Serving Mingo Junction

Melissa and Frank VostatekIn March 2010, a young couple in southeastern Ohio with two small children decided to embark on a new path. They purchased their own independent pharmacy, located in their hometown of Mingo Junction, a small, economically depressed steel town of 3,400 in Jefferson County.

When they started their business, Frank Vostatek, who graduated with a bachelor of science degree in pharmacy in 1999, and his business partner and wife, Melissa Vostatek, who has a PharmD degree from Ohio State, heard stories from other pharmacists about how reimbursements would be dreadful and it would be difficult to make a living.

The Vostateks were not discouraged, but Frank soon realized that merely dispensing drugs was not what he wanted to do. Soon after opening Mingo Pharmacy, he came home to Melissa to break the news.

“I’m going to go back to school and become a family nurse practitioner,” he told her. It was something he had wanted to pursue since graduating from pharmacy school.

Her reaction was understandable. “What? You just opened a pharmacy.”

Frank didn’t give up, and in 2011, with his wife’s full support, he enrolled in Kent State University’s nursing school. He completed a bachelor’s of science degree in nursing and recently completed his master’s degree in nursing. 

As a family nurse practitioner in Ohio, Frank is able to offer his patients much more than medicine.

“Provider status is the reason I became a nurse. I got sick of getting paid for only what I sold. I wanted to get paid for what I know,” he said.

This new practice model made Frank and Melissa recipients of one of three Independent Pharmacy Best Practice Award from Cardinal Health at this year's RBC annual pharmacy business conference.

Filling a need

For more than 40 years, five family-practice doctors had been treating patients from Mingo Junction and small surrounding communities, including Rush Run, Brilliant, Tiltonsville, Yorkville, Rayland, Smithfield, Dillonvale, and Deep Run. This year all five doctors decided to retire, leaving only one doctor to care for this region.

“So when you talk about healthcare disparities, I challenge you to find a greater disparity than one doctor for 10,000 people,” said Frank, who recently added 1,300 square feet to the pharmacy, includidng four patient suites, a reception room, an office, and a conference room. “This is not a niche I am filling, it's an absolute need for this population.”

Before construction was completed, residents of Mingo Junction wondered whether Mingo Pharmacy was expanding the front end of the pharmacy with retail space. This village of about 3,400 doesn’t have a supermarket, convenience store, gas station, or even a bank. The only place to get a hot meal is at the local pizza shop, as long as it’s after 4 p.m.

Targeted services

In addition to the patient care he is able to provide as a nurse and pharmacist, Frank also owns and operates an onsite Suboxone clinic for patients needing care for opioid addiction. For this, the new conference room is a welcome addition. His clinic, which serves fewer than 50 patients, offers “a complete wellness program” and a licensed independent chemical dependency counselor who works with patients in either group sessions or individually.

“You are allowed by law to have 100 patients enrolled in your Suboxone clinic,” Frank noted. “However, we only serve those patients that we feel are going to attain a level of health and wellness, just as with any other wellness program that you would have for diabetes, heart disease, hypertension, or smoking cessation.”

Frank is also involved in the only other local Suboxone clinic, a program of the behavioral clinic in Jefferson County, which ranks as the second largest county in Ohio for opiate-related drug overdose deaths. “Ohio is consistently in the top five states for drug-related overdoses and deaths,” Frank said.

Future endeavors

After recently meeting another nurse, who is a certified diabetes educator, Frank is partnering with her to offer diabetes education at Mingo Pharmacy. He finds that it is much easier to bill insurance companies for these services as a nurse practitioner, using office visit codes 99213 and 99214. Success with these billings is much more difficult for pharmacists, because in Ohio pharmacists are not recognized as healthcare providers.

Frank foresees a future time when he will outgrow his current facility. He hopes to move to downtown Mingo Junction. Although the old steel mill has closed and is in the process of being torn down, nowadays southeastern Ohio is a hotbed of oil and gas exploration. A number of these businesses will require drug screenings, work physicals, and other job-site-related issues.

“I see a renaissance for Mingo Junction in the next 10 years,” Frank said. “I’m working with the Mingo Junction revitalization committee and we are planning to get some grant money to tear down some of the older, unoccupied buildings.”

If that happens, Frank hopes to create a comprehensive facility, attracting other healthcare professionals to the area.