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The document is a promotional eBook for 'Pharmacy Management: Essentials for All Practice Settings, Fifth Edition' edited by Leticia R. Moczygemba, which covers various aspects of pharmacy management including operations, people, and financial management. It emphasizes the importance of management in pharmacy education and practice while providing guidelines for effective pharmacy operations. Additionally, the document includes links to other related eBooks and resources.

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0% found this document useful (0 votes)
4 views46 pages

41888

The document is a promotional eBook for 'Pharmacy Management: Essentials for All Practice Settings, Fifth Edition' edited by Leticia R. Moczygemba, which covers various aspects of pharmacy management including operations, people, and financial management. It emphasizes the importance of management in pharmacy education and practice while providing guidelines for effective pharmacy operations. Additionally, the document includes links to other related eBooks and resources.

Uploaded by

cabarizalas
Copyright
© © All Rights Reserved
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PHARMACY MANAGEMENT
ESSENTIALS FOR
ALL PRACTICE SETTINGS
Notice
Medicine is an ever-changing science. As new research and clinical experience
broaden our knowledge, changes in treatment and drug therapy are required.
The authors and the publisher of this wor1<: have checked with sources believed
to be reliable in their efforts to provide information that is complete and generally
in accord with the standards accepted at the time of publication. However, in
view of the possibility of human error or changes in medical sciences, neither
the authors nor the publisher nor any other party who has been involved in the
preparation or publication of this work warrants that the information contained
herein is in every respect accurate or complete, and they disclaim all responsibil-
ity for any errors or omissions or for the results obtained from use of the informa-
tion contained in this wor1<:. Readers are encouraged to confirm the information
contained herein with other sources. For example and in particular, readers are
advised to check the product information sheet included in the package of each
drug they plan to administer to be certain that the information contained in this
work is accurate and that changes have not been made in the recommended
dose or in the contraindications for administration. This reoommendatiOn is of
particular importance in connection with new or infrequently used drugs.
PHARMACY MANAGEMENT
ESSENTIALS FOR
ALL PRACTICE SETTINGS
FIFTH EDITION

David P. Zganick, PhD, FAPhA Ldicia R. Moczygemba, PbannD, PhD


Professor Associate Profussor
Sc:hoolofPhannacy Health Outcomes Division
Bouve College of Health Sciences The University ofTeus College of Pharmacy
Northeastem University .Associate Director
Boston, Massachusetts Tew Center for Health Outcomes .Research.
and Education
Greg L. AI.ton, PharmD
Professor and Associate Dean
South Univcnity Savannah Campus Shane P. Deuelle, RPb, PbD, FAPhA
Savmnah, Georgia Professor, College of Pharmacy
Touro Univenity California
Vallejo, California

New York ChiQ&O San Francisoo Ad=. London Madrid Mexico City
Milan New Dclh.i Singapore Sydney Toronto
Copyright© 2020 by McGraw Hill Education. All rights reserved. Except as permitted under the United States Copyright Act of
1976, no part ofthis publication may be reproduced or distributed in any form or by any means, or stored in a database or retrieval
system, without the prior written permission of the publisher.

ISBN: 978-1-26-045639-4
MHID: 1-26-045639-0

The material in this eBook also appears in the print version of this title: ISBN: 978-1-26-045638-7,
MHID: 1-26-045638-2.

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TERMS OF USE

This is a copyrighted work and McGraw-Hill Education and its licensors reserve all rights in and to the work. Use of this work
is subject to these terms. Except as permitted under the Copyright Act of 1976 and the rightto store and retrieve one copy of the
work, you may not decompile, disassemble, reverse engineer, reproduce, modify, create derivative works based upon, transmit,
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cause arises in contract, tort or otherwise.
DEDICATION

To Michelle, Seamus, Zoe, and Fiona (D.P.Z.)


To Travis and Ashton (L.R.M.)
To June (G.L.A.)
and
To Deborah and Brittney (S.P.D.)
CONTENTS

Contributors I ix
Preface I xiii
Acknowledgmcnts I xvii

I. WHY STUDY MANAGEMENT IN PHARMACY SCHOOL? 1


Chapter 1 The "Management" in Medication Therapy Management 3
Chapter 2 Management Functions 21
Chapter 3 Leadership in Pharmacy Practice 35
Chapter4 Ethical Decision-Making, Problem-Solving, and Ddegating Authority 55
Chapter 5 Creating and Managing Value 75

II. MANAGING OPERATIONS 89


Chapter6 Strategic Planning in Pharmacy Operations 91
Chapter? Business Planning for Pharmacy Programs 109
Chapter 8 Operations Management 127
Chapter 9 Managing Technology that Supports the Medication Use Process 141
Chapter 10 Ensuring Quality in Pharmacy Operations 161
Chapter 11 Risk Management in Contemporary Pharmacy Practice 187
Chapter 12 Preventing and Managing Medication Errors: The Pharmacist's Role 205
Chapter 13 Compliance with Regulations and Regulatory Bodies 233

III. MANAGING PEOPLE 253


Chapter 14 Managing Yourself for Success 255
Chapter 15 Negotiation Skills 275
Chapter 16 Organizational Structure and Behavior 293
Chapter 17 Human Resources Management Functions 325
Chapter 18 The Basics of Employment Law and Workplace Safety 347
Chapter 19 Pharmacy Technicians 367
Chapter 20 Performance Appraisal Systems 391

IV. MANAGING MONEY 415


Chapter 21 Financial Reports 417
Chapter 22 Budgeting 437
Chapter 23 Third-Party Payer Considerations 455
vii
viii CONTENTS

v. MANAGING TRADITIONAL GOODS AND SERVICES 481


Chapter 24 Marketing Fundamentals 483
Chapter 25 Marketing Applications 513
Chapter 26 Customer Service 535
Chapter 27 Supply Chain Management 557
Chapter 28 Merchandising 585

