Embarking On the Retail Pharmacy Journey

You’ve just been offered a job with a big corporation, and you’re ready to embark on your new retail pharmacy career, executive white coat powers and all. However, the odds are stacked heavily against you.

You hear the horror stories from your peers in pharmacy school. You read forums where retail pharmacists nationwide complain about their jobs and working conditions.

To top it off, the only thing you hear about your job is that the offered rate and salary is the lowest it’s been in years.

Your job code may include “manager” in the title, or it may not. Regardless, you are slated for leadership due to the nature of your profession.

Chances are, you don’t have any business ownership or formal leadership titles in your career. How do you balance your responsibilities as a clinician, as well as that of a corporate pharmacist?

You know that leading others will be crucial to your success, but feel vastly under prepared. How do you get technicians to step up and be leaders?

Soon, you will be held accountable for business metrics, patient satisfaction, and regulatory compliance from Board of Pharmacy and DEA.

It turns out your home store is a hot cultural mess and breeding grounds for dispensing errors. Staffing turnover is high due to poor management.

Your longevity doesn’t look so good. How do I know this? Because all the above is exactly what I went through. This is a good time to re-calibrate, re-align, and re-sharpen your passion and purpose as a corporate pharmacist.

Read on to learn what failures I went through, and how I overcame them to build a top-performing pharmacy.

Table of Contents

Passion and Purpose

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I thought the first step in my career was learning how to bill insurance, how to reconstitute and administer a Zostavax immunization, and how to verify prescriptions while managing DUR’s.

Boy, was I wrong.

It wasn’t long before I was getting sucked into the daily grind, losing focus and losing vision. The hours and days would blend together, and I was simply chasing the next overdue prescription and patient complaint. Fifteen minutes late on one prescription compounded over the hours, and soon I was staying 4 hours after closing. And this went on for days on end. When would I get a break from the all this chaos?

I thought to myself, “I’m a new grad, so maybe this is my rite of passage. I need to put in my time, right?” But the struggle was real, and my energy and enthusiasm started to dwindle, no matter how much I tried to stay positive and smile. I was lucky to have a job, and so many of my peers were still on the hunt to even start their careers. I told myself to start with gratitude.

Start With Why

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Then, I started to ponder, “Why did I start this journey, and why am I choosing to go down this path of crazy debt and high stress?” But the reflections didn’t stop there. The question that first came to mind only scratched the very fine surface of this massive iceberg.

So I kept pondering, unraveling more and more layers. Why did I become a pharmacist? To help people. Why? Helping people gives me purpose. 

Why? I want to wake up every day knowing that I am doing good in this world. 

Why? If I am not doing good for my fellow man, then I can’t call myself a healthcare professional, nor a good human being.

And why is that important?

When I think about what I am doing on here on Earth, I want to contribute to something greater than myself, something bigger and more meaningful than flesh, material, and tangible things that won’t stand the test of time.

I want to believe that the work I do will persist long after I have departed this life. I want to leave behind some kind of a legacy.

Why do I need to “make a mark” or “leave a legacy?” I am afraid it I don’t that I will be considered a failure in my family’s eyes. Whoa.

Why? They have supported me and my education all my life, and I want to make them proud.

When I started to ask myself these relentless questions, I had to remember to be honest with myself.

I Had to Dig Deeper

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For example, I was afraid to admit that making lots of money was a huge motivator for me. It’s okay to want that for myself, but what else is important to me? What’s going to get me out of bed in the morning when I’m sick, tired, and feeling defeated?

The crazy thing about focusing on all the reasons WHY I entered the pharmacy profession: it helped me to clarify my purpose.

With this newfound clarity, opening up the pharmacy no longer looked like a minefield. It was my training grounds to reach greatness and glory. Insurance problems and backed up queues still squeeze cortisol into my blood, but now I channel every ounce of energy into creating something bigger than myself. This was my chance to fulfill an important mission, my own mission.

Instead of being hyper-focused on the grind that was slaughtering me on the computer screen, I was now looking simultaneously on the horizon, where I was heading, and what fueled me to put on the white coat in the first place: bringing honor to my family and making a large scale impact on the world.

It’s game time, now.

Rapport and Resources

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How do I get out of this grind? Who can I ask for help?

It’s very easy to blame my circumstances. I was a new grad, new manager, facing the repercussions of a terribly managed pharmacy. The patients were mean and entitled. There weren’t enough technician hours. My team wasn’t properly trained, nor were they engaged at all. No one was helping me with anything.

But deep down, I knew the cold, hard truth: I was the pharmacy manager, AKA the leader/business owner. If it was meant to be, it’s up to me.

I had just graduated pharmacy school and completed only 6 weeks of formal graduate intern training. I still felt uncomfortable with Drug Utilization Reviews and C2 prescriptions. However, I knew that without an engaged and productive team, I wouldn’t be a fully effective healthcare practitioner.

My first step was to assess the current state of my talent pipeline. Who was on my team? What were their strengths and weaknesses? Most importantly, who could I depend on?

My team members are my human resources, and I knew I needed to tap into their potential. But, I was a new manager who knew little to nothing about them. If they were machines or tools, I could bend them to my will and use up their full functionality.

