Crummy Variety Store With 50 outlets in the District, CVS has a near monopoly on drugs, cough syrup, hair spray--and customer dissatisfaction.

With 50 outlets in the District, CVS has a near monopoly on drugs, cough syrup, hair spray--and customer dissatisfaction.

Photographs by Darrow Montgomery

On South Capitol Street SW, a consumer's nirvana has taken hold.

Eight cash registers sit atop a red counter ready to ring up purchases. Rows upon rows of shampoo, conditioner, soap, and laundry detergent are all placed neatly on their shelves, each label facing forward. The cosmetics displays are pristine--no crumbling pots of eye shadow or half-empty lip-gloss testers that bored teenage girls have dug their fingers into. Every greeting card is in its proper place--no birthday cards mixed in with the anniversary cards. Nothing spills into the aisles, and enthusiastic clerks will soon replenish the few items that are out of stock. The pharmacy is fully stocked.


And then the clincher: There is no line at the register.

This is CVS: clean, uncluttered, and welcoming.

Wait a minute: CVS is never clean, uncluttered, and welcoming. This seemingly perfect store is not an actual drugstore at all, but a "mock store" inside the CVS/Pharmacy Regional Learning Center, located at the end of a sleepy strip mall. The store is used to train new employees of Washington's most prevalent chain drugstore. None of the beautifully arranged items in this fantasy land are for sale. "We actually have people come in and try to buy things all the time," says Caroline Garrett, the manager of the center. "They think that it's an actual store."

They should know better. Anyone who has stepped in one of the approximately 50 CVS stores sprinkled around the city has been conditioned to expect a standard of surliness and disarray that's nowhere to be found at the South Capitol Street decoy.

Washingtonians really want to like CVS, but the omnipresent drugstore has consistently let us down. A tome worthy of Tolstoy could easily be filled with complaints about the chain that fall into the standard lines-are-too-long, stores-are-dirty, clerks-are-unfriendly category. One Washington-area resident even hosts "CVS Awards" on his personal Web site. The award is bestowed on area stores that exhibit especially horrific service. "CVS Drugstores is the pinnacle of bad customer service," reads the disclaimer, "but they are so terrible, so very frustrating, that they are exempt from this list."

"I can't remember the last time that I had a positive experience in a CVS drugstore," says Capitol Hill resident Julia Robey. "In general, I'll go put a prescription in, it won't be ready on time, no one will call and let me know, I end up going back in to pick it up, and they'll tell me they won't have it for three days. I guess they get by on the fact that they have lower prices and the fact that they have everything, but they don't even have everything most of the time!"

Second perhaps only to Starbucks, CVS reigns as the big bad corporation that everyone complains about--while continuing to stop in.

And what a toll those visits take. We pay exorbitant rents and sit patiently in rush-hour traffic for the privilege of living in a semi-cosmopolitan city, yet we're forced to walk across the same dull, gray carpet and squint in the glare of the same fluorescent lights as CVS shoppers in Erlanger, Ky., and Ashtabula, Ohio. Even McDonald's, the king of all things uniform and generic, panders to its urban markets with an occasional colorful mural or an architectural flourish.

Once inside, it is easy to become paranoid cruising the aisles of the store, as you discover that all of your favorite items are out of stock. Scunci hair elastics--nope. Tums Extra Strength--every single variety but the cherry-flavored that you prefer. Unscented Mennen Speed Stick, extra-dry--forget it. Even if your needed items are lying on the floor of some back room waiting for you to take them home, asking the clerks to take a look is futile--on their list of priorities, digging your deodorant out of storage ranks right down there with "Smile!"

The CVS store clerks bear the brunt of our frustrations, often unfairly. Maybe it's those red aprons they wear. Perhaps the color brings out our bullheaded nature, or, like red lipstick or a candy-apple car, gives them an instant cool, aloof aura that is the antithesis of the warmth that girds good customer service.

CVS's one redeeming quality would seem to be that the presence of three stores in every bustling neighborhood would reduce the chance of running into friends, co-workers, or exes while you stock up on personal items. However, you're more than likely to run into someone you know just as the pharmacist loudly informs you that Diflucan is out of stock, but you're welcome to grab a tube of Monistat on your way out.

