YFP 375: Breaking New Ground: Emmanuel Ayanjoke’s Vision for Altev Community Pharmacy

Tim Ulbrich interviews Emmanuel Ayanjoke, PharmD, on his journey to opening an independent pharmacy in Avondale, tackling challenges with vision, risk-taking, and community care.

This episode is brought to you by First Horizon.

Episode Summary

In this inspiring episode, Tim Ulbrich interviews Emmanuel Ayanjoke, R.Ph, PharmD, MBA, a third-generation pharmacist with a passion for community care. Emmanuel shares his remarkable journey to opening an independent pharmacy in Avondale, Cincinnati. Driven by a desire to make a difference, he pursued a pain management and palliative care fellowship, gaining invaluable entrepreneurial experience along the way. Through the support of Project Oasis, a McKesson initiative aimed at addressing pharmacy deserts, Emmanuel was able to turn his vision into reality.

Despite facing significant financial challenges, including high student loan debt, Emmanuel underscores the importance of calculated risk-taking and the power of strong relationships. Emmanuel offers insights into the future of independent pharmacy and how he has strategically aligned his personal and business financial plans to achieve his goals. This episode is a must-listen for anyone interested in the evolving landscape of independent pharmacy and the bold steps required to succeed.

About Today’s Guest

Dr. Emmanuel (Manny) Ayanjoke, R.Ph, PharmD, MBA is the proud owner of Altev Community Pharmacy in Cincinnati, Ohio. A graduate of University of Toledo College of Pharmacy, Dr. Manny has spent over 5 years serving various communities as a dedicated pharmacist. Before opening Altev, he worked at Ziks Family Pharmacy, honing his skills, and understanding the vital role of pharmacists in community health. His work as a clinical pharmacist at Ziks had notable success and he was featured as a keynote panelist at the American Pharmacist Association (APhA) 2022 conference. Alongside his clinical role at ZIKS Family Pharmacy, Dr Manny completed a fellowship in pain management and palliative care fellow at Cedarville University where he engaged in teaching, research, patient care, as well as creation of innovative ways to advance pharmacy practice.

Key Points from the Episode

• Opening Remarks and Sponsor Introduction [0:00]
• Emmanuel’s Career Path and Family Background [2:28]
• Pursuing a Fellowship and Entrepreneurial Vision [4:58]
• The Decision to Open a Pharmacy [10:45]
• Challenges and Support in Opening a Pharmacy [19:51]
• Intersection of Personal and Business Finances [27:30]

Episode Highlights

“I wanted to pursue something that allowed me to be an entrepreneur in some way; I knew it had to be something that would leverage my school as a pharmacist, and with my experience, I was like, well, in every other you know, area of pharmacy practice, they’re already really the people that are dominating. I want to sort of create my own niche.” – Dr. Emmanuel Ayanjoke [5:53]

“I wanted to sort of carve out a niche for myself in pain management, to be able to be an entrepreneur, be a consultant, pharmacist, and do all these things until the point that I was able to actually stop my pharmacy so it was still in line with my overall vision of being an entrepreneur and being able to self, direct, direct my destiny, and not, you know, be beholden to a paycheck.” – Dr. Emmanuel Ayanjoke [6:24]

“I think your biggest asset to success, for anyone, any successful person, is people.” – Dr. Emmanuel Ayanjoke [20:43]

“I’m not saying this because I’m anywhere yet, but I’m saying this because I’ve seen other people, and I learned from a lot of people, but what I found is people that tend to be successful often go against the grain, go against what the crowd typically does.” – Dr. Emmanuel Ayanjoke [23:17]

“My vision and the way I see things and my general approach to life and business is sort of like planting trees, right? And what I mean by that is, yes, you might not have the perfect nutrients for a tree that’s several feet high, but you can at least plant something for now. And that that is kind of has been my approach to everything. You might not feel like you have the financial capacity to do certain things, it’s still important to plant the tree. – Dr. Emmanuel Ayanjoke [28:37]