VI. MANAGING VALUE-ADDED SERVICES 607


Chapter 29 Value-Added Services as a Component of Enhancing Pharmacists'
Roles in Public Health 609
Chapter 30 Implementing Value-Added Pharmacist Services 625

VII. MANAGEMENT APPLICATIONS IN SPECIFIC


PHARMACY PRACTICE SETTINGS 655
Chapter 31 Entrepreneurship and Innovation 657
Chapter 32 Applications in Independent Community Pharmacy 671

Index I 695
CONTRIBUTORS

Jennifer L. Adams, PhannD, &ID


Clinical Associate Professor and Associate Dean fur Academic .Affitlrs, College of Pharmacy, Idaho State University,
Sam and Aline Skaggs Health Science Center, Meridian, Idaho

Greg L Alston, PhannD


Professor and Associate Dean, South University Savannah Campus, Savannah, Georgia
Chief Value Officer, Pharmacist Success Academy

Mitch Hamett, PhannD, MS


Associate Professor, Touro University California, Vallejo, California

John P. Bentley, PhD


Professor and Chair, Department of Pharmacy Administration, School of Pharmacy, University of Mississippi,
University, Mississippi

Steve Boone
Pharmacy Insurance Practice Leader, Heffernan Insurance Brokers, Chesterfield, Missouri

Peter T. Bulatao, PharmD, MS, MMAS, BCPS, BCACP


Associate Professor, Pharmacy Practice, South University Savannah Campus, Savannah, Georgia

Leigh Ann Bynum, PhD


Associate Professor, Pharmaceutical Sciences, Belmont University College of Pharmacy, Nashville, Tennessee

I.amen M. Caldas, PharmD, BCACP


Assistant Professor, School of Pharmacy, Virginia Commonwealth University, Richmond, Virginia

PatrickJ. Campbell, PharmD


Director of Measurement Outcomes Research, Pharmacy Quality Alliance, Alexandria, Virginia

Antoinette B. Coe, PharmD, PhD


Assistant Professor, University of Michigan College of Pharmacy, Ann Arbor, Michigan

Edward Cohen, PhannD


Executive Vice President, Pharmacy Advocacy, Michael JHennessy Associates, Inc., Plainsboro, New Jersey

Michael R. Cohen, RPh, MS, Sc:D


Founder and President, Institute for Safe Medication Practices, Huntington Valley, Pennsylvania

ix
x CONTRIBUTORS

Shane P. Desselle, RPh, PhD, FAPhA


Professor, College of Pharmacy, Touro University California, and President, Applied Pharmacy Solutions,
Vallejo, California

Andrew J. Donnelly, Pha.nnD, MBA


Director, Pharmacy Services, University of Illinois Hospital and Health Sciences System, Clinical Professor
of Pharmacy Practice and Associate Dean for Clinical AfFairs, University of Illinois at Chicago, College of
Pharmacy, Chicago, Illinois

Brent I. Fox, PhD, Pha.nnD


Associate Professor, Department of Health Outcomes Research and Policy, Harrison School of Pharmacy,
Auburn University, Auburn, Alabama

PerryL Fri
Executive Vice President of Industry Relations, Membership and Education, Healthcare Distribution Alliance
(HOA} and Chief Operating Officer, HOA Research Foundation, Alexandria, Virginia

Eric Fromhart, PhannD


Co-founder and President, Secure340B.oom, Philadelphia, Pennsylvania

Caroline M. Gaither, PhD


Professor, Department of Pharmaceutical Care and Health Systems, Senior Associate Dean, Professional
Education Division, College of Pharmacy, University of Minnesota, Minneapolis, Minnesota

David Gettman, MBA, PhD


Professor, D'Youville College School of Pharmacy, Buffalo, New York

Matthew Grissinger, RPh, FISMP, FASCP


Director, Error Reporting Programs, Institute for Safe Medication Practices, Huntington Valley, Pennsylvania

Dana P. Hammer, RPh, PhD


Faculty Lead for Student Professional Development, Skaggs School of Pharmacy and Pharmaceutical Sciences,
University of Colorado, Denver, Colorado

Karl M. HC5S, PharmD, APh, CTII, FCPhA, AFfM RCPS (Glasg)


Associate Professor of Pharmacy Practice, Director, Community Pharmacy Practice Innovations,
Department of Pharmacy Practice, Chapman University School of Pharmacy, Harry and Diane Rinker
Health Science Campus, Irvine, California

Susan E. Higgins, MBA


Independent Management and Strategy Consulting Serving the Health Care Industry
CONTRIBUTORS xi

Kenneth C. Hohmeier, PharmD


Associate Professor of Clinical Pharmacy and Translational Science, Director of Community Affairs,
University ofTennessee Health Science Center College of Pharmacy, Memphis, Tennessee

Erin R. Holmes, PhD, PharmD


Associate Professor, University of Mississippi School of Pharmacy, Oxford, Mississippi

Jan M. Keresztes, PhannD, F.ASHP


Senior Educator, Pharmacy, Talent First PBC, Orland Park, Illinois

Michael L Manolakis, PhD


Vice President, National Pharmacy Practice Group, Aon Consulting, Charlotte, North Carolina

Ema Mesic, MPH


Manager, Retail and Pharmacy Projects, Walgreens, Deerfield, Illinois

Leticia R. Moaygemba, PhannD, PhD


Associate Professor and Associate Director, Texas Center for Health Outcomes Research and Education,
Health Outcomes Division, The University of Texas College of Pharmacy, Austin, Texas

Rashid Mosavin, PhD


Dean and Professor, College of Pharmacy and Health Sciences, Texas Southern University

Md L Nelson, PhannD
Director of Research and Academic Affairs, Pharmacy Quality Alliance, Alexandria, Virginia

Jacob T. Painter, PharmD, MBA, PhD


Associate Professor, Division of Pharmaceutical Evaluation and Policy, University of Arkansas for Medical
Sciences, Little Rock, Arkansas

Evan T. Robinson, PhD


Dean and Professor, College of Pharmacy and Health Sciences, Creighton University, Omaha, Nebraska

