RALEIGH -- Tony Civello didn't go into pharmacy to sell candy or count pills. He wanted to be like his neighborhood pharmacist growing up, the guy down the street he went to first when he broke his nose playing football.
By the time he finished pharmacy school, though, the independent pharmacist was giving way to chains that dealt in greeting cards and lipstick more than health care. Civello has focused much of his career as CEO of Kerr Drug on turning back that clock.
"Our vision is to have the profession of pharmacy migrate from one of fulfilling prescriptions to providing health care services," Civello said.
It's a refrain he has returned to repeatedly in the 15 years he's led the Raleigh-based chain; it's one that has found currency as health care reform has taken a top spot on the national agenda.
Civello, 67, has emerged as a leader in the push to employ pharmacists to reduce costly and sometimes deadly mistakes caused by medication mix-ups.
He has met with President Barack Obama and worked with state Democratic leaders on health care policy - despite being a registered Republican.
And his company's innovations have left footprints in North Carolina. Kerr's 80 drugstores statewide have been incubators for ideas adopted by larger chains, from offering in-store flu shots to monitoring patients with diabetes to counseling Medicare recipients on their medications.
Civello's sharp focus on patient care is remarkable in an industry that for decades has been best known for putting huge chain stores on every major street corner.
"The world doesn't need another drugstore," Civello said. "That doesn't mean there's not room for high-quality, true health care providers."
Reviving a franchise
The original Kerr Drug store opened at Raleigh's Cameron Village in 1951 - making this year the chain's 60th anniversary. Owner Banks Kerr sold his stores to J.C. Penney in 1995.
The name was resurrected when Civello and others bought a bundle of stores from J.C. Penney in 1997. The Federal Trade Commission forced the sale, and Civello said he kept a promise to Banks Kerr to use the name.
Civello and his partners were executives from Pittsburgh-based Thrift Drug, a subsidiary of J.C. Penney, which had been buying up drugstore chains for years.
But Civello had no intention of joining the consolidation trend.
Instead, he saw in his new company a chance to work toward a change the dean of his pharmacy school predicted back in the 1960s - that by 1975, pharmacists would take over monitoring patients after a doctor's diagnosis.
Civello thought that seemed like a better use of the six years pharmacists spend training than simply filling prescriptions. But the dean was wrong.
"That never happened in '75 or '80 or '85 or '90," Civello said. "So, when I bought this company, that's exactly what we embarked upon."
Within a year of taking the reins at Kerr, he formed a partnership with UNC-Chapel Hill in which pharmacy students worked as volunteers at a Kerr-based health center, learning to explain dosages and side effects to patients, keep tabs on those with chronic illnesses, and check blood pressure, bone density and other indicators.
Kerr soon expanded the model to Campbell University, and also set up a residency program for pharmacy students that was among the first of its kind.
In 2005, the company opened a new store in Lenoir with private rooms for counseling, space for health screenings and an expanded line of health care products. That store, dubbed the Kerr Community Health Care Center, received the Retail Concept of the Year award from a trade magazine. About a dozen Kerr stores now use this model.
The company has since raked in a slew of awards since for its community pharmacy concept, including several from the American Diabetes Association and one from the N.C. Alliance for Healthy Communities.
This year, Civello won a lifetime achievement award from the Triangle Business Journal.
Kerr Drug stores have also become key stops for politicians and competitors eager to embrace the community pharmacy model.
Bev Perdue, then lieutenant governor, announced her CheckMeds program, in which Medicare recipients consult with pharmacists, at the North Hills Kerr Drug in 2007. Kerr went on to be a key participant in the program.
Sen. Kay Hagan made a stop at the same store to promote a bill she co-sponsored that would mirror CheckMeds on a national scale. She cited a recent report that found failure to take medications properly costs the country $290 billion a year.
Other chains have emulated Kerr's practices, right down to the layout of their stores, which keeps the pharmacist within view of the patients, not behind a wall. Kerr recently started offering free prescription delivery, and has set up a flu shot operation at the N.C. State Fair.
"Kerr has clearly embraced the idea of providing health care services," said Jay Campbell, director of the N.C. Board of Pharmacy. "What they're doing demonstrates to the public that pharmacy can be a very integral part of overall health care delivery."
'An emotional Italian'
Civello grew up in a blue-collar part of Pittsburgh, an only son with three older sisters. He was the only kid in his neighborhood who went to college, he said.
All four of his grandparents hail from the same part of Sicily. His father, a long-distance truck driver, loomed large in the household, both feared and revered by his children.
That doesn't mean Civello always listened to him. He wasn't allowed to play football, for instance, so he sneaked out to play the day he broke his nose.
But he did heed career advice from his father, who suggested he pursue pharmacy, and later set him up with an internship at Thrift Drug. He stayed for 32 years, rising to President of Stores.
Civello said he had decided to leave Thrift before the FTC-forced sale presented the chance to start a new company, but he doesn't elaborate. News reports at the time suggested he was passed over for a top job as J.C. Penney merged Thrift with Eckerd Drug, which it had recently bought.
"I'm an emotional Italian," he said. "They did something I wasn't happy with."
Civello projects an image of the buttoned-up executive tempered with down-to-earth charm.
On a recent afternoon, he wandered the halls of the Kerr headquarters, poking his head into offices to chat. Inside one office were two dogs; Kerr's human resources director works with a rescue group from which Civello and other employees have adopted their pets.
The culture at Kerr is tight knit. Nearly all of the 40 employees who moved to Raleigh from Pittsburgh 15 years ago still work at its North Raleigh offices.
Marketing Director Diane Eliezer credits Civello's open-door leadership, but also the company's tumultuous start, for this closeness. Employees who didn't feel strongly about the company's vision left early on, she said, leaving the converts to keep Kerr afloat amid its much larger competitors.
"These are the survivors on the island," she said. "When you're in competition for the big guys for your life, you row together."