Links Mentioned in Today’s Episode

• Emmanuel Ayanjoke LinkedIn
• Altev Community Pharmacy
• Project Oasis
• NCPA Survey 
• The Dip by Seth Godin
• Subscribe to the YFP Newsletter
• Tim Ulbrich on LinkedIn
• YFP on Instagram
• YFP Facebook Group
• Your Financial Pharmacist
• YFP Disclaimer
• YFP Newsletter

Episode Transcript

Tim Ulbrich  00:00

Hey everybody. Tim Ulbrich here and thank you for listening to the YFP Podcast, where each week, we strive to inspire and encourage you on your path towards achieving financial freedom. This week, I sit down with Emmanuel Ayanjoke to discuss his decision to open an independent pharmacy as a new practitioner, his perspective on the future of independent pharmacy and the intersection of his personal and business financial plans. Let’s hear a note from today’s sponsor, First Horizon, and then we’ll jump into my interview with the Emmanuel. 

Tim Ulbrich  00:29

Does saving 20% for a down payment on a home feel like an uphill battle? It’s no secret that pharmacists have a lot of competing financial priorities, including high student loan debt, meaning that saving 20% for a down payment on a home may take years. For several years now, we’ve been partnering with First Horizon, who offers a professional home loan option, AKA a doctor or pharmacist loan that requires a 3% down payment for a single family home or townhome for first time homebuyers, has no PMI and offers a 30 year fixed rate mortgage on home loans up to $766,550 in most areas. The pharmacist home loan is available in all states except Alaska and Hawaii, and can be used to purchase condos as well, however, rates may be higher and a condo review has to be completed. While I’ve personally worked with First Horizon before and had a great experience with Tony and his team, don’t just take it from me. Here’s what Molly from New Berlin, Wisconsin, had to say about her experience with First Horizon: “The communication and always being available to talk over the phone was great for us. It also made an impact getting an initial overview and education on the process from Gail. Being able to submit everything electronically made it more efficient.” So if you want to check out the requirements for pharmacists Home Loan from First Horizon and to start the pre-approval process, visit yourfinancialpharmacist./home-loan.harmacist.com/home-loan.

Tim Ulbrich  01:58

Emmanuel, welcome to the show.

Emmanuel Ayanjoke  02:00

Thank you, Tim. I’m delighted to be here today.

Tim Ulbrich  02:03

Me as well, and I’m looking forward to the opportunity to talk to you about your experiences opening up in independent pharmacy. We crossed paths through the Ohio pharmacy circles over the past few years, and once you announced the grand opening of your store, Altev Community Pharmacy and the Avondale, Cincinnati area, I reached out to invite you on the show so we can learn more about your entrepreneurial journey. And before we get into that, let’s talk about your career path into pharmacy, Emmanuel, what led you into the profession and to the University of Toledo, where you completed your PharmD in 2020 

Emmanuel Ayanjoke  02:38

Absolutely. So I, you know, I’m Nigerian. Grew up in Nigeria. That was born in Nigeria, till I was I grew up left Niger when I was about 15 years old, and I was fortunate enough to grow up in the family of that pharmacy is a thing. So my dad was a pharmacist and a pharmacy owner, and his dad was a pharmacy, pharmacy owner. Now, back then, they refer to them as chemists, because this was way back then in the days, but they were, you know, I come from a long line of pharmacists, and I would never forget when I was about seven years old, because I think that’s the age where everyone kind of starts to pick up on things. And, you know, observe our parents doing different things, and I remember so vividly, so many moments where patients will just come in. And, you know, one of the things I always like to say is pharmacists. Pharmacy in Niger is very different than here. Pharmacy is much more front line of healthcare. You went to the pharmacy first before going to the doctor, they actually the pharmacist referred you to the doctor in things that were too complex to be handled in outpatient. So I grew up in that setting, seeing my dad as a pharmacist, business owner, taking care of his family, but also taking care of the community. And people just come into the pharmacy asking questions, having their needs, health needs met. You know, it was a different way to impact people’s lives, and that resonated with me very deeply. I, you know, grew up in that environment that I knew I wanted to direct my own destiny and own a business. And what dawned on me over the years is what’s more important in owning businesses, doing something that impacts lives. So put it short, I’ve always been in pharmacy. I grew up in a pharmacy, and I didn’t see myself doing anything else, because that was what was just in front of me. 

