Assorted Topics to Know to Manage Effectively

• forgetting can be...

  • a by-product of rigorous thinking
  • smooth decision - making and problem solving ability are often associated with being "forgetful"
  • heightened creativity
• breakthrough thinking

  • another way to describe innovation
  • forgetting enhances breakthrough thinking by:
  • clearing the mind of past patterns
  • clearing the mind of past practices
  • clearing the mind of old ideas and old perspectives
• major memory mishaps

  • no on wants those
  • that said, --> the very, latest findings suggest that forgetting can be associated w/
  • growth of new neurons in the hippocampus
  • brain region linked to memory
• so? what's the point?

  • as a manager, you will expect certain behaviors from your direct reports
  • direct reports --> someone who reports to you, is evaluated by you, that you are their "boss"
  • your boss will expect certain performance from YOU
  • some defined, some NOT so well defined
  • some that are intuitive and normative, some NOT
• what to do?

  • an employee who becomes too laxx, too forgetful, too distracted
  • have a talk
  • ask questions
  • some open and a few closed
  • redefine expectations, job demands, and retrain as needed
• tornado bosses

  • "disruptive leaders" are in style
  • silicon valley mantra of "move fast and break things"
  • that's easy and a cliché
  • what are they going to put in place of the thing they broke?
  • that's harder
• disruptive leaders

  • show drive, ambition, persistence in the face of challenge
  • promise "big things" and deliver
• a dark side of disruptors

  • often struggle to collaborate w/ others
  • usually not team players
  • can be intimidating
  • often in a major rush to get "somewhere" w/o knowing how or where?
• survival tips

  • be ready to pivot, change course w/ little notice
  • ask boss for their help "prioritizing" projects, goals
  • learn form the "disruptors" positive traits
• a formula for creativity that often will appeal to a "disruptive manager"

  • ask a question
  • do research
  • analyze the materials
  • network w/ mentors and experts
• what about the "action" manager?

  • if you work for an "action manager"
  • keep handy and I mean on your desk:
  • a list of last years "actions" that you completed or took part in
  • a list of this year's "actions" being worked on
  • and a few pro forma actions for the "future"
• keeping the boat floating w/ sound principles

  1. move quickly

  • if you see areas to cut expenses, suggest that
  • example: open 1 hr later, or close 1h sooner to cut utilities, payroll, etc.

  1. keep up w/ state and local regulations or new state board directives

  • via internet, websites, pick up the phone and call

  1. manage cash more carefully

  • delay large purchase if possible or excess spending
  • example: it's possible you really need an upgraded security system that costs $$$'s
  • but you may not need to spend money on marketing right now (as an example)
• keeping the boat floating w/ sound principles (cont.)

  4. reach for assistance

  • suggest to your bosses (especially accounting) to connect w/ suppliers willing to re-structure or delay payments of non-essential goods/services
  • hold on to the company's or your money
  • why give it to someone else if you don't have to?
  • especially in these days of drugs that cost $$$
  • if the pharmacy is YOUR OWN, try to downsize the amount of YOUR money going into the business
• keeping the boat floating w/ sound principles (cont.)

  5. identify key staff

  • find a way to keep them
  • just a solid business action
  • you could even list to your boss your success at "retention"
  • one of the highest costs in pharmacy management is hiring and training of new staff
  • there may be payroll assistance programs from state or federal agencies
  • other incentives: what might keep YOU from leaving other than money? (i.e., insurance, benefits)
• keeping the boat floating w/ sound principles (cont.)

  • explore other ways to grow the pharmacy or add a value for pts such as:
  • local delivery -- possible "free or w/ a small charge ($4 - $6)
  • some people still use masks, gloves, and sanitize; and make sure pts know you understand this
  • plan for revenue drops, inflation impact? food or meds? rent or meds?
  • we've briefly touched on PRO FORMA revenue planning
  • at minimum, have a plan for at least 1 yr of "down" revenue
  • it's an educated guess
• cost of goods sold

  • a measurement that includes:
  • cost of product (Rx items)
  • labor costs
  • fixed costs (ex: rent)
• average inventory value in $'s

  • add all your inventory value in $'s and that's it
  • average your results over time
  • using your POS and occasional hand count of certain high dollar items
• turnover ratio

  • cost of goods sold / average inventory
  • a good goal for a pharmacy is 12 - 15
  • example:
  • for last year, your pharmacy had a cost of goods sold of $3,000,000 and an average inventory of $300,000
  • $3,000,000 / $300,00 = 10
  • turnover ratio = 10 (a bit below target)
• Rx product suppliers

  • major wholesalers
  • AmerisourceBergen
  • cardinal health
  • mckesson
• algorithms

  • an inventory management model that calculates re-orders automatically
• the goal

  • do NOT run out of key, needed drugs
  • just in time... you neither have too much inventory nor too little
• inventory management tips

  • get an accurate count
  • at least once a year, take an accurate dollar inventory, supported by a computerized system (such as a POS) or a separate inventory service (costs you $)
  • assign a key employee to monitor
  • adjust as the pt needs change
• let distributors carry risk (example)

  • very expensive drugs such as some Hep C drugs or new-ish weight loss drugs can cost many thousands of dollars
  • it isn't wise to stock on hand multiple units
  • distributors deliver "next day" or sometimes "same day"
• monitor new drugs

  • especially new generics that might diminish units of a brand Rx dispensed
  • ramp up the generic use and adjust down the brand use
  • your automated system might react too slowly
  • seasonal adjustment
  • why stock 24 tamiflu in July if usage is 6, but in November it is 48?
• return or shed excess inventory [understand this well!]

  • all suppliers have a "returns policy"
  • full or partial credit
  • seldom for a partial bottle although some services offer pro-rated credit for partials
  • watch out for controlled substance returns!
• make sure patients are really going to pick up expensive meds

  • especially initial fills
  • super higher co-pays
  • answer: call the pt to make sure they understand the co-pay
  • med synchronization programs -- for pts on multiple maintenance meds, reminders, auto-refill programs