And, although for most of us, the plastic cargo boxes and other marginalia that clog many CVS aisles are passing, quotidian annoyances, for others, they're a big deal: The Disability Rights Council of Greater Washington filed a lawsuit against CVS in July, claiming that the messy, junk-filled aisles make it nearly impossible for those confined to wheelchairs to shop.

The chain's characteristic clutter is nearly always on display at the Penn Branch outlet on Pennsylvania Avenue SE, where empty boxes and an overflowing Dumpster grace the entrance. The strip mall's tiny parking lot is generally overwhelmed by CVS traffic--idling cars wait in a long line, hoping that a space will open up. One man leaving the store on a February evening clutches his red-and-white bag and mutters to himself the thought that most of us have after leaving CVS: "I can't stand this fucking place."

Faced with persistent consumer grievances, officials at the Woonsocket, R.I.-based company insist that the best way to improve conditions at area Consumer Value Stores is by formally complaining. "Call our 800 number--we encourage you to call and register your opinion or views on any particular store so that we can respond to them," says Todd Andrews, director of corporate communications. "D.C. is a market we value very, very much--we want your feedback."

But the corporate spinmeisters might

consider another tack: "At least we're better than People's."

That would shut up a lot of folks. For those who've landed in D.C. within the past decade, here's a primer on CVS's local legacy: Until 1990, when CVS gobbled up all of its local outlets, People's Drug essentially operated on the same customer-service platform as the vintage-'80s D.C. government: Answer no questions, help no one, and then go on break.

People's' decades of misery are slow to fade from the memories of District residents. Howard Schaffer still remembers the poor service he received in August 1973 when his wife was pregnant with their first child and he went to his neighborhood People's Drug in search of baby items.

"I was completely new to the experience, and I required help, which they did not give me. I had gone in with great excitement, as you would expect, but I left completely deflated by the surly treatment I received," says Schaffer. "I still remember that experience all these years later, and CVS has inherited my bad feelings towards People's."

Although People's was far from perfect, many Washington area residents had a soft spot for it, if only because the chain, which first appeared in 1905, had been around for as long as anyone could remember. Perhaps because of this recognition factor, CVS didn't change the name of the People's stores immediately. Instead, CVS spent nearly $40 million to modernize existing People's.

Four years later, CVS decided it was time to bid goodbye to the People's name. Almost overnight, People's Drugs around the area disappeared and in their place came the glowing red-and-white signs-cum-beacons inviting us to come in and stock up on nail polish, toilet paper, and, of course, drugs.

The mourning, if any, was brief. Feelings of nostalgia for the city's oldest drugstore were soon replaced by the hope that the larger, more powerful CVS could deliver a higher level of service. Other stores in the nation boasted longer hours, discounted prices, and an array of fun and seasonal specialty items--like beach balls and patio furniture.

But after slapping its logo up all over town, CVS wasted little time in offending the local folk. It went on a historic-destruction binge of sorts, setting up stores in many of our beloved old movie houses, including the Ontario in Adams Morgan, the Sheridan on Georgia Avenue, the Biograph in Georgetown, and the MacArthur in Palisades.

Residents were also concerned that CVS, being able to offer even lower prices and more merchandise that its predecessor, would deliver a final crushing blow to independent drugstores. After all, if the smaller pharmacies that had done business in the city for decades closed their doors, residents would have few shopping options left when filling prescriptions and stocking up on toiletries.

CVS acquired Revco Drugs and Arbor Drugs in 1997 and 1998, respectively. These acquisitions, along with the People's merger, made CVS the largest drugstore chain in the United States by store count. (The Illinois-headquartered Walgreen's is still No. 1 in terms of revenue.)

In 1999, CVS rounded out its acquisitions by purchasing, the first Internet pharmacy site in the country, and was born. CVS partnered with the cyber doctors at WebMD in creating its Web site, making it a true virtual pharmacy. Overactive bladder? Not only can you learn about the condition and ways to remedy it, but you can purchase medications and Depends, as well--all in one spot.

CVS is the largest retail provider of prescriptions in the nation. It dispensed 300 million prescriptions in 2000--approximately 12 percent of all prescriptions in the United States. One out of every nine prescriptions in this country is filled at a CVS pharmacy.