Tim Ulbrich  04:33

So third generation chemist, then, right?

Emmanuel Ayanjoke  04:36

 Yes.

Tim Ulbrich  04:38

So after you finished your PharmD at the University of Toledo, you went on to pursue a pain management and palliative care fellowship. And some might be looking at that and saying, All right, so you grew up in a pharmacy environment, independent ownership, owning your own business. And this seems like a different type of an opportunity. So tell us more about the pursuit of that fellowship, and what were some of the experiences and things that you took away from that?

Emmanuel Ayanjoke  05:04

Yeah, so the reason why I went to pursue a fellowship was at the time when I was in Toledo, I was an intern, and I because I knew I wanted to own a pharmacy at some point, I decided to only work in an independent pharmacy, and that so me served me really great, because I started to experience first clients, what it took to run a business, run a pharmacy business in the United States. And I was fortunate enough to have a great pharmacy owner who showed me so many things. But you know, unfortunately, what that did to me was kind of give me a very bad perspective of how pharmacy should what pharmacy is. And I thought that, well, pharmacy is what I want to end up doing, but I don’t think it’s the time. I don’t think it’s the right time. But knowing that I wanted to pursue something that allowed me to be an entrepreneur in some way, I knew it had to be something that would leverage my school as a pharmacist, and, you know, with my experience, I was like, well, in every other you know, area of pharmacy practice, they’re already really the people that are, you know, dominating. I want to sort of create my own niche. I don’t like to follow the general trends and what people do, you know, go to AMK and those things, and those things are great, and I do a lot of that, and I did a lot of that in my career so far, but I wanted to sort of carve out a niche for myself in pain management, to be able to be an entrepreneur, be a consultant, pharmacist, and do all these things until the point that I was able to actually stop my pharmacy so it was still In line with my overall vision of being an entrepreneur and being able to self, direct, direct my destiny, and not, you know, be beholden to a paycheck. I just that idea just just doesn’t sit well with me, so that, that was why I pursued the fellowship, and was a great, great experience for me. 

Tim Ulbrich  06:58

So what I hear there, Emmanuel, is there was this throughline of entrepreneurship that’s always been there, not surprising, right? Multiple generations in the family. And so you had this thought pretty early on, of, hey, I would like to own my own business, own pharmacy. Had some real life experience in independent pharmacy working for someone else, which I always recommend people that are thinking about, Hey, open up a business, get that experience, kind of see it firsthand, see what you like, what you don’t like. But through that experience, it sounds like you you butted up against the real challenges that we’ll talk about, you know, in the profession, and maybe that tampered down some of that interest, at least temporarily. And so you pursued this other pathway all the while, this through line of entrepreneurship, was there of, hey, I’m not sure exactly what it’s going to look like or when it’s going to happen, but I want to continue to pursue opportunities that are going to put me in a position in the future when I’m ready. Is that right?

Emmanuel Ayanjoke  07:49

Yep, that’s perfectly that’s that’s accurate. That’s exactly what happened. 

Tim Ulbrich  07:53

One thing you said I’d love to hear more from you on is, you know, I knew that I didn’t want to be beholden to a paycheck. I sensed some emotion in that statement of just, you know, I know myself, right? I know that that’s not for me. Tell us more about you know that realization and why that was important to you?

Emmanuel Ayanjoke  08:12

Yeah, I think that realization has always been there in the one thing I didn’t also say was, my mom was also an entrepreneur. She had her home business, and she, you know, used to run convenience stores and couple gas stations back at home then. So I knew for a fact that, you know, that that’s just what I wanted to do. But, but one of the things that I’ve also learned about the system of America is the reality that, unfortunately, those who you know pay for everything is the middle class. And when I say middle class is those you know who are professionals, and you know, you’re hit with so much taxes and so many there’s so many downsides to being a W2 earner. So I realized that real, that part, but also the quite honest reality is that you’re never paid what you’re worth as a W2 earner. That’s just a reality down. There’s no two ways around it. If you were paid your worth, no one would create companies, right? 

Tim Ulbrich  09:15

It wouldn’t make any sense.    

