RALEIGH, N.C. — While national drug chains are successful at what they do, there is another approach to pharmacy, says Kerr Drug president and chief executive Tony Civello.

That approach is exemplified by Kerr’s forward-looking Community Healthcare Center in Chapel Hill, N.C., which emphasizes clinical pharmacy over prescription fulfillment.

Pharmacists at the store and other Kerr care centers are practicing “what they went to school for, which is patient counseling, chronic disease management and interaction with a physician,” says Civello. “It’s intervention to improve the health of patients.”

For the Chapel Hill business model to work it has to build customer loyalty. Slowly but surely it is doing just that, says Civello, resulting in prescription volume “growing very nicely.”

Awareness of the clinical services gives patients “increased reason to come back to Kerr Drug,” he says. “They bond with the pharmacist. So if a chain whips out a four-color $25 coupon it’s less attractive. Our patients actually have interacted with the pharmacist. They know him or her. He or she’s not just a person behind the counter.”

And the clinical pharmacists are extremely busy, he says, because patients have recognized that “this is the best of the best we’ve opened.”

Most recently Kerr has been successfully pursuing business-to-business opportunities, meaning it’s offering clinical services to other companies and health plans.

Also, with the state’s funding, Kerr provides medication therapy management (MTM) to North Carolina seniors on Medicare through the ChecKmeds NC program. The initiative enables Kerr pharmacists to review the medication regimens of seniors and track their compliance.

Generally, Civello says, Kerr is making its clinical approach ever more financially viable. That reflects the chain’s search for a point of difference ever since its founding, he says.

“We’ve been in this game for 13 years since we started our company. So we’ve really been educated on what programs are profitable versus which are just nice to have. We know which to invest in and emphasize.”

And at the same time that Kerr has been developing clinical services it has been breaking down the traditional silos of health care. Physicians in North Carolina are no longer oblivious to the work and expertise of pharmacists — as a number of Kerr clinical pharmacists work in medical practices.

“Through the years we’ve developed close relationships with physicians because the medical community knows that we’re dedicated to patient care and have the right people providing it,” Civello says. “Doctors are receptive to our pharmacists’ recommendations because they understand their dedication and the quality of their work.”

One unique pursuit by Kerr, and one that has significant implications for the long-term practice of pharmacy, is ­pharmacogenomics.

In conjunction with the University of North Carolina Eshelman School of Pharmacy down the road, the Chapel Hill store is conducting research into the basis for altering prescriptions for individuals’ genetic variations. The upshot could be more patient-specific prescribing.

Civello says there are too many 14,000-square-foot “catch-all drug stores with too much of the marketing and promotion that has to go with scrambling to sell them.” Regional players have to respond with sustainable alternatives, he says. “Our direction has to be total health care.”

He foresees opening pharmacies as small as 5,000 square feet — “just enough space to have a clinical presence with a fulfillment counter and pharmacists interacting with patients.” Such apothecary-style units could let Kerr be “a true partner with physicians” in a medical home setting or coordinated care center, he says.

Making Kerr’s strategy even more timely, Civello notes, is the imminence of health care reform. With the new law’s huge increase in the number of insured patients, there will be a shortage of health care professionals, particularly primary care doctors. The logical practitioners to fill the vacuum are pharmacists, he says.

“Since we’ve gone down this path, the opportunity has never been greater,” he says. “We need to move expeditiously to prove that we can be an integral part of the health care team. It’s time to seize the day — and it’s not a radical departure. It’s a chance for us to apply the professional knowledge and education that pharmacists have gotten, especially since pharmacy schools have gone to the Pharm.D. It’s an opportunity to get out from behind the counter and interact more directly with patients and physicians and play a meaningful part in health care delivery.”