Inside the Pharmacy Technician Struggle | Mike Johnston, CPhT-Adv, National Pharmacy Technician Association

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Mike Koelzer, Host: Mike, for those that haven't come across you online, introduce yourself and tell our listeners what we're talking about today.

Mike Johnston: My name is Mike Johnston. I am the founder and CEO of the National Pharmacy Technician Association, and today we're going to talk about the pharmacy technician workforce, all things tech and 

kind of how that relates to independent community pharmacy owners. 

Mike, if there's one thing I hate about being an owner is finding and hiring help. 

Mike Johnston: Absolutely. And I think that's across the board with any employer.Finding the right people for your team and helping them develop and making sure that they stay with your team is one of the biggest headaches. Certainly for the independent community pharmacist, where you've got, typically it's a pharmacist and owner who's handling just a couple of things on the average day, of all things considered, and then having to also put that HR hat on as well.

When I talk with technicians, one of the things that I hear is one of their biggest struggles and headaches is finding an employer that values them and compensates them fairly and gives them opportunity to grow and develop and so I find myself in this really unique kind of middle spot where I feel like I'm connected to both sides but there's gotta be a way to bring these two sides together.

There are so many great, amazing, quality high performing technicians that are being completely overlooked and underutilized at Walgreens and c v s and these big chains. And then you've got these incredible independent pharmacies that have got the culture and the drive and the need for these technicians.

But it's really just a matter of getting those two people connected. It's like if you, it's like if you've got two friends that are both single and they're looking for someone, and you realize like, no, these two people are perfect for each other.

Mike Koelzer, Host: I talked to one of my team members and we were kind of bemoaning the fact that. We would drive by one of the chains in town, or at least one of the grocery chains in town, and you'd see like 20 cars backed up or something like that.

 And we were trying to figure out the psychology of that and I said, well, maybe it's people. They kinda wanna follow the crowd. They figure if there's a big line there, it'd be too easy to go somewhere that just gave good service and you're happy.

So I think people sort of dig their graves saying that we gotta follow the crowd and wait in line here. And sometimes I wonder about employees, both technicians and pharmacists, if. They've heard so much about some of the negatives of the industry that they think that's just the way it's going to be, and they don't think that there's maybe more out there.

Mike Johnston: Absolutely. I. I think as with most areas, people live in an echo chamber. And so you find yourself in a situation where a lot of technicians don't realize that there are other opportunities. it would stu you, to realize how many techs and pharmacists really,in the same case that truly believe they've got two options.

They can either work for Walgreens, CVS, or they can go work at a hospital and if they want to go work at a hospital, it's really hard to get in. So it's almost not worth even trying. So these people feel stuck

and when you consistently feel stuck over a long period of time, you start to lower your standards.

And so what was not acceptable and kind of irritating at the beginning, 

 you get a little more complacent with it. And then the ownership. I'm not even gonna say management because I really feel like the store managers are doing the best that they

can.

but from corporate they say, oh, here's an opportunity to squeeze a little bit more.

We've got them, we've got them accustomed to this, so let's tack this on top of it. And you start doing that year after year, after year after year. And I think you just wear people down and get them accustomed to it and they don't think they really have an option.

Mike Koelzer, Host: It's almost like a battered spouse. where the spouse is telling me I'm the best you're gonna get. It's almost like that situation where they've spoken down to somebody so much they've almost brainwashed them to think that that's all that's out there.

and,don't look cuz you're gonna fail.

Mike Johnston: Absolutely. It is emotional, black male, emotional manipulation, whatever you want to call it. I certainly am not the most politically correct person. probably that you've had it as a guest especially that [00:05:00] represents an organization. But we don't take money from the employers for that exact reason.

we're not here to be beholden to special interest groups, or anything like that. But yeah, we gotta call it what it is. and a lot of these large chains are abusing their staff pharmacists and technicians.

Mike Koelzer, Host: Well, it brings up a point, Mike, without naming names, or without implying even names, there's some larger organizations in pharmacy that it's not clear unless you've done a little bit of digging or people have spilled the beans as guests and so on, that they're taking funding from some of the same people that they're trying to, at least on surface, trying to fight against. And so it's like, well, what kind of fight is that? If it's circular and they're putting the money in your back pocket kind of thing.

Mike Johnston: And that is exactly what happens at most professional organizations,

and it is,and I'm not faulting them for it per se, because obviously it takes money to run large organizations and provides services and benefits, but, You certainly are not gonna have the freedom to represent your members the way that they need to be represented when you're also taking large checks from the people that you're 

trying to address really serious issues.

Mike Koelzer, Host: Why is that? Why Mike, have you not done that? And maybe, let's say at least the average association is

Mike Johnston: I can't really answer for the other organizations. I think it's very similar and parallels politicians. I think there's a lot of people that get into it with the best of intentions, and then they find themselves in a system of, kind of being forced by necessity into that. But there needs to at least be more transparency.

in it. if you're going to be playing both sides, don't pretend that you're not

Mike Koelzer, Host: To not do that is disingenuous, at its mildest form 

at best. Yeah. 

 Mike, take me back to the first thought you had of forming a national organization.

Mike Johnston: I wish I could say it was more well thought out or some type of great plan, but as with most things, I kind of fell into it. So I will step back a little bit further and try to make a long story as short as possible, but I am an accidental technician. As most technicians are, I had no intentions or any interest in going into pharmacy or healthcare of any sort.