Meagan Rosenthal, PhD


Assistant Professor, Department of Pharmacy Administration, University of Mississippi School of Pharmacy,
Oxford, Mississippi

Thad Schumacher, PhannD


Pharmacist and Owner, Fitchburg Family Pharmacy, Fitchburg, Wisconsin

Glen T. Schumock, PhannD, MBA, PhD


Dean and Professor, University of Illinois at Chicago College of Pharmacy, Chicago, Illinois
xii CONTRIBUTORS

Mark H. Siska, BS Phann, MBAfTM


Chief Pharmacy Informatics Officer, Mayo Clinic, Rochester, Minnesota

Todd D. Sorenson, PharmD, FAPhA, FCCP


Professor and Associate Head, Department of Pharmaceutical Care and Health Systems, College of Pharmacy,
University of Minnesota, Minneapolis, Minnesota

Rachel Sullivan
Project Manager, HDA Research Foundation, Alexandria, Virginia

Benjamin S. Teeter, PhD


Assistant Professor, University of Arkansas for Medical Sciences, Little Rock, Arkansas

Kyle M. Turner, PharmD, BCACP


Assistant Clinical Professor, University of Utah College of Pharmacy, Salt Lake City, Utah

Benjamin Y. Urick, PhannD, PhD


Research Assistant Professor, Center for Medication Optimization, Eshelman School of Pharmacy, University of
North Carolina, Chapel Hill, North Carolina

Julie M. Unnie, PhD


Associate Professor, University oflowa College of Pharmacy, Iowa City, Iowa

Terri L Warholak, PhD, RPh


Professor and Assistant Dean of Academic Affairs and Assessment, University ofArizona College of Pharmacy,
Tucson, Arizona

Wdliam Wynn, PharmD


Assistant Professor, Experiential Education Coordinator, and Director of lnterprofessional Education,
South University Columbia Campus, Columbia, South Carolina

David P. z.gamck, PhD, FAPhA


Professor, School of Pharmacy, Bouve College of Health Sciences, Northeastern University, Boston, Massachusetts
PREFACE

• WHY DID WE CREATE THIS TEXTBOOK?


Pharmacy remains a very exciting profession; in fact, more opponunities are available for pharmacists, pharmacy
students, and educators than ever before. The roles of pharmacists in interprofessional health care teams continue
to evolve, as does their recognition by payers and policy makers. Pharmacists continue to transform the delivery
of their services to accentuate the critical nature of publlc health and proactive health care. But with new oppor-
tunities also come challenges, including the challenge of how to manage the personal and professional resources
necessary to succeed in today's ever-changing environment.
Educators must not only keep up with changes in pharmacy practice, but also anticipate and prepare our
students for opponunities and contingencies that will arise throughout their professional careers. In our efforts to
best prepare students, pharmacy management educators have increasingly had to gather teaching materials from
a variety of textbooks, journals, and other educational resources. This is due to the fact that many resources only
focus on a specific management function (marketing, personnel, accounting, and finance) or a specific practice
setting (independent pharmacies, hospital pharmacies). We believed that there would be value in a comprehen-
sive pharmacy management textbook that covered many content areas and gathered a variety of resources into
one text. We also aimed to develop a text that uses "evidence-based management"; that is, material derived from
the best and most contemporary primary literature, but that which at the same time focuses on the appllcation
of knowledge into skills that pharmacists will use every day.

• NEW CONTENT IN THIS EDITION!


In planning for a fifth edition of this text, we sought input from faculty who teach pharmacy management, as
well as from pharmacy students and pharmacists who apply management principles in their daily practice. We
llstened carefully to users also while scanning the latest advances in teaching strategies to produce the fifth edi-
tion. Of course, we also considered the many changes in pharmacy practice, management, and health systems
reform that have occurred during the past few years.

• Every chapter has been updated to reflect the fluid nature of its respective management topic.
• New trends in the management literature are reflected in each of the chapters, including management trends
within and beyond pharmacy.
• Some chapters have been revised substantially and with new authors to provide users of the text with the most
relevant information. Examples include the following:
• Sustaining medication therapy management services through implementation science as well as other mod-
els of care delivery, such as continuous medication monitoring (CoMM).
• Leveraging leadership skills into practice by guiding change management, establishing a culture of employee
self-motivation, extracting the most from your resources and infrastructure, all while advocating for your
profession and the patients you serve.
• Broadening our views of how pharmacists manage the supply chain, particularly to ensure that they can
access safe and effective medications and other resources that are needed by their patients.
xiii
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“Child, if I grant your request it will be against my will. As a
rule, I never do anything against my will. I disapprove of
your scheme. You are just a nice girl, but you are no artist,
Rosamund.”

“Cousin Geoffrey, let me prove to you that I am.”

“I don’t want you to prove it to me. There, if I think twice of


this matter you shall hear from me in a week.”

“And if I don’t hear?”

“Take my silence for what it means. I respect art—only true


votaries must approach her shrine.”
Chapter Two.
Cousin Geoffrey.

I went home and waited for the week. I was excited, I even
felt nervous. I was not a particularly pleasant companion for
my mother during these days of waiting. I felt irritable, and
the merest trifle made me speak crossly. The boys (we
always called my big grown-up brothers “the boys”) twitted
me on my London visit. They said my new hat had not
improved my temper, and, by the way, where was my new
hat?

I said, if it came home it would be in a week. I threw great


mystery into my voice when I made this remark, but the
boys were essentially matter-of-fact, and did not pursue the
inquiry.

During this week my mother talked a great deal about


Cousin Geoffrey.

At first she seemed almost afraid to ask me what had taken


place during the time I spent with him, but soon she got
over her reluctance, and then she was only too desirous to
learn even the most remote particulars that I could give her.

She both laughed and cried over my account of my


interview.