However, these were people, and they can’t be controlled; they needed to be led. So, I decided to start building relationships. I needed to build rapport.

I Wanted Them to Like Me

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And so, I started by showing them my positive attitude, being overly nice, and inviting them out to team dinners. During work, I would help them fill, ring out patients, and even do the inventory returns. I praised much and criticized very little. My goal was to show them that I was part of the team, and not just their boss.

Over time, the house of cards I had built started to reveal its weakness. Prescriptions were backing up in the queue, causing patient distress and dissatisfaction. Expired medicine stayed on the shelves, creating risk to the patients and pharmacy. Returns were completed incorrectly, resulting in charges and write-offs.

My supervisor pulled me out of the pharmacy to discuss my leadership. He told me that I was “muscling it.” My current strategy was to do everything myself, and to throw more pharmacist hours at every problem. I was the best at everything, so why not solve all the problems? Wasn’t that my job?

We reviewed a report that showed how I was the top typer, filler, and pick up person out of the entire team. We even reviewed video camera footage that showed me jumping around the pharmacy at lightning speeds. Then, it dawned on me. I was working harder, not smarter.

How could I keep up with my pharmacist and manager responsibilities at this rate?

Respect is More Important

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Shortly after, I discovered that my team really didn’t like me. That bothered me a lot at first because I am a people pleaser by nature. I always envisioned myself being friends with my team, working hard and having fun at the same time. That’s the dream of every manager, right?

However, the worst part about my relationship with the team was that they didn’t even respect me. They came to work late, called out sick once a week, and only did the bare minimum of what I would ask. There was zero engagement at the pharmacy, and my patients suffered because of it.

It took me over a year to learn this painful lesson, far too long.And all the while, my pharmacy suffered from low morale, poor performance, and subsequently, ineffective clinical care. I knew that I had to change my strategy, and I knew that I had to give up my desire to be liked as a manager. I couldn’t be friends with them, but I also didn’t want to be a dictator and boss them around. There had to be a middle ground. Balance was key.

Ask for Help

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Even though I had a plan to turn my pharmacy around, I still felt I was balancing a huge burden on my shoulders. The pressure to perform well weighed down on me, and I knew I couldn’t do it all alone. With all my competing priorities as pharmacist and manager, I had trouble choosing where to start. My patients’ healthcare? The impending regulatory and compliance risk? My pharmacy’s culture and engagement? I felt completely and utterly lost.

So what did I do? I picked up the phone, and called my fellow pharmacy managers to ask for advice. I even called people I didn’t know well. I sent text messages to pharmacists, technicians, and even my boss. I wanted as much perspective possible.

From all these outreach attempts, many proved unsuccessful. Some people gave generic advice, while others gave advice that was unsuitable for my situation. But to my surprise, I learned much about myself through the eyes of others. For example, someone told me that I “didn’t relate well to others.”

I remember practically scoffing at the remark. Me? I love working with others, especially on a team. I thrive on human interaction.

However, relating to others and collaborating with them are two very different things. After much pondering and deliberation, I accepted that seeing things from other’s perspectives posed challenges for me. This was not my strong suit, and it caused me to to lead in a one-dimensional way. I treated everyone equally, and I treated them like they were just like me.

I woke up every day to give work my all. I was willing to come in early and stay after closing. The thought of doing the bare minimum at work repulsed me. I thirsted for achievement, and I wanted to demonstrate leadership every chance I got. I needed very little supervision or motivation to do my job.

In contrast, my team had very different personalities and different motivators. They needed me to adapt and personalize my leadership. This would take me a long time to develop and master.

Accountability and Execution

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On the path of self-reflection and personal development, I turned my attention to improving my communication and delegation skills. On paper, it sounded easier than it really was. “Hey, do your job.” “I’m the supervisor, so do what I say.” I knew I could get results this way in the short term, but it just didn’t feel right to me. What would happen after a few days or weeks? Would I still get the same results, or would I be required to crack the whip each time? Would performance be consistent if I wasn’t there to push them? I highly doubted it.

Ten Steps of Accountability

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Therefore, I fell back on what I knew best: seeking resources and proactively looking for ways to improve my situation. I stumbled across this process called The Ten Steps of Accountability. I remember seeing it in on a piece of paper stashed in the manager’s drawer in the pharmacy. It intrigued me because I couldn’t find an original author or source, and the versions I found online were all different. Nevertheless, I was willing to try something new, and the steps seemed principle-based. Here’s the short, paraphrased version:

  1. Right person, right place, right time
  2. Set clear expectations
  3. Agree on mutually understood consequences
  4. Establish detailed follow up schedule and plan
  5. Be involved
  6. Assume nothing
  7. Course correct when needed
  8. Recognize good performance
  9. Be consistent
  10. If success doesn’t come, start back at step one

The Power of the Huddle

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Now the tricky part was how to incorporate 10 steps of time-consuming development and coaching time into the crazy chaos of a pharmacy on fire? My pharmacy was failing in more ways than one, and I was always putting out the flames of some crisis on a daily basis. But there had to be a way to ensure that I communicated my message to my team.

