A blog covering the health/care ecosystem and people.

My friend Rachel leads education at Sephora in the King of Prussia Mall in suburban Philadelphia, PA. I’ve come to consider Rachel as my personal guress on all matters related to skin care. She’s a trusted member of my personal health ecosystem. I met with Rachel last week to consult on what lipsticks contain SPFs that could prevent my lips from burning in the sun for my vacation week on Lakes George and Placid. She informed me that very few cosmetic lip products have sufficient sun protection ingredients to protect my lips-on-the-Lakes. We accomplished our consult for my very small

3 in 4 Americans say that out-of-pocket costs are the main reason they decide whether or not to seek preventive care, in A Call for Change: How Adopting a Preventive Lifestyle Can Ensure a Healthy Future for More Americans from TeleVox, the communications company, published in June 2013. TeleVox surveyed over 1,015 U.S. adults 18 and over. That’s the snapshot on seeking care externally: but U.S. health consumers aren’t that self-motivated to undertake preventive self-care separate from the health system, either, based on TeleVox’s finding that 49% of people say they routinely exercise, and 52% say they’ve attempted to improve eating habits.

Employers who provide health insurance are getting much more aggressive in 2013 and beyond in terms of increasing employees’ responsibilities for staying well and taking our meds, shopping for services based on cost and value, and paying doctors based on their success with patients’ health outcomes and quality of care. Furthermore, nearly one-half expect that technologies like telemedicine, mobile health apps, and health kiosks in the back of grocery stores and pharmacies are expected to change the way people regularly receive health care. What’s behind this? Increasing health care costs, to be sure, explains the 18th annual survey from the National

While there is big uncertainty about how health reform will roll out in 2014, and who will opt into the new (and improved?) system, health cost growth will slow to 6.5% signalling a trend of moderating medical costs in America. Even though more newly-insured people may seek care in 2014, the costs per “unit” (visit, pill, therapy encounter) should stay fairly level – at some of the lowest levels since the U.S. started to gauge national health spending in 1960. That’s due to “the imperative to do more with less has paved the way for a true transformation of the

The notion of consumers’ greater skin in the game of U.S. health care — and the underlying theory of rational economic men and women that would drive people to greater self-care — permeated the agenda of the 2nd annual Consumer Health & Wellness Innovation Summit, chaired by Lisa Suennen of Psilos Ventures. Lisa kicked off the meeting providing a wellness market landscape, describing the opportunity that is the ‘real’ consumer-driven health care: people getting and staying well, and increasing participation in self-management of chronic conditions. The U.S. health system is transforming, she explained, with payors beginning to look like computer

This has been a week of shocking contrasts for women’s body image: from the triumphant, empowering public health role model of Angelina Jolie, whose op-ed column, My Medical Choice, appeared in the New York Times on May 14th, to the marketing message snafu of Abercrombie & Fitch. First, the Abercrombie affair: Mike Jeffries, CEO, said the following in a 2006 Salon interview that virally surfaced: “Because good-looking people attract other good-looking people, and we want to market to cool, good-looking people. We don’t market to anyone other than that,” identifying the “cool kids” as the company’s target market. “A lot of

The registered dietitian is an in-demand labor resource for grocery stores around the U.S. Advertising Age covered the phenomenon of the growing clout of dietitians in food chains (April 14, 2013). Let’s dig further into this phenomenon through the Health Populi lens on healthcareDIY and peoples’ ability to bend their personal health care cost curves. Stores such as Giant Eagle, Hy-Vee, Safeway and Wegmans are morphing into wellness destinations, with pharmacies and natural food aisles taking up valuable square footage to meet consumers’ growing demands for healthy choices. Some stores are formalizing their approach to food = health by formulating a

  With U.S. health consumers spending $45 billion out-of-pocket for prescription drugs in 2011, pharmaceutical products are morphing into retail health products. As such, as they do with any other consumer good, consumers can vote with their feet by walking away from a product purchase or making the spend based on the price of the product and its attributes, along with whether there are substitutes available in the marketplace. When it comes to prescription drugs, it’s not as clear-cut, according to the Centers for Disease Control‘s analysis of data from the 2011 National Health Interview Survey titled Strategies Used by

