NAME: Joe Garrett, Medical Center Pharmacy

ADDRESS: 215-M Oak Drive South, Lake Jackson, Texas 77566

PHONE #: 409-297-7776

FAX #: 409-297-8877

E-MAIL: jgarrett@compounder.com

Joe Garrett provides several innovative services for his patients. These services include pain control, hormone replacement therapy and nutrition counseling. In his pain control program, Mr. Garrett has a contract with the local hospice. Patients who do not have their pain under control - which is defined as a score of 2-3 on a scale of 1 to 10 - are referred to him. He uses dextromethorphan and ketamine to "reset" the mu receptors. If the patients respond, he is able to decrease their morphine dosage and obtain pain control. He has had successful results for these patients and reports that this service is very fulfilling.

The hormone replacement therapy service involves mostly estrogen and progesterone replacement. Patients who are interested in natural hormone therapy instead of synthetic or animal-derived hormones are referred to Mr. Garrett. His pharmacy compounds capsules, gels and creams for the patients. The hormones are obtained from PCCA. Mr. Garrett reports a growing interest in this area.

The nutrition-counseling program is based on the idea that there are two types of enzymes in the body. One type is for maintenance and repair, and the other is for digestion. Each organism has a finite capacity to produce these enzymes. In certain therapies or disease states, the digestive enzymes, for example, may become used up. This will cause the other type of enzymes to do the work of the digestive enzymes, thus altering homeostasis. For example, a chemotherapy patient with a low white blood cell count is given enzyme supplements and the patient’s white blood cell count increases. In order to determine the patient’s status, blood is drawn and sent to a lab in Denver. A very detailed report outlining diet management, exercise, nutritional supplements, etc., is sent to Mr. Garrett. Mr. Garrett compounds the enzyme preparations. He obtains the enzymes from Enzyme Therapy Clinics of America located in Tyler, Texas. This program has been in place in France for quite some time. Mr. Garrett has not offered this program long enough to determine what the long term results will be, however it is apparently successful in France.

Payers: patients - Mr. Garrett allows the patients to "fight the insurance wars."

Reimbursement Rate: Payment for the pain control and hormone replacement therapies are tied to the product. The nutritional counseling program has a $75 fee for the initial consultation with additional fees for results and follow up visits.

Specialized training required? Yes. There is no certification, but these programs require a knowledge base. Joe Garrett attends a great deal of seminars. He has attended 60 to 100 hours of seminars so far this year.

Software/instrumentation required? Yes. Joe Garrett uses PharmCare software developed by Jean Anne Stasny of Jascorp. This software is flexible and can be adapted for whatever purpose needed.

Interviewed by: Livia Anne Cotney