Emmanuel Ayanjoke  09:17

Yeah, it wouldn’t make any sense, right? So I just didn’t like that idea. I felt like there was a lot more I need to do in this world than to have my, you know, my impact kept by being by working at a place. But that’s just what drives me, you know, again, it’s okay for most people, and that’s, that’s fine. There’s nothing wrong about it. I just didn’t, I don’t think that aligns with me, internally and throughout my life experiences. 

Tim Ulbrich  09:43

Yeah, it’s interesting. And we’ll talk about the challenges of owning your own business. You know it’s real. I know it’s real. There are highs, there are lows, but it certainly does take off the ceiling. It also takes off the floor, right in terms of, you know what could go wrong, but you know what you’re sharing is very real. There’s no knock whatsoever to the path of a W2 you know, for many people, that is what makes the most sense, for a variety of reasons, but it is a reality that in the US, from a tax standpoint, the tax code is very much written in favor of people that own a business and own real estate. Those are really two things. And you know, it’s interesting we think about a lot of independent pharmacy owners, despite the challenges. You know, they’re really tapping into both of those things, and I can really sense how it was important you have that autonomy to be able to pursue not only the decision making in the business, but also to have some of the financial upside flexibility. But I want people to hear this loud and clear, like there is real downside as well when it comes to owning the business. And both must be considered, and we’ll talk about that here in a little bit. So take us back then you open the doors of the pharmacy in the Avondale, Cincinnati area in April of this year. And so at some point, you know, while you might have temporarily went away from Hey, I’m ready to open my pharmacy, it came back, right. So what was the moment where you said, All right, I’m ready to do this. And what led, what was the spark to really get into that place of alright, let’s go.

Emmanuel Ayanjoke  11:11

Yeah. So this was in 2022 which feels like last year, but two years ago, when I was in the middle of my fellowship, and I, you know, one of the things I value is network and having people around you that always look out for you. That is the value of that has just been immense in my life. But, you know, I was in my fellowship at the time, I was working part time, sort of, I mean, I wasn’t the official pharmacy manager, but I was basically the manager at the independent pharmacy that I worked at. So I was quite busy, you know, being the fellowship, doing research, and doing all these different things, and still fully commit, you know, helping out at the retail pharmacy. And I remember it was Stu Beatty, actually, from OPA. 

Tim Ulbrich  12:04

Oh, no way. 

Emmanuel Ayanjoke  12:06

Yeah, yes, yeah. He sent me the flyer to Project Oasis, which is the program that I got the opportunity to open the pharmacy through. And I started to learn about it. And initially I brushed it down. I was like, Well, this is some national program. There’s no chance that I’ll even get anywhere close to this. And I sort of didn’t even, you know, want to, I knew that’s what I wanted to do, but I really didn’t think I would get anywhere. And then, you know, two weeks later or so, Antonio Ciaccio who have gone to me, you know, through different experiences, and we’ve connected very well, he’s forwarded that same flyer to me, saying, Hey, I think you’d be a good candidate. I think you should apply to this. I was like, Oh, my so I guess the stars are aligned, and everyone thinks that I’m, you know, I tend to think of myself more humbly, and I didn’t think I would get anywhere. But you know, was these two folks that believed in me and encouraged me to go out and apply, and I took on the process and started doing my due diligence, drawing from my knowledge, and really leaning in on people that I know. Again, once I started to digest and understand what Project Oasis was trying to accomplish, it was almost mirror of what I wanted to do in every way right, make an impact in a place that doesn’t have a pharmacy, be the pharmacy, be the pharmacy shepherd, quote, unquote, in that community and helping address the needs and concerns of the community. So that just resonated with me on a very personal level, and it just aligned. And the biggest part of all that was that you got to open a pharmacy, but not just by yourself. You had the back end support of so many people that are committed to seeing this successful. So to me, was like, a no brainer, to at least pursue it. If it didn’t pan out, at least I learned a thing or two about writing a business plan that needed to be presented in like, you know, really, really hire people in McKesson, and so I applied for it, and that’s basically all where the story started.