Consumers who patronize Walgreens can get rewarded for tracking their physical activity   For the Steps with Balance program kickoff, self-tracking consumers can earn 20 points for every mile walked or run and 20 points for tracking weight. Walgreens implemented the Walk with Walgreens program in 2012. The program won an Effie Award for an outstanding marketing program. With the success of Walk with Walgreens, the retail pharmacy company has expanded the program beyond simple steps to include weight tracking and health goals for earning loyalty points. The program enables a few of the most popular self-tracking devices to sync so

While health care cost growth has slowed nationally, most Americans feel they’re going up faster than usual. 1 in 3 people believe their own health costs have gone up faster than usual, and 1 in 4 feel they’re going out about “the same amount” as usual. For only one-third, health costs feel like they’re staying even. As the second quarter of 2013 begins and the implementation of the Affordable Care Act (ACA, aka “health reform” and “Obamacare”) looms nearer, most Americans still don’t understand how the ACA will impact them. Most Americans (57%) believe the law will create a government-run health plan,

Digital health is attracting the likes of Bill Clinton, Lupe Fiasco, Deepak Chopra, Dr. Sanjay Gupta, Arianna Huffington, and numerous famous athletes who rep a growing array of activity trackers, wearable sensors, and mobile health apps. Will this diverse cadre of popular celebs drive consumer adoption of mobile health? Can a “cool factor” motivate people to try out mobile health tools that, over time, help people sustain healthy behaviors? Mobile and digital health is a fast-growing, good-news segment in the U.S. macroeconomy. The industry attracted more venture capital in 2012 than other health sectors, based on Rock Health’s analysis of the year-in-review. Digital health

It’s America Saves Week (February 25-March 2, 2013). Do you know what your savings rate is? If you’re in the center of the American savings bell curve, you probably don’t have a savings plan with specific goals and don’t know your net worth. Two-thirds of U.S. adults say they have sufficient emergency savings for unexpected expenses like a visit to a doctor. However, only one-half of non-retired people believe they’re saving enough for a retirement where they’ll have a “desirable standard of living.” This six annual survey by the Consumer Federation of America, the American Savings Education Council, and the

Health and wellness motivations among women cross all generations, driving them to purchase products that bolster health as they define it…not how media and stereotyping advertising have typically portrayed it, according to a survey report from Anthem Worldwide, What Women Really Want From Health and Wellness. Over all generations, 3 in 4 women say they make choices to benefit their health and wellness. Anthem asked women about the “external voices” of health/wellness messaging versus their “internal voice.” The external represent societal expectations: over 80% of women expect to take responsibility for their family’s health, and about 70% of women say the

PwC has seen the future of health care for the next year, and the crystal ball expects to see the following: Affordable Care Act implementation, with states playing lead roles The role of dual eligibles Employer’s role in health care benefits Consumers’ role in coverage Consumers’ ratings impact on health care Transforming health delivery Population health management Bring your own device Pharma’s changing value proposition The medical device industry & tax impact. In their report, Top health industry issues of 2013: picking up the pace on health reform, PwC summarizes these expectations as a “future [that] includes full implementation of

One of the fastest-growing segments at the 2013 Consumer Electronics Show in Las Vegas this week is digital health. And within that segment, there’s a battle brewing for what technology companies seem to think is the most valuable part of real estate on the human body: the wrist. I counted at least fifty products as I cruised aisles 26000-27000 in the South Hall at the Las Vegas Convention Center that had wristbands, usually black, plastic or rubbery, and often able to click in and out of the band for use in-hand, in pocket, or in a few cases, on a

85% of U.S. health consumers say that emails, text messages, and voicemails are at least as helpful as in-person or phone conversations with health providers, according to the TeleVox Healthy World study, Technology Beyond the Exam Room. The study was based on surveys conducted with over 2,200 health providers across specialties, and 1,015 U.S. adults over 18. Furthermore, one in 3 consumers admit to being more honest when talking about medical needs via automated voice response systems, emails or texts than face-to-face with a health provider. And 3 in 10 consumers believe that receiving digital health communications from providers such

Estimates on health spending in the U.S. are under-valued, according to The hidden costs of U.S. health care: Consumer discretionary health care spending, an analysis by Deloitte’s Center for Health Solutions. Health spending in the U.S. is aggregated in the National Health Expenditure Accounts (NHEA), assembled by the Department of Health and Human Services (DHHS) Centers for Medicare and Medicaid Services (CMS). In 2010, the NHEA calculated that $2.6 trillion were spent on health care based on the categories they “count” for health spending. These line items include: Hospital care Professional services (doctors, ambulatory care, lab services) Dental services Residential