No chain that handles such a volume of transactions can avoid pissing off customers. One customer outlet for complaints against the store is the Better Business Bureau of Metro Washington and Eastern Pennsylvania. Currently, the Washington-region stores have an "unsatisfactory" report with the bureau due to unanswered complaints.

"The company responded to some customer complaints with an explanation of its policies, contacted the customer and sometimes provided a refund or adjustment. Other complaints remain unanswered in our files," reads the bureau's report, which covers all CVS stores in the Washington area during the past three years.

Judy Tankersley, director of operations for the bureau, says that the complaints are "all over the place"--relating to photo finishing, pharmacy service, and product refunds. Metro area CVS stores had 26 complaints filed against them in the past three years. Tankersley notes that 26 complaints isn't excessive for a company with so many stores. "It's not an overwhelming number," says Tankersley. "Think of the number of outlets they have."

Of course, not everyone who gets miffed files a complaint with the Better Business Bureau. In fact, CVS stores rarely outrage their customers, at least not enough to spur them to seek formal action. Most people don't experience one monumentally bad episode but rather a continuous series of nuisances that eventually become unbearable, in a process not unlike water torture. People are reluctant to complain because, finally, they still need a place to get their prescriptions filled, and customers often think their complaints fall on deaf ears, anyway.

"It's not worth it to complain because the people you're complaining to don't care," says Robey. "It's definitely a corporate problem. The people who work there aren't paid enough money, and they aren't given a sense of pride, so they don't care."

One former employee, speaking about CVS on condition of anonymity, agrees that the attitudes of overworked, underpaid employees infect the stores.

"They hire people, but don't give them enough scheduled hours to earn a living," says the former clerk, who worked in a Northeast store from 1998 until 2000. "They want you to give your all, but aren't willing to do the same for their employees. There were always problems with paying employees on time, and they expected us to work unpaid overtime. When other employees wouldn't show up for work, they expected those of us who were there to cover their shifts--without [extra] pay."

Andrews denies that such payment violations occur at a CVS store. "CVS pays its employees on time and in accordance with all laws and regulations governing overtime," says Andrews.

Complaining about the city's dominant pharmacy is one of the luxuries of a gentrifying District. Struggling neighborhoods, after all, don't get a second look from the corporate location people. "CVS doesn't affect our business, because in the neighborhood that we happen to be in, there is no other pharmacy nearby," says Crystal Shaw, a pharmacy technician and store manager at Neighborhood Pharmacy, a small independent drugstore on Martin Luther King Avenue in downtown Anacostia.

Despite its placement of training facilities in Ward 8, CVS operates few stores there--or in any other less-than-tony areas of the city. In fact, of its 50-odd stores in D.C., just two are located in the portion of Southeast that is east of the Anacostia River.

Neighborhood Pharmacy owner and pharmacist Dr. Sahr Bockai believes that because it largely stays out of neighborhoods with poorer populations, such as Anacostia, CVS is disingenuous in stating: "Our mission is your well-being."

"CVS doesn't want to come into this neighborhood," says Bockai. "They are only concerned with economic growth; they don't care about coming into neighborhoods that need and deserve their services."

"They target areas where residents have a lot of money. They don't come into poor, minority neighborhoods," Bockai continues. "Look at Connecticut Avenue, Wisconsin Avenue, K Street. They have two stores on each block. In my area, there are thousands of people and only one CVS in this part of Southeast."

HQ dismisses such theories. "We have stores in every part of D.C.," says Andrews. "In some areas, there are more than others--Wisconsin Avenue, K Street, Upper Georgetown, Connecticut Avenue. We're looking for areas with a high population density, high traffic, with a lot of businesses and office workers and commuters--people using disposable income. There are more stores in these areas than in a neighborhood."

"We put stores in areas where they're going to do good business," Andrews continues.

Larry Demaree, president of the Bethesda-based consulting group Demaree and Associates, says that when companies like CVS go shopping for commercial property, their primary concern is not serving the community. "The value of a commercial property to a retail tenant is absolutely driven by the amount of business that they can do out of that location," says Demaree. "Lower-income neighborhoods have lower incomes, less money to spend, so a site would be less viable there. For them, it all goes back to sales."

