The role of the pharmacist in the Arab-American community often goes beyond that of mere prescription filler, extending to community leader and unofficial first-opinion doctor.

They are the trusted, well-known faces of the community on the high street to whom Arab Americans turn to for vital meds, on-the-spot medical advice – plus a smile and a chat.

Many of them are also civic leaders who advocate for their neighborhoods at local government meetings, and are active in national and local Arab-American associations.

But their role might be on the wane, as the survival of their businesses is threatened by the economic downturn.

Recent N.Y. state budget cuts have left many independent pharmacies, among them many Arab American-owned ones, struggling to stay in business, say several pharmacists spoken to for this article.

The cuts and other industry changes contributed to a record 1,000 closures of independent pharmacies statewide in 2009, said Craig Burridge, CEO of the Pharmacists Society of the State of New York.

The most recent financial blow was the September 2009 4 percent roll back of the reimbursement rate on certain Medicaid-provided drugs, as part of the state's deficit reduction plan.

The lower rate means that pharmacists are actually losing money on several medications.

"You can't deny someone their medication," said Habib Joudeh, owner of Bay Ridge's Pharmacy on Fifth, "so you end up paying out of pocket."

The cut affects independent pharmacies the most because they get over 90 percent of their income from filling prescriptions.

Chain drug stores, on the other hand, like Rite Aid and CVS, get 68 percent of their income from prescriptions; mass stores like Wal-Mart get less than 10 percent, according to the National Community Pharmacists Association.

Another ongoing pull on clients is the growing mail-order industry, which can undercut neighborhood pharmacists' prices. More and more insurance companies are switching to mandatory mail order for some medications.

Hossam Maksoud, owner of Manson Pharmacies in Briarwood, Queens, and George Arsof, owner of Nu-Edge pharmacy in Bay Ridge, both report a 20 percent loss of clients to this trend.

They agree that mail-order clients lose out on face-to-face communication with their pharmacists.

"The costs in terms of personal service can outweigh the benefits," said Maksoud.

Those costs are especially high for Arabic speakers, who rely on med-taking guidance in their native language.

Indeed, if Arab-owned pharmacies start to close, Arabic speakers may have a tough time.

"They will have to go somewhere they cannot communicate. They will suffer because of it," Joudeh said.

Mayor Bloomberg enacted a mayoral order in September 2009 requiring New York City chain pharmacies to provide oral interpretation to limited-English speakers. The order does not, however, cover businesses outside of the city or state.

A bill (A09139) is currently languishing in the state Assembly which aims to redress some of the financial damage done by the budget cuts.

Some pharmacists said the bill isn't perfect but lawmakers need to act to stem the loss of community businesses.

"If things continue as they are, we'll all have to pack up," said Joudeh.