As soon as the pharmacy gates opened up, a line had already formed at Pick Up. My heart starts to beat faster, and my anxiety slowly builds up.
My technicians are both up front helping patients, and I can overhear conversations escalating.
I’m trying to focus on my pharmacist duties, but the volume of voices increases up front. I can’t concentrate knowing there’s a crisis impending.
We’ve only been open for a total of 5 minutes. Help.
On this day, I showed up 2 hours early to this pharmacy.
Even though it’s my own store, I needed the time to mentally prepare.
I walked in, only to be greeted by 4 dozen stacks of prescriptions waiting for verification. I volunteered 4 hours after closing last night, but it wasn’t enough time.
The alarm company that normally calls to verify my early presence had stopped calling since this was my 4th day in a row coming in at 7 am.
I’m a regular now, and we’ve become best buds.
Fast forward two hours later.
A patient at Drop Off presents a narcotic prescription and looks like she means business.
As predicted, I have many concerns about her pain regimen and some red flags I need to resolve. A polite, respectful explanation does nothing but cause offense.
She proceeds to call me names, uttering, “You are NOT a doctor, and you need to fill what my doctor prescribed.”
Everyone else in line is staring now. Surprisingly, no one comes to my defense.
I finally weasel my way out of the embarrassing interaction, and discovered that in my absence, 5 more waiter prescriptions became overdue.
The fax machine, phone calls, and electronic prescriptions never stopped, and everything was getting lost in the messed up work queue.
When would I get time to think? I already knew that I would be eating dinner behind closed pharmacy gates again.
The beginning of my professional career started like any other person.
I was just like you: a pharmacy student who wanted to help people. I wasn’t at the top of my class, and I wasn’t at the bottom either.
There were some disease states that induced slumber within seconds, but topics like cardiology really lit me up. Ultimately, I was unsure of how I would use my PharmD once I graduated.
All I knew was that I cared deeply about helping people.
While on rotations as a student, I gave amazing customer service. I was never late to work, and I loved the feeling of being productive and helpful.
Because I had 6 months of pharmacy technician experience, I had developed the fastest hands at production and the quickest feet to help at pick up.
I loved retail pharmacy. The thrill of bouncing around and getting work done invigorated me.
I played a ton of football, basketball, and table tennis in my life, and the fast-paced, physical labor re-ignited some of my muscle memory.
My interactions with patients were especially heart-warming. The stories I would hear, and the genuine connections I could make energized me.
Although I considered myself an introvert, I loved being able to solve someone’s problem or make someone’s day better. Even if someone was in a bad mood or taking out frustrations on us, there wasn’t a person I couldn’t win over.
Well, most of the time. We all have those one or two patients that just get under our skin.
My Internal Desires
But I knew retail pharmacy was where I wanted to end up after graduation. There was just something about this place that made me feel good and at home.
I think it was because I was really good at it. This PharmD knew how to solve people problems and loved to bust a sweat.
I could influence a lot of people’s health, and I could make a lot of people smile at the same time.
Winning and accomplishment were never second nature for me, but I wanted them fiercely. And I was able to do so because of the relentless support I had from my family.
Everyone wants to feel loved, accepted, and respected by others. Deep down, we all want to change the world.
For me, I deeply wanted to make my family proud of me. I was their golden child, the first to get a college degree.
But that wasn’t enough for me.
The fact was: my parents were getting older. They were in relatively good health, but they had no retirement set aside because they always spent on their children and family unconditionally.
Their idea of saving money was stashing cash in a safe box for rainy days.
I was the man of the family, and it was up to me to take care of them.
There was no other way, but to move up in the game of life.
I had to be the be a successful pharmacist. I just had to.
How else was I going to support my family in the future?
My Plan Was In Jeopardy
After I passed my NAPLEX, I was ecstatic. I shouted out to the world of my accomplishment, waiving my imaginary license around. I was going to change the world.
Before I could, I had 6 weeks of pharmacist training. And it flew by. Honestly by the end of it, I still didn’t feel completely ready.
I thought to myself, “I’m going to need to float to other stores and learn from the seasoned pharmacists.” I still had so many unanswered questions.
First day out of training, I show up to my “home store” where I was greeted by a welcome party consisting of the store manager, district manager, and another pharmacist.
I remember thinking to myself, “Wow, this is so nice. All I did was complete my training.”
But I knew something was up.
Turns out, everyone was there to announce my role as the new Pharmacy Manager. I did not ask for this, and I sure as hell was not ready for it.