“Just like Geoffrey!” she exclaimed, when I quoted his


remarks about art and artists. “Just like Geoffrey,” she said
again, when I told her about the mutton-chop cooked by his
own hands, and the delicate and rare wine served in the tall
Venetian glasses.
My mother seemed to know his home well; she asked about
the position of certain pieces of furniture, and in particular
she spoke about the Paul Veronese. She knew its value well
enough—she was no artist, but she could appreciate its
merits. Her cheeks glowed, and her eyes grew bright as she
spoke of it.

“Ah, Rosamund,” she said, “I helped him to unpack it—long


ago—long, long ago.”

When I told my mother how Cousin Geoffrey said she was


the only relative who was not kind, she turned her head
away.

I knew why she did this—she did not want me to see the
tears in her eyes.

The week passed.

I got up early on the morning which saw its completion, and


went down-stairs myself to answer the postman’s ring.

There was no letter for me. I did not cry, nor show
disappointment in any way. On the contrary I was
particularly cheerful, only that day I would not talk at all
about Cousin Geoffrey.

In the evening my father returned by an earlier train than


usual; my brothers had not come back with him. He came
straight into our little drawing-room without removing his
muddy boots, as his usual custom was. My mother and I
had just lighted the lamp; the curtains were drawn. My
mother was bending over her eternal mending and darning.

When my father entered the room my mother scarcely


raised her head. I did—I was about to remark that he was
home in specially good time, when I noticed something
strange in his face. He raised his eyebrows, and glanced
significantly towards the door.

I knew he wanted me to leave the room; he had something


to say to my mother.

I went away. My father and mother remained alone together


for about a quarter of an hour. Then he came out of the
drawing-room, called to me to get supper ready at once,
and went up to his own room.

I helped our one maid to put the dishes on the table, and
then rushed into the drawing-room to my mother.

She was sitting gazing into the fire. A stocking she had
been darning lay on her lap. Her face was very pale, and
when she turned round at my step, I saw by her eyes that
she had just wiped tears away from them.

“Rosamund,” she said, in her gentle, somewhat monotonous


voice, “my child, you will be disappointed—disappointed of
your hope. Cousin Geoffrey is dead.”

I uttered a loud exclamation.

“Hush,” said my mother. “We must not talk about it before


your father. Hush, Rosamund. Why, Rosamund, my dear,
why should you cry?”

“No, I won’t cry,” I said, “only I am stunned, and—shocked.”

“Come in to supper,” said my mother. “We will talk of this


presently. Your father must not notice anything unusual.
Keep all your feelings to yourself, my darling.”

Then she got up and kissed me. She was not a woman to
kiss any one, even her own child, often. She was the
sweetest woman in the world, but she found it difficult to
give expression to her feelings. Her tender caress now did
much to make up for the sore and absolutely certain fall of
all my castles in the air.

The next day, I learned from one of my brothers that Cousin


Geoffrey Rutherford had been found seated by his desk,
quite dead. A policeman had found him. He had seen that
hall-door, which was practically never off its chain, a little
ajar, and had gone in and found Cousin Geoffrey.

The day but one after the news reached us, my mother got
a letter from Cousin Geoffrey’s lawyer.

“As you are one of the nearest of kin of the deceased, it


would be advisable that you should be present at the
reading of the will.”

“I think, Andrew,” said my mother, handing this letter


across the table to my father, “that I will go, and take
Rosamund with me; I am quite sure Geoffrey cannot have
left me anything,” she continued, a vivid pink coming into
her cheek. “Indeed, I may add,” she continued, “that under
the circumstances I should not wish him to leave me
anything, but it would give me gratification to show him the
slight respect of attending his funeral—and I own that it
would also give me pleasure to see the old house and the
furniture again.”

I had never heard my mother make such a long speech


before, and I fully expected my father to interrupt it with a
torrent of angry words. Even the boys turned pale as they
listened to my mother.

To our great astonishment her words were followed by half


a moment of absolute silence. Then my father said in a
quiet voice:—
“You will please yourself, of course, Mary. I have not a word
of advice to give on this matter.”

We buried Cousin Geoffrey in Kensal Green. After the


funeral was over we all returned to the old house.

When I say “we all,” I include a very goodly company. I am


almost sure that fifty people came home in mourning-
coaches to Cousin Geoffrey’s desolate house.

It presented, however, anything but a desolate appearance


on the day of his funeral. No one who saw that long train of
mourning relatives could have said that Cousin Geoffrey had
gone unsorrowed to his grave. Now, these sorrowing
relatives wandered over his house, and after a cold
collation, provided by the lawyers out of some of Cousin
Geoffrey’s riches, they assembled to hear the will read in
the magnificent drawing-room, where the Paul Veronese
hung.

Mr Gray was the name of Cousin Geoffrey’s lawyer. He was


a most judicious man, and extremely polite to all the
relatives. Of course he knew the secret which they were
most of them burning to find out, but not by voice, gesture,
or expression did he betray even an inkling of the truth. He
was scrupulously polite to every one, and if he said a nice
thing to an excitable old lady on his right, he was careful to
say quite as nice a thing to an anxious-faced gentleman on
his left. Nevertheless I felt sure that he could be irascible if
he liked, and I soon saw that his politeness was only skin-
deep.

My mother and I did not join the group who sat round an
enormous centre table. My mother looked terribly pale and
sad, and she would keep me by her side, and stay herself
quite in the background, rather to the disgust of some of
the more distant relatives, who could not make out who my
mother was, nor what brought her there.

At last Mr Gray cleared his throat, put on his glasses, and


looked down at an imposing-looking parchment which lay
on the table at his side.

Instead of opening the parchment, however, as every one


expected, he suddenly took off his glasses again, and made
a little speech to all the relatives.

“I may as well premise,” he said, “that my good friend who


has passed away was extremely eccentric.”

“Ah, yes, that he was, poor dear! Undoubtedly eccentric,


but none the worse for that,” murmured the red-faced old
lady at Mr Gray’s right.

He turned and frowned at her.

“I should feel obliged to you not to interrupt me, madam,”


he said.

“Quite right, too,” said the testy old man on the left.