I fell into it accidentally, while I was in school and it was a great part-time job. Around that time, the Texas State Board of Pharmacy came out and initiated this thing called national certification made mandatory. This is way back in the nineties, and I've always been kind of an overachiever.

So I said, well, let's, let's just go ahead and get this knocked out of the way cuz it's a nice job to have while I'm in school. And so I wanted to get that taken care of, and studied for the exam. And, I was working for a company, I don't wanna say their name, but it rhymes with Kroger at the time.

And, I was making a whopping $5 and 25 cents an hour. And became one of the, one of the early technicians to get nationally certified in the state of Texas. 

Mike Koelzer, Host: And this is back in the nineties

Mike Johnston: this is back in the nineties.

 So I went to my employer and they were really proud of me, congratulated me and my job duties were getting increased and I thought there would be some type of raise. Honestly, I was looking for 25 cents, 25 cents an hour. So that's what, $500 over a year?

Mike Koelzer, Host: Yeah.

Mike Johnston: And, they said no. They said, this is all so new. We don't know what we're gonna do. You just gotta give us some time. And it was really upsetting. What I heard was, and what they were telling me was I was not worth 25 cents.

And so I pulled out a little thing called the yellow Pages back in the day and started thumbing through to the pharmacies to look for a different place to work.

And,I found a listing for a place that I had never heard of and just drove over there, walked in. It was a little independent pharmacy, and looked super sketchy. It was in a strip center in the corner, and didn't really have a lobby or anything. Come to find out it was a [00:10:00] closed door compounding pharmacy.

Mike Koelzer, Host: yeah.

Mike Johnston: And, I just walked in and said, Hey, are you hiring? And they said, no. And I was like, well, great. but we had a conversation and I got to know the owners, it was a husband and wife. They were both pharmacists. They literally didn't even have any tech at that point. And we had a conversation and they ended up offering me a job.

Mike Koelzer, Host: Wow.

Mike Johnston: And, they just really liked me, I guess. And they offered me 25 cents. Now, I can tell you now at this point, with hindsight and being an employer, I know that was a big risk. That had to be really scary for them to create a whole new position when they weren't even looking for that. But they did. And about three weeks after they brought me on, their daughter was stricken down with meningococcal meningitis. She was in pediatric I c U for 40 days, in the hospital for I believe another 40 days after that. They were brought in to tell her goodbye twice. She was about eight years old at the time. Now, if the two pharmacists and the two owners. And your daughter is in a pediatric ICU on her deathbed. The pharmacy is not anywhere in your thought process.

Mike Koelzer, Host: Yeah.

Mike Johnston: But again, I had only been there for about three weeks and I took it upon myself because these people had taken a risk on me and I respected that and I appreciated it.

So I took a risk on them. I kept that pharmacy running. I called every pharmacist that I knew, brought 'em in to work their days off as relief, called relief agents, whatever I had to do.

They did not step in that pharmacy for over a month. No phone calls, no nothing, because they were truly in their darkest days when they came back to the pharmacy, not only was it still operating, I had hit their highest sales numbers they had ever had.

And so that's when I really fell in love. With independent community pharmacy because it was that relationship, the risk that they took on me, the risk that I took on them, and really being able to make a difference and an impact. Shortly after I had done that with them, and they came back and it was basically like, Hey, what can we do to support you? And they kind of inspired me to start a calculation. Kind of tutoring class, if you will, on the weekends to help other techs that were being required to pass this exam.

Because there were no schools, there weren't textbooks, and you had all these retail techs that were suddenly having to do aseptic calculations and I was always good at math, so techs started driving to Houston from all across the state. I was running an eight hour kind of calculation workshop on Saturdays, and it was the first time that I started meeting other technicians that worked at other pharmacies and realized that we all had similar concerns.

When you're stuck in that one pharmacy, it can be very isolating and you can think, oh, this is just how it is here.

Mike Koelzer, Host: Yep. Yep.

Mike Johnston: But suddenly I was talking with these other techs and realizing, no, we're all facing this. And so I decided to do what. Any 20 year old would do. Right. start a national organization. So it was me and three people in a holiday inn express, in Northwest Houston, Texas.

nothing natural about it at all, but I've always had, I guess big dreams. And so I was like, how hard could this be? Let's start an organization. And that's what it was.

Mike Koelzer, Host: I remember in the mid nineties vividly one of our customers came in and I said, Chris, what do you do? He says, well, I do the, The web, I do stuff on the web now, this is mid 

nineties, so our listeners are gonna think this is crazy.

and I'm like, mid twenties, I said, what is the web? 

What does that mean? And he said, well, it's this and this, it connects this and that. And I think also what people don't remember is like, we already had computers. That was running the pharmacy.

It's not like the web and computers came at the same time. We 

had nice looking Mac computers and the web came after that. So I remember looking up and I was like, How do you do this? I remember, I think I was on like web crawl or something. Google wasn't around 

yet. And you could just start to look stuff up.

So the question, Mike, how did you know there wasn't another one? And maybe the answer is you didn't know

Mike Johnston: I didn't. 

turns out there was, and, they did not take kindly to me thinking that there was not,[00:15:00] that other group is still around. Apparently the rumor mill got started because I was in Houston, my dad was a powerful oil tycoon and that, and this was just a little game to me and not to worry.