Still, CVS is reluctant to say that the sole factor affecting store location is revenue. "The commercial strip in Anacostia isn't too long--maybe one store there is enough," Andrews continues. "There is no other national company with the presence in Anacostia that CVS has."

The Anacostia "presence" Andrews refers to is largely the CVS Regional Learning Center, which is located inside a One-Stop Career Center run by the D.C. Department of Employment Services (DOES), which is technically in Congress Heights. CVS also donates money to several programs that affect Anacostia residents, including a mobile medical van that screens at-risk children.

The front of the career center houses the DOES portion of the operation, where job seekers have access to the Internet, telephones, and fax machines, and can sign up for a variety of services to boost their employability, including resume assistance, job placement, and career counseling. Those who express interest in working at CVS are recommended by the DOES, get interviewed by a CVS representative, and, if hired, begin training at the mock store.

"It was a great opportunity--especially for this area," says Stephen Wing, director of government programs for CVS. Last year, the center trained and hired 1,225 individuals at the learning center. Wing estimates that 85 percent to 90 percent of those were city residents, and a large portion of those were from Ward 8.

The center has been instrumental in "Project Empowerment," a fancy name for the welfare-to-work partnership CVS has with the city. Welfare-to-work programs have been universally criticized for placing people in dead-end low-wage jobs, but CVS argues that opportunities for promotion abound and that skills learned in the photo lab and the pharmacy are easily transferable. In addition to its other accomplishments, Wing insists, the center has spruced up Congress Heights. The one thing still missing from the neighborhood, however, is a working CVS drugstore.

Classic ghetto economics drives Woonsocket's approach to serving east-of-the-river neighborhoods. While the company wants business from those neighborhoods, it's unwilling to build enough outlets to serve them individually. The result is a couple of gigantic stores that are dirtier, and more poorly stocked, in both front-end merchandise and pharmaceuticals, than their Northwest counterparts.

The CVS on Naylor Road in Southeast is a case in point. The stand-alone store, which sits between a Burger King and a liquor store, is so large that clerks have a difficult time restocking items quickly. Plastic "totes" filled with items ready to be placed onto shelves sit in the aisles. A display of diapers that spills onto the floor creates a labyrinth. The pharmacy, however, is one of the nicest in the city. A lot of the customers are elderly, and the pharmacy technicians know that many of them have endured long walks and crowded buses to get there.

"People here don't have transportation," says Bockai. "They need a nearby pharmacy more than anyone. CVS needs to serve those in need."

The CVS at the East River Park shopping center at 40th Street and Benning Road NE is among the nastier retail spaces in the city. It would be difficult to find a store with more trash strewn about, both inside and outside the building.

"Eeewww! Look! Somebody's drink!" exclaims a little girl to her mother upon entering the East River Park CVS. On top of a stack of plastic totes in the magazine aisle is a sweating McDonald's cup, complete with a perfect lipstick print on its rim. The clerks at the front are faced with long lines; the clerks at the pharmacy are faced with long lines--nobody has spotted it.

In July 2001, the Disability Rights Council, along with three disabled city residents, filed a lawsuit against CVS in U.S. District Court. The suit charges that the cluttered aisles of the store are more than merely inconvenient--they make CVS stores inaccessible to people in wheelchairs, thereby violating the Americans With Disabilities Act.

"We got enough complaints from people having difficulties getting through the aisles. I'm in a wheelchair, and I saw that all of the stores were a mess and thought that something has got to give," says Margaret Mann, who works for the Disability Rights Council and is one of the plaintiffs named in the lawsuit.

In fact, Mann, along with others with her organization, surveyed every single store in Washington and found aisles filled with boxes, and cardboard displays at the ends of aisles that made it difficult for wheelchairs to pass through. "One time, I somehow caught one of the displays in my scooter trying to pass and knocked it down, scattering phone cards far and wide," she says.

Although Mann says that CVS employees assist customers with special needs by reaching items on high shelves or moving obstacles out of the way, she contends that she shouldn't be forced to ask for a hand. "It's embarrassing. CVS employees are eager to help, but it's embarrassing to ask for help, especially in dealing with personal products," she says.

