Working in vs. working on your business

A video came up on one of my feeds recently. It was a man walking on a beach with a cellphone to his ear. The caption: “Didn’t want the shackles of working 9 to 5, so I opened my own business and now I work my 100-hour weeks whenever I want.” This made me laugh out loud.That’s just it, isn’t it? As pharmacy owners we work in a prison of our own making. We feel we have freedom as we’re “in charge,” but we are chained 24/7 to the business. Today I want to reflect on a phenomenon that struck me a few years into owning my pharmacy—the concept of working in your business vs. working on your business.Working in your business is great. You set the standard for care, the expectations, the processes and you create the relationships. Patients come to know you. Staff rely on you. Physicians expect you on the phone when they call. I’ve always believed if you look after the patients, the bottom line will be taken care of. And while this is true, to an extent, it makes growth very challenging. Because growing a business requires focus on that as a separate entity and not an extension of the care.Working on your business means planning, watching cash flows, taking meetings to create opportunities, advertising, business-focused continuing education. It means the dreaded metrics. But metrics doesn’t have to be a dirty word; those numbers tell you about the health of your business: your cash flow, your growth, your staffing.The place where I see the switch happening is in pharmacies around the 50k script count. At that level you need more staff. They are the most important part of your business (see my April column). And they’re an expense. To keep up with the rising costs, you need to grow the business, which is hard to do while standing behind the counter. This is something I’m not convinced many of us balance well (myself included).I used to take comments like “I haven’t seen you around much lately!” or “Oh, you’re working today!” quite personally knowing that even though I wasn’t behind the counter, I was still slogging away at my 100-hour weeks. But the work of growing the business is less visible, to both your staff and your patients. That doesn’t make it less important.For my part, I decided to focus on growth through pain-point reduction. From the systems perspective (why are patients coming in, what do they need?); from a patient perspective (is it about urgency, care, access or all of the above?); the physician perspective (how can we support their work and be a partner in care?) and a staff perspective (what really bothers them in the day to day?). Becoming the problem-solving pharmacy has allowed us to grow based on trust and outcomes in the community and beyond.Other owners may grow with a focus on their front store. Some scale with packaging technology. Others build upon clinical services. There is no right way to focus on growth or work on your business, but we need to be comfortable making the shift to see the growth. The most successful owners are not the ones who make the most money. They are the ones who’ve created a clearly defined role for themselves within the business and are happy with it. (At least, that’s my definition of success.)And the beautiful part of on or in is that it doesn’t have to be all or nothing. I spend most of my time working on my business. Community outreach and meetings. Creating standard operating procedures for my staff when I say ‘yes’ to yet another project. I’ve only recently started seriously monitoring key performance indicators; not to set targets for staff, but to understand how best to support the operations with proper workflow and resources. But I also still love those days when I’m in the business. I will often work the first few flu shot clinics where I see our oldest and most in-need patients, especially the ones who’ve been with us from the beginning. It’s a good reminder of why we do what we do.It is very hard to monitor everything from behind the counter, yet standing back there gives you a good sense of how things are running. Wherever you stand these days, give yourself permission to explore the other side. Might it be time to put an extra focus on the business? Might you feel a bit disengaged and want to do a couple shifts in the business? However you work your 100-hour weeks is truly up to you—and isn’t that the glory of owning a pharmacy in the first place?Kristen Watt owns and operates an independent pharmacy in rural Ontario and is a strong advocate for community pharmacy as clinical practice.