One of the last old-fashioned pharmacies is facing tough times due to 20^th century laws. The Pillbox Pharmacy is an independent pharmacy, convenience store, and ice cream parlor all in one. Despite the hundreds of independent pharmacies that have closed across the nation, the Chicago family-owned business refuses to stop serving the Kaimuki community.

James Lee McElhaney sold his pharmacy in Chicago, drove his family across the country, jumped on a boat to Hawaii and later opened The Pillbox Pharmacy in 1974 at 1133 11th Ave. Known as “Dr. Mac” in the community, McElhaney employed local residents and those with little direction, including prostitutes.

“He changed pharmacy in Hawaii because he brought the south-Chicago style of doing things, which was emergency service, long hours, and accessibility to the pharmacist,” said Stuart McElhaney, James McElhaney’s second-eldest child who is now the store owner and main pharmacist.

James McElhaney brought service-oriented pharmacy to Hawaii. It was vital that his patients have access to the pharmacist at any time during the day. While pharmacies were already closed by 5 p.m. on Sundays, The Pillbox Pharmacy was open from 7 p.m. to 11 p.m., even until this day. McElhaney connected the business telephone line to his home, which allowed patients to get in touch with him at any hour of the day for an emergency consult that cost $40.

Incidentally, it was not always an easy road for the McElhaney’s who lived in Kaimuki in the ‘70s. High levels of criminal activity took place, including burglaries. Fortunately, the business was able to stay open because James McElhaney was a “nasty south-Chicago guy” that was able to sort through the issues and earn respect in the community.

Again, with the recent medical insurance policy changes the family is faced with what could be the biggest challenge for the business. In 2003 the Medicare Modernization Act (MMA) made several changes to health care services for the elderly in the United States. According to Drake University, Medicare Part D, also known as the senior drug benefit, “created a voluntary drug benefit program, where beneficiaries pay a monthly premium to receive covered medications at the cost of a copay or coinsurance, similar to a private insurance drug plan.” Although Medicare Part D is expected to relieve the burden of high out-of-pocket drug costs, many independent pharmacies are suffering because of the low pharmacy reimbursement rates by prescription drug plan providers, which are often commercial managed care companies.

“You have to be big in order to function in the way the government has decided health care is going to be,” said Stuart McElhaney. “You simply can’t make a living anymore.”

Earlier this year, all 10 Mina Pharmacy locations in Hawaii were acquired by Longs Drugs (which was bought by CVS Health in 2008). Opened since 1998, Mina Pharmacy owners decided that it was in the best interest of the company to sell to Longs Drugs according to the Hawaii Tribune-Herald. The Pillbox Pharmacy, on the other hand, does not intend to close or sell the business any time soon.

After 40 years since its opening, Stuart McElhaney feels it is important to remain open and give back. Profit margins are the last thing on his mind. To be able to remain open will mean the world to him even if it means he must break-even. His customers and long-time employees who have worked at the store for 20 years, and one employee as little as eight years, are some of the reasons Stuart continue to push forward.

Starting next year, Stuart will revitalize the store to attract a new kind of customer. A variety of showcases will be displayed to hopefully bring in tourists. A section will be dedicated to the history of the store itself, another on historical prescription in which McElhaney has acquired prescriptions of Duke Kaahamanu, and another on Hawaiian healing and plants.

In addition, Stuart will bring more attention to the old-school alcohol bottles that were produced in the 1800s that the family has collected in the past. They are unique to the nation because they have Japanese inscriptions, in which most have Latin inscriptions. Stuart hopes this and the showcases will attract Japanese tourists.

As for the ice cream, which is what it is mostly known for, is a gift to the community. They have been serving ice cream since the beginning, but recently have started selling Cascade Glacier Ice Cream, an Oregon creamery that has been a hit with customers. The ice cream had only once price increase, from $1.50 a cone to $2 a cone. Each serving comes with a heaping scoop of ice cream, which will easily cost customers $5 plus elsewhere. Flavors include buckleberry, coconut pineapple, salted caramel and more.

“Times are hard. The joy I get having people walk through my store with a bowl of ice cream, talking to each other, smiling at each other, and making eye contact,” said Stuart who believes in intimately connecting with others and still does not intend to own a cell phone.

More than 40 years later, old-time customers and former employees alike are coming in commending James McElhaney on his good work and expressing their thanks for making a positive difference in their lives. Even with his passing a few years ago, Stuart and the rest of the McElhaney family continue to uphold his legacy and remain positive.