I, this all would fizzle out in a year or two. And I went home and I asked my dad, I was like, well, where the hell is all this oil money that I'm hearing about?

Mike Koelzer, Host: Yeah.

Mike Johnston: But no, I didn't hear about it. And, they had maybe a hundred members or something like that. It was more of a social club.

but I had something different in mind. And so, today we've got over 80,000 members 

around the world. 

Mike Koelzer, Host: What became of that other one,

Mike Johnston: There's still a social club.

Mike Koelzer, Host: Did they use that same name?

Mike Johnston: Oh no. They have their own name. they, their name is separate. Yeah.

Mike Koelzer, Host: They were never the National Pharmacy Technician Association

Mike Johnston: No, a national organization. 

Yes. 

Mike Koelzer, Host: Oh, well, hey, xfl NFL 

Canadian League,, wishes to everybody and the winner wins.

Mike Johnston: Yeah. I've never had any issue with them.

Mike Koelzer, Host: 80,000. I know there's like 300,000 pharmacists in the US or something. I'm not sure what these other organizations have number wise, but 80,000 is a lot. I know.

Mike Johnston: It is, there's roughly maybe about 400 to 450,000 pharmacy technicians in the United States that are active. But we are certainly right up there membership wise with a P H A and a S H P and the other big national organizations.

Mike Koelzer, Host: Is it a membership fee?

Mike Johnston: Yep. Yeah, we have.

Yeah,

Mike Koelzer, Host: how's that set up, Mike? Are all the organizations set up about the same as far as, I don't know what the hell I'm talking about. one of my pharmacist friends, he said, how the hell are you a business owner? And I kind of dumb it down for him a little bit. But are all the organizations the same thing?

They're all nonprofit, this and that. Or do some have different ways to configure themselves?

Mike Johnston: So that is one of the big differences with us. Most of the organizations are nonprofits. When I set the PTA up, I kind of looked at the landscape and I was like, to me, that's part of the problem. I don't want to be reliant. On other organizations that have got money that they can throw your way.

Cuz I don't want them controlling our voice. And so I established N PTA as a privately held corporation. We run just like any other trade association. But in my mind, it actually makes more sense because I'm not gonna be successful unless I make sure that our members are being successful. 

And trust me when I say the nonprofits are not nonprofit, they just don't pay taxes.

Mike Koelzer, Host: Yeah. Right. Exactly. Exactly. It's like the Holy Church of this association or something like

Mike Johnston: Yeah. So I feel like by structuring it the way that we did, first of all, we protected our independence and our voice, which was very important. And number two is it really made. The US aligns our goals and values with the success of our members.

Mike Koelzer, Host: I can't speak poorly about it cause I don't know enough about it, but you got some big nonprofit, just blowing through money and all these big grants and all that stuff.

It doesn't seem related enough. It's like I want my organization to kind of be like a big version of me.

Mike Johnston: Yeah, it's that being able to relate. I can sit down with another independent pharmacy owner and I can shoot straight with them, and I understand their needs and their concerns as a pharmacy owner, as a business owner, and I'm, and I really feel like that's been a big part of our success is being able to, Understand both sides of the equation, understand the business aspect of the pharmacy and understand the people aspect of the pharmacy and getting the right people together,to get connected.

Mike Koelzer, Host: N P T A leadership? Do we have you and then a bunch of air, is there a team? What is the staff of the N P T A?

Mike Johnston: We have a full staff and office here in Houston. We try to provide as many opportunities for our members as possible. So everything from writing opportunities, speaking opportunities, cuz we know. All of those opportunities are ways for them to get more experience, differentiate themselves a little bit,and also to take a more active role in the profession, but we also pay them for that because we value their time just like it should be.

So we have independent contractors and volunteers, and a full staff.

Mike Koelzer, Host: what do you mean by full staff? how many [00:20:00] FTEs do you have, would you say?

Mike Johnston: We have about 20 in Houston.

We've got a full creative team. We do lots of different events and publications and CE programs and yeah, we're a pretty busy crew.

Mike Koelzer, Host: So Mike, this is your full-time thing. This is your in quote job.

Mike Johnston: It is for the past 24 years.

Mike Koelzer, Host: Wow.

Mike Johnston: Yeah. I do have a couple of other businesses as well. 

Mike Koelzer, Host: What else do you have? 

Mike Johnston: So I have a company called Mock Mets. we're one of three companies in the world where we. In essence, make fake drugs to sell to schools. so for like nursing school, pharmacy, school, 

I took my pharmacy knowledge and my compounding knowledge.

And,we manufacture about 450 different SKUs of all the different medications that are available, but there's no active ingredient.

Mike Koelzer, Host: No kidding.

Mike Johnston: I can send a fake amoxicillin, reconstituting powder that looks the exact same, smells the exact same. It's gonna smoke up when you open the lid, like the real thing.

But there's no actual meds. So that way they're able to practice in their labs and simulation.

Mike Koelzer, Host: Now, do you call it stuff like Ben and Jerry's? Like you'd have fake names for it, or is it really called that stuff?

Mike Johnston: We label everything with generic drug names because we want to provide us with realistic training. Opportunity is possible. Obviously it's only sold to schools,that have been verified 

and there's 

warning 

labels everywhere.

