,000 a year. Mr. POTVIN. That would be the average gross for the entire dru store, not just the pharmaceutical aspect. Mr. FEDDER. That is correct. Mr. POTVIN. Could you estimate what a reasonable ballpark g on the net might be, on that kind of gross? Mr. FEDDER. With salary-with the pharmacist drawing his salar plus net, no more than $20,000. That is a ballpark figure. Mr. POTVIN. How many pharmacists in this area have closed duri the last 5 years? Mr. FEDDER. I do not have that. I know since this matter came # there have been two closings since August-in the last 8 months. Mr. POTVIN. Would it be accurate to regard that as not typical of the last 5 years? Mr. FEDDER. I guess so. Mr. POTVIN. It would be your opinion that perhaps one or two a year over the last 5 or 6 years. Mr. FEDDER. Yes, at least that many. Mr. PoTVIN. And you feel that this closure rate would be substantially accelerated? Mr. FEDDER. It certainly will accelerate. Mr. ADDABBO. Do you have many chainstore operations in this area? Mr. FEDDER. No. Mostly individual ownerships. I have a copy of the list of pharmacies here. Mr. Porvin. We would like to have it. Mr. WILLIAMS. Are those keyed to the numbers on the map? Mr. ADDABBO. Without objection it will be made part of the printed record. (The material to be furnished for the record referred to by the chairman, follows:) MARYLAND PHARMACEUTICAL ASSOCIATION, KELLY MEMORIAL BUILDING, BALTIMORE, MD. PHARMACIES IN PROVIDENT HOSPITAL NCH CENTER AREA (1) Adams Drug Store, 1401 Edmondson Avenue. (2) Belford's Pharmacy, 1601 Edmondson Avenue. (8) Downes Brothers Pharmacy, 823 W. North Avenue. (9) Harlem Park Ethical Pharmacy, 925 Harlem Avenue. (10) Irvin's Pharmacy, 631 W. Lexington Street. ((11) Keystone Pharmacy, 1301 W. North Avenue. (12) Kinnamon-Briele, Inc., 801 Park Avenue. (13) Klotzman's Pharmacy, 1041 Edmondson Avenue. (14) George J. Kreis Pharmacy, 1400 W. Baltimore Street. (23) Meyer's Pharmacy, 2101 W. North Avenue. (27) Payson Pharmacy, 255 N. Payson Street. (28) Penn-Dol Pharmacy, 1200 Pennsylvania Avenue. (29) Poltilove Pharmacy, 442 N. Fremont Avenue. (30) Read's, 1143 W. Baltimore Street. (31) Read's, 501 N. Howard Street. (33) Read's, 1536 W. North Avenue. (34) Reliance Pharmacy, 1101 Myrtle Avenue. (35) Rex Park Drug Store, 201 W. Franklin Street. (36) Robinson's Drug Store, 2139 Pennsylvania Avenue. (37) Sachs Brothers Pharmacy, 2423-25 Reisterstown Road. (43) Wich's Pharmacy, 1230 N. Stricker Street. (44) Young's Pres. Pharmacy, Inc., 1140 Druid Hill Avenue. NEARBY PHARMACIES IN PROVIDENT HOSPITAL NCH CENTER AREA (1) Charles Street Pharmacy, 1001 N. Charles Street. (9) B. T. Smith Company, Inc., 1122 N. Charles Street. (11) Edmondson Pharmacy, 2501 Edmondson Avenue. Mr. ADDABBO. If there are no further questions, thank you ve much for your appearance here today. The next witness is Mr. Louis Taisch, pharmacist, Baltimore, M TESTIMONY OF LOUIS TAISCH, PHARMACIST, BALTIMORE, MD. Mr. TAISCH. Mr. Chairman, and gentlemen, I would like to tha you for this opportunity to speak to you. Primarily, I would like t say that I believe you are looking at a fairly good composite of th pharmacists of the target area. My business represents not the minimal nor the maximal type operation in the area, and I believe I can speak to you on the Mr. ADDABBO. Please give your name and address. Mr. TAISCH. Louis Taisch; I am one of the proprietors of Caplan Drug Store, Inc., at Edmondson and Carey, Zone 17, in Baltimore! am not familiar with the map, but I am pretty well in the center of th target area. I do not particularly care for the word "target" because I talk pe sonally. I believe we are sort of a target. I would like to go on the record as speaking for most of the m in this central area. I headed a committee and contacted the proprietors of various phar macies in the area. I speak not only with my own sentiments but wit their feelings, too. Now, we all would like to go on record as saying that we are m strongly in favor of a very good, comprehensive, health center for t poor people of Baltimore. We feel they should have the best in eve facet of medical care that is available, whether it be internal, obstetr tude of people who will daily come for service at an institution I psychiatric, pediatric, whatever-fine. We feel, though, that the mult that will need the followup care in the form of medication in prac cally every one of their ailments. thousands, would take a great number of pharmacists and warehous To service a great number of people, which numbers into the mul to supply those needs. Now, just as a matter of record, in the 40-some stores that are spread uniformly through the area, stores which vary from little organizations to fairly large comprehensive complete service drugstores, we can supply a minimum of at least 500 and better man-hours per day. I am speaking of professional man-hours-the people who can supply this medicine. The result of their multitude of stores is really in effect a multitude of warehouses-sources of supply is well distributed. Also our delivery facilities, by nature of our service, becomes a great unit. It is something that one center could not begin to compete with-if it was put on a competitive basis, which I am certainly not looking for. For the small businessman to have to compete per se with a Government agency, I think, is a losing proposition from the very beginning. We are looking for a cooperative entity. We feel that our knowledge and service as professionals, with years of service in the field-speaking personally, 40 of