He got a deeper frown from the lawyer, who, after a


moment’s pause, resumed his speech.

“Our friend was eccentric. I make this remark with a


reason. I am about to communicate some news which will
astonish—and disappoint—every individual in this room.”

This short speech made a profound sensation. All the


relatives began muttering, and I cannot say that I once
heard poor Cousin Geoffrey spoken of as “dear.”
“I repeat for the third time,” continued the lawyer, “the
remarks I have already made. Our friend Geoffrey
Rutherford was extremely eccentric. He was not the least
out of his mind, his brain was as sound, his reason as clear
as any man could desire. Nevertheless he was a very
uncommon character. He lived a queer, lonely, inhospitable
life. As regards money he was miserly. And yet, and yet,”
continued the lawyer, “I have known him generous—
generous to a fault.”

“Perhaps you will oblige us by coming to the point, sir,” here


interrupted the testy old man.

Mr Gray favoured him with a short, impatient glance.

“I will,” he said. “Yes, I will come to the point without


further delay. The point is the will. I am about now to speak
of my friend’s will.”

Here all the company settled down into a hushed, expectant


state. Their interest was so keen that the proverbial pin
might have been heard to drop.

“If Geoffrey Rutherford was more eccentric in one particular


than another,” continued Mr Gray, clearing his voice, “it was
on the subject of wills. In the course of his long life he
made several—to each of these wills he added codicils. The
wills and the codicils were all peculiar, but none, none so
peculiar as the last. It is with regard to the last will and
testament of my esteemed friend that I am now going to
speak.”

“You will read us the will, perhaps, Mr Gray,” interposed an


anxious-looking relative.

Mr Gray gave her a long glance.


“Under the circumstances, no,” he said. “My friend’s last will
is long, and full of technicalities. It is without a flaw
anywhere; but to hear it read would be tedious, and you
must excuse me, ladies and gentlemen, if I refuse to gratify
what can only, at the present moment at least, be regarded
as idle curiosity. For the will as it now stands affects no one
present.”

“It is scarcely fair not to read it, however,” said the red-
faced lady. “After a funeral the will is always read. This is, I
think, ordained by law, and ought to be enforced.”

“I am sorry,” repeated Mr Gray, taking no notice of the old


lady’s remark, which made her frightfully irate. “It would be
tedious to read the will, so I decline to do so. I have,
however, a letter from my late client, which embodies the
principal provisions in it, and that I shall be happy to read
aloud for the benefit of every one present.”

Here Mr Gray cleared his throat, and putting on his glasses,


began to read.

Cousin Geoffrey’s letter ran as follows:—

“My dear Gray:


“The more I think over our interview to-day the better
pleased I am at the arrangement we have arrived at.
You know how particular I am about my wills. I regard
them from a serious and even an artistic point of view. I
look upon a will as the crowning stone of a man’s life, a
crown to be placed on the shrine of his memory, a
monument to hand down his name to the ages. My last
will pleases me much. It is finished in all its details. It
is, I may venture to say, truly original. I do not think it
has a flaw in its construction, and, when carried into
force, it will be a means of diffusing happiness and
adding to the benefit of the human race.
“As you are well aware, Gray, I am a rich man; the rich
have many trials: they are the envied of the poor, and
that in itself is disagreeable; they are also much worried
by relations. I have never married; there is, literally, not
a soul in the world belonging to me who bears my
name, and yet I have relatives—many relatives. All my
relations are kind, and solicitous for my welfare. When I
am dead they will one and all express sorrow at my
departure. There will be a goodly gathering of them at
my funeral, and they will congregate afterwards at my
house to hear my will read. I don’t wish my will to be
read. You, as my only trustee, are to take the necessary
legal steps with regard to it, but I don’t wish it to be
read aloud to my relatives. As, however, they will be
naturally curious to know in what way I dispose of my
property, you may mention to them, in any manner you
think fit, the following particulars:
“I have appointed in my will heirs to all my worldly
estates, my property in lands and houses, in stocks and
shares. The names of my heirs I have not thought fit to
disclose; they may turn up at any time between the
date of my death and five years after, and whenever
they do appear on the scene, prepared to fulfil a
condition which I have named, my property goes to
them as appointed in my will.
“If, five years having gone by, the true heirs do not
come to claim the property, one-half of it is to go to
different charities named at full length in my will, and
the other half is to be divided in equal shares among all
my blood relations.
“Until the end of the five years, or until the true heirs
appear, my property is to accumulate; my furniture,
plate, valuable china, and jewels are to remain unsold.
“I have, however, given directions in my will that a
certain small legacy is to be given without any delay to
a young girl, the daughter of a relative.
“This girl came to me a week ago with a request that I
should give her sufficient money to enable her to attend
a school of art. I hate art schools; the word art, as
applied to them, is a misnomer. I have my own views
with regard to art—she is a mistress who must be
wooed in a very different manner. This girl, Rosamund
Lindley is her name, trod severely on my most
cherished prejudices when she made her daring
request.
“To show, however, that I bear her good-will, I leave
her, and request that it may be given to her at once, the
valuable ruby ring which belonged to my mother, and
which for many years I wore myself. You will find the
ring in my mother’s jewel-case, in drawer fifty, room
eight, in the second story of this house.
“Rosamund Lindley and her mother may possibly attend
my funeral. I hope they will. In that case, please give
Rosamund the ruby ring in the presence of my other
relatives, and, although I lay no command upon her in
the matter, tell her, if she values the memory of old
Geoffrey Rutherford, not to sell the ring.
“I am, my dear Gray,—
“Yours faithfully,—
“Geoffrey Rutherford.”

Immediately after reading the letter Mr Gray put his hand


into his waistcoat pocket, and drew out a small, old-
fashioned morocco case.

“You will like, ladies and gentlemen, to see the ruby ring,”
he said, in his blandest tones.
Chapter Three.
The Octagon Room.