What I was facing were technicians who ignored patients and demonstrated no sense of urgency. My staff pharmacist at the time refused to support or coach the team. Customer service went down the drain, along with patient loyalty as they took their prescriptions elsewhere. Prescriptions would be billed improperly, causing tons of re-work and third party agency audits. Something needed to change.

At first, I tried to conduct 1 on 1 huddles outside of normal pharmacy hours. I needed to put my foot down, but I didn’t know quite how. I asked my technicians to come in early and stay after closing, and I was willing to pay them for it. All so I could get their undivided attention. I was nervous because I had never formally conducted structured coaching conversations before. I was too afraid of being strict or condescending that I diluted the message by asking about their personal lives, exchanging superficial jokes, and even giving them unwarranted praise.

Somewhere in these 5-10 minute coaching conversation, I implanted the real message I was hoping to get across: the “clear” expectations. I wasn’t very effective with my messages at first because performance barely increased. But I was consistent. Armed with a weekly alarm for each colleague, I forced myself to get into uncomfortable huddles with people who didn’t like or respect me. I tried tactics like FRAME and FUEL to give myself some comfort and organization. I made it a point to seek understanding and to be influenced before pursuing my own agenda.

Slowly, I learned to organize my thoughts and speak more deliberately, with clear goals in mind. Over time, I learned not only to agree on mutually understand negative consequences, but also to highlight the positive consequences as well. I learned that it was important not only to make a detailed follow up plan, but to actually do what I promised. For example, if we agreed to talk every Monday at 2 P.M., I made sure to make it happen, no matter what. No excuses. If they weren’t holding up to their end of the bargain, I would bring up their exact words and commitment, “Last week, you told me […]”

Using this principle of holding people accountable to their own words, I was able to establish some credibility with them. At least I was loyal to my word and kept my own promises. It encouraged them to take me seriously and to do the same.

What I loved most about these huddles was the opportunity to share positive remarks, or recognition. But not just any superficial recognition, like in the compliment sandwich technique. No, true, genuine recognition for someone’s actions, character, or results they achieved. I had heard that a 3-1 ratio was the appropriate amount between recognition and coaching. I found ways to note down when my team was doing anything that I approved or loved as their manager. It was hard at first because I had to monitor my team vigilantly. My ears had to be tuned in to all conversations, and one eye always had to be on them while verifying. It was the only way to make recognition genuine and impactful.

Disciplines of Execution

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How does a manager get results from people? How we help our teams execute on business priorities? As a fledgling manager, I used metrics and reporting to inspire my team. I put numbers up on a white board and use markers and highlighters to show my excitement for our scorecard. Huddles consisted of inflated praise and unflattering progress updates. “Let’s go team! We need to get 500 flu shots this season!” After 2 weeks of constant reminders, there was no engagement or excitement, not even from the leader. How do you establish a cadence of accountability and keep your technician team energized and performing at a high level? How do you do it without nagging or micromanaging?

At first, I only knew how to generate my own enthusiasm. I am a competitive person by nature, so I channeled that energy in order to strive for better results. Customer service low? I thought of ways to promote more guest surveys. Operational metrics taking a hit? I printed more and more reports to analyze performance at each hour of the day.

My pharmacy was always at the bottom of the district, so I felt compelled to improve. I hated getting calls from the boss. Not because I was annoyed, but because I was struggling to engage and inspire my team. I was failing hard, and I felt embarrassed.

One thing I learned that forever changed the way I led teams was this idea of lead measures. Lead measures are metrics that directly impact outcomes. For example, most pharmacists will track how many flu shots they have administered in a given season to determine how successful they are. But does the season to date score actually improve the result? Does tracking shots actually increase performance or save more lives? Not at all. However, tracking my technicians’ ask rate determines if the right behaviors are being executed.

Couple that with a powerful purpose or why, and I started to see a sustained improvement in my team’s performance. I observed independent decisions that supported the higher goal. I observed them working towards the goal in ways that I didn’t teach or could think of myself. I learned that if I governed the way my technicians did their job, any success or failure turned into my own. Only when I gave up the reigns and let my team manage themselves did they show responsibility and own their failures. In turn, they took pride in their successes.

The trick to balancing autonomy and execution is in the process. Identify the purpose, choose lead measures, track them, then use 10 steps of accountability to ensure the team is engaged.

Importance and Urgency 

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Competing Priorities

For me, the hardest part about working in retail pharmacy is managing all the competing priorities. Someone or something always stood in the way of me getting my work done. Patients demanding attention, corporate initiatives, technicians making mistakes.

I would struggle and stress out because I couldn’t figure out how to get everything done. If I focused on my workflow, customer service dropped. If I focused on being a good clinician, workflow efficiency would suffer. Then, when I mustered up and turned all my resources and energy to safety, service, and sales, my manager duties fell behind.

There was always something I was forgetting or failing to give enough attention. Regulatory audits, technician training and development, emails. I chased and chased the next to-do on my never-ending list. I felt as if there wasn’t enough time in the day.