The Disability Rights Council and CVS are currently in the process of negotiations regarding the suit. Andrews says that CVS is working hard to remedy the problem of messy stores. "The Disability Rights Council raised legitimate concerns, and we are in negotiations with them to address those concerns," he says.

"Outside of that, we're working to make sure stores are easier to navigate," Andrews continues. "We're reducing the number of cardboard displays, so they don't creep into the aisles. Also, the plastic totes that are used to restock items--we're giving training and guidelines for how long the totes can be in the aisles--we're teaching people to think about keeping those aisles clear."

Despite new policies, the process is far from perfect. Evidence from several visits to several area CVS stores suggests that the totes are often in the aisles--in many cases for longer than one shift. At the Naylor Road store, an aisle full of plastic totes that was present on a Thursday visit was still in place the next Monday morning.

Andrews admits that it is a tricky problem to tackle, but suggests that Washington-area shoppers take part in keeping the stores neat by speaking up and complaining when stores are less than tidy: "On your register tape--one out of every 10 gives an 800 number you can call where you're given a survey about your experience. One question is 'Was the store neat and uncluttered?'"

Andrews cites factors that make the D.C. market especially troublesome in terms of store cleanliness. "We're working hard to address this issue. D.C. is challenging because we're not usually in stand-alone locations. We don't have a lot of square footage and flexibility in the older urban buildings. We're making a concerted effort to address this concern--which we believe is a legitimate one."

Mann blames Woonsocket for the obstacles: "[One manager] told me that the reason things are in the aisles is because there is almost no storage space at their store, but that corporate headquarters gives no slack in terms of items carried by the store. The smaller stores shouldn't be required to carry the amount of merchandise that the larger stores do."

And the former CVS clerk says that ringing up rushed customers takes precedence over clearing aisle space.

"I can't speak for all stores, but at my store, we would straighten up before closing--vacuuming, putting things back," the clerk says. "During the day, especially if we were short-staffed, we wouldn't get a chance to keep things up because there are so many people in and out during the day--you can't keep up. In my store, we had to keep an eye out for shoplifters, and deal with other problems that would come up, so we really wouldn't get a chance to clean up."

The health-care industry is moving away from doctor visits and hospital stays in favor of managing many illnesses and chronic conditions with drugs. The trend means that there are more drugs on the market--and more prescriptions being filled than ever before.

It also means that your local CVS could well drop the ball on your next prescription.

Capitol Hill resident Mary Fran Miklitsch stopped using the pharmacy at her Eastern Market CVS several years ago, following an incident when she was given a completely wrong prescription.

"I avoid CVS at all costs," Miklitsch says. "I don't use the pharmacy at all. There was a mix-up with the pharmacy several years ago that was sort of the last straw in a series of mishaps. I went into the store to get a prescription filled. I waited for it, paid for it, and went to leave. For some reason, I decided to check it before I left the store. I checked it and it was completely wrong--it was a medication that I had never used in my entire life. I decided that this is too risky."

"If you encounter or even suspect an error has been made in your prescription in any setting--hospital or pharmacy--you should immediately notify the pharmacist before taking the medication," says Andrews. He also notes that Miklitsch's experience happened several years ago, before CVS put new pharmacy safeguards in place.

"Over the last several years, CVS and other pharmacies and hospitals have invested in technology and other systems designed to assist the pharmacist in accurately filling prescriptions," Andrews says. He mentions pharmacy computers that display the image of the prescribed pill, as well as enlarged views of a doctor's handwritten prescription.

Miklitsch's complaint is a particularly serious one, but lesser offenses occur in pharmacies every day. One frustrated Dupont Circle CVS customer has had a string of bad pharmacy experiences at the store.

"I went in to pick up a prescription. There was one other woman in line ahead of me and three women behind the counter working," says the customer, who wishes to remain anonymous. "They kept the woman in front of me waiting for about 10 minutes before they would even look at her--she was obviously frustrated. She was looking at her watch and tapping her foot. Meanwhile, they're behind the counter chatting with each other."

