Expanded scope plus business smarts equals pharmacy success

 

More from Canadian Foundation for Pharmacy

 

Yes, they can.

That’s the quick answer to the question of whether pharmacists can provide the services made possible under expanded scopes of practice and a growing slate of government-funded services.

The numbers appear to back this up. As captured in the Canadian Foundation for Pharmacy’s (CFP’s) annual services chart, pharmacists administered an astounding 18 million COVID-19 vaccines in less than a year. Flu shots also jumped during the pandemic and prescription renewals climbed.

More recently, pharmacists in Ontario appear to be assessing and prescribing for minor ailments at a steady clip. Since the program’s launch this year on January 1 to April 30, pharmacies have submitted 182,932 claims for assessments to the provincial drug plan.

Other numbers, however, paint a sombre picture. Nine out of 10 pharmacy professionals are at risk of burnout, according to a survey conducted by the Canadian Pharmacists Association in early 2022. Forty per cent considered leaving their position and 32 per cent thought about leaving the profession. Fifty-two per cent stated that inadequate staffing had a severe negative impact on their mental health.

So, while pharmacists can do additional services, the bigger question is how can they do them, day after day after day?

“We’re having a workforce crisis at the same time that we’re increasing scope and convincing the public and governments of the value of pharmacy,” says Amy Oliver, a pharmacist with a Master’s in Business Administration who founded Amy Oliver + Co in 2018, a firm that helps drive organizational leadership and behaviour in independent pharmacies and other independent, community-based healthcare practices.

“Pharmacists are highly motivated to do well,” she continues. “Clinically they are very, very competent. But they’re not super confident in their ability to operationalize all these things while maintaining a healthy and engaged workforce.”

In this article, part of CFP's Spring 2023 Changing Face of Pharmacy magazine, CFP shares guiding principles from Oliver and Janice Rudkowski, Assistant Professor at the Ted Rogers School of Retail Management, Toronto Metropolitan University.

Effective leadership is the linchpin for success in today’s high-opportunity, high-risk environment, states Oliver. “How do you work collaboratively with your team? How do you motivate people to change? How do you get them enthusiastically engaged in serving a community and working as part of a team, rather than as a group of individuals who happen to be working alongside each other?”

The answers to these questions start with a flip in mindset. “Traditionally we try to get a workforce that supports our business. What we should be doing is figuring out how to craft a business that supports our workforce and the communities we serve,” explains Oliver, adding that “this is how you make all the good ideas come to life.”

More practically speaking, it likely means training in leadership and management, which Oliver points out are “different skill sets.”

Today more than ever, running a business and managing a team are not things to learn—or do—on the fly. “We need to retrain our brains on the business and leadership side to be better planners and better risk managers, and to objectively measure how well the business is doing,” says Oliver, who holds certifications as a leadership coach and in project management, emotional intelligence and advanced strategic management.

Rudkowski agrees. Her simple message to pharmacists who are also managers or owners: “You’re both a pharmacist and a businessperson.” While you don’t need to be hands-on for all aspects of operations, successful management requires enough of an understanding of the business to be able to hire the right staff for the right roles.

Understaffing may well be an issue in community pharmacies, she continues, but the solution can involve more than an increased head count. “It could be a matter of rethinking the roles of each employee and who is best suited do what. My observation of pharmacies is that it’s more like a one-size-job-description-fits-all. People tend to wear many different hats to do many different things. Perhaps that’s just not the best way to deliver services, at least not anymore,” says Rudkowski.

Along those lines, pharmacies may need to step back and strategize on their services, based on the community’s needs and personal professional passions. “Pharmacists are trained as generalists and as a result pharmacy is an excellent option to fill gaps that exist across our healthcare system. But it’s very difficult to be really good at everything,” notes Oliver.

While she agrees that this is a “pivotal moment in time for pharmacies to become community health hubs,” that does not necessarily mean every pharmacy does everything.

