Podcast Summary
Episode Overview
Podcast: Becker’s Healthcare Podcast
Guest: Dr. John Pastor, PharmD, President of Fairview Pharmacy Services
Host: Laura Dardo
Date: January 31, 2026
This episode features Dr. John Pastor, President of Fairview Pharmacy Services, who discusses Fairview’s core philosophies, the recent expansion and innovations in their pharmacy operations, ongoing challenges in the industry, and his vision for the future. He shares leadership insights, details about facility transformation, and broader perspectives on pharmacy's evolving role within healthcare systems.
Key Discussion Points & Insights
1. Background and Philosophies at Fairview Pharmacy
- Dr. Pastor introduces himself as a pharmacist with over 30 years of experience, primarily hospital-based but also now in ambulatory care.
- Fairview is a large Minnesota-based nonprofit health system: 10 hospitals, 60 clinics, 34,000 employees, 1.2 million patients.
- Pharmacy Philosophy: More than just prescription fulfillment; pharmacy is integrated into the entire healthcare journey for patients.
- “We're a vital part of how our patients experience healthcare.” — John Pastor [00:45]
2. Major Initiative: Relocation and Expansion of Central Pharmacy Facility
- Fairview Pharmacy doubled in size over the last 5-10 years, necessitating a major facility upgrade.
- Undertook a multi-year project relocating to a new 150,000 sq. ft. pharmacy shared services facility in Shoreview, MN.
- All core central pharmacy teams consolidated in the new site.
- Facility supports 26 retail locations, specialty pharmacy serving all 50 states (16,000 patients), home infusion pharmacy (3,000 patients), and 10 hospitals.
- Over 200,000 prescriptions filled monthly.
- “Frankly, it was a four- or five-year project in whole from start to we got the final team moved.” — John Pastor [03:33]
3. Lessons Learned from the Expansion (Advice for Peers)
- Admits this was a new-scale project and sought advice from national peers.
- Integrated best practices from other health systems into new designs, particularly in:
- Infusion Center: 16 specialized suites for adults, adolescents, and pediatrics, each tailored for specific patient needs.
- Technology: Invested in state-of-the-art, often first-in-US-market pharmacy technology for safety and efficiency.
- “One of the things on our list that they don't teach you in pharmacy school: how to do a big project like this.” — John Pastor [04:25]
4. Priorities and Headwinds for 2026
- Industry Growth: Pharmacy is now an $800B+ industry (trending toward $1T), with specialty pharmacy as a key driver.
- Access Challenges: Major closures of pharmacies nationwide (chains and independents); nearly 45% of pharmacies in Minnesota have closed since 2013.
- Patients in rural and urban areas may have limited pharmacy options.
- External Pressures:
- Federal legislation and policy changes.
- Manufacturer restrictions and 340B program uncertainty.
- Workforce shortages and persistent supply chain/drug shortages.
- Healthcare costs rising faster than reimbursement.
- “Pharmacies across the country continue to close at an alarming rate... patients living… with significant access issues.” — John Pastor [06:50]
5. Strategic Planning Amid Uncertainty
- Stays proactive about legislative and market shifts; strong emphasis on a responsive, well-informed team.
- “Staying abreast of what's happening around us... making sure we have all the right members on our team engaged.” — John Pastor [09:11]
- Drug shortages can shift daily, requiring nimble responses and teamwork.
6. Leadership and the Challenge of Complexity
- The pharmacy business has grown dramatically in complexity, making adaptability and teamwork more vital.
- “The hardest thing... is being able to respond in a timely way to external changes... the business has become very complex compared to how it was when I started.” — John Pastor [10:12]
7. Growth Opportunities and New Ventures
- Strong belief that health systems should strive to retain and care for their own patients through integrated pharmacy services.
- Launch of Fairview Pharmacy Solutions (2025): New enterprise to help other health systems replicate Fairview’s successes and retain patients.
- “Our goal there is to help other health systems do a lot of the things that we've done over the last 25 years and optimize their care delivery.” — John Pastor [11:38]
8. Philosophy of Shared Success
- Emphasis on collaboration and shared progress for better patient outcomes.
- “When we can all serve patients better, we all do better, and that's our goal.” — John Pastor [12:27]
Notable Quotes & Memorable Moments
- "We're a vital part of how our patients experience healthcare." — John Pastor [00:45]
- “One of the things on our list that they don't teach you in pharmacy school: how to do a big project like this.” — John Pastor [04:25]
- “Pharmacies across the country continue to close at an alarming rate... patients living… with significant access issues.” — John Pastor [06:50]
- "Staying abreast of what's happening around us... making sure we have all the right members on our team engaged." — John Pastor [09:11]
- “The hardest thing... is being able to respond in a timely way to external changes... the business has become very complex compared to how it was when I started.” — John Pastor [10:12]
- “Our goal there is to help other health systems do a lot of the things that we've done over the last 25 years and optimize their care delivery.” — John Pastor [11:38]
- “When we can all serve patients better, we all do better, and that's our goal.” — John Pastor [12:27]
Timestamps for Major Topics
- 00:25 — Dr. Pastor’s background and Fairview overview
- 02:00 — Overview of the new pharmacy shared services facility
- 04:20 — Lessons learned and advice for others expanding pharmacy services
- 06:03 — Current and future priorities for Fairview Pharmacy/industry
- 08:22 — Planning and pivoting amid external pressures
- 10:10 — Biggest challenges for the coming year
- 11:08 — Growth opportunities and launch of Fairview Pharmacy Solutions
- 12:27 — Closing philosophy on collaboration and serving patients
Tone and Closing Thoughts
The episode was marked by candor, humility, and a focus on teamwork and patient-centered care. Dr. Pastor offered both a strategic lens on the business of pharmacy and granular insights for other leaders navigating expansion, change, and industry headwinds. The conversation closed with optimism about collaboration and continual improvement in healthcare and pharmacy services.