On another visit to the same store, the woman had a similar experience: "I go back a few days later to pick up another prescription, and there are five people behind the counter and only one is dealing with customers. They keep me waiting 20 minutes before anyone will help me--20 minutes is a long time. They're just behind the counter talking to each other, and hollering out people's business. So finally, after a line begins to form behind me, someone comes over and says, 'Yeah?'"

Such treatment doesn't quite jibe with the pharmacist's self-image.

"Pharmacists are trained health-care providers. They're not just pushing pills. Their main goal is to make sure that patients take their medications in the correct way," says Crystal Wright of the National Association of Chain Drug Stores (NACDS), an organization that represents CVS and other chain pharmacies.

Most pharmacy grievances are minor infractions related to customer service, but scarier experiences, like Miklitsch's, are becoming all too common in drugstores across the country. Unlike housekeeping problems, pharmacy screw-ups largely stem from larger, industry-wide trends, and CVS is hardly the only pharmacy having trouble tackling them. There is a nationwide pharmacist shortage, which is making good help increasingly hard to find. The overworked pharmacists, to boot, are working with more drugs, a higher volume of prescriptions, and, thanks to managed care, complicated billing systems and prescription cards.

Pharmacy schools in the United States have also recently moved from five-year programs to six-year programs, meaning that there have been fewer pharmacists graduating and entering the workforce in the past few years.

"Our clients have reported more than 7,000 vacancies," says Wright. "There are short-term responses to the problem--such as reducing pharmacy hours to reduce the burden on pharmacists--and longer-term solutions."

In the latter category, the NACDS is currently working with state legislators to make the dispensing process easier on pharmacists. It's pushing for easy-to-read, vibrantly colored labels and a standardization of insurance-card information.

"The pharmacist shortage is a result of many different factors," says CVS's Andrews. "There are more and more drugs available than ever before as managed care turns to drug therapies because of their lower cost. Also, we have a rapidly aging population. These factors have created a greater demand for pharmacy services."

"In 2001, we hired 2000 additional pharmacists. We are in the best shape we have been in in many years in terms of pharmacy staffing. There are pockets of problems--D.C. is one of them. There is a great demand for pharmacists in the D.C. area because of its high population density. There are intangible and tangible factors--the cost of living in D.C., for example, can be prohibitive for pharmacists looking for jobs," says Andrews.

And chains have been hit much harder by the pharmacist shortage than smaller, community pharmacies that have a much lower staff turnover rate. Many independent pharmacists, furthermore, are also owners and therefore have a vested interest in the business.

"There is a pharmacist shortage nationwide, which impacts all of us, but the chains even more so," says Ed Dillon, owner and pharmacist at Grubb's Care Pharmacy on Capitol Hill. "In community pharmacies, the pharmacists are often the owners, too, so they are willing to work the longer hours that are needed to keep up, and they're not going anywhere. Chains are cannibalizing each other trying to steal the best pharmacists away from each other--not only CVS, but stores like Rite Aid, too."

CVS's workforce woes, however, won't extract much sympathy from the hordes of customers who stand in line, sandwiched between magazine racks and cough-syrup displays, waiting to get their prescriptions filled.

"The problem with the pharmacy is that they don't give good estimates," says the former CVS clerk. "They could tell you your prescription will be ready in 30 minutes, but they're not factoring in the workload they already have, so you have to sit around and wait for a long time. If you say you're coming back, you don't get priority, so when you come back, your stuff still might not be ready."

"CVS is the 800-pound gorilla--they won't go away," says Dillon, whose Grubb's Care Pharmacy is one of the few longstanding independent community pharmacies that have weathered the CVS invasion and emerged unscathed.

CVS has long been accused of pushing smaller mom-and-pop operations out of business. The accusation was correct until very recently. Between 1997 and 1999, independent community pharmacies across the country were shutting their doors at a rate of 451 per year. In 2000, however, the trend reversed, and new independent stores are opening all over the country--244 in 2000 alone. Independent-pharmacy owners in D.C. attribute the industry comeback to, among other things, public frustration with chain pharmacies.

"It's good to have a CVS right across the street, because when people get tired of their crappy service, they'll come to us--they're all terrible," says Michael Foer, a co-owner of Foer's Pharmacy. Foer says that his downtown store, at 18th and I Streets NW, is surrounded by six CVS drugstores.