Mike Koelzer, Host: I was gonna say, like Amazon, you can buy a hundred dollars bills, but it says like, in Amazon we trust something on there. So you know that it's not the

real thing. 

Mike Johnston: Yep.

Mike Koelzer, Host: So we covered the fake business. That's what my friend calls me. Calls me a fake businessman. It's all a shtick. I do, it's like my brother-in-law's. We went over to my mother-in-law's house and she would need new shingles, a new roof.

 This was 15 years ago. I showed up a little bit late from the pharmacy. I got my tie on, I never wear a tie except on the day that they're up on the roof working, and then I pick up the wrong end of a hammer or something like that. So then these guys are up on the roof.

It's a hundred degrees, and I'm the lemonade guy, just go on and fill the cups up. I'm not stupid, you know? All right. So you got the fake medicine business. What other things do you have your hand in?

Mike Johnston: I've published quite a few textbooks in the pharmacy space, so I've got about 12 textbooks. that's pretty involved with just keeping up revisions and stuff with that.

And, then I did also own an independent compounding pharmacy for several years, cuz that was just always a goal of mine cuz I really love it.

Mike Koelzer, Host: I saw that. what are the rules in, was that in Texas

Mike Johnston: Yeah. In

Texas, 

Anyone can own a pharmacy. Obviously I had to have a pharmacist in charge on staff. 

but yeah, no, anyone can own it.

Mike Koelzer, Host: I think in Michigan it's, 25% of the pharmacy has to be owned by a pharmacist.

Mike Johnston: how does Walgreens get by with that?

Mike Koelzer, Host: I don't know,

Mike Johnston: Yeah. 

Mike Koelzer, Host: I found a way to bring them down. No, it's something like that. I don't know what the thing is. I don't know. It's something like that. But

Mike Johnston: I think in Texas there might be a thing. That limits physicians or prescribers from being a majority owner of a pharmacy that they're referring scripts to.

Mike Koelzer, Host: Yeah. Yep. 

Mike Johnston: But no, there.

there were no requirements. No.

Mike Koelzer, Host: Mike, what are the biggest complaints of technicians about pharmacists? I know it's not all rosy. You gotta have some beef going on. And I don't mean to pick on technicians.. Any group has to have some beef going on to keep it exciting.

Mike Johnston: Yeah, no. I was speaking at, Lisa Foss event earlier this year in Orlando, and as I got up to speak and talk about technicians with all these pharmacy owners, they were, Communicating to me that techs are sometimes their biggest pain, right? And I said, well, congratulations, you're the tech's biggest pain many times.

Mike Koelzer, Host: So it's all fair play now that we got that outta the way. Wait a 

minute, why are the texts? I can see technicians complaining about pharmacists because of any reason anybody complains in life, whether it's wages or this group gets more privileges than this group and so on. But I've never heard the other way, really, a pharmacist having beef with techs.

Mike Johnston: I don't think it's so much that they are techs as much as its owners talking about employees, right?

So 

Mike Koelzer, Host: course 

there. Yeah. 

Mike Johnston: there 

and so, 

Mike Koelzer, Host: yeah. You gotta have headaches with employees, but not pharmacists because they're techs.

Mike Johnston: No, I, I think that may have been the case, further back. I think there certainly was some turf war,

right? [00:25:00] Pharmacists were afraid that techs were gonna take their jobs. Techs are afraid that robots are gonna take their jobs. None of that is the case.

Mike Koelzer, Host: Nope.

Mike Johnston: I think it's a pretty big distinction, whether you're looking at the independent community space, the health system space, or the chain of retail.

I think chain of retail has done a masterful job in pitting techs against pharmacists, because as long as they're focused on each other,

Mike Koelzer, Host: Oh,

Mike Johnston: they're not looking up,

Mike Koelzer, Host: That's really interesting.

Mike Johnston: right? So it's more of a prestige of, like, y y'all just focus on each other. And the reality is they're both being treated terribly. By these organizations, but I think that those walls are starting to come down and I think that's where you're seeing pharmacists and technicians realize they've been on the same side this whole time.

Mike Koelzer, Host: That's really interesting. I read a book, well, quoting Norm McDonald. Either read a book or saw a headline somewhere in USA Today. But, they were saying that things aren't always the way they appear. Like I remember they were saying something about how announcements come over them.

Loud speakers in airports and they talk about, if you see somebody, leaving a bag, this and that kind of thing, make sure you know who the person is and ask you to watch their luggage and all that kind of stuff. They said the purpose of that was to let the traveler think that everybody's watching. and the airport's got everything under control. and gonna tell everybody to do this because it's a feeling of security. It doesn't have a whole lot to do with someone asking you to hold their bomb.

It's really interesting you bring up that those in charge are pitting them against each other to not look up and see the realities.

Mike Johnston: That's who it serves the best is the actual corporate management. I think in any situation like that where you're all employees, I if you are. Dissatisfied and unhappy and dealing with these types of issues, you're typically going to look at and blame the person closest to you that you can blame 

so for a technician, they're immediately looking up at their pharmacist and they see, oh, this is, a doctor of pharmacy, they've gone to college, they're in a management role, potentially. so surely these are their issues. They're their problems. What they're not seeing though is that the pharmacists are being treated the same way the pharmacists are coming out of all of this, education with little to no training on management and being thrown in a management role.