There was immediately a great buzz and clatter in the


room. All the relatives rose in a body, and pressed round
the table near which Mr Gray stood. My mother and I,
surely the most interested persons present, were thus
pushed quite into the background.

We had not a chance of seeing the ring until the other


relatives had first gazed at it.

It was taken out of its velvet bed, and handed solemnly


from one to another. I don’t think an individual praised it.
The comments which reached my ears were somewhat as
follows:

“What an old-fashioned shape!”

“Dear, dear, how clumsy!”

“The centre stone is large, but is it real?—I doubt it.”

A very morose-looking Scotchman pronounced the ring “no


canny.” A lady near immediately took up the sentiment, and
said that the gem had an evil look about it, and she was
truly thankful that the ring was not left to her.

A gentleman, who I was told afterwards was a poet and


wrote verses for the magazines, said that the ruby itself had
an eye of fire, and if it were his he feared it would haunt
him.
In short, one and all of the relatives expressed their scorn
of the ring, and their utter contempt for Cousin Geoffrey.
Not a woman in the room now spoke of him as a poor dear,
nor a man as an eccentric but decidedly jolly sort of old boy.
There were several muttered exclamations with regard to
Cousin Geoffrey’s sanity, but no expression of affection
came from a single pair of lips.

At last Mr Gray’s voice was distinguished, rising above the


general din.

“If you will permit me, ladies and gentlemen,” he said, “I


should be glad to show Miss Rosamund Lindley her
property. Allow me, madam.” And he took the ring out of a
sour-faced lady’s hand. Immediately all eyes were turned
on me. I heard the stout person who had spoken of Cousin
Geoffrey as a “poor dear,” pronounce me nothing but a chit
of a girl. Notwithstanding this withering comment, I had,
however, the strength of mind to come forward, and with
outward calmness receive my property.

“Take all possible care of this ring, Miss Lindley,” said the
lawyer. “If it has no other value, it is worth something as a
curiosity. The setting of the gem is most uncommon.” Then
he put the case containing the ring into my hand.

One by one the relatives now left the room, and my mother,
the lawyer, and I found ourselves alone.

“If you will permit me,” said my mother in her gentle,


charming sort of manner to Mr Gray, “I should like to go
over Cousin Geoffrey’s house, and to look once again at the
old furniture. You are not perhaps aware of the fact that I
lived here for many years when I was a young girl.”

Mr Gray smiled slightly.


“I happen to know some of Mr Rutherford’s history,” he said.

My mother blushed quite prettily, as if she were a young


girl. She turned aside and took my hand in hers.

“We may go, then,” she said.

“Undoubtedly you may go, Mrs Lindley, and pray do not


hurry; take your own time. I am going to put a caretaker
into this house, and until he arrives shall stay in charge
myself, so you and Miss Rosamund need not hasten away.”

My mother thanked Mr Gray, and then she and I began our


pilgrimage. I don’t think I ever before spent such an
interesting afternoon. Cousin Geoffrey’s death had cast me
down and destroyed all the hopes on which I had been
building, still—perhaps it was the effect of the ring—I felt a
curious sense of elation. The task of looking over the old
house was the reverse of depressing to me. I never had
been in such an antique, curious, rambling old mansion
before. It was not like an ordinary London house; it had
unexpected nooks, and queer alcoves, and marvellously
carved and painted ceilings, and quaint balustrades and
galleries. It must have been built a long time ago, and when
the precious London ground was comparatively cheap, for
the building went back a long way, and was added to here
and there, so that it presented quite an irregular pile, and I
don’t believe another house in London in the least
resembled it. It towered above all its fellows in the square,
and looked something like a great king who owned but a
shabby kingdom. For the neighbouring houses were fifth-
rate, and most of them let out in tenements.

But Cousin Geoffrey’s house was not only curious in itself—


its contents were even more wonderful. I never saw a
house so packed with furniture, and I don’t believe there
was an article in it which had not seen at least a hundred
years. The quaintest bureaus and chests of drawers inlaid
with brass and ivory and mother-of-pearl were to be found
in all directions. There were great heavy glass cupboards
full of rare and wonderful china; there were spindle-legged
tables and chairs of the most approved last-century
pattern; there were Chippendale book-cases, and Queen
Anne furniture of all shapes and sizes. At the time I was not
a connoisseur of old furniture, but my mother was. She told
me the date of the furniture of each room, and said that the
house was so full of valuables, that it would make in itself
quite an interesting museum. I never saw my mother look
younger or prettier.

“Ah, I remember this,” she exclaimed, “and this—and this.


It was by this mirror I stood when I was dressed for my first
ball, and as a little child I used often to climb on to this
carved window-sill.”

We came to a room presently which seemed to have been


taken more care of than the rest of the house. Its approach
was up a little turret stair, and the room, when we entered
it, was an octagon. Each of the octagon windows contained
a picture in richly-coloured glass; the pictures represented
the same child in various attitudes.

“Oh, how lovely!” I exclaimed. “Even the dirt and the


neglect can’t spoil these windows.”

“No,” said my mother, but she turned a little white, and for
the first time showed signs of fatigue. “I did not know
Geoffrey kept the room in such order,” she said. “Why, look,
Rosamund, look, it is fairly clean, and the glass in this great
mirror shines. I believe Geoffrey took care of this octagon
room himself.”
“This was your room, mother,” I said, flashing round upon
her, “and I do believe this was your face when you were a
child. Oh, what lovely, quaint, uncomfortable chairs, and
what a brass fender to the old grate, and what a wonderful
bit of tapestry hangs across that alcove! This was your
room, your own, wasn’t it, mother dear?”

“I used to sit here a good deal,” answered my mother. “And


Geoffrey’s father had the windows representing childhood
put in specially for me. Poor Geoffrey! I think he drew all
the designs himself.”

“Then Cousin Geoffrey was an artist?”

“Oh, my dear, did I never mention that?”

“No. How could you have kept such an interesting secret to


yourself? And I talked art to him, and fancied myself so
wise?”