Tim Ulbrich  14:22

You know, it’s interesting. Back to the through line of entrepreneurship. Emmanuel, I often say that, you know, for people and your story is such a good one, the synchronicity here is not accidental, right? So you might have kind of taken a sidestep or a pause, but it chased you down eventually, right? It chased you down in the form of Stu Beatty, now the Dean at Ohio Northern and Antonio Ciaccio, two incredible individuals in the profession and Ohio pharmacy practice that clearly saw a potential and an opportunity, and really, you know, that was a big nudge and an avenue forward. You mentioned Project Oasis a couple times. Tell us more about that for those that are listening, what exactly is that? How is that helpful to you getting this off the ground?

Emmanuel Ayanjoke  15:03

Yeah, so Project Oasis, was, you know, being that, you know, of course, I’ve been involved in no ins and out. But if you know, McKesson always tries, tries to tell everyone to just, you know, say certain lines. But I’ll give more, more back into how we started. You know, in Avondale here we had one of McKesson employees who lives and doesn’t live in Avondake, but family’s from Avondale here and has a very personal ties with community. This is way back then in 2018-2019 and he started to notice that his community was losing access to so many things. Grocery stores were closing, pharmacies were closing, and a community that’s in the heart of Cincinnati, literally, you see, health is right behind us, doesn’t have these critical things, grocery store, a pharmacy and so many other things that were needed. And there was this general talk within McKesson of trying to do a community impact project, something that would impact lives. And I think every organization of business should always try to do something beyond just their typical mission of whatever it is that they do to impact lives, because that’s where that’s all that matters at the end of the day. So they, you know, he took on the idea with support of folks within his division McKesson, that was a Russo O’Neill, okay? And he pushed his idea that, hey, let’s try to start a pharmacy where it’s needed. And they did an analysis and found that Avondale, Cincinnati, truly was, like, top of the list in terms of, you know, an urban region that doesn’t have a pharmacy, health isn’t where it needs, where it needs to be as a community level, and so many other things, disparities that were going on in Avondale, and that’s where it all started from. And, you know, fortunately, those within the higher ups of McKesson saw the impact that this project could make. And, you know, they dubbed the Project Oasis with the term that, you know, desert, pharmacy desert, and you’re putting the pharmacy there. And so, yeah, that’s what, that’s where Project Oasis started from, but one of the things that I learned through applying to it was the level of commitment that people had, not just as you know workers within this, you know, Fortune 10 company, but also the personal connection that people had towards a Project where people you know, you meet folks, are like, hey, whatever you need to be successful. I am happy to help you out. This is important. We want to make an impact in your community. So that was really, that’s really what Project Oasis is about. Now I don’t know what their what McKesson and their goal is right now with Project Oasis. But the goal was to sort of address this pharmacy deserts that come across, you know, the United States. 

Tim Ulbrich  18:07

So we’ll link to that in the show notes for folks that want to learn more about that program. Do you have an idea? Manu, I’m just curious now, how many pharmacies have been supported by Project Oasis?

Emmanuel Ayanjoke  18:19

Oh, so right now, I am the first.

Tim Ulbrich  18:21

Let’s go!

Emmanuel Ayanjoke  18:22

Yeah, I’m the only one so far. And you know, it’s quite, quite a responsibility to be success, to make this successful, because a lot of other communities are, hopefully, maybe might be impacted by this. So failure is not an option. That’s how I see it. So I’m sort of a test run to see, yeah, if this can work.

Tim Ulbrich  18:45

Well, you and I both know, from a business standpoint, there will be micro failures that happen along the way. I hear you in the global failure, right? But, but naturally, for you to see this vision through, you’re going to have to embrace some level of failure along the way and take some risks. One of the things that stands out to me, Emmanuel, is that, you know, I talk with a lot of people on a regular basis, they have an idea, but it often dies at that point, right? The idea doesn’t go forward. It’s a whole nother level to actually execute, take on risk and begin to see that vision through and and I’ve since in your journey, while you’ve always thought about owning your own business, clearly the support and the resources through Project Oasis have been huge for you to say, All right, I’m ready to jump. I’m ready to move this forward. In addition to project Oasis and the team from McKesson that support you, what other resources have been critical to you as you’ve gone through this, this journey of open your own pharmacy?

