Ade Stack is 20 years in the pharmacy business and has built a nationwide chain of 18 pharmacies with more than 200 staff. Despite her success, many people may not be familiar with her business, which Stack is absolutely comfortable with. Stack’s business model focuses on detaching from retail and investing more in the community. She does not believe in sales targets or sales links and still managed to record revenues of more than €25 million last year.

In this interview with Alison Cowzer, Stack spoke about:

• The importance of knowing the customer and not giving a hard sell
• How more than half her customers receive home delivers
• Why she had a support office as opposed to a head office
• Why you should not sell something you would not buy yourself
• The importance of growing your own staff
• The potential impact of Coronavirus on healthcare
• The importance of technology and data analytics
• Why pharmacies will be a different place in 20 years
• Why Feargal Quinn was an inspiration for her.

Alison Cowzer: (AC) You’re very welcome. My guest today is Ade Stack. Ade Stack is the woman behind Stack’s pharmacies, which has grown from one outlet to now 18 stores around the country. You may or may not be familiar with the with the brand, but you’re very welcome. Ade, welcome to the podcast.

When I say you may or may not be familiar with the brand, we see so much of the large groups now in the pharmacy area and you are essentially running this without that benefit of a massive group behind you. You started it very organically from one store. How does that work in the industry?

Ade Stack (AS): I suppose there are groups that will be really well known. And I suppose if you’re in a retail pharmacy, if you see yourself as a retail pharmacist, then brand recognition, knowing who your core customers are is really important. Our pharmacies have primarily grown out of a need in particular areas for a particular type of pharmacy. So, you won’t find us in a shopping centre. We don’t do really ‘main-street.’ We’re generally medical centre based, outer suburban. So, where we can get to know our customers who may become our patients and also we look after a lot of patients who are no longer solely looking after their own medicine.

So, if you’re in a hospital or a nursing home or refugee centre. Originally, we help set up the medical pharmacy services in the prisons in the early part of this decade. So, all of those areas where people need different types of supports, that’s where I found I’m particularly interested.

AC: So that’s the niche that you’ve identified as being anything that needs to be served?

AS: Yeah, in the modern world, we’re shocked when there isn’t a solution or there isn’t a therapy. But actually, probably the biggest issue in the western world is compliance. Taking the medicine correctly, taking it at the right time, making sure that our families take their medicine correctly. And I’m really interested in that area. Our group has grown out of a need for people who say I need help, particularly with my compliance. Like: “Do I need to take something four times a day? Is there a way it can be taken twice a day, that might be easier for my mum? Or is there a way it can be package or presented that will make it easier? Or is there a way that we can communicate with the pharmacy 24 hours a day that suits so that I can actually have better compliance?”

AC: You’re really extending that service level out of the simply filling a prescription and handing it over the counter model? It’s much deeper than that.

AS: More than half of our patients we would deliver to.

AC: Deliver to their individual houses?

AS: Houses, homes, hospitals, nursing homes, sheltered housing. Thankfully in Ireland we’ve moved from an institutional care model and we really should be bringing way more of our healthcare to community-based primary care. Much cheaper, much more effective, and most importantly, where most of us are happier in our community rather than in a hospital or residential facility.

There is a really big need for them. But it’s a minority who need that. And by having a service that allows people to stay as long as possible in their community, that not only makes economic sense, but as a community, that’s what we want. We want to stay together as long as possible.

AC: You don’t see yourself as being what many of the chains have morphed into? A combination of retail, beauty, lifestyle, all that goes with it. And in many cases, their product range is probably almost geared towards that.

AS: You’re right. We are 80 per cent OTC (over the counter) and prescription. We are very much evidence based. We stock items based on evidence. We stock items in one way we’re a bit like a Lidl, that we have a cost-effective brand. We would have the market leader and we’ve a premium when you want to pay premium. But premium is often a law of diminishing return. The difference between the best seller and the premium, maybe a very small percentage. So to give people the choice of; we have a value brand, like we do our own vitamins manufactured in Ireland, based on what we think are formulations that stand up to scrutiny. Best sellers because people still want Coca-Cola, and also premium.

And really beyond that, it’s difficult in any sector to justify, in my opinion, more than three choices. If you get to know what your patient or customer wants, you should be able to solve most issues without having extensive brands.

AC: And does that extend then to that model of maybe limited choice, but maybe maximum efficiency, moving into the pharmacy and what goes on behind the counter bit? Does that extend to your view on generics versus branded?

AS: We try and support Irish generics and we try and support companies who are doing most of their manufacturing in Europe. We think that there’s a safety decision to be made there. So, a lot of our raw materials for medicines can come from all over the world. But, you know, there is a benefit, for example, with Brexit going on over the last few years, we’ve really looked at saving for medicines where we only have one or two suppliers. Are we really better off to be sourcing them in Ireland? Because that means with Brexit, we’re not worried about what’s going to get stuck at the border. And that’s not scaremongering. That’s just decisions we all make to say can we streamline. You know, 24 out of the 25 top pharma companies in the world are based in Ireland. We are so lucky to be able to make those decisions. Not every country would be able to make those decisions so lightly, where we can and reduce cross-border travel for our medicines. I think that for us it’s a good decision to make. Price isn’t everything.