So they also don't know what they're doing a lot. A lot of times you've got a brand new pharmacist, That may have never even stepped foot in a pharmacy prior to their rotation that's coming in and now being told that they have to manage technicians that may have worked there for 20 years.

And so it's certainly set up in a way to create a little bit of an issue with that.

Mike Koelzer, Host: the last thing they want is for pharmacists and technicians to be, plotting against the district manager all the way up to the top kind of 

Mike Johnston: Mm-hmm. 

Yeah.

Mike Koelzer, Host: One of my guests was more than the fact that there is no association for chain pharmacists, just the chain pharmacist.

But what is the association, if there is any, with, leaderships in the chains in regard to technicians? Do you ever get the opportunity to talk to the leadership of these chains where you hear all this, pizza not working stuff and all of that?

Mike Johnston: they're not particularly looking to speak with me, um, just because I'm not gonna. play the games with it. Now. I always have open invitations. I'm happy to sit down and talk with any of them if they want to talk about real solutions. and I am more than happy to also take back to the technicians and explain reasonable issues that the companies are trying to deal with and face.

I do understand there are two sides to it, but what I won't do is play these games like, this huge shortage is affecting, working hours and all the things that 

they want to do except for, to actually take accountability.

Mike Koelzer, Host: Our listeners who well know this, but the current talking point for the chains, I guess is there's not enough pharmacists and technicians to support the Longer hours that we've been used to [00:30:00] in, community pharmacy.

But the fact is there's enough people, there's not enough people that want to do it.

Mike Johnston: That is willing to anymore. 

Yeah. 

Which is why I feel like all of this chaos in the chain is an incredible opportunity for the independent community pharmacies to really bring in some great talent. and double down on the culture. And I, look, I want to be clear, I'm not disillusioned to think that everything is roses and rainbows at independent pharmacies too.

You've got issues, you've got situations, 

but it is on such a different level and there's such an opportunity to work together to resolve those types of issues and fix cultures. It's just a completely different situation. So to me, it's a great time of opportunity

Mike Koelzer, Host: 

Mike Johnston: shift the best of the best technicians into the independence because they need that.

They need technicians that understand business, that understand the revenue side and the cost side, and that are not there just simply entering prescriptions or working on the bench, but really helping to run and build these businesses. Because the owner and the pharmacist can't do it on their own.

Mike Koelzer, Host: yep.

Mike Johnston: But I think if we can really match these groups up, then you may have an opportunity to really give the chain drug stores a run for their money.

Mike Koelzer, Host: I've got a team now, non pharmacist. If they picked up tomorrow and went home, I'd pretty much lock the door. I don't have the skills that they have. I don't have the knowledge they have of some of the background stuff. And part of it's just a time issue. I gotta be doing this while 

they're doing that.

But, there's really no secret. I mean, it's not great bargaining. tactic on my side to tell somebody if they left, I'd shut the business down. But, it's not a big secret. I have other things I can do and I just don't have the knowledge there.

Mike Johnston: It may not be a bargaining tactic, but one of the most valuable things to attack out there right now is to feel respected.

And appreciated and valued

and making those kinds of comments to attack goes so far.

Mike Koelzer, Host: Frankly, I don't want a pharmacist doing that. I mean, if I'm paying a pharmacist, which I think is an ungodly amount of money,I don't know why the hell wages got so high, supply and demand. But the last thing I want is my pharmacist doing the stuff that my good technicians are doing?

and I can say not necessarily the tech, cuz I suppose they could be doing it without the tech, but there's so much intertwined between knowing the business and knowing about the medicine and what milligrams are and what prices of units versus this and that. I mean, it's all pretty much intertwined,the technician part and the finance part.

You'd be hard pressed to bring in somebody who was a financial person without any technician background and hope they were gonna do very much for you.it's all, interwoven.

Mike Johnston: Yeah, and I think they bring the focus of patient care to the equation. a, a technician, they can be trained in the business stuff,and be such a valuable asset, but they're always still gonna have that, that tie in connection to serving patients 

that you can't really replicate with a non-healthcare type individual.

Mike Koelzer, Host: In my store, when we set policy for the team and so on, it's like I might not be living everything that they do, that they're dealing with Mrs. Smith at their register but I'm like either four feet away or I'm, an office away, a phone call away.

 And even that sometimes feels a little bit removed from . I can't even imagine a policy being set six levels up for what's happening in the store.

Mike Johnston: With people that have no clue as to what it's like to actually work in that environment.

Mike Koelzer, Host: No, for sure. Mike, what complaints do you think there's, from pharmacists and technicians that you've heard or have seen online that you think is the wrong approach or you say, Why are you focusing on that? If we're gonna focus on something, let's focus on X instead of Y and Z, which is just smoke, but it's not gonna go anywhere.

Mike Johnston: This question really gets to one of the more challenging parts for me because the way that I am [00:35:00] made up, the way that my mind is wired to think. It is very difficult for me to relate with people that sit behind a keyboard on Reddit every day bitching about their job, but going there every single day and not actually doing anything about it.

I don't know in the current environment that it's really feasible and possible to shift the culture at some of these large chains, but what I do know is that just complaining about it, especially on internet forums or whatever, is not gonna do anything. 