“It also means there are great opportunities for pharmacies to become more niche practices,” stresses Oliver. “A rural pharmacy may be positioned wonderfully to become a minor-ailment prescribing, walk-in clinic type of environment, for example, while urban pharmacies have more opportunities than ever to really niche down clinically, for example in cardiac care or oncology, or for people who identify as 2SLGBTQ+.”

In terms of the customer journey, the primary endgame—cemented during the pandemic—is convenience, emphasizes Rudkowski. Whether the pharmacy as a health hub is more generalist in nature or highly specialized, convenience is at its foundation. “You are bringing together touch points that naturally go together to save customers’ time. This is how you create loyalty.”

On the flip side, she warns against over-promising or under-delivering, citing recent personal experiences with pharmacies that involved misleading advertising and malfunctioning online services. “If a touchpoint doesn’t make sense or a consumer becomes confused or frustrated, that negative experience levels up to your brand image. Your reputation can really take a hit in the long term,” says Rudkowski.

She advises pharmacy owners and managers to think of it as a balance between professional services and retail best practices. “It’s not just, ‘Oh, we received government approval, we can do this now.’ It’s got to make sense to the consumer and there are a lot of different aspects of retail that need to be considered.”

It all ties back to the customer journey, or putting yourself in your customer’s shoes. That journey is divided into three basic stages: pre-purchase, purchase and post-purchase. “You then really need to consider the sub-stages within each stage. For pharmacy, I would say education is an important sub-stage within pre-purchase. For example, how are you going to educate your consumers on this new ‘minor ailment’ opportunity and translate that so they can understand what you actually offer? And then what are the retail best practices that will guarantee delivery against your promises?”

For business best practices, both Rudkowski and Oliver highly recommend mentoring or formal education that looks outside the box. In other words, learning from pharmacy practices in provinces where billable services are more established, such as Alberta and Québec, from other healthcare practices, such as dentistry or veterinarian, or from other service-driven retail sectors.

Oliver has seen the cross-pollination of ideas in action during her organization’s “The Healthy Business” virtual workshop. “Pharmacists are learning best practices from physiotherapists and dentists, and vice versa. The program is not only an opportunity to cover the translational business and leadership topics, but it’s also a safe space to have discussions that don’t feel competitive.”

One of the biggest learnings for participating pharmacists? “Communicating their value and advocating for their value,” says Oliver. “A pharmacy may not launch a great service if it’s not compensated publicly because they are hesitant to ask for money. But veterinarian and physiotherapy and dental practices have these conversations with patients every day. We can learn a lot from other professionals.”

“I always tell my students, look outside your industry to get inspiration,” echoes Rudkowski.

Your customers think you can, too

Canadians are on side with pharmacists doing more, according to a survey conducted in August 2022 by the Canadian Pharmacists Association and Abacus Data:

• 94% agreed that governments need to expand and fund community-based care, like health services available through pharmacies.
• 90% agreed (39% strongly) that pharmacists can help address gaps in care caused by shortages of healthcare providers.
• Canadians see a larger role for pharmacists in providing vaccinations (61%), walk-in services to assess and prescribe for common ailments (53%) testing and lab services (47%), contraception prescribing (44%) and chronic disease management (42%).
• 67% perceived that pharmacists play an essential role in delivering health care in their community, up from 54% in 2015.

Resources for leadership and business acumen

• Local universities and colleges for programs that accommodate work schedules. For example, the Certificate in Retail Management, Chang School of Continuing Education, Toronto Metropolitan University
• “The Healthy Business” workshop, Amy Oliver + Co, a live, virtual program that addresses 10 topics in 10 weeks
• Executive education days and micro-credentials from local business schools (e.g., Canada Coach Academy), such as certifications in leadership and change management
• The Canadian Foundation for Pharmacy’s textbook, Pharmacy Management in Canada and, based on this textbook, the Ontario Pharmacists Association’s online learning program, “Managing Your Pharmacy: The Business Essentials”
• Books, reports, newsletters, podcasts and webinars available through Canadian retail consultants, such as Retail Prophet and Trend Hunter

This article is reprinted from CFP's Spring 2023 Changing Face of Pharmacy magazine.