Using tech to help the customer

AC: You mentioned 24 of the largest 25 pharma companies are at some point manufacturing in Ireland or based in Ireland. And I think many people would believe that’s quite detached and divorced from the reality of the products that we actually consume in this country. But we are using those products on a retail environment through stores like yours.

As a country where we have so many tech companies based here, to still be in a paper system when Hungary, Lithuania has all left that behind because the safety is so important.

Ade Stack

AS: We make decisions even on our stocking, on medicines, on simple things like does it look like the well-known brand? So, most people wouldn’t buy a pink Coca-Cola even if it tasted exactly the same. Nobody would buy green baked beans even if they tasted exactly the same. Particularly when you look at who uses a high amount of our medicines, it’s generally the over 55s. So, actually having things that make life easier, we take that into account. We don’t like changing brands. We’re very reluctant to change brands unless we can justify more than financially why we would do it.

AC: And you mentioned the demographic of many of your customers being in that over 55s group. And yet you’ve taken a very tech led and tech enabled model for your business. How have are you married those two things together? Knowing that, clearly we’re not painting all over 55s as being tech illiterate, but is there an education job to be done there?

AS: A lot of our technology has been back-room. We have the largest amount of automated packing machines in Ireland in our company. A company nobody will probably have much awareness of.

And what we do is in our back room, we use our technology. So, when we’re communicating with our nursing homes, we use cloud-based communication. So, doctor, pharmacist and a nursing home management can all communicate. So, when one of us does an input, we can all see it. As a country where we have so many tech companies based here, to still be in a paper system when Hungary, Lithuania has all left that behind because the safety is so important.

The technology doesn’t mean you have to be a tech user to benefit from it. In fact, most good tech means that the end user doesn’t see really very much change at all in what their processes are. But back-room for me means that if somebody says that tablet was missing, I can pull up a photo of their medicine at that day at that time and see what left the pharmacy. All of those safety checks really allow us to spend more time with the people and less time on admin and double and triple checking. It’s all checked. But more and more by machine.

AC: That’s a very different model to the traditional pharmacist, with the measuring out the number of pills in behind the counter and in the white coat, what made many customers would be familiar with. That’s changed a lot in the last number of years. What do you see as the next big changes in pharmacy?

AS: We’ve introduced an app that is to allows people to go, while thinking on the couch, I must reorder my medicine, that they’re going to communicate in a really simple way with their pharmacy. We have 24 hour pharmacists on call for over 3000 of our patients because sometimes people need advice and they need to be able to have a question that when their own pharmacy team come in the next morning, there may be something that needs to be escalated.

I think that we can do 24 hour care, while not necessarily increasing hours by actually consolidating resources.

The impact that Feargal Quinn and his family have had on how I see what we do is huge. We have no link sales.

Ade Stack

AC: So, it’s not about having the shop open, paying the rent and having the lights on and having staff out on the ground?

AS: No, if you look at somewhere like Holland, they think our hours here are crazy because what they would have is, in an area covered by 13 or 14 pharmacies, one pharmacy that opens from 6:00 in the evening until 8:00 or 9:00 in the morning, does weekends and they all work there and they all do that rota like that makes perfect sense.

AC: We’ve all had that experience of getting a prescription late in the evening and Googling where’s the late-night pharmacy, where’s the place I have to gallop over to, to get it filled? Whereas your system really takes a much more holistic view.

AS: And we would like to see more collaboration in that because we think that’s what other European countries have done really well.

Expansion, growth and a contrarian approach to sales

AC: You’ve got 18 stores now and I know you’re still on the expansion trail. One of the things, I had a little look through your website, that I found really interesting was you don’t call your head office, your head office. You call it your support office. And that reminded me of something many years ago, Superquinn, an organisation under Feargal Quinn. He did the same. He didn’t have an HQ. He had a support office. And he believed that was there to support everybody in the organisation and not dictate. A very strong cultural message there.

We try not to sell medicine. It’s really weird. None of my staff have a sales target. I don’t believe in sales.

Ade Stack

AS: Oh yeah. The impact that Feargal Quinn and his family have had on how I see what we do is huge. We have no link sales. We have no loyalty. We’ve a lot of things that are seen as a most in retail, because actually I see it as having to have a relationship. That my team in Skerries, in Rathfarnham, want a relationship and you don’t count by points people who you have a relationship with.

AC: So, you have no loyalty scheme where you buy X and you get Y if you come in again four times later?

AS: No because we try not to sell medicine. It’s really weird. None of my staff have a sales target. I don’t believe in sales.

AC: And you’ve turned over €25 million last year. How does that happen? I think anybody listening would love the secret.