It goes back to that living in an echo chamber.

 To me, if you want to try and be a change agent, try it. do your best. I'm not trying to dissuade people from that. But if you can't, at a certain point, you gotta be willing to make a change. See, with my story, I could have stayed where I was and been miserable and gone on and done, my schooling to, to go to the career that I initially expected,

but I wasn't willing to tolerate that. And so, it was a risk, it was a gamble. It was hard, but it's better than staying in the status quo. So that's probably my one area where whether it's a tech or a pharmacist, at a certain point, I don't understand why people stay.

Mike Koelzer, Host: That's how some people are and. I was that way for a while too, I suppose, in my business. And I think maybe I could make an excuse for it. Like, well, it was a family business, so I couldn't make a lot of changes. I kind of knew what I wanted in the future.

I wanted to be a part of it. So the best I could do was just kinda bitch about it and not leave and so on. But that's not true now, and it's not true for people. the griping, if you're gonna gripe, give it like 10%, but then swear that the amount of time that you spent griping, you're gonna multiply that by nine to get 90% to do something. That's just not in that gripe session.

Mike Johnston: It's a lot of energy to invest into complaining without change, it's a whole lot of energy to invest into just becoming bitter.

Mike Koelzer, Host: I want to agree with you, Mike, but it kind of seems like the easier route just to bitch about stuff. 

Mike Johnston: I agree. It is the easier way. It's the way that more people act. What I have learned is that for the individuals that get stuck there, I can't help them they 

I don't want to be helped.

Mike Koelzer, Host: I think it's kinda like my example earlier of like waiting in line for 20 customers at a chain, because you think that's what has to be, if it was better, why aren't people doing it? So I'm gonna get in line with the 20. Why do people want to complain and why do they want to be stuck? It's almost like they want it in a way.

Mike Johnston: I think there's a lot of people that thrive in drama negativity, those different areas.

Mike Koelzer, Host: They want the drama.

Mike Johnston: And so for those people, stay where you are.

Mike Koelzer, Host: People want that drama. They wouldn't know what to do with themselves if there was a clear path to get out of something. They thrive in that way.

Mike Johnston: And look, I like drama too. At the end of the day, I like to watch an episode of The Real Housewives, right? But I like to limit my drama to a TV screen for 45 minutes that I can turn on and off. I don't want to live in it and marinate in it all day long, every day.

Mike Koelzer, Host: I tell my wife sometimes she's got some people that maybe idk her a little bit, and I'm like, why do you keep bringing up so and so? She said, well, I saw him on Facebook. I'm like, Margaret, if you want drama, get some real drama with Hollywood people.

Let's talk about million dollar houses, and let's talk about all the cocaine use and, breast augmentations or the duck lips and all that kind of stuff. Let's really go for drama. don't do drama with some person you knew three years ago from, your child's, elementary school or something like that.

If you didn't get drama, really do the drama and then get back to real life because the drama you're talking about, they're like local [00:40:00] Facebook people. Go to the top.

Mike Johnston: Yeah. Yep. Gotta be able to turn it off.

Mike Koelzer, Host: Mike, you said that the chains like pharmacists and techs to go at it, but. What are some complaints of technicians about pharmacists that maybe pharmacists are oblivious to? 

Mike Johnston: I think one of the biggest things that a tech is looking for is respect and appreciation. Those don't cost anything. 

Those don't have to be approved by a corporation. They're not contingent on a good day or a bad day. That's something that every pharmacist can freely provide to their tech and that will make some sort of impact on their technicians just to know that their coworker, their colleague appreciates, respects and validates them and their presence.

Because again, remember a lot of technicians are like me. They're accidental.

You didn't become a pharmacist by accident. 

You invested a lot of time and a lot of money 

in order to get there. 

A lot of technicians don't go through that journey, so there's not this internal sense of recognition or value potentially.

So to have that validation from. A pharmacist, a coworker, a manager plays a critical role for them.

But to be fair, It works the opposite way. And I'm never shy to tell a technician this as well. That pharmacist that you're working with has made a tremendous investment of time and energy and money and resources to, they chose to go to school and to earn this degree and to become, the most knowledgeable individual about patients and medications that there are 

in the healthcare system.

And so that also deserves respect. So even if you've been a technician working at that pharmacy for 20 years, and you may be able to do circles around that new pharmacist that's just coming in

it, it doesn't mean that, that pharmacist is to be on a pedestal to be tried, treated like better than anybody else.

But there is a tremendous amount of respect. And value to show to that pharmacist as well. So it's a two-way street.

Mike Koelzer, Host: One of my brothers, his memory of the pharmacy, I'm the only, brother that or sister that continued on. One of his memories of the pharmacy was my dad said, like, Do this for me and my brother said something like, yep.

Or something like that. And my dad took it a little bit offensive and he said, just do it. Or the answer's yes, or something like that. The problem is that was not typically my dad and that really wasn't my brother. Until that stress comes in, you can take the best person and you put 'em under stress and it can make an animal out of a lot of people.

And then as soon as that stress leaves, they're like a different person sometimes.

Mike Johnston: I never personally served in the military, but I would use that as an analogy. If you're in a foxhole with your fellow soldiers, you want them. Performing at their peak. You want them in their best mental capacity as possible because you're on the same side, 

and so that is not the enemy.