Notwithstanding the fact that most phones on U.S. streets are “smart” ones, most adults surf the net for health information, and most people try to change a health habit each year, Americans haven’t adopted healthier long-term relationships with food. The International Food Information Council has conducted the Food & Health Survey: Consumer Attitudes Toward Food, Safety, Nutrition & Health poll since 2006, thus enabling us to track peoples’ attitudes and behaviors over the past several years. The latest polling results appear in Is it Time to Rethink Nutrition Communications? A 5-Year Retrospective of Americans’ Attitude toward Food, Nutrition, and Health online in

The ubiquity of mobile phones, increasingly smart ones (one-half of all mobile phones in the U.S. ), means people are walking around, working, playing and driving with self-tracking devices and ultra-mini computers in their pockets and totebags. 52% of smartphone owners seek health information on their phones, and overall 1 in 3 people seek health information on all mobile phones — nearly doubling the percent of those seeking health info via mobile in 2010 (17%). People who are sicker, caregivers, and those who have had a big change in health are also more prone to using phones for health, as

Wired magazine, longtime evangelist for all-things-tech, has played a growing role in serving up health-tech content over the past several years, especially through the work of Thomas Goetz. This month, Wired featured an informative section on living by numbers — the theme of a new Wired conference held 15-16 October 2012 in New York City. This feels like the week of digital health on the east coast of the U.S.: several major meetings have convened that highlight the role of technology — especially, the Internet, mobile platforms, and Big Data — on health. Among the meetings were the NYeC Digital Health conference, Digital

A teddy bear in the arms of a child with diabetes can change health care. At least, Jerry the Bear can. Yesterday kicked off the sixth autumn mega-version of the Health 2.0 Conference in San Francisco. Co-founded by Matthew Holt and Indu Subaiya, a long-time health analyst and physician, respectively, this meeting features new-new tools, apps and devices aimed at improving individual and population health, as well as health processes and workflows for physicians, hospitals, pharma, and other stakeholders in the health care ecosystem – even health lawyers, who met on October 7 to discuss up-to-the-minute  e-health law issues. Yesterday was

As the Web Goes Mobile, Healthcare Stands Still, sums up a survey from Makovsky Health and Kelton. Their research finds that, while consumers have beloved relationships with their mobile devices (phones and tablets) and use them regularly for aspects of daily living, healthcare information search is still largely managed via desktop and laptop computers. The infographic organizes some of Makovsky-Kelton’s findings. Of note is that parents are more likely to seek health answers online, Wikipedia has gained in health use since 2011, women are more likely than men to research before filling a prescription, and recommendations from friends and family are

Just as people go online for travel planning. photo development. and financial transactions. they’re looking for health engagement with their doctors and health records online, too. Harris Interactive heralds this as The Age of the Healthcare Consumer. Harris Interactive polled U.S. adults and found that people are interested in a range of technologies for engaging in their health, arrayed in the chart: when asked which would be important for health providers to implement, consumers said (NET = very important + important): – Online medical record access to visits, Rx, test results, and history, 65%. 17% of consumers said their doctor

It’s become evident that more health care does not often lead to better health: Shannon Brownlee’s seminal book, Overtreated, uncovered the negative relationship between more health care and worse outcomes. However, when it comes to accessing primary care, more may be a good thing. In Extended Office Hours and Health Care Expenditures: A National Study, published this week in the Annals of Family Medicine, researchers found that offering longer office hours, into evenings and weekends, leads to lower total health care expenditures for patients than practices without extended hours. Extended hours are also associated with lower prescription drug and office visit

As women are generally thought of by marketers as the Chief Health Officers of their families, images of men in health advertising and media have been fewer than their female counterparts. In 1998, Pfizer promoted Viagra through Bob Dole. In 2003, Magic Johnson represented GSK’s HIV treatment Combivir. That same year, Mike Ditka, football coach, hawked Levitra, the ED drug, for GSK. Dr. Robert Jarvik has repped Lipitor (controversially), and Bobby Labonte, a NASCAR driver, endorsed Wellbutrin XL. But since the advent of direct-to-consumer health advertising, there haven’t been as many celebrity men promoting health as there have been women. Now, it’s the

