KHI News Service

Will Kansas be able to find enough rural pharmacists?

There are a few like Jonathan Brunswig, but not enough

By Mike Shields | January 17, 2011

There are a few like Jonathan W. Brunswig, but not enough to go around.

Brunswig, who grew up in the small western Kansas town of Tribune, graduated from the University of Kansas School of Pharmacy in 1998. He then decided to return to rural Kansas to earn his livelihood.

Now, Brunswig and his wife (Jena Robertson Brunswig, also a KU pharmacy grad) own and manage pharmacies in the small towns of Lakin, Leoti and Scott City.

Each of the pharmacies is the only one in its county, which means the residents of sparsely populated Kearney, Wichita and Scott counties in far, west central Kansas have local pharmacy services when they need them thanks to the Brunswigs' energy and enterprise.

Leoti went two years without a pharmacy before the Brunswigs arrived. Lakin went three years without. Scott City has always had the benefit of at least one drugstore.

Hospitals and nursing homes in the region also rely on the Brunswigs.

In addition to managing the retail operations, Jonathan Brunswig serves as pharmacy director or consultant for five small hospitals in Quinter, Scott City, Dighton, Lakin and Leoti. The Brunswigs consult with nursing homes in Garden City, Scott City, Leoti, Lakin and Dighton.

Scott City residents recently approved a ballot question for a new hospital. When the new facility is completed, the Brunswigs (along with the local optometrist) plan to have a new pharmacy building built beside it. Construction is slated to begin on the new pharmacy structure in May.

Coming back home

The Brunswigs’ success has been a magnet for others.

Jonathan Brunswig’s sister, Jenifer Brunswig Nemechek, also graduated from KU’s pharmacy program (in 2004) and now works with her brother in Scott City. A fourth and more recent KU graduate, Tyson Mullen, also has joined the Brunswigs' business. He mans the pharmacy in Leoti. Each of the four earned a doctorate in pharmacy.

Scott City Health Mart, one of the retail locations owned and managed by the Brunswig family.

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Two initiatives could help

“My wife and I and my sister grew up in Tribune, which is just down the road,” Jonathan Brunswig said. “Tyson was originally from Leoti, so we kind of all came back to western Kansas.”

But finding pharmacists to work in rural Kansas is not easy, according to recruiters and others.

Brunswig said the lack of additional pharmacists is the main obstacle to his business expanding more. For example, he could foresee opening a satellite operation in Wallace County.

“We see that there are other opportunities to expand,” he said, “but the problem is getting pharmacists to come out to western Kansas. We kind of home grow our own. There are a couple of students that are from each of our communities in school now and we hope they want to come back. Our biggest limitation to expanding is finding help.”

At least 30 of Kansas’ 105 counties are considered “underserved,” because they have only one pharmacy. Six counties have none, according to statistics from the University of Kansas School of Pharmacy. And here’s another troubling fact: A third of the state’s independent pharmacists are ages 54 or older, which means a wave of retirements and necessary replacements looms on the horizon.

Tasting city life

Auburn Weber is senior recruitment coordinator for the University of Kansas Medical Center’s Office of Rural Health Education and Services.

She said persuading pharmacists raised in rural, small towns to go back once they finish school can be an uphill battle. Not everyone is like the Brunswigs.

“The issue you run up against is students come in from smaller communities and get a taste of city life,” she said, “and in the case of new graduates, it’s kind of tricky to pull them away from the amenities they got used to while going to school. Sometimes the best success is finding someone who has a family or who is looking for a family-oriented lifestyle. That seems to be the best fit.”

Weber and fellow recruiters help rural communities that are trying to find pharmacists, doctors and other medical professionals. Like Kansas weather, the recruitment business can be unpredictable.

“I think the personality of each graduating class is very different,” she said. “We’ll have some years when we have people just banging on the door ready to go rural and then there are other years. Well, when it’s dry, it’s very dry. It really comes in cycles."

Weber said communities often will begin looking a year or more in advance for a replacement pharmacist or physician because they know it can take months to find one.

Government programs that help pay off the student loans of graduates who agree to work in underserved areas, “have certainly helped,” Weber said.

And rural employers of health professionals have become better as marketing themselves, she said, by offering modern technology and work conditions amenable to family life.

“A lot of people who come through our door want a good balance of working and spending time with their families,” she said. “A lot of employers now allow for job sharing or shared calls. The days of expecting providers to work 24-7 are slowly but steadily coming to an end as this generation puts emphasis on their work and also their family life.”