Mike Koelzer, Host: it gets twisted sometimes,the upper management might not be listening and the customer, you're supposed to get these metrics and blah, blah, blah.

And so you either save it till you get home and kick the dog. Some people say kick the cat, but I think that's a good thing. so I use Mike, dad, do you have a cat?

Mike Johnston: I don't know. I'm allergic.

Mike Koelzer, Host: When I was like 10, you know, the old coat, the, they were dark blue and they had the fur around the top, and they were orange on the inside, the parka coats or something. I remember standing at a bus stop and all of a sudden the wind goes a certain way and you realize that your cat has peed all over your coat that was lying there. I think my mom would let it lie there on purpose cuz she knew the cat might get to it to teach us a lesson. But, So kicking the cat's. Okay. But you're either gonna kick the dog or you're gonna kick the figurative [00:45:00] dog who is your fellow employee, cuz you wanna take it out somewhere and it gets transferred to somewhere.

Unfortunately, it's probably a fellow team member.

Mike Johnston: Yeah. Yeah. We just have to be mindful of it. It's the same in a relationship, right? you and your spouse, you're. On the same team, but that's typically who you take it out upon. Whereas in, in that analogy, the shared enemy is the child that you're raising. I've got a four year old, so that's my focus.

Mike Koelzer, Host: Mike, do you like the spotlight of the job? Because I'm imagining you've got some conventions and this and that. Do you like that part of it?

Mike Johnston: I hate it. I absolutely hate it. Most people would not believe that. 

I am as introverted as you can possibly be. I don't like the spotlight. I don't like the public part of it. but what I had to learn early on, actually it was after our very first conference.

Mike Koelzer, Host: There was something that happened where I got up on a stage and there were technicians from all over the country that had gathered, and there, there had never been a voice for our profession, really.

Yeah.

Mike Johnston: And then suddenly you've got someone standing up on a stage and there's lights hitting them, and they're saying everything that you've been thinking and feeling for how many years. And so there's this certain element that gets transferred onto you whether you want it or not. I certainly did not see that coming.

I remember early on people would want me to autograph their magazines or something like that, and I would say, no. Are you kidding me? Not realizing it actually made me look like a jerk, thinking I was too good for it when I meant I'm just like you.

Mike Koelzer, Host: You are like them, but they needed their Moses, they needed that figurative leader to put some energy behind.

Mike Johnston: Yeah. So it is something that I do because I understand there's a need for it. 

But do I enjoy it? Absolutely not.

Mike Koelzer, Host: How many functions are you going to do? To, let's see, a year. Do you have a convention? Do you have something else that you have to go to? How many times are you, well, let's say this. How many times are you on stage each year?

Mike Johnston: We are primarily doing virtual stages now, just because it's, since Covid, everything shifted. It's so much more affordable. My team here is. Absolutely incredible. They have found a way to make virtual events fun and exciting and engaging. Like this is not some boring event, but used to. I traveled and spoke a lot, these days because I do have some other priorities

 raising a son and all of that.

I have scaled way back. So I will go and speak for a handful of people like Dr. Foss, who I'm just very close with and have so much respect for. But otherwise I tend to only speak at our own events, and so we have four of those a year.

Mike Koelzer, Host: How about the news? Do you ever have a news station calling you where you're representing that?

Mike Johnston: Yeah, I do quite a bit of interviews,with media and publications, things like

Mike Koelzer, Host: Yeah. Do you ever do a panel like, here's Mike against somebody else and you guys are screaming at each other.

Mike Johnston: No, but that would be kind of fun, I think.

Mike Koelzer, Host: It would be kind of fun,

See like on some of these, they're more drama shows than news. some of these cable things, where these people are just screaming at each other.

Mike Johnston: I would do that.

Mike Koelzer, Host: you would do that. Get in there with the chains and things like

that. 

Mike Johnston: Yeah.

Mike Koelzer, Host: Mike. given the opportunity that someone says to you, Mike, you get 15 minutes in a room. With any one person, whether it's a CEO of someplace, whether it's a government, whether it's a celebrity, you get 15 minutes with somebody for the good of technicians, who's that gonna be? and what's that meeting gonna be about?

Mike Johnston: For the good of the techs and the good of pharmacy? It's a great question. 

I would want 15 minutes with, with, uh, CVS Karen Lynch, ceo.

Mike Koelzer, Host: Let's say she agrees to this. You walk in. How many people do you think you have with yourself? How many people do you think she would have with her?

Mike Johnston: She would probably have a team. I would probably just take one person, not trying to,play that game.

Mike Koelzer, Host: Bombard right?

Mike Johnston: Yep. And I would go in

and ask what can we do [00:50:00] together to make things better?

I wouldn't go in with a list of demands or complaints. She is fully aware,

but I would ask, what can we do together to make a significant change? Now, I don't know how she would reply and how authentic it would be, but that would be my approach.

Mike Koelzer, Host: To me, I don't spend a lot of time thinking about chain stuff. but to me it seems like. As you said, it seems like those leaders know, they know everything. They don't need to be told what 

the complaints are. It almost seems like the methods have to be either a group embarrassing, calling out, or coming in with an honest approach to do something.

And I, I don't know what value those have, but it sure doesn't do a lot to go in and repeat the same things that they've heard hundreds of times a day and millions of times if they're looking on social media.