Target, the beloved retail channel for many design-minded value-conscious consumers, has opted in to mobile health through its purchase of SMARTCOACH mobile health coaching devices. SMARTCOACH is part of a growing category of wearable devices that monitor health behaviors like walking and calories consumed. What differentiates SMARTCOACH is the “coach” element, which provides real-time feedback throughout the day. Most other devices in the market simply track and record data. And it’s feedback loops that more experts say are key to sustaining health behavior change. Target will bring the device into stores for purchase in the fall. Like some other wearable

One-half of the members of Kaiser Permanente use the plans’ personal health record system, MyHealthManager. The most-used function of MyHealthManager is accessing lab results, according to KP. Now that Quest, the lab and health information company, has launched the mobile phone app, Gazelle, more health citizens will have access to lab test results. This could be a health-activating opportunity inspiring patient engagement. While Gazelle is a fully functional personal health record (PHR), it’s the connection to lab test results that’s the lightbulb moment. PHRs have been available to health consumers for over a decade. There are millions of users of

With the stunning Supreme Court 5-4 majority decision to uphold the Patient Protection and Affordable Care Act (ACA), there’s a Roberts’ Rules of (Health Reform) Order that calls for liberating primary care beyond the doctors’ office. That’s because a strategic underpinning of the ACA is akin to President Herbert Hoover’s proverbial “chicken in every pot:” for President Obama, the pronouncement is something like, “a medical home for every American.” But insurance for all doesn’t equate to access: because 32-some million U.S. health citizens buy into health insurance plans doesn’t guarantee every one of them access to a doctor. There’s a

While 2 in 3 U.S. adults are active on social media, we are skeptical about trustworthiness of the content we find there. Welcome to the 13th quarterly Heartland Monitor Poll from Allstate and National Journal, surveying how U.S. adults look at social media, trust, and the political future of the nation. The Poll surveyed, by landline and cell phone, 1,000 U.S. adults over 18 in May 2012. The most common social network used is Facebook, among 51% of U.S. adults, followed by Google+ (28%), Twitter (13%), LinkedIn (12%), Pinterest (6%), and MySpace (5%). While Americans are drawn to using social

Trust is a precursor to health engagement. Trust impacts health outcomes such as a patient’s willingness to follow a doctor’s or health plan’s instructions. Two new studies point out that U.S. consumers don’t trust every touchpoint in the health system. Online medical information has become a trusted channel. Health plans? Not so much. Wolters Kluwer’s Health Q1 Poll on Self-Diagnosis found that consumers trust online health information to inform themselves — even for self-diagnosis. 57% of U.S. adults turn to the Internet to find answers to medical information; 25% “never” do, and 18% rarely do. Two-thirds of people say they trust

Once upon a time, patient satisfaction with visits to doctors’ offices used to be a function of bedside (exam room) manner, demeanor and responsiveness of the reception and insurance staff, and the age of magazines in the waiting room. Today, waiting time is a key factor, and social media is raising expectations around response time in health care. See the first chart, based on data from PwC’s survey, Social Media “Likes” Healthcare, published in late April 2012. The poll found that when U.S. adults use social media in healthcare, at least 4 in 10 people want complaints and information requests responded to

As I leave Asia, where I’ve been for the past two weeks, for the U.S. today, I am reading the daily newspaper, the Korea Joongang News. On today’s op-Ed age is The Fountain column titled, Embracing the do-it-yourself attitude. In it, Lee Na-ree writes, “Making something with your own hands is part of the American pioneer spirit.” He describes the Maker Faire events and the project of Caine’s Arcade, a game developed by a Los Angeles boy who used auto parts from his dad’s shop. Na-ree observes that Americans are ‘regretting’ mass consumption. Health Populi’s Hot Points: I happened upon

Dr. Andrew Weil, the iconic guru of all-things-health, was joined by a panel of health stakeholders at this morning’s Edelman salon discussing Wellness Ignited – Now and Next. Representatives from the American Heart Association, Columbia University, Walgreens, Google, Harvard Business School, and urban media mavens Quincy Jones III and Shawn Ullman, who lead Feel Rich, a health media organization, were joined by Nancy Turett, Edelman’s Chief Strategist of Health & Society, in the mix. Each participant offered a statement about what they do related to health and wellness, encapsulating a trend identified by Jennifer Pfahler, EVP of Edelman. Trend 1: Integrative