Foer's Pharmacy has four outlets in the Washington area--two in Northwest and two in Bethesda. Foer's had a Capitol Hill store from 1987 until 1999, when, to the dismay of neighbors, it was replaced with a CVS ProCare--a subsidiary of CVS that focuses on chronically ill patients, such as those dealing with HIV/AIDS, organ transplants, infertility, and cancer.

ProCare apothecaries specialize in serving patients who need "complex, highly expensive drug therapies over an extended period of time," according to a summary of ProCare in CVS's 2000 annual report. CVS says it would be "impractical" to stock such medications in every CVS store, so the company created ProCare as a place where sicker patients could receive more individualized attention from pharmacists and easily obtain needed drugs not necessarily available in a standard CVS pharmacy.

There are now 46 CVS ProCare stores in 18 urban markets--including one in the District. CVS plans to open 100 to 125 additional ProCare stores over the next few years, but some believe that the company may have missed the bus in terms of capitalizing on the chronically ill.

"They're behind with ProCare--they should have done it five years ago," says Foer. "Still, no matter how you package CVS, it's still CVS."

The ProCare pharmacy that replaced Foer's Capitol Hill outlet closed a few months ago. "The landlord actually contacted us about re-opening in that spot," says Foer, "but we've since opened up a fourth store, in Bethesda."

Smaller pharmacies are also able to offer individual attention that impersonal big chains just can't. ProCare was CVS's attempt to offer just such care--in effect, an effort to create the anti-CVS CVS. But smaller pharmacies are more experienced at that game. Grubb's Care offers special "club" packages designed to help chronically ill patients learn how to monitor their diseases. For example, Grubb's' Blood Glucose/Diabetes Club includes meal planning and education on proper usage of insulin injections and oral medications.

"We built our business on specialty services. We are able to focus on the sicker patients--those with HIV, diabetes, high blood pressure-- and offer them refill reminders and other things that the big chains can't do," says Dillon.

Bruce Frishman, president of New Hampshire Pharmacy and Medical Equipment, notes, "Basically, the independents that are still around are strong because they have captured a market niche. No one can compete with CVS in selling shampoo and detergent. All of us have a niche. Homeopathic medicine, for instance, is a niche. Ours is medical supplies."

After her drug mix-up at CVS, Miklitsch filled prescriptions at Foer's and, after it moved, at ProCare. "I went there for a while, but, again, over time their service went down the tubes," she says.

When the Capitol Hill Foer's closed, neighbors were afraid the store had fallen victim to a corporate takeover, but Foer says that was not the case. He willingly sold to CVS and put the profits into financing one of the Bethesda stores.

"Our business on the Hill was good. We weren't forced out--we sold the store to them," he says.

While independent pharmacy owners say their stores are doing well, chain pharmacies are left floundering to fill pharmacist positions. Another reason independent pharmacies are making a comeback is that they are better able to handle the pharmacist shortage and the influx of new drugs than big chains are.

"There are new medicines coming out all the time, because the emphasis is on getting people to take medicines that will keep them out of the hospitals. With more prescriptions, and less good help, it is hard to keep up. Chain drugstores have been hit hard--they're victims of their own success," says Dillon. "They're faced with problems, and we're faced with problems, but because their business is on a much larger scale, it's harder for them to deal with. We're able to focus on our neighborhood and our patients."

Chain drugstores have also tried to persuade consumers that they can offer drugs at much lower rates than smaller druggists. However, although you may be able to use your CVS ExtraCare card and get a steal on notebooks, or maybe catch an advertised special on hair mousse, medications are another matter.

"Chains have tried to convince consumers--sometimes rightfully so, but often just as good advertising, that their prices are cheaper. Well, studies have shown that community pharmacies are competitive, if not less expensive than the big chains," says Dillon.

Says Foer: "People come to community pharmacies not because they hate CVS, but because our service is so much better than that of a big chain. They can't compete with our service--but they do sell nice beach chairs." CP

Art accompanying story in the printed newspaper is not available in this archive: Photographs by Darrow Montgomery.

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