Retail pharmacy has grown during Washington’s history from small (and occasionally haphazard) operations, sometimes run out of grocery stores or doctor’s offices, into a sophisticated industry handling hundreds of millions of dollars of prescriptions and retail products annually. This essay tracks the history of retail pharmacy in Washington from early stores that sold a handful of drugs, along with retail products such as lamp oil and paint, to the pharmacies of today (2011), where you can buy anything from prescription drugs and early-pregnancy-test kits to office supplies, greeting cards, cosmetics, toasters, and socks.
The first pharmacies in Washington Territory opened in the 1850s, though calling them "pharmacies" is a stretch. One of the earliest, opened by Dan Kiser in Olympia in 1852 or 1853, also served as a meat market. In the United States in the nineteenth century, many pharmacies were incorporated into the community's grocery store. Others, such as a drugstore opened by Dr. U. G. Warbass in Olympia in 1855, were operated straight out of a doctor's office.
Bona fide pharmacies followed almost immediately. Washington’s first full-fledged pharmacy opened in Olympia in 1853. It was owned and operated by Dr. G. K. Willard (1808-1866) and later by his son, Dr. Rufus Willard.
Retail pharmacies in the nineteenth century were a far cry from what they are today, or for that matter, what they would become in the early twentieth century. Nineteenth-century drugstores typically had ordinary storefronts with red and green globes in the windows to identify them as pharmacies. Inside, the store was usually a long rectangle, with display counters along the aisles and shelves on the walls. In a few stores these shelves stretched up nearly to the ceiling, requiring clerks to shinny up ladders to reach products there. The store interiors themselves, although in many cases rather similar to each other, were not uniform as we know them today.
Plant Extracts and Patent Medicine
Drugs and retail products available in pharmacies were far more limited than today, and what was available depended in part on where the store was located. Stores in the cities and larger towns could offer more than rural stores, not that there was that much more to offer. For example, in Bartell Drugs’ first store in Seattle, opened in 1890, George Bartell sold drugs extracted from plants such as bloodroot, belladonna, and foxglove. He also sold bark from cascara and cinchona trees, and oils and medicinal chemicals, including sulfur, ipecac, and saltpeter (which could also be used to some extent as a food preservative, handy indeed in the days before refrigeration). Crude opium was a popular pain reliever sold in nineteenth-century pharmacies, and many pharmacists kept 15-pound blocks of opium on hand. If a customer came in complaining of pain, the pharmacist could just cut a chunk off the block and hand it to the customer, who would soon be feeling much better.
Patent medicines were available in drugstores by the late nineteenth century, and were widely used. They continued to increase in popularity into the first years of the twentieth century, until a tightening of drug laws in the United States put the end to their heyday. Patent medicines frequently contained liquor, morphine, or opium, but these ingredients weren't required to be revealed to the consumer. Nor did these medicines require a doctor's prescription; a pharmacist could -- and regularly did -- make recommendations for a specific medicine to his customers. Lydia Pinkham's Vegetable Compound was arguably one of the most successful patent medicines of the day, and was particularly favored by women looking to soothe "female problems." (The 20 percent alcohol content in the medicine likely played a large soothing role.) The laxative Castoria was also an enormously popular patent medicine; it was typically given to children.
Manufactured drugs were rare, and most pharmacists prepared and compounded their own prescriptions, often from drugs derived from plants such as belladonna and bloodroot. Herbs and spices were sold in nineteenth-century drugstores, and some stores sold lamp oil, paint, and other chemicals. Then, as now, you could find tobacco in drugstores. Women’s beauty products were not typically found in these early drugstores, but that soon changed.
A Plethora of Products
As the nineteenth century segued into the twentieth, there was a dramatic increase in the number of products that became available in drugstores. You can get an idea of this surge from national figures: In 1880 there were 2,700 different items and sizes of pharmaceutical products sold on the market nationally. By 1916 this figure had grown to 38,000, and by 1933 it had reached 60,000. This growth had a huge impact on retail pharmacy in the early decades of the twentieth century.
By 1925 a trip to the drugstore in Washington state, especially in the cities, meant something far different than it had in 1900. Manufactured drugs were starting to become more widely available (though most pharmacists in the twenties still compounded their own prescriptions). Drugstores were also offering a much wider range of retail products. You could get hair brushes and hair tonics, toiletries, ladies’ cosmetics, pots and pans, and other household items at your local drugstore.
Bartell Drugs (and presumably a few other large stores) also offered exercise equipment and “tobacco habit cures.” By the 1920s soda fountains were ubiquitous in drugstores, and many of them offered hot food. Additionally, some of the larger urban stores offered photo labs capable of developing pictures in as little as five hours, lightning-fast by the standards of the day. By the late 1920s a trip to some of the larger drugstores in the state had become a one-stop shopping experience.
Another big change took place in retail pharmacy in the early twentieth century with the rise of chain drugstores. The biggest was United Drug Company and its franchise, Rexall. Walgreens had also become a major chain by the end of the 1920s. These chains bought up hundreds of smaller, independent drugstores. Some states, attempting to combat their rapid growth, passed laws restricting ownership of drugstores to registered pharmacists, but in 1928 the U.S. Supreme Court struck down these laws.
