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A pharmacist with lots of experience

Photo by Jenny Kirk Pharmacist Dave Koster is the newest face at Shopko Pharmacy. The 81-year-old not only brings a wealth of knowledge and experience to his part-time role at the Marshall store, but he also shares his passion for the profession.

By Jenny Kirk

jkirk@marshallindependent.com

MARSHALL — A person would have to really look hard to find a pharmacist with more experience than 81-year-old southwest Minnesota native Dave Koster.

By the time he and his wife, Liz, sold Koster Pharmacy that was located in Tyler, Dave Koster had already spent 50 years in the profession. Today, he still works two days at week at the job he not only loves, but is really good at.

“I started working at Vadheim Drug in Tyler when I was going to pharmacy school at South Dakota State (University),” he said. “As it turned out, when I graduated and was looking for a job of course, one of the pharmacists that was working there opened up his own store in Pipestone, so there was a slot open.”

Koster said he began working there as a staff pharmacist and later, her became a partner.

“Then Liz and I bought Roger (Vadheim) out and we ran it for probably 15-20 years by ourselves,” Koster said. “So I had about 50 years experience in pharmacy before we ever sold our store in Tyler.”

By the time they sold the pharmacy, Koster said he was only working part-time and thought transitioning into full retirement might be easy. He jokes that his wife knew differently.

“I was spending a lot of time at home, probably underfoot, and Liz finally said, ‘Dave, you need to get another job,’ “ Koster said. “So I ended up working in Olivia for 10 years. I typically worked three days a week and drove back and forth or spent the night there at the Sheep Shedde Inn, which has a restaurant connected right to it. I could still probably recite the whole menu.”

While there were two independent pharmacies in business at that time, Koster said both sold out when Thrifty White Drug came to town.

“Thrifty decided to come to town and open up a drive-through pharmacy,” he said. “My boss sold out to Thrifty and the other store also sold out to Thrifty. That meant, at the age of 80, I was out of work — not that I needed to work,” Koster said. “But I was still of the opinion that I wasn’t ready to retire. I wanted to continue working, so I started looking around.”

Koster said his son-in-law, Kevin Peterson, who is a nurse anesthetist at ACMC in Marshall, had evidently been checking around for him as well.

“His daughter, my granddaughter, had worked here at Shopko for a couple of years before she headed off to college, so he asked whether there might be an opening here for an 80-year-old pharmacist,” Koster said. “They said, ‘Well, I think we’re looking for somebody.’ So I came in and applied and ended up working here now.”

Now 81, Koster works one day a week at Shopko in Marshall and one day a week at an independent pharmacy in Hendricks.

“I’ll tell you, it’s a whole different atmosphere (at Shopko) than at an independent store,” he said. “They call it a big box store, but it’s actually the Wal-Marts, K-Marts, Shopkos, Walgreens and those kinds of businesses, where it’s all about volume. We’re busy. But of course, that’s what keeps them going. Volume is everything because insurance companies keep nipping away at your contracts. Then the profit starts declining quite a bit.”

While the experience is much different than what he’s used to, Koster said he’s still enjoying it.

“I’m working with some great techs, like Stacey (Ticher) and Holly (Rock), so we’re getting along fabulously,” he said. “I like it. And I hope I’m lending to their business, with supporting it and making it a little better.”

Koster joked about the likeliness of working until they carry him out in a pine box.

“That probably won’t happen, but I mean that,” Koster said. “I feel healthy. A lot of people look at me and don’t think I’m 81 years old. I’m kind of happy that’s the case.”

That isn’t to say Koster has it easy. While his mind is sharp and he still has a lot of passion and drive, he does suffer from hereditary neuropathy, which can make it difficult to keep his balance.

“Out of seven of us kids, five of us have it,” Koster said. “My mom had a little bit of it, but she had some brothers, my uncles, who had it more severely. Some wore braces. You can walk, but the problem is that you cannot balance. You don’t know if you’re on the ball of your foot or your heel or whatever, so you’re tipsy. I’m to the point where if I’m standing, I need to hang onto something or at least balance myself on something.”