Eventually, my lack of prioritization caught up with me because I failed to meet deadlines. My pharmacy team didn’t care. They all had their own priorities to worry about. My supervisor politely reminded me each time, and I reassured him I would get them all done. Nothing is more embarrassing than falling back on your own word.

Finding Clarity

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Over time, I learned to clarify importance versus urgency. Because I would react to everything at the pharmacy, they all seemed important and urgent. It was in my face, so I needed to address it. My second mistake was erroneously thinking that I was the only one who could solve the problem. I became the master fixer of all thing unimportant and non-urgent.

Only went I asked myself to assign priority to my tasks before organizing them did things start to change. For example, I used to consider Prescription Waiters as Important and Urgent. I had to meet the promise time and drive customer service. But when I asked myself, “Am I the only one who has the means and ability to complete this task?” I realized that I needed to broaden my perspective.

Truly Important tasks are things only the Pharmacy Manager can do. Hiring and on-boarding new staff, creating immunization push/pull strategy, analyzing profit and loss, etc. It was hard at first not to do what I loved: helping every patient at Pick Up and filling prescriptions. Nothing makes you feel more productive than helping out in workflow. But the reality is: if the manager does all the common responsibilities, the pharmacy business and team will never grow.

More and more, I would give up and delegate responsibilities with the purpose of building leaders and strategically using my time. I eliminated wasteful activities so that I could proactively execute on important tasks that had not yet become urgent. In this way, I managed projects before they turned into crisis and chaos. Now, I finally had enough time to meet the demands of my job.

Healthcare and Business

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Tunnel Vision

After graduation, my primary focus was passing the NAPLEX and the law exam. I wanted to make sure I knew how to take care of my patients’ health and their disease states. As a grad intern, my biggest fears were verifying incorrectly and creating a dispensing error. DUR checks and patient questions took up a lot of my time. Narcotic regimens and the unruly patients scared me.

At first, I spent time in my own world double and triple checking everything. I was so focused on the computer screen, everything around me turned into white noise. I had no idea what was going on around me, nor did my patients or technicians know what was going on with me. I was on my own little island at the verify station.

Conversely, there were times where I was so stressed out, I could only focus on the constant beck and call of patients. There were times I verified prescriptions much too quickly and without full confidence of safety. DUR’s started to look the same, and I would barely remember anything about a prescription once I bagged it.

Dispensing narcotics was a nightmare. I inherited a customer base of entitled patients with supremely high dosages. And I had no idea how to help them. I flat out told some patients “no” without being able to adequately explain why other than “being uncomfortable.” For others, I was uncomfortable even bringing up discussion at all and threw in the towel. I failed some patients by turning the other cheek

Before I graduated, I had very little experience with non-flu vaccinations. None of the retail pharmacies I had ever worked at ever stocked or pushed immunizations. In order to utilize my license and practice pharmacy at the highest levels, I knew I had to change that.

My first attempt to order 4 vials of Zostavax backfired because the next day 40 of them showed up in the order. I never had reconstituted this vaccine before, and now I had to find a way to get rid of forty before they expired. This was close to $15,000 worth of inventory.

Increased Bandwidth

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As the years went on, I became more proficient at handling new situations and balancing my clinical responsibilities with the business. Clinical interventions and narcotic dispensing rightfully take more time, and I learned to set those expectations up front with my patients. Over time, I practiced communicating transparently with my patients and technicians so they would know my intentions and plans.

I vowed never to lie to patients about C2 inventory, and to explain my hesitations and concerns when refusing to fill. It was hard for some to hear, and I didn’t handle them well at first. But each encounter helped me become more resilient, more caring, and more fluent in demonstrating my roles and responsibilities in the treatment process for pain management. Before I knew it, I created a sustainable way to grow my business, treat patients’ pain, and manage risk and liability. Narcotic inventory increased, but so did the growth of non-controlled substances as well.

After my vaccine fiasco, I quickly learned to hold immunization screenings at the counsel window. With limited time and a powerful mission to prevent hospitalizations, I used my influence to educate patients about the importance of prevention. Coupled with insurance formulary checks, my team was able to do more than just use up the Zostavax inventory. We were able to administer the most non-flu immunizations in the region out of 200 stores that year. Nothing like adversity to inspire greatness.

DUR checks and MTM are now part of workflow, and my technician team is very invested in helping the pharmacists clean up medication profiles. No matter how busy, every patient gets screened by the pharmacist for a counsel. They may have to wait more than a few minutes, but they are informed that “the pharmacist would like to have a few words with them.” This is ten times more impactful than asking if they have any questions.

We pride ourselves in practicing MTM every day during our regular interactions at Pick Up, Drop Off, and on the phone during Verify. Very rarely does a patient have duplicate therapies, or do they have undocumented interactions. Patient outcomes are the top priority for our team, and everyone is bought into the purpose. This is why we continue to grow profitably every year. This is what it feels like to have a successful Healthcare Business. You can’t have one without the other.