Emmanuel Ayanjoke  19:41

I mean, if I started to list them out, you provide spend the next hour of this going through it. But I think the most important resource for me, in addition to the things that I try to do personally, like reading a lot of books, listening to a lot of audiobooks, has been people, the people that have gotten to meet. For me, I value relationships at a very high attribute, a very high value to relationships. So people that played a key part in my life, as been my former boss that I worked with in Zik’s Pharmacy. He’s just been a terrific human being to me, and has helped me with the realities of owning the business and how to be successful. So it’s people. I mean, I could go down a list of folks at Cedarville who have helped me personally my personal growth as a pharmacist, helping me understand certain things. It really is just people. I think the big, your biggest asset to success, for anyone, any successful person, is people. 

Tim Ulbrich  20:49

Yes, relationships, people, absolutely. Especially in our profession, you know, where that community is is so small, right? Relatively speaking. And one of the things I asked you, before we hit record, I said, Hey, Emmanuel, how you doing? And you said, Hey, I’m going 1000 miles an hour, but I have so much support, so much support, and I think that speaks to the work that you’ve done in fostering those relationships, and the growth that has come from those. Emmanuel, I have to ask the obvious question that I think a lot of probably new practitioners that are thinking about owning their own pharmacy, or anyone, for that matter, that maybe is thinking about owning on a pharmacy, which is Wow, opening a pharmacy in this climate, right? We know the challenges are real. According to a recent NCPA survey, over 30% of respondents reported that they’re considering closing their doors in 2024 because of the financial challenges, and over 90% of them said that they may drop out of Medicare Part D in 2025 if the challenges still persist. So from the outside looking in, it doesn’t appear to be the best time to be launching a new pharmacy. So tell us more about how you’ve been able to, you know, see through that despite those challenges being real, and say, Hey, I’m still going to go at this. 

Emmanuel Ayanjoke  22:02

I think the first thing I’ve learned in life is nothing is truly as good as it seems, and nothing is truly as bad as it seems. It’s always all gray. There’s no exactly this is black and this is white. It never is that way. It’s always all gray. And what I mean by that is, will you dive deeper and understand in a specific market the factors and headwinds going on in that market is very different. For example, in Ohio, if you’re in a Medicaid an area that has high Medicaid concentration, you have a fair dispensing fee that covers your costs of operating as a business. So that alone is a huge difference than a pharmacy that doesn’t have a high Medicaid area, right? So, yes, there’s always there. They are real, harsh realities of the pharmacy right now, even as a new business, when I look at my Medicare, you know, scripts, and performance in those scripts, I mean, I want to, I would throw my hands up and just, it’s, it’s horrifying sometimes, you know, but the reality of what I’ve learned is, you know, typically, to be successful in life. And I’m not saying this because I’m anywhere yet, but I’m saying this because I’ve seen other people, and I learned from a lot of people, but what I found is people that tend to be successful often go against the grain, go against what the crowd typically does. And there’s cycles in life. There’s always going to be naders and high points. And I think pharmacy is out of Nader right now. But when you are the Nader, that’s not necessarily negative thing. That’s a good thing when you started a native because it’s only high from there. And there’s a lot of factors and a lot of things and challenges that are going to happen in next 10 years for pharmacy to be where it needs to be. But I think that I am hopeful that we’re at the lowest point, and from here it’s just moving forward. 