The Beginning Of My Career
Of course, I didn’t want to seem ungrateful. I could only imagine the look of terror on my face, but I didn’t want to turn down a promotion.
I didn’t want to let anyone down, especially my family.
So I accepted the new role, not truly understanding what I was getting myself into. It really didn’t feel like I was given a choice.
At first, I suppressed my fear and anxiety. I told myself, “Other people think I’m ready, so I can do this.”
I turned the feeling of queasiness into excitement, and I tried to think positively. And it worked for a short time.
For the first few weeks, it felt like I was an intern again. I was able to work fast, zipping around the pharmacy shelves, delivering amazing customer service, and making a name for myself.
This was my pharmacy, and I was beginning to feel unstoppable.
But then the days started getting long, and the work started piling up.
Hitting The Brick Wall
Slowly, operational deficiencies compounded.
Promise times weren’t being met, and customers were getting angry. And the narcotic patients were the worst of them.
I had no formal training on how to triage, evaluate, or even think about dispensing opioids. To be honest, every narcotic script scared the hell out of me.
I started unilaterally refusing to fill prescriptions based off whimsical merits and fleeting feelings.
Complaint after complaint devoured 90% of my time.
Everyday, I heard, “Let me talk to your manager.”
And everyday, I had to disappoint them by pointing to my name badge.
With each passing second, the pressure of the clock built up my anxiety, and I felt so overwhelmed.
I would get daily phone calls from my boss reminding me of deadlines that were overdue.
Managerial tasks I had never done before were now on my to do list and following me home until my head hit the pillow at night.
All of a sudden, I felt like I was in over my head. I wasn’t ready for this.
So what did I do? I muscled it and put in over time. A lot of over time.
“Everyone goes through this rite of passage,” I thought to myself.
I was a new pharmacist: reasonably slow and unable to verify fast enough.
I was also a new manager, so I definitely didn’t know how to run a business.
My solution? To do what I did best: work harder.
I decided I would go in 2 hours early and be a beast in workflow. Uncontested, I could get so much done.
This worked for a while, and the days would seem better and less stressful.
But after a few weeks, the work would pile up again. New manager duties would pop up, and more prescriptions kept coming in.
It was a never-ending cycle.
Phone call after phone call, visit after visit from the boss.
I wasn’t meeting goals. My team resented me. Work was always behind, and patients were always complaining.
Never in my life had I experienced anything like this. I was the worst pharmacy manager ever.
I stared at the mountains of prescription baskets left over from the few days before and the pages of overdue prescriptions in the computer, feeling like a complete failure.
Everyone else could handle their workload. Why couldn’t I?
So what did I do? What I did best.
For weeks on end, I decided to go in 2 hours early, and stay 4 hours late. That was the only system that would clear my work queue and allow me to time to think during the day.
It made things a little less stressful, and I tried to stay positive. But weeks turned into months.
The despair crept up inside me, and I couldn’t see a way out of this dark hole.
What did I get myself into?
Then one day, I thought to myself, “Why did I choose Retail Pharmacy? Is this really the rest of my life?”
Pharmacy School told me that I was going to make interventions, save lives, and positively impact my community.
They told me this was a respectable profession, and that Pharmacists were the #1 trusted healthcare professional.
If that was all true, why was I living in this nightmare?
I looked back at my experiences as an pharmacy intern. Some stores were apocalyptic nightmares to work at, so much that I would question patients’ safety.
Back then, everyone I knew blamed the companies and bosses they worked for. “Not enough tech hours” and “rude, ungrateful patients” were the root causes.
But at other pharmacies, the work was hard, yet satisfying. It was busy wherever I worked, but the pharmacists sure didn’t show up 2 hours early and work 4 hours after closing every day.
They looked happy, and they had work/life balance.
What were they doing that I wasn’t? How did they create a fun place to work where all the work was finished and they had time to actually breathe?
Why was their pharmacy environment so healthy while mine felt like a rotting, diseased store?
During college, I had read a book titled The 7 Habits of Highly Effective People by Stephen Covey. Back then, it changed my whole perspective on life and ultimately started me on the path to personal development.
One thing that always resonated with me was this idea of controlling the controllables. Covey called it the acting within the “sphere of influence.”
Instead of focusing on external factors that I had no control over, I needed to focus on what I could influence. That included my own thoughts and actions.
I couldn’t keep doing the same thing and expecting different results.
So, I decided to study, plan, and act to be a better leader.