Highmark is the next health plan to launch mobile health programs, signalling a tipping point in health insurance companies getting up-close-and-personal with members’ wellness. Encouraging Words of Wisdom is a personal nutrition coaching program for plan enrollees who meet with dieticians. Members can opt-in to receive motivational text messages and support ongoing commitments to healthy eating. One such message reads, “The best food comes in its own package.” Another app enables members to find a doctor using GPS or to calculate their co-pay amount for a service. Highmark’s head of health services strategy said in the company’s press release, “We understand

Every patient carries her or his doctor inside, said the great Renaissance man, Albert Schweitzer. Based on Euro RSCG Worldwide’s Prosumer Report – My Body, Myself, Our Problem: Health and Wellness in Modern Times, health citizens globally have begun to take on Dr. Schweitzer’s vision. Clement Boisseau of Euro RSCG points out that people, globally, are fairly schizophrenic when it comes to thinking about empowerment over illness: check out the chart for perceptions by condition and disease state. Boisseau says that people perceive health today both in modern terms (such as feeling empowered to control some conditions), and archaic or “magically

U.S. health consumers’ purchase and use of over-the-counter medicines (OTCs) generate $102 billion worth of value to the health system every year. Half of this value accrues to employers who sponsor health insurance for their workforce; 25% goes to government payers (e.g., Medicare, Medicaid); and, 25% returns to self-insured and uninsured people. For every $1 spent on OTCs, $6.50 is saved by the U.S. health system, shown by the chart. For millions of health consumers, OTCs substitute for a visit to a doctor’s office: most cost-savings generated by OTC use are in saved costs of not visiting a clinician, as discussed

Most U.S. primary care physicians realize the health of their patients is largely out of their hands — with their social needs ranking as important as addressing their medical conditions, according to the 2011 Physicians’ Daily Life Report, conducted on behalf of the Robert Wood Johnson Foundation by Harris Interactive in September-October 2011, results published in November 2011. In fact, unmet social needs are directly leading to worse health for Americans, say 9 in 10 doctors. With that recognition, most physicians feel they’re unable to address patients’ health concerns caused by unmet social needs. This has led to most doctors confessing

Walmart issued a Request for Information to expand its retail health footprint in the communities in which the world’s largest company operates. That was a strong sign that retail health has surpassed a tipping point. Now, there are hard data to support this observation from a RAND Corporation research team. Trends in Retail Clinic Use Among the Commercially Insured, published in the November 25, 2011, issue of The American Journal of Managed Care, quantifies retail clinic utilization among a group of Aetna health plan enrollees between 2007 and 2009. In those two years, use of retail clinics grew 10-fold. RAND looked

The signs of the primary care crisis in America are visible: A growing number of visits to the emergency room for treating commonplace ailments Waiting lists for signing up with and queuing lines to see primary care doctors Fewer med students entering primary care disciplines Maldistribution of primary care practitioners (PCPs) in underserved areas, rural, exurban and urban. The implementation of the Affordable Care Act will (try to) enroll at least 30 million newly-insured health citizens into the U.S. health system. That’s the objective: whether being insured will actually provide people access to needed primary care is a big question given the current supply of

More people with higher levels of concern about their health feel they are in good health, see their doctors regularly for check-ups, take prescription meds “exactly” as instructed, feel they eat right, and prefer lifestyle changes over using medicines. And 40% of these highly-health-concerned people have also used a health technology in the past year. At the other end of the spectrum are people with low levels of health concern: few see the doctor regularly for check-ups, less than one-half take their meds as prescribed by their doctors, only 31% feel they eat right, and only 36% feel they’re in

Health professionals are go-to sources for medical diagnoses, information about prescription drugs and alternative treatments, and recommendations for doctors and hospitals. On the other hand, health information seekers turn to fellow patients, friends and family for emotional support in dealing with health issues, and quick remedies for everyday issues. And increasingly, those health information searches are going mobile, with 17% of U.S. adults having ever used their cell phone to look up health or medical information. This proportion nearly doubles for 18-29 year olds, and is also higher for wealthier people, Latino’s, college graduates, and urbanites. 1 in 10 people with a

