Whilst it’s hard to quantify, it’s safe to suggest that in the last 20 years community pharmacy in Australia has moved from a predominantly owner-operator model to a largely multi-site owner model. I’d suggest that Pharmacist owners in 2024 are less likely to be working 38 hours a week (or 45, or 60) in the one pharmacy alongside their team when compared to the early 2000s.

Whether that’s a good thing or not is a discussion for another day. My interest in this model shift is how change is being managed by owners who may not be shoulder to shoulder with their team at the coal face day in and day out.

Let’s start with the simplest change model, the Lewin 3 step model

Lewins model has the unfreeze, change, refreeze steps, which is best explained using ice. You buy a large ice block in a cube shape, but you would like to change its shape. You unfreeze the cube, exert the change (create the mould, method, desired shape), and then refreeze the melted cube into the changed shape you desire.

In pharmacy terms, the owner manager might decide that you’d like to hit your 20 Medschecks per month after a lean trot. You call a team meeting/dispensary huddle and decide on your new procedure change(unfreeze), you ensure your pharmacists know the qualifying criteria to perform a Medscheck, make sure they are on the lookout for opportunities to perform the service, and have all the resources they need (exert change) and then observe and fine tune the procedure, tweaking it where needed to perfect it (refreeze).

In the above example, the owner of the pharmacy is involved in each step of the process, able to explain the need for change, able to answer questions, take suggestions and be immersed in the change process.

Contrast this with a pharmacy under management.

The owner who is not there every day has a meeting with the managing pharmacist, tell them the change he wants to see. It’s now the manager’s responsibility to receive that communication and exert the change. 

One of the biggest frustrations I see in change management is a disconnect between what the owner wants and the messaging that is being received by the manager and the team. Your classic communication breakdown. Has the owner conveyed the message to the manager? Has the manager conveyed the same message to the rest of the pharmacy team? Has the team received that message? Had their questions satisfactorily answered? Understood the reasons behind the proposed change?

When this disconnect occurs, it renders the Lewin model ineffective – the exerted change is not the intended change, an the refreeze process becomes ineffective.

The corporate world has several change management models that they utilise when strategic goals need to be executed by those in management positions (Kubler-Ross Model, Kotter’s 8 Step Change Model, Prosci’s ADKAR model) each of which has different key foci and each with its pros and cons, but each has its roots in building communication and momentum, while minimising resistance to change.

These models are designed to assist with strategic change, ensure that everyone is on the same page, has the resources required, and understands what business as usual looks like in the future state, but it often requires great planning and facilitation, and is difficult to make these changes on the run.

As pharmacy has grown to a more corporate model, has pharmacy managed strategic change in a manner that has also grown? Pharmacy has become a great adapter to change exerted upon us (hello covid vaccinations, 60 day dispensing and Vapes!), but very few pharmacy owners and teams successfully communicate and implement internally driven strategic change well, preferring instead to allow the status quo to rule, or place it into the too hard basket. As Pharmacy owners grow to become multi-site owners, a growth in change management process needs to accompany them.

More about the Author!

Simon Rudderham is a Pharmacist and Change Management Practitioner. He has owned multiple pharmacies since 2003 and has worked in corporate pharmacy roles.

He completed an MBA in 2019, and in 2020 co-authored the Amazon best selling book “What The Hell Do We Do Now? An Enterprise Guide to Covid.”

In 2024 Simon began Change Pharma, a pharmacy specific change management consultation company designed to help pharmacy owners and groups to navigate change and improve their status quo.

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