That’s when I started reading tons of business and leadership books. Everything from operational management to building trust to sales principles to influencing other people.
Here I was, a new grad pharmacy manager working 80 hour work weeks, and getting home at 1130 pm to study.
All the while, my boss was visiting my store multiple times per week, and I felt like I was on the verge of losing my job.
I needed to do everything possible to succeed as a Pharmacy Manager.
I gained some hope and inspiration from some of the books I had read, but there was nothing pharmacy related.
Everything sounded great on paper; but when it came time to implement the principles, nothing worked.
I didn’t have the real-world skills or experiences required, and I always felt I needed more time.
The stressful work environment and negativity began to eat away at my spirits.
I felt trapped and defeated. This felt like the beginning of the end for me.
So, I decided to take a stand and look at my problem differently. I wasn’t going to give up on my profession and more importantly: myself.
I couldn’t keep working 80-hour work weeks, and I had to make a change.
I was a clinician, and I earned a doctorate in Pharmacology. If I could solve complex disease states, why couldn’t I solve my pharmacy problem?
One day, a patient came up to the counsel window and exclaimed, “Help, I think I might have diabetes! I just checked my blood sugar, and the reading says 200!”
Of course, I knew that a blood sugar reading was only a snapshot and one piece of a larger, complex puzzle.
He continued, “Should I see the doctor? I looked it up, and the Mayo Clinic website says I could be at risk for serious complications.”
He’s right, but I have been trained not to take things at face value.
Was that a preprandial or postprandial reading? What’s his A1c? Was he symptomatic?
All these questions surfaced naturally, and the gears in my head started grinding through the years of clinical training I received.
Then, it hit me like a train.
I looked at my patient who was overwhelmed and anxious about all the numbers, facts, and potential implications. He cared deeply about his health, and he just didn’t understand what to do.
In this moment, I had so much in common with him because I too, was facing a disease state that I had no experience solving for.
My own pharmacy.
Every day, I was freaking out because all the numbers were telling me that I was failing as a pharmacist.
The promise times, the survey scores, the profit and loss report.
Patients belittled me and my team resented me. And I accepted it all without question, internalizing the message.
In turn, each day wore me out, making me more bitter and demotivating me further.
What I needed to fix this was a doctorate’s equivalent in pharmacy business and the confidence to exercise my own voice.
What I realized after years of pain and suffering, is that I hated following someone else’s diagnosis and prescription.
I spent years studying and practicing to get my PharmD in order to be a clinician. To master the foundation of pathophysiology and utilize my expertise to treat disease.
I was sick and tired of letting someone else tell me how to run my pharmacy. I despised jumping through hoops to chase false negatives and meaningless goals.
But in order to do this, I had to tune out the computer screen, the patient complaints, and the micromanagement.
Things had to change, and I decided to fall back on something else I was really good at: how to solve a disease state, utilizing my understanding of pathophysiology, pharmacology, and clinical lab values.
I had to transform clinical ownership into business ownership.
It would take me 4 years (another degree) to master and execute this idea.
I learned that knowledge was worth absolutely nothing in the real world of retail pharmacy.
With my PharmD and MBA, I was no better prepared than anyone else just starting their careers.
But I had one advantage: I was placed in the worst-performing pharmacy, with the most tenured, jaded staff, in a war zone filled with big problems, high drama, and never-ending adversity.
What I lacked in experience, I quickly made up in grit. When faced with a business or leadership problem, I reacted, failed, and tried again.
But through massive failure, I was able to execute differently and learn new skills each time.
At many points in my career, I briefly considered taking the path of least resistance. Why did I need to work this hard?
But I persevered. I pondered, ask questions, learned new ways of thinking, and got right back up to try something else.
It started to become a game to me. How could I mess up even more (without hurting anyone or losing tons of money)?
What I gained in 5 years of this crazy, “no-fear-of-failure” strategy became invaluable and is my greatest asset within my professional portfolio.
During this time, I learned that business ownership is exactly like exercising clinical expertise. But instead of monitoring lab values and treating a person, we’re analyzing metrics and treating a business.
Fast forward to today:
I get a call from my district manager.
DM: “You’re over on payroll this month by more than 50 tech hours. Your store metrics shows that you’re not making your promise times, either. What in the world are you doing?”
Me: “For the last 3 years, script growth has averaged 20%+ over budget. I’m overspending pennies to capture dollars in increased foot traffic. The promise time metric is also a false negative. My customer service is highest in the district, and no one is complaining about promise times.”