If the chain drugstores couldn’t buy out the smaller stores, they sometimes just lowballed their prices to try to drive their competition out of business. Congress confronted this problem when it passed the Miller-Tydings Fair Trade Act in 1937. This gave manufacturers the ability to control the minimum price of various products purchased from the manufacturer for resale, including certain cosmetics and over-the-counter drugs. But the law didn’t really have the intended effect. It eventually came to be largely ignored and pharmacies lowered their prices below the minimum anyway, which had the same deleterious effect on the law-abiding pharmacies that the act had been designed to prevent. The act was repealed in 1975, but by this time far more wide-reaching changes had taken place in retail pharmacy that had a bigger impact than the act’s limited attempt at price controls.
Retail pharmacy underwent a fundamental change during the middle of the twentieth century. Some large chain drugstores -- for example, Liggett’s and Rexall -- faded from the scene, though other large chains, in particular Walgreens, are still going strong in the early twenty-first century. Discount stores, such as House of Values and Gov-Mart Bazaar, opened and for several decades gave stiff competition to the more established pharmacies. Pay ‘n Save, a chain drugstore opened in Seattle in 1940 by Monte Lafayette Bean (1899-1982), was another aggressive competitor and was a leader in retail pharmacy in Washington state for several decades up to the 1980s.
At the same time stores began adopting what we would today (2011) consider a more modern look, with low-profile shelves (shelves that could be reached by the average customer), better lighting, and an emphasis on self-service as opposed to full-service. Pay ‘n Save was an early convert to the new look, and other pharmacies soon followed. The new look also focused on a uniform appearance for all the stores owned by a particular company, with a cleaner, sleeker look to entice the customer. The soda fountains that had been so popular during the first half of the twentieth century fell out of vogue between the 1950s and the 1970s, and by the 1980s most drugstores no longer had them.
Advertising also became more sophisticated. The window displays in the storefronts disappeared and were replaced by television commercials. In the 1970s retail pharmacies began using electronic transmissions to place their own orders with suppliers, doing away with the suppliers' salesmen and enabling the stores to more effectively manage their inventory. And as part of the overall modernization trend in retail pharmacy between the 1950s and 1970s, more drugstores began hiring managers with no pharmaceutical experience to manage their stores. This enabled the store pharmacist, who in many cases had little retail acumen, to do what he (and in more cases as time rolled on, she) did best -- handle prescriptions. Many pharmacists welcomed this change.
Since 1980 rapid technological improvements have transformed the retail pharmacy. An obvious change is the now-widespread use of computers. Personal computers were available in 1980, but the technology was rudimentary by today’s standards and most pharmacies weren’t using them. That quickly changed as the decade unfurled, and by the end of the 1980s one would have been hard-pressed to find a store in the state that was not using a computer for some part of its operations.
The rise of the point-of-sale (POS) computer system in the 1990s had an even bigger impact on retail pharmacy operations. This is a centralized system where all of the scanners in a store report to a centralized database. (There may be a dozen or more scanners in one store, from those at check-out to hand-held scanners.) The system made it easier to track inventory, letting employees know at a glance an item’s sales history. It could also alert employees when a product was running low, so they could quickly order more, and it made it easier to manage pricing. Best of all, the system allowed many aspects of the store's operations to be connected and operated within a single, integrated system. This not only saved time but also make tracking of the store's operations more accurate and efficient.
The Internet arrived in the mid-1990s, first allowing pharmacies to order products online and a few years later (once Internet use became more widespread and the technology improved) to develop their own websites. Pharmacy websites allowed the stores to advertise online, to list employment opportunities, and to provide to their customers general and specific information about the stores and their products.
Age of Insurance
Another, more subtle, change in retail pharmacy since 1980 has been the method by which pharmacies are paid for prescriptions. There were, of course, insurance plans that covered prescriptions in 1980. But they didn’t play as much of a role as they do today, and managed care, with its HMOs and PPOs, was only a blip on the horizon. For much of the twentieth century, prescriptions were paid for by the customer with cash up front, with an occasional credit purchase, or with an insurance plan picking up some or all of the cost.
The emergence of managed health care in the final two decades of the twentieth century changed how drugstores were paid for prescriptions. Pharmacies now deal with a variety of managed-care plans, with varying amounts of coverage for prescriptions and varying co-pays that the customer has to pay up front. In addition to increasing the workload for pharmacy employees, managed care also postpones when the store can expect to receive full payment for prescriptions.
Finally, the business of retail pharmacy has continued to grow. In a throwback to the nineteenth century, many grocery stores now have pharmacies tucked away in their stores. Discount stores, such as Wal-Mart and Target, also continue to offer pharmacies. The number and types of drugs available has also grown, reflecting the continuing evolution of retail pharmacy in Washington from small, independently owned businesses with just a few products available, to large, corporate-owned businesses with an ever-increasing array of products and services.In today's drugstore you can find all kinds of over-the-counter medicines, from cold remedies to eye drops to hair-regrowth products. In some pharmacies a pharmacist will write a prescription for you and give you a vaccination; if you're a diabetic, you can buy a kit to electronically monitor your blood sugar level. Need crutches? You can probably find them at your local drugstore, and you can also find diapers for incontinent adults. You can buy snack foods (peanuts, jerky, and candy), non-stick cooking spray for frying pans and the pans themselves, energy drinks (flavored drinks with extra caffeine), and in some stores, beer and wine. You can even buy compact discs, flash drives, and USB computer cables for your computer. And this is just the tip of the iceberg. A trip to the drugstore today is an experience that in the nineteenth century would have been unimaginable.