Culture and Work/Life Balance 

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My Vision

During Pharmacy School, I always imagined running a pharmacy where everyone loved coming into work. Smiling faces all the time, jokes and laughter filling the room. Patients and colleagues taking part in back and forth banter. Technicians would be excited to work hard, do well, and be friends with one another. We would all go out as friends after work to see movies, have dinner, and be part of each other’s lives to some degree. Work would never be stressful, and we would all play a role in creating work/life balance for the team as whole.

Instead, my first year as a new Pharmacy Manager gave me a team that was disengaged, unmotivated, and borderline insubordinate. They showed up late to their shifts, and produced work that showed they didn’t want to be there. The technicians constantly spoke poorly of one another during closed-door discussions, but put on pleasant facades in public. My staff pharmacist contributed to the drama instead of checking and managing it. The team constantly complained about her. The only jokes they would tell consisted of bashing the patient behind their backs. Who knew what they were saying behind mine? Work was a nightmare, patients and technicians were unhappy, I worked off the clock every day, and stress came home with me and even accompanied my dreams.

Forced Culture

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I came on board armed with enthusiasm and energy. I had that going for me. But what I failed hard at doing was putting myself in my team’s shoes and looking through their eyes. I talked to them like we were friends, without time to build a proper relationship. I spoke of mission statements and vision planning, not realizing that I was forcing them to be part of this culture I envisioned. I created group chats via text message, not knowing that I was infringing upon their work/life balance. I was phenomenal at scheduling per budget demands, but terrible at balancing my technician’s needs. Everything was my way or the highway because I was unapproachable in their eyes. I spoke to them like I always had the best idea, and my voice was always the loudest.

During huddles, I would always ask, “What can I do better? What feedback do you have for me?” My techs always said, “Nothing, you’re doing great.” But nothing could be further from the truth. Their voices weren’t heard, and they didn’t trust me enough to speak plainly. No one showed up to the team build invites I would send. No one would challenge me out in the open. I cast a big shadow, and I didn’t even realize it.

Compound Effect

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Years later, I find myself on the road towards that vision I foresaw as a new grad. My mission I practice and preach every day is, “Work/Life Balance and longevity.” I take care of my team first and foremost, and the only thing I enforce is for them to take their paid 15 minute breaks. I am usually the last to take lunches or breaks, and my team cares enough about me to protect that luxury. I don’t have to worry about staffing these days because my team owns the business needs. In exchange for helping me run and own the pharmacy, I give them the schedule and hours that they desire. They understand that more availability gives them more opportunities for hours, but I have learned that staffing more talented part timers makes the scheduling more effective and easy.

I am careful to protect the work environment from negativity and cynicism. There’s enough of that from the patients. As a result, my team is always happy and respectful of one another. We are a family now, and we all have each other’s backs. The technicians never call out without a backup plan. Scheduling conflicts are resolved between colleagues before a manager is even involved.

Huddles and meetings are voluntary, but the technicians look forward to them now. They are not coaching sessions or disciplinary actions, but rather rapport building and development. Each team member is praised for their unique contributions and their work is aligned with their personal goals and talents. Career development is a very huge focus of my pharmacy, and the pathway for promotion is very clear. I play a huge role in this process, and I love teaching them and getting to know their career aspirations.

Sometimes, we are working in silence, but not because we are estranged. Most of us our introverts, but we all have one thing in common: we love peace and quiet. Other times, there’s loud music and jokes. But the best part about work now is the mutual respect and love for one another. Drama free is the way to be.

Hiring and Firing

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Eventually, my early failures as a manager polarized my team. They were forced to be in either one of two groups: hired or fired. They were not performing to the standards that I had set, and corrective actions ensued. I was very consistent with coaching, but because the lack of rapport and trust demotivated my team. Not only did they stop responding to instructions and assignments, they became less engaged and productive. Eventually, some people decided they were not fit to be on my team and decided to find employment elsewhere.

One particular technician posed a different problem for me. He wanted to stay on the team, but could not meet the demands of the workplace. Unable to fulfill his basic core roles and responsibilities, I was having to meet with him daily and course correct. Things ranging from basic service protocol to accurate triage and transcription of prescriptions. I gave him my all for two years before finally letting him go.

Fire Quickly, Hire Slowly

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This eliminated much contention and cultural distress, but left me with many problems. One, my pharmacy was not only understaffed, but I did not strategically prepare for staffing changes. I rushed the hiring process, bringing on board inexperienced team members. For the next year, I faced high turn over, grueling correction action processes requiring daily, weekly, and monthly documentation and written counselings. My supervisor could see the distress all this was hiring and firing problems was causing me, but ultimately this was something I had to fix on my own.

After 2 years of high turnover, I became proficient at selection, hiring, and development. I learned through much trial by fire, costing the company thousands of dollars of lost productivity and profit. Not to mention the countless hours I spent training and developing without any talent and results to show for it. The lesson I learned: fire quickly and hire slowly. Time and resources are limited.

Thirty and Ninety Days

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In retail pharmacy, the hardest part about the job are all the different stressors, distractions, and competing priorities. In the beginning, I was very reactive, and only moved when something in front of me compelled me to. Waiter in the queue? Time to fill. Customer complaint? Time to de-escalate. Metrics galore and so many managerial responsibilities. I was always frantically chasing and missing my deadlines because everything was already late anyway. My strategy consisted of completing the most urgent matter, not usually the most important.