Mike Johnston: For me, I would want to be able to leave that meeting. Although I would not expect anything but to be able to leave knowing that I offered a solution oriented approach. And if that approach was rejected, then certainly anything else would have been rejected as well. any type of more intense conversation.

but I would be able to go back to the pharmacy community with my head held high and say

We genuinely tried to find a solution with them.

Mike Koelzer, Host: What would be the best thing? That she could say after meeting with you. professional to professional, that she heard you? What would she be saying to you that you would say she got ?

Mike Johnston: Help us do better.

Mike Koelzer, Host: She would say that to you.

Mike Johnston: I don't think anything is going to come out of that, of one single meeting. 

 But I would imagine in this scenario, helping us do better is telling me two things. Number one, it's an admission, and number two, it's a invitation and request for ongoing 

dialogue 

Mike Koelzer, Host: Mm-hmm. 

Mike Johnston: change.

I don't want to hear, I'm sorry.

I don't want to hear the, anything else is an excuse or whatever 

help us do better.

Mike Koelzer, Host: Yeah.

Mike Johnston: AndI like the mystery to that, let's say, because, in my opinion, somebody that's six layers apart or whatever layers there are, needs that help.

And you're not going in and demanding what better means

Now,

Mike Koelzer, Host: or who it's focused on. It's just better. And typically in the pharmacy scenario to me, everybody can do better. , not as a demand. I'm saying , as a welcome, because if everybody does better, even the finances work out better because they're not wasted on, whatever the waste is in the pharmacy , everybody can truly do better.

Mike Johnston: Yeah, my approach would not be to go in and beat her over the head for being one of the most profitable companies in the country. She's got shareholders 

that she's equally responsible to. I'm fine with that. I'm not going in there and saying that they should take all of their.

Profit and reinvest it across their staff. every single penny of that. I get it. It's a business. It's gotta, it's gotta run a profit, but there's a lot that could be done. But in the meantime, I'm gonna invest my time and energy helping the independent community pharmacies do this with the best performing technicians and help the business owners that are willing to accept that help.

Mike Koelzer, Host: And Mike, how is that gonna look like this mission to match those up? Is this going to be just more of a movement or is there gonna be technology behind it? What does this look like, this mission to match those up? ?

Mike Johnston: I think it's gonna be evolving over time as we identify more specific needs, but specifically we [00:55:00] want to help on the front end with recruiting and attracting the best quality technicians that are available. and there's a wide variety of ways that can happen. Again, I've got 80,000 members, I've got a pretty good pool

to tap,

of technicians and get people connected with.

But to me, even more importantly, are the training and development and retention, because it's a whole lot cheaper and more efficient for the business to develop your team. And have the resources where you're gonna retain them instead of having the turnover and continuing to do that. So right behind compensation for technicians as their biggest pain point are career opportunities.

So if you think about that, it's literally 75% who have stated that they're leaving the industry because of pay. 72% are leaving for a lack of career opportunities.

 technicians saying, I want to do more.

I'm willing to take on more responsibilities to have a more advanced role. So to me that's a very fair and equitable proposition to say, yes, I want to earn more, but I'm also willing to do more.

And so if we can help the pharmacies create. Career ladders and opportunities that are tailored for the staff. You're gonna have some staff that are super extroverted, so they may have some really great opportunities to help build the business kind of front of house. 

And then you're gonna have other techs like me that don't want anything to do with that.

Don't try and lump 'em together and force 'em to be something they're not. Let's train them on ways to reduce cost or, in increasing profitability.

Let's create these ladders and opportunities to help build the business, improve patient care, improve career opportunities. And by doing that, the staff is going to be more engaged, more satisfied, they're gonna stay there, and it's gonna be at a fraction of the cost of dealing with turnover.

Mike Koelzer, Host: Turnover. I told one of my team, I'm like, we need a couple new people in there. They're like, wait a minute, we need one new person here. Because one new person is negative because they're making mistakes and you're teaching 'em, and you can't afford two new people because it's gonna be like having, two times in reverse kind of thing.

Mike Johnston: So we're literally in the process. I'm referring to it as, I'm assembling my team of technician Avengers. 

I know the best of the best across this country, and they're all. Super skilled in certain specific areas. And so for this training and development part of it's gonna be mentorship so that way a, an independent pharmacy can plug their staff into regular mentorship with technicians that have already done this, they've already excelled in it.

they know what pitfalls to avoid and they'll be able to be there to help them through that process. So we can duplicate these super techs, if you will, all across the country 

in as short of a time as possible.

So it's not gonna just be me, obviously I'm not the person to do this, but I've got a team of people that are gonna be incredible mentors.

Mike Koelzer, Host: What I like. Hearing from you Mike, is just to calm confidence of not trying to rouse the troops, and not trying to bring others down to bring your stuff up, but just to calm confidence in what technicians can do. such a needed group and on behalf of pharmacists, thank you for what you're doing because it's much needed.

Mike Johnston: I really appreciate that, and that is exactly what we're trying to do. we're just trying to help the techs, help the independent pharmacist, and ultimately it's gonna help the patients.

Mike Koelzer, Host: All right, Mike, we're behind you. Keep it up and we'll be watching closely.

Mike Johnston: Thank you so much, Mike.