DM: “If you overspend payroll, you have to pay it back. That’s not your money.”
Me: “If my job was only to make what the company thinks I’ll make, my pharmacy wouldn’t surpass sales and script budgets. We are twenty percent over company’s projections, and I am converting all profit drivers to the bottom line. This is also a 3 year running trend right now.”
DM: (short pause).. “Do you need help with anything?”
Me: “I could really use help replacing these old carpets in the pharmacy.”
When I first started my pharmacy career, I sought fame and glory in all things. I wanted to crush all the metrics and win all the awards. I even wanted to get promoted.
But through this journey, I achieved even more valuable accomplishments.
I learned that business analytics is kind of like looking at lab values for patterns and trends. Out of range values can be red flags, but they can also be sub-clinical.
I also learned that we don’t treat lab values; we manage the symptoms and treat the disease. We have to be experts on the microscopic data, while also having a big picture mentality.
Moreover, leadership is kind of like collaborating on an inter-professional healthcare team. Some people you won’t get along with or understand at first.
But then you realize they can do things that you alone couldn’t. Imagine trying to treat a hospitalized patient with no physician, nurse, or medical assistants.
We are all crucial components of the treatment process, and good leadership recognizes the value of each team member.
Also, personal development is kind of like completing continuing education credits. We need to continually renew ourselves and stay sharp in our charge as healthcare leaders.
Left unchecked, our brains will rot from stagnation, along with our efficacy as healthcare providers and business leaders.
It took me 5 years to see the big picture and own my role as a pharmacy leader, and I don’t even remember the exact turning point.
But now I’m happier than ever because I have a world-class pharmacy team that supports me and my vision.
I am also grateful to have amazing peers and a boss that supports me whenever I need help.
I truly love my retail pharmacy career, and I’m in transition right now to take the next leadership role for my company.
I’m on the path to elevate the pharmacy profession and build the next generation of pharmacy leaders.
Nothing feels better than to practice the Oath of the Pharmacist day in and day out.
The One Big Thing
Looking back, there was ONE THING that made all of this possible. The secret ingredient that filled me with purpose and energized me every morning I woke up.
Over the years, I’ve learned that the key to my success was developing my personal mission. I had to drown out the voices of others and listen to my own.
There were always people complaining about the profession and their circumstances. Those blaming patients for not being nicer.
Retail corporations not promoting better work environments. Micromanaging bosses that never get off your back.
Not to mention all the jaded and cynical pharmacists that hate their jobs. With all these voices swirling around, it’s easy to lose focus on who’s voice is really important: my own.
I didn’t set out for this transformation to happen. Looking back in this past 5 years as a pharmacy manager, I realized that my growth as a leader had manifested through that relentless series of continuous failures.
Each time I hit a wall, messed up, or fell on my face, it was a kick in the butt to revisit the drawing board. I pondered and reflected hardcore, while tweaking my mindset and behaviors. Rinse and repeat.
The Corporate PharmD
My personal mission, my life-blood now is to serve others: my patients, colleagues, and other pharmacists.
You’ve heard the saying. “Give a man a fish, and you feed him for a day. Teach a man how to fish, and you feed him for a lifetime.”
What gets me up out of bed every day is this opportunity to teach someone not only how to fish, but also to help others level up and get excited about teaching others what they learned.
Giving my technicians something that will enable them to change their own lives forever.
Engaging with my patients and helping them achieve their own “A-Ha moment” just as I did.
Helping fellow PharmD’s tune out the work minutiae, brush off micromanagement, and activate their clinical brainpower to solve everyday business problems.
I do this all in concert with my company’s vision and resources. There is no room for negativity and cynicism anymore.
I am a Corporate PharmD.
When you have good leadership backed by a massive, purpose-driven corporation, you are unstoppable. Unlimited resources, world-class training and development, credibility and influence, perks and work/life balance.
Once I accepted my role as a Corporate Pharmacist, unlimited support opened itself up to me. Company resources were at my disposal and made my job easy and fulfilling.
I was able to build a network of allies and business partners who could help me unleash my vision.
And most importantly, I earned the freedom to run my business how I see fit. No one can tell me how to run my pharmacy because I know my business better than anyone else.
I am a corporate pharmacist who loves what he does. And through my pharmacy practice, I am able to impact the lives of thousands of patients in my community.
Watch out pharmacy world, this is only the beginning of my legacy.
-Mr. Corporate Pharmacist