Small moves to keep your business in great shape

There is a fatigue only a pharmacy owner knows.It’s the fatigue of being first in and last out running a shop, and the only one who carries each weighty repercussion of rent increases, insurance premiums, hydro bills, staffing stresses and compliance costs—all while keeping a smile on your face at the counter.It’s the sensation of running a healthcare centre without getting funded like one. Somehow, you are meant to keep the doors open, keep your staff calm and keep patients content—and maybe even prevent yourself from burning out.The emotional reality: When the bills outpace the income, each month brings a new punch. You’re left asking yourself: “How do I keep everyone afloat when the numbers don’t work anymore?” Every owner feels it. Yet, in the midst of this storm, there are paths forward; real-world solutions rather than theories.A pharmacy at the breaking pointDuring the pandemic, a medium-size independent pharmacy in Ontario was grappling with:A $1,400/month rent increaseHydro that doubled from $650 → $1,120Insurance premiums doubled from $9,800 → $17,500A mandated hood recertification upgrade at $50,000A sluggish year with 9% fewer scripts.The owner told me: “I was working harder than ever, yet seemed to be only just keeping my head above water.”Here’s what they did—and it saved the business:Introduced fee-for-service for specialized deliveries The pharmacy began to issue small fees for:Urgent after-hours deliveriesEmergency medsSpecialized packaging for complex clientsPatients didn’t leave. In fact, they like transparency.Partnered with two local clinics to offer minor ailments and follow-upsTheir simple line: “We’ll look after your patients—everything for follow-ups.” Doctors loved it.Moved one technician from front shop to workflowThey didn’t hire more people; they invented new roles. Taking away refill calls, blister prep, and documentation made all the difference: The result? Not as much overtime, with no chaos.Reviewed every vendor and renegotiated:InsuranceWaste disposalPOSSuppliesPhone/InternetIn just five months, the pharmacy transformed a $9,000/month loss into a $2,800/month profit—and the owner could finally stop holding his breath. All without cutting staff. All without compromising care. All without “selling out.”It’s not that owners are weak; the system is toughYou’re not failing because you’re getting it wrong. You’re struggling because you’re doing it all, in a healthcare system that thinks pharmacies can make it on 2005 margins in a world of 2025 costs. And yet there you are, still fighting for your patients. Still mentoring your staff. Still keeping your community alive. Still showing up.Here is a solution-seeking survival strategy, created with emotional reality in mind:Charge for the value you bring. Your time, your delivery, your packaging, your expertise—there is no “free.” These services have real value, and patients are willing to pay for stability.Find your profitable niche.Free your mind so you can thrive not just survive.Audit every quarter as if your life depends on it.Pharmacy owners are under more pressure than ever. Just in case you haven’t heard this lately: I think you are doing a great job.Don’t underestimate your own strength. Your pharmacy is more important than you think. This is not necessarily an easy industry, but it’s populated with owners who won’t accept defeat—and that’s what will transform pharmacy in Canada.Niki Shah is a passionate and dedicated pharmacist with extensive experience as a pharmacy owner.