WALL, S.D. \u2014 Stacey Schulz parks in a rear lot to avoid the crowded Main Street entrances to her local pharmacy.<\/p>\n

\u201cDuring the summer, it\u2019s kind of hectic,\u201d she said after greeting the pharmacist and technician by name.<\/p>\n

That\u2019s because Schulz\u2019s pharmacy is tucked inside Wall Drug, a tourist attraction that takes up almost an entire block and draws more than 2 million visitors a year to a community of fewer than 700 residents.<\/p>\n

The business is named after the town of Wall, which is just off Interstate 90 near Badlands National Park. Colorful, hand-painted billboards dot the roadside for hundreds of miles, telling motorists how far they are from Wall Drug\u2019s free ice water, 5-cent coffee, and homemade doughnuts. Visitors can pan for gold, listen to singing animatronic cowboys, try on Western wear, and shop for souvenirs, including plush jackalopes \u2014 mythical jackrabbits with antelope horns.<\/p>\n

Despite being part of a booming tourist attraction, Wall Drug\u2019s pharmacy faces challenges common to independent rural pharmacies<\/a>.<\/p>\n

It\u2019s the lone pharmacy in Wall, serving locals year-round. Some, like Schulz, live in town, while others live on ranches as far as 60 miles away. The next-nearest pharmacy is a 30-minute drive northeast.<\/p>\n

Wall Drug also serves tourists who forget their prescriptions at home, get sick while roaming the country in their RVs, or hurt themselves while hiking through the otherworldly rock formations of the scorching Badlands, said Cindy Dinger, its sole pharmacist.<\/p>\n

