Growing a new path for pharmacy

When pharmacist Bryan Gray sees a health care need in the community, he does whatever it takes to fill it—even if it means forging unconventional partnerships to make it happen. This serial entrepreneur showed his propensity for leading even as a pharmacy student, having won the Commitment to Care Award for Student Leadership (an awards program developed by Pharmacy Practice + Business) back in 2012. Since graduating from Dalhousie University in Halifax and moving back to his hometown of Thunder Bay to start his own pharmacy in 2014, he has expanded to a total of five locations and 60 staff—with a sixth clinic in the works. Plus, he’s only 32! Today, under the Oak Medical Arts banner, all five locations operate as a network of clinics run by local health professionals, focused on team-based, patient-centred care. Beyond medication management and other pharmacy services, there is medical, chiropractic and foot care, along with physiotherapy, kinesiology and massage. Mental health, addiction and nutrition services are also available. With multiple locations, each clinic can tailor their services to the needs of the area while making it easy for patients to transfer between practitioners. The sixth location opening this summer, will be a sports medicine clinic affiliated with Lakehead University offering physical therapies only. Front row left to right: Don Di Giuseppe, pharmacist; Bryan Gray, director; Robyn Despins, manager professional practice and pharmacist; Back row left to right: Justin Stachowich, chiropractor; Sasha De Agazio, nurse practitioner; Nathan Vastamaki, general manager; Shannon Buchan, pharmacy administrator, Oak Medical Arts, Thunder Bay, ON. Did you always want to own a pharmacy? It wasn’t so much about wanting to own one as much as wanting to have autonomy to pursue my own programs and services. Tell us about the first pharmacy that started it all. It was in a medical clinic near the regional hospital and started with just me and a pharmacy assistant. My vision was to provide patient-centred care, with a focus on point-of-care testing. We featured something new every month, from bone density and cholesterol to A1C testing for diabetes. We added in INR testing for warfarin which has continued to this day. I was working 50-60 hours a week to get it going, but we generated a lot of awareness, becoming known as a clinical pharmacy offering professional services. It’s still operating in the same location. So you were an early adopter of point-of-care testing? Yes, we were able to position it as something that made sense for patients—it was our core strategy in getting started. Some testing we’d offer complimentary, but others we’d charge for in the range of $25-$50. Plus, we did additional billings through MedsCheck and other professional services. How did you make the transition to multiple clinics? As the first pharmacy got underway, I heard about another location with a larger footprint that used to have a full pharmacy and clinic that had been sitting vacant. I thought we could expand out with a second pharmacy and use the extra space for other health professionals so patients could have multiple services in one space. With the success of my first location, I thought I’d have a flood of providers wanting to join us, but it was slow-building. We got our first major win when a chiropractor I’d gone to high school with agreed to practise full-time in the space. It was an unusual pairing but it worked and eventually others came on board. This second site is where we really launched into being a multidisciplinary team, with pharmacy being just one division. For our third location we were able to partner with a group that works with HIV and addiction medicine. We were looking at this as a great way to expand into an area that was under-serviced. At that point we also decided to rebrand under Oak Medical Arts for consistency and really position ourselves as taking an all-encompassing, holistic approach to health care. Given the substantial funds needed to start a pharmacy, how did you make it work? It definitely took time to get my script count and professional services to a point that I was no longer running a loss, so I started a consulting firm on the side with a pharmacist colleague (Corozon Consulting) to supplement my earnings and continue to grow. I probably would have had to stay at my first site a lot longer if I hadn’t done that. I also partnered with others as more clinics were added. What kind of consulting did you do? There was a lot of interest in the point-of-care services I was offering and there were many in the pharmaceutical industry looking to connect better with pharmacy. So we “packaged up” these great programs and services (e.g,, bone density screening, INR testing) for our industry partners (i.e., pharmaceutical companies) so they could have something to share with pharmacies to add value for their patients. It was a great way to either bring programs developed at my site level to others, or take great ideas from consulting and bring them to my site. As director of Oak Medical, what does your role currently entail? Over the course of the week, I try and have regular meetings with our different managers to check in on the sites and discuss next steps and strategies for growth. I’m trying to focus more on things I can’t delegate, such as financing, finding new partnerships and new sites. I still maintain practice hours too, covering shifts and holidays. You recently opened a café too? Yes, it’s called Carte Blanche Cafe and I opened it with my partner Robyn Despins (who is also a pharmacist) in December 2020. That’s kind of my after-hours fun project to work on. How have you avoided burnout throughout the years? One of my biggest challenges as a business owner was in recognizing the symptoms of burnout, which were starting to appear three/four years in. There is always work to be done but if you don’t sit down and take care of yourself, your productivity decreases and you’re less efficient. Once I realized that and decreased the pressure, I was able to find enjoyment in what I was doing again. A skill I’m still learning and refining today is how to delegate. Now we have team members dedicated to things like payroll, marketing, technology and infrastructure which helps. How has COVID-19 affected business? We had challenges, especially with our physical practitioners (i.e., chiropractors, massage therapists) who couldn’t see patients, but we refocused and modified our work. We offered more phone appointments and virtual visits and did everything required to practise safely once we could. I think a good rule with risk mitigation is diversification and we have that here. What about competitors? We actually have more competitors than one would normally. We compete with walk-in clinics and telemedicine providers. Some of these groups don’t even operate from Thunder Bay. But our advantage is having a close-knit, multidisciplinary team. We also have lots of students and work closely with the universities, so we’ve built the community relationships. What’s been most rewarding so far? It’s the perspective I’ve gained from all the challenges and growth. It has expanded my vision beyond medication to learning about other professions and how they practise. It’s given me tools and resources to apply to other areas of my life. I’ve also learned patience. When something bad happens today, you don’t have to fix it that second. Having a wider team means you have people you can lean on. What makes you a good leader? Having experience working with boards and advocacy groups really broadens your perspective. It’s a completely different skill set as you’re starting to run a small-to medium-sized business. I also had some key mentors who were really influential; two were pharmacists and the other was my family. I did my MBA, but that didn’t teach me about the realities of the world. I learned from their wins and mistakes, and they served as a sounding board to run ideas by. What ultimately drives you? Curiosity and interest to do more, learn more and take on more challenges. Are you satisfied with what you’ve accomplished? There is always more to do and new opportunities to explore, but I’m happy about where I am at this point in my life.

Growing a new path for pharmacy

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