“Rosamund dear, I am glad you have got the ruby ring.


From a man like Geoffrey it means much. Cousin Geoffrey
must have taken a great fancy to you, Rosamund.”

“Well, mother, I wish he had left me some of his money.”

My mother’s face turned still paler. She made no reply, but,


walking across the octagon room, she spent some little time
examining the old furniture, and touching it with reverent
fingers.

“Rosamund,” she said suddenly, “I am tired. This day has


been too much for me. We will go home now.”

I took the ring home in my pocket. This was a dangerous


thing to do, and Mr Gray looked somewhat grave as he saw
me slip such a precious relic into so insecure a hiding-place.
“Do keep out of crowds,” he said. “Beware of pickpockets
when you get to Paddington, and, above all, keep your
pocket side next your mother when you get into the train.”

I don’t think I attended to any of these directions, but the


little old brown morocco case containing Cousin Geoffrey’s
legacy arrived safely at Ivy Lodge, the name of our humble
abode.

My mother and I got back in time for supper. My father and


the boys arrived home as usual, and we sat down together
to our supper.

I felt excited and full of my subject.

Surely on this night the departed relative might be


mentioned; the curious scene after the funeral might be
detailed for the benefit of those who were not present. But,
as we approached the table, my mother held up a warning,
finger.

“Not a word about Cousin Geoffrey,” she whispered to me.

The evening meal was even more dull than usual. No one
alluded to the events of the day. George read a battered
novel as he sipped his tea, and my father perused the
evening paper, as was his invariable custom.

After tea, Jack, my youngest brother, came up and asked


me a question.

“Any money left to you by the old miser, eh, Rosey?”

“No, Jack, certainly not.”

“Well, miss, you needn’t look so fierce. A pity not, say I.


Girls are of very little value nowadays unless they have a
good supply of the chink to add to their charms.”

“Jack, you are positively vulgar, I hate you to talk to me like


that.”

“All right, my dear. I have no desire to have any further


conversation with you. I’m dead tired and have a headache.
I shall go to bed.”

Jack mounted the stairs to his own loft in the roof, and, as
soon as possible, I followed his example. Having locked my
door and lighted the precious inch of candle which was all
that was ever allowed me to go to bed with, I took a key
out of my pocket, and unfastening the box which contained
all my greatest treasures, proceeded to place some wax
Christmas tapers in various small sconces, and then to light
them one by one. I had quite an illumination, as I sat down
by my dressing-table to examine leisurely the legacy which
had been left to me that day.

I took the little case out of my pocket, pressed the spring,


and gazed at the treasure within. The fire which lay in the
heart of the ruby leaped up at once to meet the illumination
which I had made for it. I now perceived what I had not
noticed before, that the ring contained three rubies. One of
unusual size in the centre; one much smaller at each side. I
saw at a glance that they had all eyes of fire, that they were
beautiful, fantastic, bewitching. I suddenly pressed the little
ring to my lips.

“Gift from Fairyland, welcome!” I said. “Open, sesame, and


let me into your magical secrets! My life is so prosaic, so
commonplace. Comfort me, little ring! Reveal to me the
world of romance! Show me dreams, bring to me visions!
Speak with those fiery eyes; speak, I listen!”

I suddenly stopped this rhapsody with a laugh.


“If my respected father and brothers heard me now they
would think that I had taken leave of my senses,” I
soliloquised. “Well, this is a dear little ring, and I am glad
Cousin Geoffrey gave it to me. How small it is—it won’t go
on my tiniest finger. I wonder what kind of woman wore it
last. It is of heavy make to be a woman’s ring. How solid
the gold is, and how quaintly carved. I see there is the
device of a serpent worked very richly into the gold at each
side, and the smaller ruby forms the eye. Really, this looks
like witchery, a serpent with a fiery eye. Two serpents,
rather, for each is complete in itself. How much to get into
so little. No wonder the ring is heavy. Very different from
that little slender hoop of mother’s which contains the single
small bright diamond, which used to delight me when I was
a child.”

Having examined the ring from every point of view I


presently blew out the precious Christmas tapers. They
were much too valuable to waste, so I put them back into
my box, placed the ring in its case by their side, and got
into bed.

The next morning I spoke to my mother. “I have been


disappointed in my first effort to open the oyster-shell,” I
said.

“What do you mean, Rosamund?”

“Only that I must seek some other means to secure the


necessary money to take me to the Slade School.”

“My darling, I wish you would put such a futile idea out of
your head.”

“Mother dear, I cannot. It is fixed and established there by


this time. I must go to the Slade School, and I must find
the means for defraying the necessary expenses. Now, if I
were to sell my ruby ring—”

“Oh, Rose, you surely are not serious.”

My mother’s face turned pale with apprehension.

“I don’t think I am,” I said. “I don’t believe I could part with


the pretty thing. I love it already. Besides, Cousin Geoffrey
did not wish me to sell it.”

“Rose, dear, your father doesn’t know that Geoffrey left you
the ring.”

“Very well, mother, I shan’t enlighten him.”

“I believe that ruby ring is of considerable value,” continued


my mother. “I know it well. It belonged to Geoffrey’s
mother, and was left to her by an old ancestress, who
brought a good deal of money and considerable misery to
the house. Geoffrey’s mother would never wear the ring,
but he was fond of it, and had a link made at the back to
fasten it to his watch-chain. I know the large ruby in the
middle is worth a great deal.”

All the time my mother was speaking she was going on with
that endless darning which always gave me a sore dull
feeling in my heart. If there is a dismal employment it is
darning, and my mother’s little delicate fingers looked as if
they were surely never meant for such an ungainly task.

“I wonder who Cousin Geoffrey has left all his money to?” I
said suddenly. “I wonder if the rightful heirs will appear
within the five years. I certainly should not like any of the
relatives to have it.”
“I would not think about it, if I were you, Rosamund. We, of
course, are completely out of it.”

“I don’t know why we should be. You are one of the nearest
relations.”

“Well, dear, we are out of it, so that ends the matter.”