Pharmacist Cindy Dinger says her corner of the store would struggle without the rest of Wall Drug. \u201cAll this stuff around us \u2014 the poster and print shop, the boot shop, the fudge shop, the caf\u00e9 \u2014 they pay our bills,\u201d she says.(Arielle Zionts\/KFF Health News)<\/span><\/figcaption><\/figure>\n
Wall has no hospital, but a clinic is open four days a week. Schulz, a medical assistant there, said she and her co-workers see a lot of summer tourists. They send them to Wall Drug to pick up prescriptions.<\/p>\n
\u201cAnd then we tell them to get fudge before they leave,\u201d Schulz said.<\/p>\n
Rural pharmacies, especially independent ones, closed at a higher rate from 2003 to 2021 than pharmacies in other areas, according to a study by the Rural Policy Research Institute.<\/a> By 2021, the institute found, nearly 8% of rural counties were left with no pharmacy<\/a>. The Wall Drug pharmacy has fewer customers than a typical city pharmacy, which can mean less profit, Dinger said.<\/p>\n
She said some of its prices are higher because the store can\u2019t negotiate discounts as steep as the deals suppliers grant chain pharmacies. Rural drugstores also lack leverage with insurers, and they face increasing competition from mail-order pharmacies.<\/p>\n
Another challenge is staffing<\/a>. When Dinger needs time off, she finds a fill-in from Rapid City, nearly an hour\u2019s drive away.<\/p>\n
\u201cIt\u2019s a challenge getting relief if I want to go on vacation or if I need a cover so that I can go to a doctor\u2019s appointment,\u201d she said. \u201cYou take what you can get and try to schedule around it.\u201d<\/p>\n
\n
\n\t\t
\n\t\t\tEmail Sign-Up\t\t<\/a>
\n\t<\/h4>\n
\n\t\tSubscribe to KFF Health News’ free Morning Briefing.\t<\/p>\n<\/div>\n
Dinger said her pharmacy would struggle without the rest of Wall Drug.<\/p>\n
\u201cAll this stuff around us \u2014 the poster and print shop, the boot shop, the fudge shop, the caf\u00e9 \u2014 they pay our bills,\u201d she said.<\/p>\n
The pharmacy\u2019s white facade, with stained-glass signs and windows, is modeled after that of the original drugstore, which was across the street. The window displays and top shelves inside the store are filled with vintage pharmacy supplies, including manuals, glass medicine bottles, and a suppository-making machine.<\/p>\n
Tourists carrying shopping bags and sporting new cowboy hats stop to look at the displays. \u201cIt\u2019s a real pharmacy,\u201d a woman said, sounding surprised.<\/p>\n
Dinger and Sylvia Smith, the store\u2019s only pharmacy tech, ring customers up below a Tiffany-style light fixture and retrieve prescriptions stored behind a wooden desk and wall.<\/p>\n
\n
\n
\n
\n\t\t\t\t\t $\"\"$
\n\t\t\t\t\t\t\tWall Drug\u2019s pharmacy, across from its chapel and sandwiched between the fudge and rockhound shops along \u201cCowboy Alley,\u201d takes up less than 1% of the space within the 76,000-square-foot tourist attraction in South Dakota.\t\t\t\t\t\t(Arielle Zionts\/KFF Health News)<\/span><\/figcaption><\/figure>\n<\/p><\/div>\n
\n
\n\t\t\t\t\t $\"A$
\n\t\t\t\t\t\t\tDinger checks out tourist Will Lovitt after giving him advice on treating a mysterious rash he developed while visiting the Black Hills of South Dakota.\t\t\t\t\t\t(Arielle Zionts\/KFF Health News)<\/span><\/figcaption><\/figure>\n<\/p><\/div>\n<\/p><\/div>\n<\/div>\n
\n
\n
\n
\n\t\t\t\t\t $\"\"$
\n\t\t\t\t\t\t\tSylvia Smith, the sole pharmacy tech at Wall Drug, works behind a wooden counter. Shelves display vintage equipment alongside modern medicine.\t\t\t\t\t\t(Arielle Zionts\/KFF Health News)<\/span><\/figcaption><\/figure>\n<\/p><\/div>\n
\n
\n\t\t\t\t\t $\"\"$
\n\t\t\t\t\t\t\tStacey Schulz has to navigate around tourists when she picks up medicine during the summer from her local pharmacy, Wall Drug.\t\t\t\t\t\t(Arielle Zionts\/KFF Health News)<\/span><\/figcaption><\/figure>\n<\/p><\/div>\n<\/p><\/div>\n<\/div>\n
Customer Will Lovitt said a friend advised him and his wife to stop at Wall Drug during their drive from Indiana to the Black Hills in western South Dakota. Lovitt developed a rash on the trip and ended up using the visit to get Dinger\u2019s advice on treating it.<\/p>\n
He said it can be difficult for tourists to know where to find medical help, especially when driving through rural states like South Dakota.<\/p>\n
\u201cI think it\u2019s time that America gets back to the grass roots of the small-town doctor and the small-town pharmacist,\u201d Lovitt said.<\/p>\n
Alex Davis and a friend decided to visit Wall Drug on their road trip from Kansas to Yellowstone National Park.<\/p>\n
\u201cThen, when I saw there was a little pharmacy, I thought I\u2019d grab something that I needed,\u201d she said.<\/p>\n
Davis bought Dramamine to treat car sickness on the long drive.<\/p>\n
Dinger said she occasionally sees unusual situations, like the time several years ago when a park ranger needed antibiotics after getting bitten by a prairie dog.<\/p>\n
\u201cYou never know what kind of diseases they might be carrying,\u201d she said of the animals, which recently were hit with an outbreak of plague.<\/u><\/a><\/p>\n
Rick Hustead is the chairman of Wall Drug. The store was opened in 1931 by his grandfather, pharmacist Ted Hustead. Ted\u2019s wife, Dorothy, had the idea to advertise its soda fountain and free ice water to tourists traveling along unpaved roads during the hot years of the Dust Bowl era. Rick\u2019s father, pharmacist Bill Hustead, began expanding the store in the \u201950s, turning it into the tourist magnet it is today.<\/p>\n
$\"A$
Rick Hustead, chairman of Wall Drug, works the restaurant counter when things get busy. Hustead, whose grandfather opened the store in 1931, says he\u2019d never close the pharmacy, even though it\u2019s not the main attraction. \u201cWe can\u2019t be Wall Drug without being a drugstore,\u201d he says.(Arielle Zionts\/KFF Health News)<\/span><\/figcaption><\/figure>\n
Rick Hustead didn\u2019t follow his father and grandfather\u2019s path to pharmacy school, so he had to recruit pharmacists from elsewhere.<\/p>\n
Hustead found Dinger in 2010 after writing a letter to each pharmacist in the state.<\/p>\n
Dinger said she was living at the time in Sioux Falls, South Dakota\u2019s most populous city. But she and her husband were interested in raising their kids in a small town, the way she grew up. Dinger was also attracted by the store\u2019s limited hours: She\u2019d be done working by 5 p.m. on weekdays and have the weekends off.<\/p>\n
Hustead said his family has never considered closing the pharmacy, even though it\u2019s not the main attraction for most visitors.<\/p>\n
\u201cWe can\u2019t be Wall Drug without being a drugstore,\u201d he said.<\/p>\n
\n
\n\t\t\t\t\t\t\t\t\t\t\tArielle Zionts: <\/span>
\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t azionts@kff.org<\/a>,\t\t\t\t\t\t\t\t\t\t\t
\n\t\t\t\t\t\t\t@Ajzionts<\/a>\n\t\t\t\t\t\t\t\t\t<\/p>\n<\/aside>\n
\n
\n
\n\t\t\t\tRelated Topics\t\t\t<\/h3>\n
\t\t\t\t
\n\t\t\tContact Us\t\t<\/a>
\n\t\t
\n\t\t\tSubmit a Story Tip\t\t<\/a>\n\t<\/div>\n<\/section><\/div>\n