Koster said he’s fortunate that gabapentin helps with the nerve-ending pain.

“It helps, but what’s happening is that the nerves are dying in the extremities,” he said. “Then when they die, it doesn’t stimulate your muscles, so they go to pot, too. There’s no cure. There’s also diabetic neuropathy. A lot of diabetics have those extremity issues, but usually more with circulation. A lot of them end up losing feet.”

Koster said the crew he works with are extremely helpful, which makes his life a lot easier.

“I do the majority of my work sitting,” he said. “I can get up and pull stock bottles off the shelf, but the techs are very good about helping me with that. I thank them many times because if they weren’t here, I probably wouldn’t be either.”

In the past, Koster said people seemed to look at pharmacy as a “count and pour thing.”

“You pour the pills on the tray and count them — that’s the first line — but there are many other things that go on that hopefully assures the patient is getting the right medication and it’s helping them to have a better life,” he said.

While human error can happen, computer programs today help cut down on the negative interactions that might happen to an individual taking several different medications.

“With the number of drugs we have today — I mean there are lots and lots of interactions — so you need to keep on top of that,” Koster said. “Computers have programs that kind of alert you to those interactions. Computers help keep better track of those things.”

Double-checking everything also minimizes the chance or error.

“The techs can count and pour basically and they enter the profile into the computer,” Koster said. “The prescription comes in, goes to the tech, the tech goes to the computer and enters the prescription into the computer and if we’re not real busy, the pharmacist will fill it. Otherwise, the tech will fill it, present it to us (the pharmacist on duty) and we examine it to make sure the right drug was chosen and the right directions are on the bottle. We also check each prescription a second time.”

Koster said “very seldom is a wrong drug ever used.” If there is an error, it’s by and large the “wrong strength of drug used.” With human lives on the line, accuracy is vital. That’s why the current checks and balances are in place.

“As a pharmacist, you have to realize you’re not foolproof and you better not think you are,” he said. “If you think you are, you’ll probably run into trouble.”

LOOKING BACK

Over time, Koster said pharmacy has changed so much. After graduating from SDSU and transitioning from a student pharmacist to a pharmacist with a great deal of responsibility, he said he was “scared out of his mind” the very first day. At that time, Sen. Joe Vadheim owned the Tyler store, which was later owned by his son, Roger.

“Joe said, ‘Dave, we’re going to have you fill iron capsules today, so I’d take ferrous sulfate crystals, put them in a mortar and pestle and grind them,” Koster said. “I ground and ground them and then took them out to Joe and, ‘OK, is it ready?’ And he’d say, ‘No, it has to be finer than that. You have to grind it some more.’ So I spent a lot of time that first year filling those iron capsules.”

Early on in his career, compounding was more common.

“Then it kind of graduated to where most of the medication that was dispensed was purchased,” Koster said. “We didn’t make it — compounding, you’d call it — where you’d weigh out different ingredients on a balance and scale and mix them up and put them in capsules or power papers.”

Koster remembers walking into the store and being hit with a couple different smells.

“The first thing that hit you was the smell of peanuts in the vending machine they had,” he said. “It was heated, so the aroma came out and was really, really great. Beside that was a cigar case and that had to have a humidifier in it. You had to check that. That was one of my jobs. Another thing was the muriatic acid that plumbers used a lot of to clean out the sewage lines and clean out the toilets.”

Koster said they’d buy a 25-gallon glass container and you’d have to tip that over into a funnel to fill gallon jars.

“You didn’t want to get close enough to get a whiff because it was very toxic, very irritating, so you needed to be careful,” he said.

Farmers were also able to purchase strychnine back then.

“We sold a lot of strychnine to farmers for killing gophers or rats,” Koster said. “It’s forbidden now. It can get into the water system and if it did happen to kill a rat and a dog came along, it could kill the dog, too. They finally decided it was too unsafe.”

Koster said pharmacies seemed a lot more mysterious years ago as well.

