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(CANADA) 5 years in - my experience as an independent owner
Here is a stream of conscious thoughts from an independent owner 5 years in.
Location is a small community but where most residents commute to a larger city for work so my competition is still the big chains, Costco, Walmart, Shoppers, even though my employee pool is smaller and salary costs are higher. Total rented size 2500 sq feet. Aim was for focus on providing excellent pharmaceutical service and having just enough on the floor to cover basic needs.
If I had to do it over I would go for 3000 sq ft to have 2 consultation offices instead of 1 so that I could rent out the 2nd office to another health professional (dietitian, nutritionist, nurse, ect) to help bring in traffic. I would have a slightly larger storage room because I had no idea how much room stupid toilet paper, kleenex, paper towels and water bottles take up when a different brand is on sale every bloody week. I would consider having my compounding/preparation area set up for sterile products. I have already had to renovate to meet new guidelines (serious, stainless steel counters, gown, mask, hat to do a hemmoroid cream that the client is going to stick their finger in and wipe on their ass and that will expire in 28 days anyways!) - it might have made sense to to just put in a real fume hood and designate that corner for both compounding and sterile products as there are some good margins to be had and not many pharmacies do it. I'm happy having a personal office that is not shared with other pharmacist employees. I am happy having a computer workstation in the storage room. Could have used 1 more aisle on the floor.
Starting out I was unprepared for the Human resource nightmares - honestly, it is 80-90% of the troubles I have in my pharmacy and I was completely unprepared for it. 5 years in we have it under control with an excellent policy and procedures manual but building it through trial and error has been an unbelievable amount of work.
Try and find a mentor or two to help guide you through the process. Pay them a consulting fee and it will be worth every penny. Try to get someone else's employment manual and procedures manual that you can modify to your needs. You want all your techs/pharmacists treating lost Rx, early narcotic renewal, insurance problems, ect the SAME UNIFORM way. You need to be a leader and set the standard for how your pharmacy is run and what sort of customer service you want to provide.
You also need help on setting up your front store (are you going to be pharmacy only, small floor, large floor?), managing your accounting, payroll, ect. Understand your labor laws and make sure you are signed up with all the relevant gov programs in advance of starting.
CONTROL your costs! At the beginning and even 5 years in I survey the floor and maintain control. If you are with a chain they are going to screw you on your stocks. They use you as a warehouse and fill your shelves from front to back. Yeah, I don't need 12 of every single variety of tylenol + every generic + + + when I am filling 25 Rx per day. And 14 fleet enemas, really?!? Stuff expires like crazy and you eat the cost. Instead, as an independent, I would stock only 2 of every item and as soon as 1 sells order a replacement which arrives with the next days order. This allows you to see what works in your area and what does not. High selling products get stocked in larger quantities. Any product that expires on the shelf without selling is removed from the planogram and never enters into my pharmacy again. Baby food, I'm down to just 1 for emergencies, I can't compete on prices with Costco/Walmart so I will use my shelf space for something else. Keep your planogram's up to date, "new" products are coming out all the time (they change the packaging and advertise the stupid cream as "new and improved" all the time!).
I also worked to find products not generally stocked by my competitors (bio/natural cosmetics, face creams, ect) that have a good margin 30-40% markup and sell really well in my well off area.
Paper products (klenex, toilet paper, ect) is a nightmare. Every week a different brand is on sale in the flyer so you have to have huge stock but make essentially no profit because it is a stupid loss leader. They are HUGE boxes and take up 50% of my storeroom space. After 1 year my total profit on ALL paper products is around $600 TOTAL. Makes me want to barf.
A good pharmacy technician is worth their weight in gold. Pay them well. I budgeted for a technician covering all hours from the start. Sure doing 30 Rx per day is totally fine with just the pharmacist but you have 3 clients and a doc on the phone during the afternoon "rush" and all of a sudden you are bottle-necked. You need those first clients to have excellent service right from the start so they switch from their established pharmacy. Back to techs, trying to get enough to cover all the evening hours and weekends is tough. You either try to get 2 full times to split evenings/weekends (and have high turnover because everyone hates evenings/weekends) or you have a core 9-5 team (better retention) and then have students cover evenings and weekends. Problem with students is training them is a bitch and turn over is high as well and you keep having to start from scratch which is draining. We have had best success by trying to get science/health program university students. They have core competencies, comfortable with calculations and can memorize drug names so after 3-6 months they are competent and with a 4 year bachelor you can hope to keep them a while to recoup your training investment. Be very discerning in interviews and we give them scenarios (looking for judgement) as well as practical tests (eg. calculate drug doses, ect). This lets us see how they thing, can they calculate, are they detail oriented. We do this for UNTRAINED techs and it has saved us several times from hiring someone who just can't do it at all. Interviewing trained techs get different interview questions (more detailed toward pharmacy operations) but they get the same practical questions and blister pack as we have found some supposed trained techs suck too.
Cut your losses quickly. Person can't handle criticism, is arrogant, can't calculate, ect. Get rid of them quickly in the probation period, it will only get worse. We have a concrete rule, if an employee starts coming home with us, their ass is fired (eg. we start talking about an employee repeatedly over dinner or in bed, they are GONE!)
For part-time techs we have had best success with hiring young, smart kids for the cashiers on the floor and finding out over the months/years who is smart, hard-working and then bring them into the lab part-time for training and then when there is lab tech sick call or turn-over you have an immediate, trained replacement ready to go. Our return on training investment is way higher on the kids we brought from floor to the lab than those who were hired directly into the lab.
Find out how your book-keeper and accountant wants your paperwork. I send all my paperwork to my book-keeper BUT I also scan EVERY SINGLE invoice/bill/gov form, ect, (using paperport) and file them electronically by folder then date. Eg. McKisson folder. 17-01-23.pdf. This saves your ass when you get audited or need to find a bill from 2 years ago instead of having to dig through 100's of pounds of banker boxes to find the paper. Also gives you a backup in case of fire/flood (I have local backup + encrypted cloud backup).
Good luck. I have had problems with anticipated community growth in my area not happening at the speed projected. Between the slow ramp up in prescriptions (110/day after 5 years), huge cuts by government, continued downward pressure from private insurance and competition from the big banners (Walmart, Costco, Shoppers) who use the pharmacy as a loss leader, it is VERY hard to make a profit offering quality pharmaceutical care. I've been profitable since year 3 but so far I would have been better off financially having stayed an employee. If a national pharmacare program comes out, if they switch to forcing clients to take 3 months at a time with only 1 dispensing fee, ect I will be in real trouble. After 6 years the bank will be paid off, after 8 years my personal and partners financial contribution will be paid back. BUT that will have been 8 years of taking $0 salary. I'm not sure I will ever recoup that 8 year, $960,000 salary loss given the way the pharmacy field is moving.
Add on the proposed Corp tax changes being proposed by Trudeau and you could say it is better to be an employee and when the key goes in the front door your brain can turn off.
Fun times. So to all those starting out. Good luck. We're all going to need it.
Paperless Solutions? PDF Scan Management / Manipulation (rotate, del, insert)
I'm looking for a basic software solution for my new & ever growing PDF library.
Here is what I'm looking for:
- Free Paperport-like alternative
- Windows Explorer Like Library - using existing folder structure
- Quick rename feature - while being able to preview contents
- Simple tools: Rotate, Delete Page, Insert Page - from another PDF
Note: I would just stick to the default Windows Explorer for management and renaming, BUT the PREVIEW feature is very laggy and doesn't seem to cache previews.
As for basic edits, I've tried Acrobat free and DC. Paperport was OK but paying for it isn't justifiable considering my needs.