Why I Still Work the Pharmacy Counter

I own four businesses and I still fill prescriptions. Not because I have to. Because the moment I stop, I lose the thing that makes the rest work.

There is a school of thought in entrepreneurship that says the founder should remove themselves from day-to-day operations as quickly as possible. Delegate everything. Work on the business, not in it. That advice is correct in principle and dangerous in practice if you apply it too early or too completely.

I have watched pharmacy owners step away from the counter and, within a year, lose touch with their patients, their staff dynamics, and the operational realities of their business. They manage from spreadsheets. They make decisions based on reports instead of firsthand experience. Slowly, the quality degrades and they do not notice until the Google reviews start telling them.

I refuse to let that happen at Cloud Pharmacy. So I still work the counter. Here is why.

The Counter Is Where the Intelligence Lives

Every patient interaction at the pharmacy counter is a data point. Not the kind that shows up in a sales report — the kind that tells you what your business actually does for people and where it falls short.

When I am behind the counter, I hear what patients say about their experience. I see which processes cause friction. I notice when a technician handles something brilliantly and when a workflow breaks down. I observe which medications are being prescribed more frequently, which insurance plans are creating problems, and which patients are struggling with adherence.

This information is invaluable for strategic decisions. When I decided to specialize Cloud Pharmacy in HIV and PrEP care, that decision came directly from counter experience — seeing an underserved population, understanding their specific needs, and recognizing an opportunity that no report would have surfaced.

Founders who operate exclusively at the strategic level are making decisions with incomplete information. The best intelligence in any service business comes from the front line. If you are not on the front line at least some of the time, you are guessing.

Credibility With Your Team

There is a specific kind of respect that comes from a business owner who still does the work. Not the kind that comes from authority or title — the kind that comes from demonstrated competence and shared experience.

When I ask my pharmacy team to maintain a certain standard of patient care, that request carries weight because they see me holding myself to the same standard every week. I am not an absentee owner issuing directives from a distance. I am a colleague who works beside them, deals with the same difficult patients, navigates the same insurance headaches, and faces the same pressures.

This dynamic applies across all of my businesses. At Bird Sitting Toronto, Samantha and I are involved in operations, not just management. At Canadian Web Designs, I still review code and sit in on client calls. The principle is consistent: your team's respect is proportional to your proximity to the actual work.

I am not suggesting that business owners should do every job in the company. That is not scalable and not their role. But maintaining a regular presence in the operational work — even a few shifts a week, even a few hours — preserves a connection between leadership and execution that pure delegation destroys.

Keeping Your Skills Sharp

Pharmacy is a clinical profession. Skills atrophy if they are not practiced. Drug information evolves. New medications launch. Clinical guidelines change. If I stopped practicing for a year, I would come back to a counter that had moved on without me.

I invested years of my life earning a Doctor of Pharmacy from the University of Toronto. That training is not something I am willing to let rust because I got busy with business operations. The clinical skill is the foundation of everything Cloud Pharmacy does. If the founder of a specialist pharmacy is not clinically current, the specialization is hollow.

Beyond the practical consideration, I genuinely enjoy the clinical work. Counselling a patient on a new medication, catching a drug interaction that could have caused harm, helping someone navigate a complex insurance authorization — this is meaningful work. The administrative and strategic components of running businesses are important, but they do not provide the same direct human impact that a patient interaction does.

The Balance Point

I am not behind the counter five days a week. That would not be sustainable given my other responsibilities. The current balance is deliberate: I work regular shifts at Cloud Pharmacy that keep me connected to patients and operations, and I allocate the remaining time across my other businesses and strategic work.

The balance shifts depending on the season. When Cloud Care Clinics was launching, I reduced my pharmacy counter hours temporarily to focus on the buildout. When Canadian Web Designs had a major client onboarding, I shifted hours there. The counter time is consistent but not rigid.

The key insight is that "working on the business" and "working in the business" are not mutually exclusive categories. You can do both if you are disciplined about your time allocation. The danger is when founders treat operational work as beneath them or as a sign that they have not scaled enough. Sometimes the highest-value use of a CEO's time is filling a prescription, talking to a patient, or handling a customer complaint personally.

What I Would Lose If I Stopped

If I stopped working the counter entirely, I would lose three things: the firsthand intelligence that informs my decisions, the credibility that underpins my team leadership, and the clinical practice that is the foundation of my professional identity.

I built Cloud Pharmacy because I wanted to serve patients, not just run a business. The counter is where that service happens. Moving away from it entirely would mean optimizing for growth at the expense of the purpose that justified the growth in the first place.

There will come a day when the scale of my operations makes regular counter work impractical. When that day comes, I will adapt. But I will not rush toward it. The counter is not a constraint on my growth. It is the anchor that keeps the growth meaningful.

---

Related reading:

• Building a Niche Pharmacy: What I Learned Specializing in HIV Care — The niche that makes counter work meaningful
• Why Pharmacists Make Great Entrepreneurs — Clinical skills as business assets
• The 5 AM Operator: How I Run 4 Businesses Without Burning Out — How I structure time across all four businesses