Eventually, I was wearing myself thin, and my team had an ineffective leader who didn’t unify and align them. They didn’t know what was important to work on. Everything was important all the time, and they became tired and less productive. My boss decided to sit me down for a heart to heart talk. I learned that I needed to think more strategically and be proactive about solving problems in order to prevent crisis from happening so often. With less fires to put out, I would have more time to act on less urgent, but wildly important goals.

So, I started with 30 day goals, outlining my managerial goals. Then 60 and 90 days out. It was hard to think that far out at first. How could I know what I would need to accomplish that far in advance? But I remember to keep my goals SMART, and one of those requirements was being “achievable.” Therefore, I made sure to limit the number of goals each month to 3 or less.

Teamwork and Trust 

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I was a brand-new manager, having been a lowly student at that very pharmacy just 6 months prior to my promotion. No longer, did the team see me as part of the team. I was one of them, corporate management.

One minute, I would show up to work, greeted with happy, positive vibes. The next minute, they greeted me with nervousness and silence. I may be dramatizing this a bit, but there was no doubt about a shift in vibes.

Collaboration Vs Relating Well To Others

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I gave them the benefit of the doubt, and I vowed to earn their approval by demonstrating teamwork at the highest levels. I wasn’t going to be the manager that barked orders and micromanaged my team.

To do this, I showed them that I was willing to roll up my sleeves and get things done, side by side. I took out the trash, I helped my team fill prescriptions, and I wasn’t afraid to ring patients up at the register.

There was nothing I wasn’t willing to do, and I made it very obvious that I was there to support my team. While I did have an ulterior motive of demonstrating teamwork, I performed genuinely because I love producing and working hard.

Where I failed was assuming that everyone else enjoyed working hard like me. Instead of being a team player, I essentially became the whole team.

I was the type of worker that paid close attention to the needs of others. I wanted to be helpful, useful, and do my part.

In return, I expected the same from my colleagues. They should pay attention to my needs and offer help in any way possible.

However, a different outcome played out.

Ultimately, I overshadowed everyone with my superior performance, quick feet, and world-class customer service.

My team was not interested in being like me, and this only further alienated me from them.

Muscling It

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My pleas to rally them together during challenging times fell upon deaf ears. Execution always seemed to slip beyond my grasp.

Deadlines were my biggest nightmare because I was the only who cared about them. Competitions were pointless.

Team huddles, one on one huddles, and team builds outside of the pharmacy did nothing (and were rarely attended). The only time they would partake is when I arbitrarily called meetings “mandatory.”

“Why couldn’t they step up and be more like me?” I would ask myself.

Nothing I was doing was working.

What do you do when you fail? Get back up and try again.

So, I pushed myself hard and harder.

I tried to motivate using energy and enthusiasm. I wanted my strategy and tactics to work, even if it killed me.

I would text them outside of work about ways to win at work, make work fun, and build a better pharmacy.

I figured that text messages were harmless because people could choose to ignore or read it on their own terms.

However, unbeknownst to me, a mutiny was rising. My team tired of my relentless attacks on their autonomy and work/life balance.

Over time, they probably felt I was trying to change them. Partly because I was.

I wasn’t happy with the status quo, and I was there to disrupt.

In addition, I wanted things done a certain way, my way. I was the fastest, most efficient, so I expected people to be more like me.

Hence, they grudgingly worked and followed my lead (with 1/10th the effort).

I was not putting myself in their shoes, nor was I considering their ideas, strengths, or personalities.

I chose to lead my team as if they were all me. Biggest failure of my career.

Trust vs Respect

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The reason I tried so hard to win my team over was partly because I wanted them to like me. But even more important than that, I wanted them to trust me. 

With trust, I knew that operational excellence would be easy to achieve. I also knew that teamwork would be better, work would be more fun, and that my job as a manager would be a cake walk.

However, I wasn’t ready for the disastrous outcomes ahead. Because I didn’t relate well with my team, I essentially alienated and pushed them away.

I set the bar so high without helping them get to the next step, they eventually gave up.

I realized then that my approach was backwards.

I shouldn’t have been searching for trust so soon. Trust takes time to build.

What I was really looking for was respect as a leader.

But I went in to my new job as a manager, hoping that they would give me their all.

And I felt discouraged because it didn’t happen overnight. It didn’t even happen for years.

Eventually, my focus on trust and lack of attention on building my own credibility kept me from doing my job effectively.

I could never get past the barriers of operational excellence.

Eventually, my technicians and staff pharmacist slowly pulled away.

They each couldn’t shape up to my standards and the performance management that entailed caused them to leave my pharmacy, one by one.

At the time, I justified these outcomes by telling myself that they weren’t good fits for my team.

They were not A-Players, and I could do without them.

But looking back, I realize that if I had given up my obsession with trust and focused on building credibility and respect, I would have had time to build trust.

But each huddle, coaching conversation, delegation, and team interaction became wasted energy because of the walls they had built up to keep me away.