“The pharmacist usually had his long, white coat on and they’d disappear behind some swinging, double doors,” he said. “You’d hear some clanking back there and the pharmacist was mixing his potion. Then he’s come out and present it to the patient. Basically, patients didn’t know what they were getting as medications. That’s the way the physicians decided they wanted it.”

Now, everything is pretty well out in the open. Koster said physicians typically want their patients to know what they’re taking and why they’re taking it.

“That’s been a big change, which is good,” he said.

While hundred of independent pharmacies used to exist in Minnesota and in other states across the country, that is not the case any longer.

“The era of the small retail pharmacy is almost dead,” Koster said. “There are very, very few independent pharmacies out there now. It’s the medium-sized retail outlets like Thrifty and Lewis Drug now.”

Koster said insurance companies had a lot to do with that.

“I think, by and large, the insurance companies who now contract with different pharmacies for filling prescriptions for a patient, they pretty well control the price,” he said. “They’re so big. When I was an independent pharmacy in Tyler, I was expected to negotiate with Blue Cross, Blue Shield as an individual and try to reach a contract. Well, it got to the point where they’d present a contract to you and say take it or leave it.”

If you balked at the price, Koster said they’d threaten to take your customer base, which they knew, and advertise for those individuals to go to another store 10 miles away to get their medication.

“It got to be a case of numbers and how many prescriptions you were filling a day,” he said. “If you didn’t increase that, your revenue stayed flat or went down. That’s our system. That’s the kind of health care we’ve wanted, so it is what it is.”

LOOKING FORWARD

While a lot has changed, being a pharmacist is still a great occupation, Koster said.

“It’s a job where you can work as much or as little as you want,” Koster said. “It’s great for a young woman who might want to raise a family and in the future, might not want to work five days a week. So there’s an opportunity to have children and still maintain her profession.”

Male workers also have that option, but it affects the women more since they are the ones bearing the children.

“I know for a fact that women outnumber men in pharmacy, in graduating classes, and by a fairly substantial margin,” Koster said. “That’s nationwide.”

Koster said it’s important to find somewhere you enjoy working. He praised Shopko for its focus on customer appreciation.

“The one thing I think Shopko spends a good deal of time promoting is friendliness,” he said. “They place the customer first. They don’t ignore a customer. They’re there almost immediately and they answer the phone in a certain, quick response. I see a lot of people here that I think come here because of the atmosphere.”

The first time pharmacy sparked Koster’s interest was when he was about 11 years old and he was with his dad picking up his prescription at Steven’s Pharmacy in Lake Benton.

“The store was not well lit and this pharmacist came out of those swinging door in his white coat and presented my dad with a bright red liquid bottle of medication,” he said. “It just kind of intrigued me.”

Later, as a sophomore in high school, he was thumbing through a career book to compete an assignment and came across the profession of pharmacy again.

“I think from then on, I knew I was going to be a pharmacist,” Koster said.

Koster said his four years of college went well, with the exception of his least-favorite class — organic medicinal.

“It was an absolute nightmare,” he said. “The professor would come in with two pieces of chalk and the minute he walked in the door, he would erase anything that was on the board, start writing and never quit explaining organic medicinal to us until the hour was up.”

While Koster had the opportunity to study at the University of Chicago (Illinois), he’s just fine with his career path.

“If I’d pursued that, I’d have been in some lab, trying to devise new drugs, or in a hospital setting or teaching,” he said. “But I was a little scared about going to Chicago to school.”

The prospect of discovering new drugs still excites Koster, though.

“I think with the advent of manufacturing and lab work and so forth, where they discover drugs, that has just exploded,” Koster said. “We have so many different medications on the shelf now for so many different things. The future could conceivably be where medications that you, as a patient take, are designed specifically for you. It’s going to get that individualized, that precise. It’s called genetic medication, where they take the genes you have and decide what you need. I’m excited about it.”

Koster hopes that his and his family’s issues with neuropathy can be improved in the future, as well as other diseases and conditions such as cancer.

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