In early 2017, I was leading a consulting team in Jakarta for a public sector healthcare conglomerate. The government of Indonesia had just launched a universal healthcare program called BPJS covering all of Indonesia’s population, effectively democratizing access to healthcare for lower income groups. Our client, among other healthcare industry stalwarts, was expecting a massive surge in revenue in the next three years (projected at ~2X of 2017 levels) and needed our help to build and execute a rapid growth program. One of the key pillars of this program was to enable their existing pharmacy footprint of hundreds of pharmacies across Indonesia to increase sales in their respective regions.

Given the large number of pharmacies and the limited size of my team, I decided to adopt a pilot approach. I chose two pharmacies in Jakarta and over a period of four weeks completely transformed them. I leveraged best practices I had observed at CVS, Walgreens, Shoppers Drug Mart and other global pharmacy leaders. All aspects of running a successful pharmacy were explored including signage and hygiene outside the pharmacy, planograms within the pharmacy, consultative selling, inventory review, even employee recognition and incentive programs. At the end of the 4-week run, revenue rose by ~60% for one pharmacy and ~80% for the other.

My team and I were celebrating when I received a call from the VP of Operations of the Pharmacy division. He sounded concerned. Our pilot had exposed the untapped potential of his network and he was now under pressure to cross-pollinate the improvements to all locations as quickly as possible. I met him the following day with a two-part plan. The first part was about inviting representatives from all pharmacies to Jakarta for a day-long best-practice sharing session. As part of the session we would share the success story of the pilot stores and end the day with a visit to the two stores where the representatives could see the improvements in real time. My expectation was that the representatives will go back to their pharmacies energized and start implementing improvements on their own. The second part was about dividing the network into clusters and giving my team the go-ahead to start improving just one pharmacy per cluster one after the other, bringing it to the same level as the pilot stores.

My second recommendation was shot down immediately. Visiting 25 clusters one by one would take a lot of time. We tried to squeeze the 4-week pilot timeline into a very tight 2-week program but even then, it meant a one-year long exercise, a timeline that the VP forcefully disagreed with.

My first recommendation met consensus and we agreed to action it immediately. On a fine Tuesday morning soon after, hundreds of pharmacists arrived in Jakarta from all over Indonesia. I personally delivered the daylong training in a large auditorium otherwise used as a wedding hall. It was almost impossible to gauge the engagement level of such a large audience. We provided them with printed materials and were surprised to find most of it left behind in the auditorium. The pharmacy visits fared better than the training. The transformed pilot stores were well received but given that each participant could barely spend five minutes inside the pharmacies there was limited engagement. Soon, it was evening and they started rushing out to airports and train stations to find their way back home.

We were stuck in this strange place where broad spectrum, one size fits all approaches were proving ineffective and there was no time to do the kind of deep dives where we had proven the concept through our pilots. In other words, we did not know how to scale with speed. The client was getting antsy, and the team was beginning to get nervous.

We followed up with ten pharmacists who were part of the trainee contingent and organized either in-person or over the phone training feedback sessions. We learnt that the trainees had an excellent grasp of the material. In fact, many of them played back to us not just the improvement concepts we had shared but also examples of how they had implemented them in their pharmacies in the past. We also learnt that despite a good grasp of the material none of them chose to replicate the successful initiatives from the pilot in their pharmacies. From these interviews, we inferred that beginning to make changes in their pharmacies was equated with an admission that their pharmacies were inferior to the pilot pharmacies, something they were too proud to admit. Moreover, the pharmacists felt it was unfair that the successes of the two pilot pharmacies (and their pharmacists) were showcased at a broad stage while their silent achievements of several years went unnoticed and uncelebrated.

Armed with these insights we set out to create a new sort of cross-pollination program. We resuscitated our 25-cluster classification and created a ‘Whatsapp Kaizen Group’ for each of the clusters. Within a cluster every pharmacy was asked to showcase a best practice or an improvement action once a month. Every day a different pharmacy got a chance to present some of the best ideas they had successfully executed. These ideas were either applauded or constructively critiqued within the cluster. Every afternoon my team collated all best practices from the cluster groups and sent them to an internal jury for review. Every night the best among the twenty-five was published and circulated as ‘Best Practice of the Day’ along with the names of the pharmacy and its pharmacist. This new program was tremendously successful. As we started collating revenue improvements, we noticed an average uptick of ~25% throughout the network with some pharmacies effectively doubling revenue within a month.

We bolstered the recognitions further by showcasing hard metrics like changes in revenue, profitability, and footfall. To our surprise, as the pharmacists became hungry for ideas, they started coming to us and requested soft copies of the training materials we had prepared for them a month ago. Some enterprising Jakarta area pharmacists sought me out at the HQ and got me to share ideas I had picked up during my work with big-name western pharmacy brands.

My team and I moved on after running the program for a year, but I kept in touch with the leadership team. Pharmacy revenues had grown to about 2.5X by late 2019. During Covid-19, the extensive well-run pharmacy network played a massive role in organizing Indonesia’s commendable response to the pandemic.