At a time when more than one independent pharmacy in the U.S. closes nearly every day, leaving rural communities without adequate health resources, University of Florida pharmacy students and graduates are paying attention — and centering their career goals on serving those populations.
Garrett Smith, Pharm.D., a 2019 graduate of the UF College of Pharmacy, is helping set this example. In his hometown of Jay, Florida — a rural community of 500 people nestled in the northwest Panhandle — Smith opened Equity Rx to care for the friends, teachers and neighbors he has known his entire life. Offering everything from after-hours deliveries to face-to-face counseling, Smith has built a pharmacy centered on accessibility and trust.
“Independent pharmacies provide a vital health care service to communities, especially in rural areas,” Smith said. “I will oftentimes drive prescriptions to patients who have no reliable transportation to get to a pharmacy.”
Smith’s path to ownership began in 2020 during his community pharmacy residency at UF. When he learned a local pharmacy was closing, he committed to opening one himself. With no playbook, he navigated financing, licensure and regulatory hurdles to keep pharmacy services available in Jay.
Independent pharmacies under stress
Smith’s story reflects a broader challenge. Independent pharmacy ownership is rarely covered in pharmacy school, leaving graduates with little guidance on how to pursue it.
To address the gap, the UF College of Pharmacy hosted the Pharmacy Ownership Forum in Orlando in mid-August, bringing together more than a dozen independent owners and industry experts to discuss financing, operations, billing, medical coding and other essentials of pharmacy ownership with current students.
“Independent ownership isn’t often highlighted in the pharmacy curriculum,” said John Gums, Pharm.D., executive associate dean in the UF College of Pharmacy and a co-organizer of the event. “Yet independent pharmacies are cornerstones of their communities. They play a crucial role in advancing patient care across the nation. At the forum, we wanted students to see ownership as an attainable goal, supported by a strong network of owners.”
Owning an independent pharmacy has never been more challenging. Independent pharmacists face low reimbursement rates, competition from retail and mail-order pharmacies, heavy regulation and significant operating costs.
The National Community Pharmacists Association, or NCPA, reports that independent community pharmacies declined from 19,432 locations in 2023 to 18,984 last year — a loss of more than one independent pharmacy per day.
The decline is felt most in rural communities, where residents rely on local independent pharmacies for prescriptions and everyday health guidance. According to the RUPRI Center for Rural Health Policy Analysis at the University of Iowa, rural areas lost 16.1% of their independently owned pharmacies between 2003 and 2021.
These statistics reflect the difficult reality Smith faces every day — owning a rural pharmacy is not easy. But the positive impact on the community is invaluable.
“Being an independent pharmacy owner allows you to go the extra mile and practice pharmacy your way,” Smith said. “It’s so fulfilling because my patients are people I have known forever, and that kind of connection is missing in most pharmacies today.”
Successful independent pharmacy owners are finding new revenue streams by broadening their services to include immunizations, point-of-care testing, compounding and durable medical equipment. Some owners are also contracting directly with providers and employers. The NCPA reports that these non-dispensing services now make up a larger share of revenue, showing how innovation is keeping independent pharmacies viable while expanding patient care.
Pharmacy Ownership Forum fills a gap
For many students attending the Pharmacy Ownership Forum, the day was about exploring whether owning an independent pharmacy could be a viable career path.
Alexandra Ortiz, a second-year student pharmacist, was impressed by the personal stories shared at the forum and is now considering returning to her native Puerto Rico after graduation to open a pharmacy.
For Jonathan Salas, a first-year student, the forum was instrumental in helping him find his calling in pharmacy and explore different career paths.
“I want to use my time in pharmacy school to find the area where I can make the greatest impact as a pharmacist,” Salas said. “This event reminded me to keep all doors open, and now I’m interested in doing a rotation in an independent pharmacy to broaden my perspective.”
Forum organizers built the program with these kinds of discoveries in mind. Delivering the keynote address, Randy McDonough, Pharm.D., M.S., president of the American Pharmacists Association and co-owner of Towncrest Pharmacy in Iowa City, Iowa, drew upon his career to inspire students.
He described his bold decision to leave a faculty position at the University of Iowa to prove that innovative approaches could transform community practice. McDonough urged future pharmacists to embrace new revenue opportunities, adapt to changing reimbursement models and always focus on improving patient care.
“You have to be innovative, creative and brave to be an independent pharmacy owner,” McDonough said. “The reward is knowing you have made a difference in the lives of your patients.”
hosted by the uf college of pharmacy
Pharmacy Ownership Forum