In the pharmacy market battle between Davids and the Goliath, David wins in the latest Consumer Reports survey on best drugstores according to consumers: independent pharmacies come out on top, and Walmart ranks last on the roster. The most highly-rated chains, highly indexed at 90 or more points, Health-Mart, The Medicine Shoppe, Bi-Mart, Publix, Hy-Vee, and Wegmans. Target, which was just ranked the #1 retailer in brand equity by the Harris Poll (where Target also beats Walmart in general retailing brand equity), ranked lower with an 88: much higher than Walmart with a 78 index, but below Walmart’s Sam’s Club and several grocery

“The tipping point for smartphones is now,” claims BabyCenter, the mom-focused internet portal. Mothers are 18% more likely to have a smartphone than the average person, according to the 2011 Mobile Mom Report, a survey from BabyCenter. Why do moms like smartphones? According to BabyCenter, the smartphone is a mom’s “helping hand.” Nearly 1 in 2 say the smartphone helps them decrease stress, and 1 in 4 say it gives them a sense of calm. So is the smartphone in itself a health-promoting device? For readers of Health Populi, the answer is “yes” based on this poll. In the past

Health consumers are at least as keen to access their medical history online as they are to manage other aspects of their personal lives. Intuit, the people who brought Quicken to the market to help consumers manage their personal financial lives, are keen to do the same for health care. And they’ve got the survey data in The Intuit Health Second Annual Health Care Check Up to make their case for the online personal health information management market. It is no surprise that the survey found that 70% of U.S. adults are concerned (very or somewhat) about managing their health

“Can Walmart Make America Eat Healthier?” asks The Week. Walmart, the world’s largest retailer and #1 company on the Fortune 500 list, has come out in favor of bolstering health in the food it sells through its 800+ discount stores, 2,700 supercenters, 158 neighborhood markets, and nearly 600 Sam’s Clubs in the U.S. The Financial Times today reported that the company’s plan won the compliments of First Lady Michelle Obama, who is a proponent of healthy and local foods and was present at Walmart’s announcement. The company’s stock price is up over a dollar today, probably based on this news and

‘Tis the season…perhaps, era…for scenario planning in health. The activity consumes a lot of my consulting time these days for stakeholders falling under the broad umbrella of “health.” With the news that Sam’s Club will offer health care for $99 out-of-consumers’ pockets, it got me wondering…where might Walmart be in the health care ecosystem in a few years, say 2015? Sam’s Club launched The Prevention Plan in January 2010, with a partner, U.S. Preventive Medicine. The “Plan” isn’t a health plan, per se; it’s a year-long subscription that gets the user some coaching for managing health risks. Step 1 is a blood

Medical drug benefits meet doctors and their patients via mobile platforms: that’s the prescription for a retail health care experience with the consumer’s checkbook in mind, brought to you by Walgreens pharmacy and Epocrates, the #1 most widely-used mobile drug information source among U.S. physicians. In this offering, Walgreens will channel its discount formulary information through Epocrates’s mobile application. About 300,000 U.S. physicians use the Epocrates drug database for prescription information. These users will be able to use Epocrates to check a Walgreen PSC member’s formulary profile against the prescription drugs the doctor is considering. At that point-of-prescription, the doctor can have a conversation with

Contrary to stereotypes, older people can adapt, learn, and use new products and services. The introduction of Medicare Part D five years ago was an experiment in public policy, with some policymakers fretting about seniors’ ability to navigate a new system. It appears Medicare Part D is a hit, and people are working well with it across gender, age cohorts, incomes (from very low to upper-income strata), educational levels, and especially very sick and disabled people. Among all seniors, 90% have prescription drug coverage. 61% of U.S. adults 65 and over have a Medicare prescription drug plan, 16% are covered by an employer-sponsored

Cost-competitiveness is driving overall consumer satisfaction with pharmacies in 2010, 2.5 times the importance that cost had in 2009. But even so, customer service and convenience still trump price in the pharmacy. For brick-and-mortar pharmacies, the key factors driving consumer satisfaction are: Prescription order and pick-up process (convenience) The condition of the store Cost competitiveness Non-pharmacist staff The pharmacist. In 2010, cost competitiveness accounts for 24% of overall satisfaction among brick-and-mortar Rx shoppers; that number was 9% in 2009. The retail pharmacy chains garnering highest satisfaction nationally are the Good Neighbor Pharmacy, Health Mart, and The Medicine Shoppe Pharmacy, all awarded