my 55 years have been spent in pharmacy. There are other men who have spent even more. We feel as an adjunct rather than as a competitor we can help the overall health of the poor people. Now, when we say poor people-poor people of necessity are limited in so many fields of education and simple knowledge that so many things are overlooked. And you gentlemen-I don't like to sound altruistic-but a pharmacist has to be an unselfish person. The pharmacy per se has not changed too much from when you gentlemen were sent to the store by your mothers to wait for medicine, and sat down on a long row of chairs, and carried the medicine home-the scope has increased, but basically, it is a source of medicine for the ill. In our inner city, where people are limited as to education and general knowledge, you do not find places where they will go to the health center and say "Will you dial the phone for me"-"Will you tell me how to take my medicine”—and be instructed of the difference between a teaspoon and tablespoonful. Our services are so great. We do them by serving routinely, day in and day out. Furthermore a Government agency, by the very nature of its service, is itself a limited service agency, because it works on limited hours, it will not have a very comprehensive service at night or on Sundays or on holidays. Our service drugstores in the center of Baltimore work 7 days a week, we work Sundays, holidays. That is routine. And it seems to be part of our service. That is why I say this with an altruistic bend— but the fact is there. Now, as I mentioned, the service which we offer as pharmacists, basically, is the provision of medicine to aid and abet the diagnosis and treatment which the people will get by the professionals at the health center. I go along with the idea that there should be a limited service, pharmaceutically speaking, in the center, because there will no doubt be moments when instant medication will be necessary or as an adjunct to treatments going on at the center. As pharmacists, we readily understand the necessity for that. However, I remember one time in England I was speaking to some of the pharmacists there who have had a demise because of the various proposals that have been put into effect in England, economically speaking, that is, where we could increase our services, but we who have to more or less be smiled upon by existing bodies like the AMA, and the pharmaceutical boards. For instance, we could work in cooperation with the center like taking of temperatures, reading of blood pressures-not diagnosing, but just reporting-a basic urinalysis, the dissemination of informa tion by official agencies like the Social Security Board, the Medicaid Board, the AMA, and whatever. There are things we do in our every-day business. The recordkeeping which was mentioned a while ago is-can easily be added to our service, because it is an inservice proposition. We keep multitudinous records, and it would just be a bit of duplication, which probably could be done by carbons and things like that. So records and reports and surveys are something that the Federal agency could depend on us for cooperation. And just a glance at the map can show how quickly we could come up with a certain group of data, very easily, without a long-term, I might use the term, Ι Federal case. Now, as you know, through the years, gentlemen, the pharmacist has been the confidant and the adviser of the people of the neighborhood. Now, by being there-the big thing is that we are there, and we are threatened with removal by economic pressures. Now, by the mere virtue of being there-can you count how many dangers, possibly deaths, have been averted? Mismedication, overdoses, wrong medicine. I give you this. So many of the people in the inner city are mothers who are just a tiny bit older than their children. Many many times I have had people come to my store, and I am sure my colleagues have, too, with ideas of medication for an infant not a month old that positively can make the hair rise on your scalp. Only by being there can these trag. edies be averted. If you have to run to a center, forget it. By the same token, how many case of incipient poisoning, things that never reach the newspapers, have been averted by prompt treatment at the drugstore, or by throwing the patient literally into my car and taking him to the closest poison center or hospital. These services are something that are there. And they can be rendered only by being there. Now, the attrition in the pharmacies in the inner city of Baltimore is escalating. If we have to lose a certain portion of our-s great portion of our income to a center which will fill a multitude of prescrpitions, for this reason. They say there is free choice. I admit that the choice is free. But let me put it to you. If you were sick, and you have been bounced from pillar to post, from clinic to clinic all day long, and the doctor says "Take care of the prescription, and here is a pharmacy, you will be so happy to have it taken care of. so you can get home into bed. The free choice is not there-only in print. However, as was brought out by Mr. Fedder, for subsequent care, for subsequent refills, for advice, for discussion, the neighborhood drug store is there, and there is no place else to go. We cannot go to God-the religion is there, but not for a dose of medicine. The druggist is irreplaceable. I am speaking from a health viewpoint. Our economic impact has been brought out, and it is true. So, gentlemen, I feel that speaking for the men in the central ares |