Tim Ulbrich  23:59

Yeah, I really hear mindset there Emmanuel, which I think is huge as a business owner, but I also hear optimism. I’m an optimist by nature, you know, as well. But I agree with you, actually, you know, it reminds me of Seth Godin talks about this in his book, The Dip, where, you know, often we go through these cycles, could be a project, could be a business, wherever you know, where we have an initial momentum and surge, and then we, you know, for whatever reason here we’re talking about market conditions and factors and reimbursement. You know, we kind of go down right, and we get to this low point, and we start to just come out of the other side of it, but we can’t yet see what’s coming. And that’s the point where a lot of people give up, you know, is when they’re in that low point, in that dip. And I think that it feels, and again, I’m a half glass full person, it feels like all signs are pointing towards some reform and these things, I think you and I look at this just as a common sense business owner, and we’re like, How in the world can this be okay to operate a business with these practices going on right? Now there’s a lot of headwinds that we’re facing in terms of why that’s the case, but I’m curious to hear from you as you look at as an owner and someone who shoulders some of the responsibility to advocate for, you know, the viability of community independent pharmacists to be able to provide the value that we know. The literature is very clear, the positive value and outcomes that a pharmacist can provide in their community, especially in an area where there’s a lack of access to healthcare. The data is clear. It’s there, but we continue to be undervalued and under reimbursed globally speaking. So as you look at this from, hey, I’m a business owner, but I’m also an advocate for the profession, what are some of those key issues that we really have to address?

Emmanuel Ayanjoke  25:35

Oh, where do I start? I think the biggest key issue is, you know, we live in a capitalistic society, and we just have to accept that reality. Our businesses are not, you know, they’re not you know, pharmacies are not nonprofits. They have to be able to make money doing a certain service. And there are two ways to incentivize people to do things. You either use the carrot or use the steak method, right? And to really move the needle on a lot of things in pharmacy practice, to get community pharmacy practice to be where it needs to be, there has to be payment reform. Reform in a sense that it covers us to operate as a business and provide those scripts, but also reform in a sense that we’re actually paid for the clinical knowledge that we provide. So those are, I mean, that sums, encapsulates lots of challenges, but those are the key. I think those are two things that need to happen for pharmacy, community pharmacy, to be where it needs to be. I think the values there. I mean, everyone is the values there. I’ve been opportunity to be on the tables with payers, physicians. I mean, everyone, even patients, everyone agrees that the values there. The challenge now is just getting rid of those barriers that allow us to be able to create a clear path to making these realistic, or, I guess, tactile, changes in the payment models that allow pharmacists to be paid.

Tim Ulbrich  27:08

Yeah, amen, you know, I think we it’s very clear. We don’t need another study to demonstrate the value of what a pharmacist can bring, right? We don’t need another pilot project, you know, to demonstrate that. They’ve been done. We see the value and the reimbursement, I think, is really the issue. And two individuals you mentioned earlier that were pivotal, you know, you started the pharmacy, Antonio Ciaccio, Stu Beatty, have been key advocates of this in the state of Ohio, you know, over the last decade, if not more. So last question I want to ask you is really the intersection between the business and the personal side of finances. You know, I talk with a lot of new graduates, and it’s not uncommon for me to hear something along the lines of, Hey, Tim, I would love to do X, Y or Z. And that could be on a business that could be, you know, do something different, work part time. It could be a variety of different things. But what comes next is my $200,000 of student loans, or insert any other financial challenge that is so common among new practitioners is a barrier to being able to go work towards these other goals that they have, right? And I think the golden handcuffs can be very real when you’re looking at a couple $100,000 of debt, and you can sign up and work for 120 130 $140,000 it’s hard to say no for that, and it doesn’t incentivize a whole lot of people to take risk in the way that you have done. So tell us about your decision, your journey to reconciling your own financial plan as a new practitioner, and ultimately making that decision to take on some risk as a business owner.

