Health & Wellness Compounding Pharmacy
“It all started when a customer — on his way out of the drugstore where I was working — waved at all the other types of products we carried and suggested that I ought to start a specialized compounding pharmacy using my specific skills,” recalled Mark Binkley, DPh.
The customer pointed out, “After all, only a trained pharmacist can do drug therapy. From a business standpoint, what you do is unique.”
That was in 1982 … but the offhand comment started Binkley thinking about taking a different path. What he consequently developed was The Health & Wellness Compounding Pharmacy.
The original business was located next to the Donut Den in Green Hills. It was the first pharmacy in the city dedicated to compounding medications to fill physicians’ orders for special medications for their patients.
The Pharmacy has since moved to the area around Baptist and Centennial Hospitals because Binkley wanted a more clinical setting … one near the offices of the medical practitioners the business serves … in order to grow the company from an apothecary-style practice to a service focused on finding solutions for individual healthcare problems.
In this “one size fits all” world (or as one optimistic manufacturer touted, “one size fits most”), the market appeal of the special and unique is growing, especially in the area of healthcare. While the concept might seem fairly new, it actually stems from ancient roots.
Chemists have always been familiar with various natural substances and the ways they could be used in medications, dyes, incense, perfumes, ceremonial compounds, preservatives and cosmetics. In the 19th century, perhaps because they were seeking gold … or maybe the mythical fountain of youth … drug compounders drove the Alchemy Movement, which eventually led to the creation of the modern pharmacy and the principles of pharmacy compounding.
Compounding combines an ageless art with the latest medical knowledge and state-of-the-art technology, allowing specially trained professionals to prepare customized medications to meet each patient’s specific needs. Fundamental to the pharmacy profession, compounding became the standard means of providing prescription medications before drugs were produced in mass quantities by pharmaceutical manufacturers.
The demand for professional compounding has increased as healthcare professionals and patients have come to realize the limited number of strengths and dosage forms that are commercially available might not satisfy the needs of every patient. Recognizing some patients need a dosage outside the norm that is prepared “just for them,” compounding pharmacies have the ability to customize medications to meet an individual’s need.
Additionally, the medication could be prepared in forms that are not commercially available, such as transdermal gels, “chewies” or even lollipops. The prescriptions also could be prepared without troublesome ingredients such as dyes, sugar, lactose or alcohol, and various compatible medications could be combined into a single dosage form for easier administration and improved patient compliance. There are now more than 20 compounding pharmacies in the Nashville area.
Binkley, who grew up in Nashville and graduated from Hillsboro High School, received a degree in biology from David Lipscomb University. He then received his pharmacy degree from Samford University in 1976. Binkley was named ‘Pharmacist of the Year’ by the Professional Compounding Centers of America in 1989 and received the ‘Innovative Practice Award’ from the Tennessee Pharmacists Association in 1999.
He noted that, at the Health & Wellness Compounding Pharmacy, they could fill any prescription or special medication order or customize anything to fit the physician’s orders. He said his pharmacy also fills a need for manufacturers and other industries that are required to have emergency prescriptions on hand for occurrences such as acid spills and other industrial emergencies.
“Ingenuity and experience are essential,” Binkley said of the process of delivering the medication as it is needed.
Binkley noted that many specific medications are still controlled by patent laws. However, when the medicines are not available from the manufacturer … even if still under patent protection, the law allows compounding pharmacies to produce the medication on the doctor’s order.
There are acute shortages of a number of medications that are still under patent protection, and compounding pharmacies have seen the demands grow to three times what they have had in the past. Compounding pharmacies have “had to get involved to actively meet the shortages.” Binkley noted that the situation gets worse every week and it is not clear what is causing the dramatic spike in demand.
Binkley admits that many physicians do not perceive the need for what compounding pharmacies do. Physicians often are not aware of the options compounding offers and might not realize what the pharmacists are allowed to do and are capable of doing to meet the needs of patients. Binkley also consults with a number of patients who are referred to him by medical practitioners for evaluation, “usually 10-15 consults on a given week” he said.
“Talking with patients is the fun part of what I do. Usually the therapies are simple and just a matter of hormone balancing,” Binkley said, suggesting that it is often a matter of “functional endocrinology.”
He continued, “We start working because there is a problem, and we can suggest several options, design a personal program for the patient and write a prescription.”
The Health and Wellness Clinic works very closely with Brooke Faught, RN, MSN, APN, at The Women’s Institute for Sexual Health (WISH), a division of Urology Associates. WISH provides specialized care to women facing the unique challenges of sexual function. Binkley said that Faught trained in Philadelphia, where she worked closely with a compounding pharmacy so “she came looking for us when she was setting up the practice.” He appreciates being able to be part of their work.
Binkley is always pleased when his team comes up with a unique solution for a patient. He said one of the “most rewarding” parts of his professional life is when he gets “thank-yous” from patients and physicians.