This was a case of ineffective leadership, and I only had myself to blame.

Different colleagues require different approaches to communication, and I used a one size fits all solution for my entire team.

I couldn’t put myself in their shoes to see that I was an overbearing, overwhelming leader no matter how energetic and enthusiastic I seemed to be.

I didn’t know how to relate with my team because I was all about work, all the time.

My expectations were not unreasonable, yet my team did not buy into them because they didn’t buy into me as the leader yet.

Engagement and Inspiration

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But the days got better, mostly because the toxic team members left the pharmacy.

The effect of having negativity and cynicism was wearing me out. I had to fight back with positivity every day because people were undermining me every day.

Sometimes, I felt like my own stores of energy were depleting, and I had very little to give to others.

I’m sure it was visible on some days, but I vowed that I would never bring negative energy into the work place.

It was my responsibility to build the culture I wanted.

What I wanted to see was a work place filled with energy and enthusiasm.

Technicians who loved their job and put their all into their work.

Staff pharmacists who wanted to do more than verify at the computer.

Teams who would want to win competitions, and who did their job without being asked.

How could I instill the same sense of energy and enthusiasm in others?

As a young manager, all I knew how to do was look inward.

What I liked was recognition, praise, and anything else that boosted my status or ego.

So I did what I knew best, find ways to spread the love.

At first, I would compliment people on their actions in the pharmacy as I saw them.

“Great job filling that waiter so quickly!” or “Thanks for putting the prescription bags away.”

I had learned along the way somewhere that I was supposed to give recognition three times as much as constructive feedback.

But it became harder and harder to keep up. At the time, I had 3 technicians, and it was very difficult to come up with 3 times as many positive things to say.

I felt like I had at least half a dozen coaching conversations per technician per day. It was a nightmare already, and now I had to come up with nice things to say to them?

At first, I tried very hard to keep the ratio alive. But then my recognition turned fake, and they felt forced.

When I noticed the awkwardness, I decided to change my strategy.

I started writing down my observations and pain points so that I didn’t have to deliver back to back negative feedback.

I know that coaching is best done in the moment, but not all of the pain points were created equal.

Some were simply annoying like not putting the bags away on time or missing a refill when typing a prescription.

Others, however, needed to be addressed right away such as when a technician unknowingly and accidentally counseled a patient on medicine.

Because I was writing everything down, I felt more at ease because I knew I could come back to it later and address it.

Over time, I became more relaxed and let the small things slide and came up with a rule that first mistakes could be ignored (for some things).

However, 2nd offenses would be pointed out, no big deal.

Third occurrences of pain points signified a pattern and this would be the time for me to step in.

I told my team that if I was talking to them about something, it’s because I was started to see a pattern.

Everyone is human and makes mistakes, but a pattern of mistakes would have to be addressed.

This was accepted broadly, and my team began to respect the way I coached.

I always gave them the benefit of the doubt, never assuming they intentionally made mistakes or did it to get on my nerves.

Combining this fair approach with 3 times as many recognition or positive remarks about performance had a huge impact on my team.

Over time, they began to let their guard down with me.

Because I was approaching them with good things to say, they started to look forward to huddles and conversations with me.

Engagement First, Then Inspiration

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Now that I had their undivided attention, I could put my energy and enthusiasm to work.

People like to hear genuinely good things about themselves, and I became a natural at observing, listening, and giving my team the autonomy to succeed.

So when it came time to sit down and talk about development, it was always an exciting things to look forward to.

Coaching to correct behaviors never feels good, and I used to shy away from delivering bad news.

But when it was about good news and helping my technicians level up in their careers, I wasn’t shy about my excitement.

I practically shouted from the rooftops (while still trying to maintain confidentiality).

My general rubric consisted of using the ReFUEL rubric: Recognize, Frame the conversation, Understand the current state, Explore desired state, and Lay out a plan.

I forgot where I learned the FUEL template from, but it helped me stay on track and keep the huddles short and engaging. I added the recognition piece myself because it was my personal mission to do that all day, every day.

I don’t know why or how, but this process became habit for me.

Daily, weekly, and sometimes more, I would have these sit down huddles with my technicians outside of workflow (believe it or not).

They were important to me, and I took them very seriously.

I was serious about giving them credit where it was due, and I was serious about building them up to the very best.

Now, these conversations were not one way.

I always had my own agendas, but I would always ask them, “How are things going?” and “How is work going?” to open them up for suggestions.

Then, I would ask, “What would make your job easier?” or “What are you current professional goals?”

Getting your direct reports to share dreams, ambitions, and personal goals is difficult.

But because I was actively engaged with them, they opened their hearts to me.

Now it was my job to align work with their personal goals and to personally keep track of progress.

Method Behind The Madness

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Documenting observations

Public Recognition

1v1 Huddles and ReFUEL

Infuse with 10 Steps of Accountability


Delegation and Development

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With respect, engagement, and growing trust, I reached a point where I finally could delegate tasks.

I always felt uneasy telling people what to do in the fear that I would turn dictator on them and destroy morale.

I never wanted to micromanage because I myself hated being told what to do.

Still, I had to make sure that the intention behind my requests were always clear.