Emmanuel Ayanjoke  28:35

Yeah, absolutely. My vision and the way I see things and my general approach to life and business is sort of like planting trees, right? And what I mean by that is, yes, you might not have the perfectly, you know, I guess nutrient swallow for a tree that’s several feet high, but you can at least plant something for now, and that that is kind of has been my approach to everything, and why you might not have the financial capacity to necessarily, you know, you might not feel like you have the financial capacity to do certain things, it’s still important to plant the tree. And that’s, that’s how I see things. So I have about, honestly, have just slightly I’m a little bit better, and in comparison to a lot of pharmacy graduates, I have about $103,000 in student loans, which, which is still a lot of money, quite a lot of money. But it’s not nothing compares, in comparison to others who are just graduating. But the thing I would say is the way I would approach this is, do I have the cash flow to sustain my ability to eradicate those loans in a reasonable way? And if I do, or if I don’t, what ways can I mitigate that, even if I went to going to you know, own a business, that would be how our approach is. Because no matter how you see it, right, if owning a business is your end goal, if that’s where you want to be, time is going to go on. You know, time doesn’t wait for anyone. 10 years down the line, you’re going to be in the same place having, I mean, if you’re lucky, cleared all this debt, but at the end of the day, if this is something you want to do, you have to figure out to make your finances accommodate that in a way that makes sense. Now, again, it doesn’t mean you’re just blindly taking risks, right? Yeah, you actually have to calculate and see, okay, yeah. What is the worst case scenario if this happens, you know XYZ, and be able to be okay with that. If you can’t be okay with it, then maybe, I mean, some people, just maybe, the reality is that they actually are aren’t fit from a mindset perspective, to own a business, and that’s okay because it requires that you’re okay with, like, literally, things burning down. You just being by yourself and being able to weather through storm, you have to be okay with that reality, and that shouldn’t, shouldn’t scare you or deter you from accomplishing what you actually want to do. Yeah,

Tim Ulbrich  31:12

What I really hear there is, is, there is risk. It’s real, but it’s calculated risk, right? You’re not blindly entering into something, but we’re also not being paralyzed, you know? We could wait forever for the stars to align, you know. And I think that’s something I had to reconcile on my own entrepreneur journey. Is sure, could there be a tomorrow where it’s a better time, maybe, but there’s also a lot of things I don’t know that are going to happen tomorrow. And the question I always ask myself, not only in starting a business, but also in making decisions within the business, is, how high is the ceiling and how low is the floor. And I think my mindset, and probably for a lot of pharmacists, that I’ve kind of untrained myself, or I’m still untraining myself over time, is, you know, we tend to overestimate the worst case scenario, when, in fact, if we write it on paper, often it’s not as bad as we think it is, or built it up to be in our heads, and we maybe give we underestimate the potential of where this could go. Now, you got to be careful about that, right? If we have naive optimism, you know that that could burn us, but really assessing risk, you know, I think risk can bring a ton of emotions of fear, and we lose the objectivity of what are we actually talking about, right? What is the worst case scenario, and how can we begin to work through that? So I appreciate you sharing that as it relates to your own journey. Well, this has been fantastic. Dr. Manny, right as your patients call you, so grateful for you taking the time before you open the store today. A lot of inspiration that you provided to me in your own journey. I look forward to continuing to stay connected with you and to see where the journey goes going forward. Thank you so much for taking time to come on the show.

Emmanuel Ayanjoke  32:41

Thank you so much. Tim. Glad to be on.

Tim Ulbrich  32:45

Before we wrap up today’s show, I want to again thank this week’s sponsor of the Your Financial Pharmacist Podcast, First Horizon. We’re glad to have found a solution for pharmacists that are unable to save 20% for a down payment on a home. A lot of pharmacists and the YFP community have taken advantage of First Horizon’s pharmacist home loan, which requires a 3% down payment for a single family home or townhome for first time homebuyers and has no PMI on a 30 year fixed rate mortgage. To learn more about the requirements for First Horizon’s pharmacist home loan and to get started with the pre-approval process, you can visit yourfinancialpharmacist.com/home-loan. Again, that’s yourfinancialpharmacist.com/home-loan. 

Tim Ulbrich  33:30

As we conclude this week’s podcast, an important reminder that the content on this show is provided to you for informational purposes only and is not intended to provide and should not be relied on for investment or any other advice. Information in the podcast and corresponding materials should not be construed as a solicitation or offer to buy or sell any investment or related financial products. We urge listeners to consult with a financial advisor with respect to any investment. Furthermore, the information contained in our archive, newsletters, blog posts and podcasts is not updated and may not be accurate at the time you listen to it on the podcast. Opinions and analyzes expressed herein are solely those of your financial pharmacist, unless otherwise noted, and constitute judgments as of the dates published. Such information may contain forward looking statements which are not intended to be guarantees of future events, action results could differ materially from those anticipated in the forward looking statements. For more information, please visit your financial pharmacist.com/disclaimer. Thank you again for your support of the Your Financial Pharmacist Podcast. Have a great rest of your week. 

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