My mother spoke with quite unwonted irritation.

“It was a very curious will,” I said after a pause; “very


eccentric.”

“Geoffrey was always eccentric, Rose, I’ve told you so


scores of times.”

“I wish I knew who was the heir,” I repeated, getting up


restlessly and standing by the fire. “Mother, have you any
messages for me to do in town to-morrow?”

“In town? Surely, Rosamund, you are not going up to


London so soon again. You have got no money; how can
you pay your fare?”

“Yes, I have half-a-sovereign from my last allowance.”

“Oh, but that is extravagance.”

“I can’t help it, mother. I must go to a jeweller to ask him


to value the ring. Oh, no, I shan’t sell it, but I cannot rest
until I know its value.”

My mother looked vexed, but she knew it was useless to


argue with me when I had fully made up my mind.

“I do not know what girls are made of in these days,” she


remarked in a plaintive voice. “They are quite a different
order of being from the girl of eighteen whom I used to
know, when I was young. They are obstinate, and are quite
sure to tell their elders every hour of the day that they
know a great deal more about the ways and doings of life
than they do, that they are quite capable of guiding their
own actions.”

“Mother, you are not angry?” I said suddenly. “Oh no, dear,”
she replied at once.

“I cannot help taking my own way, but I love you with all
my heart,” I said irrelevantly. “I must take my ring to town
and have it valued, but believe me, I shall do nothing really
rash.”

“I must trust you, Rose,” she said then. “You are a queer
girl, but I have never known you do a really imprudent
thing in your life, except on the rare occasion when you
would force yourself on Cousin Geoffrey’s notice.”

“Mother dear, was that rash? I have got my beautiful ruby


ring.”

My mother smiled and said no more. I left the room,


knowing that she would make no opposition to my going to
town on the following morning.

When the day broke, I got up early, for I felt too restless to
sleep. I wore my best dress when I came down to
breakfast; and when my father and brothers were ready to
start for London, I accompanied them.

On the way up I noticed how ill Jack looked. He had a much


nicer face than George, and I could have been fond of him
had he ever shown the slightest desire to win my regard.
But from his babyhood he was reserved and morose, and
shared my father’s ideas with regard to women. Jack was
serving his time to a solicitor in the City. At present he was
earning no money, but the happy day when he could add to
the family purse, and so relieve some of the dreadful
burden of penury and scanty living, was not far distant. In
two months’ time he was to earn sufficient to pay his
weekly mite to the household exchequer.

George, who was three years older than Jack, was doing
quite comfortably as a clerk at Lloyd’s, and already spoke of
taking a wife, and having a home of his own. I used to
wonder what sort of a girl George would marry. I must
frankly say I did not envy her her husband.

This morning I found myself seated by Jack’s side in the


railway carriage.

“How is your headache?” I whispered to him.

He looked round and favoured me with an almost glassy


stare. He knew I spoke to him, but had not heard my
question. I repeated it.

“Oh, better, better,” he said hurriedly. “Don’t speak of it,


there’s a good girl,” and he lay back against the cushions
and closed his eyes.

I felt sure at once it was not better, but it was like Jack to
shut himself out from all sympathy.

We got to Paddington in good time, and I once more found


myself in an omnibus which would convey me to Regent
Circus. Presently I got there. I had made all my plans
beforehand. I was a curious mixture of the practical and
romantic, and I thought it best not to rely entirely on myself
in choosing the jeweller who would value my ring. I wanted
to get at the real value, and a jeweller who naturally would
suppose I wished him to be a purchaser, would think it his
province to run the ring down. I knew a girl from our
village, who was serving her time now to a dressmaker in
Great Portland Street. The girl’s name was Susan Ford. She
had often helped me to turn my dresses, and was a very
sensible, matter-of-fact, honest sort of girl. I knew she
would do anything for me, and as she had been over a year
in London, she must have a tolerably wide experience to
guide her.

Regent Circus was only a few steps from Madame Leroy’s


address. The house bore the customary brass plate on its
door. I pulled the bell, and a boy in buttons answered my
summons.

“Is Susan Ford in?” I asked.

The boy stared at me from head to foot, and made a


supercilious and irrelevant reply.

I saw at once that people who called to see the apprentices


must not expect politeness from the buttons. Nevertheless I
held my ground, and said firmly that I wished to see Susan
Ford if she could be spared to speak to me.

“I’ll take up your name, and inquire,” Buttons finally


condescended to say.

I said I was Miss Lindley, from Thorpdale. I was then


requested to wait in the hall, where I sat and shivered for
quite five minutes. At the end of that time Susan, jubilant
with smiles, joined me.

“Oh, Miss Rosamund, how kind of you! How very kind—I am


delighted!”

“Susan, I particularly want to ask your advice. Would it be


possible for you to come out with me for a little?”
“Oh, miss, I’d like to, awfully, but I’m afraid it’s against the
rules. Still, it would be a treat to take a walk with you, miss,
and Madame Leroy is very good-natured. I have a good
mind to try if she’d spare me for an hour; we are not
particularly full of orders just now.”

“All right, Susan, do your best, for I really want your help,” I
answered.

Susan nodded and disappeared. In an incredibly short space


of time she returned, wearing a very smart jacket and
stylish hat. Oh, how dowdy I looked by her side!

“I’m just given an hour, Miss Rosamund,” she said.

The moment we got into the street I told her what I


wanted.

“I have got a curious old ring with me,” I said, “very old-
fashioned; I want to find out what it really is worth. Do you
know an honest jeweller who will tell me the truth, Susan?”

Susan’s eyes sparkled.

“There’s lots of jewellers in Oxford Street, miss,” she said.

“I don’t wish to go to one of them. They will fancy I want to


sell, and will run my ring down.”

“Then,” proceeded Susan, “there are men, Jews, most of


them, who lend ornaments to my missis, which she hires
out to her ladies.”

Susan’s eyes shone very brightly when she revealed this


little secret to her country friend.
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