I never just delegated, but told them why I was assigning a particular task to them.

Whether it was for their personal development, for the good of the patient, or plain old because I had manager duties to do instead, I made it a routine to explain myself.

This mode of communication made it easier for me to delegate because now my team’s knew where it was coming from.

It helped them accept the responsibility and to grow whenever it was a task they had never done before.

Development had a whole new meaning at my pharmacy.

All of a sudden I wasn’t just focusing on the tasks at hand or to better my pharmacy.

Instead, I chose to focus on my colleague’s development, according to their own terms.

Maybe they didn’t want to move up in the company, but rather make work fun and easier.

Maybe they wanted to get promoted, and to make more money.

No matter the reason or the pathway, I challenged myself to align their goals with real world work experience.

Soon the people on my team were rising to the top, and my pharmacy was gaining notoriety for the results we were achieving.

Scope and Authority

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You could say that I had reached a Pharmacy Nirvana because my technicians were all engaged and motivated to perform.

My job as a Pharmacy Manager now was creating systems and delegating to make more time for myself.

That way I could focus on growing the business, creating a better culture, and protecting my employees’ work/life balance.

But as my team became more proficient at their core roles and responsibilities, it became harder and harder for me to challenge them.

At some point, the things I wanted to delegate were outside of their pay code.

Things like making the schedule, accounting for metrics, auditing payroll, and analyzing profit and loss statements.

I didn’t want them to get bored or feel like they were plateauing in their current roles.

I knew that feeling all too well, and stagnation is the quickest killer of career aspirations.

How could I align the scope of this delegation with each colleague’s personal mission?

What if they were threatened or afraid of this uncharted territory? What if they thought it was unfair?

Getting Rid Of Limiting Beliefs

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I was battling excuses every day to withhold development outside the scope of their authority.

I told myself things like, “They only make X dollars an hour, and they already bust their butts.”

I couldn’t bring myself to add more onto their plates.

If I keep adding onto their plate without being able to give them raises, they are going to burn out quicker.

But then I thought to myself, “What if I were in their shoes, and my boss wanted to challenge me with projects with larger scopes?”

Even if it was outside my pay grade, wouldn’t it be fun to be given a chance to level up a little and play supervisor?

Who knows? Maybe some day the experience would pay off, and I would look back with gratitude for the chance to practice.

For me, money wasn’t the most important thing, as long as I was given the opportunity.

That was it! The light bulb went off in my head, and I knew I was on to something.

As long as my technicians are given the opportunity and autonomy to decide for themselves, I could continue to set the bar high for the sake of their development.

Therefore, I would learn to align work development with my technician’s personal goals and then continue to give them higher-scope responsibilities.

This showed them I trusted them to do their jobs, and all credit would go to them.

On top of that, they would be given the chance to buy into the development because it wasn’t mandatory.

I learned that with each new role or responsibility I would give them, I also would take something menial off their plate or give them additional resources to use.

That way, they would not be overwhelmed or feel burdened with too many things.

What a revelation this was, and this idea would become the overriding mantra for my pharmacy: continuously developing A-Players.

Coaching and Corrective Action

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While positive talent development became my favorite part of the job, the performance management side was the exact opposite.

One particular colleague was not pulling his own weight.

Mistakes happened on a daily basis, the same ones over and over.

There was a complete disregard for patients who walked up to the counter, and the pharmacy was hemorrhaging thousands of dollars a month due to negligence.

Of course, I took full responsibility for all of these failures.

It was very stressful managing this one technician because he took up all of my time and energy.

Yet, there was little to no results to show for it.

Daily huddles, weekly write-ups, and formal documented corrective actions would all happen in the background on top of all the other competing priorities I had in the pharmacy.

I collected observations and action plans for weeks, which turned in months.

I knew this technician wasn’t going to make it.

But I didn’t want to give up on them. I saw potential, and I clung to it.

All the while, my other technicians were getting less of me.

Something had to change because it wasn’t fair to them.

Late night discussions with my boss and partnership with HR led me down the formal corrective action pipeline.

Yet, I still had trouble communicating the real message: this person wasn’t mean to be on the team.

No matter how much coaching they received, or how many times I sat down with them, they could not meet expectations.

Risks and Rewards

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Making Sound Business Decisions

Always calling the boss to ask for permission

Overspending on hours

Giving gift cards

Replacing product for free

Paying technicians to scout

Using students to conduct flu clinics

Losing C2’s

Systems offline


Duplication and Empowerment

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Pain point of doing and fixing everything

Right person, right place, right time

Best practice vs Superior Practice

Duplicating myself

Letting go of the how

Embracing differences

True empowerment

Bandwidth and Synergy

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Worker vs. Manager Bandwidth

Calendars, planners, post its, delegation

Working with low and high caliber talent

Well-oiled machine

Operations and Enterprise

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Retaking my autonomy from the queue

Vision and Mission

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Purpose and Alignment

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Reporting and Metrics

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Profit and Loss

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Discipline and Execution

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Systems and Succession

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Stakes and Stakeholders

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Policy and Politics

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Leadership and Ascension

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