AS: The secret is don’t sell something that you wouldn’t buy yourself. So, if the person doesn’t need it or they actually only need twelve or they only need 24, why would I encourage them to have more? It doesn’t make sense because actually we’re not in a shopping centre where you go to it once a year or once a month to a big shop. We are down the road. I believe that I know when I’m being sold to and I don’t want people to sell drugs. We don’t sell drugs.

AC: The word trust is hugely important there?

AS: Yeah. And actually, it’s funny because we use a product, a data analytics product, which actually allows us anonymously as a community and retail pharmacy to share average transactions. And we’re nowhere near the bottom. So, isn’t that strange that actually the data says that by us not having sales targets, not link selling, allowing pharmacists to choose what medicine they want. We don’t even have preferred products because ultimately, why would a professional tell them what to do? It doesn’t make sense.

AC: There’s huge autonomy at store level?

AS: Autonomy at store level once the product is evidence based. So, if they wanted to sell in hocus pocus Skinny Tea, I’d kind of have a problem with it because, in my opinion, it doesn’t stand up to the science journals and peers.

AC: So, when a customer goes into your store then to purchase their medication or whatever, you’re guaranteeing them that whatever they buy is going to work?

AS: No, can’t guarantee. I wish I could. We’re all individuals. And even for most medicines, it’s based on the likelihood of it working for all people. What we do say is, come back into me, let me know how you’re getting on, because if it isn’t working, sometimes what people describe, even with the best professional questioning, in reality the situation can change. I wish I could guarantee. But what we do say is, let us know so that we can actually review and see based on what’s there now, what would we do. What would we now recommend?

When they looked at who was the most trusted for health promotion in the north of England. They found hairdressers were really trusted.

Ade Stack

AC: So, you may not have a loyalty scheme, but you must see loyal customers coming in?

AS: Yeah, because if people feel that they can ask somebody, like I have a certain KPIs. So, one of my KPIs is that there must be a granny in the pharmacy. We have coffee machines in our pharmacies, which is for most people quite unusual and people can have free coffee. It allows people to chat with their neighbour.

AC: When you say there must be a granny in the pharmacy, is that behind the counter?

AS: What I mean is there must be somebody who were part of their day. Does that make sense? So actually, that they’re there and we are part of their day. They may not be there to pick up medicine. They’re just there.

AC: So, you’re blending that community and business model completely?

AS: Yeah, I think the coffee machine was to try and explain to people that we wanted them to feel comfortable there, and not as a shop.

AC: You want them to linger?

AS: Not even linger? Because linger would mean buy and then you’d be on waiting time. It’s actually to say, if your dog is lost come to the pharmacy, does that make sense?

AC: So, you’re almost replacing the post office?

AS: Maybe we are. I don’t want to replace the post office.

AC: There’s a gap there maybe?

AS: There’s a gap for saying, like when they looked at who was the most trusted for health promotion in the north of England. They found hairdressers were really trusted. For head lice and things like that. People often didn’t trust their doctor or trust their pharmacies. You want somewhere that you can ask a question without repercussions, because really, that’s what it’s about. About being a safe place to talk about how you feel and how you are without that judgment.

Building talent, deveoping an ethos

AC: That requires an enormous amount of empathy and emotional intelligence on behalf of your team. How do you build that? How do you recognise it first and then retain it within the team?

AS: We grow our own. I’m 20 years in business and headhunting doesn’t work for us. If you have grown up with an incentive for the end of the month, you’ve got X amount of euro extra because of link sales, sales targets. If you come to us, you’re not going to be happy. So, we work really closely even with the Department of Social Enterprise and Social Protection. And I would say 20 years ago, we might not have Departments of Protection and Enterprise, but we’re finding them really enterprising now.

And looking at people who, let’s say we work with two centres, one in Donaghmede and one in the south-side of the city for people who want to come back into work, who are doing courses. And about people who really care. Because education and caring, there is no connection. You can have a PhD and really not care that much and you can be somebody who is an early school leaver and really care. So, what we’re looking for is people we can grow into who have the natural talent which they want to be able to express in their work every day. And we will train them. We use a lot of online training. We use 4front Pharmacy and we use a lot of training videos and online.

Some businesses, you do have to headhunt. For us, it has been about a support office and growing your own. I was training in Carlow last Thursday night on looking at risk with people who work on an OTC counter. Looking at the people we need to be more careful of ensuring they get the right care, not because we have had a situation, but because even coming into a situation now of higher demands with the coronavirus, that is going to be something where we need people to be watching for how they can help.

AC: You mentioned coronavirus, and it’s something that’s clearly top of mind for so many people at the moment. That bridge between the doctor and the patient is very much available at the pharmacy in terms of advice, medication and just general information.

It’s not the people who go to a St Patrick’s Day parade. It’s when they go to visit a granny two days later and they’re healthy with a little sniffle and suddenly we have caused this.

Ade Stack

AS: This is something that we look at and the way that this virus is spreading. We’re going to have to make decisions that aren’t just health care decisions. And we’re going to have to use our resources in ways that they probably aren’t designed for. So, you design most buildings in Ireland not for earthquakes because we don’t get them. But this is a bit of a healthcare earthquake.

Now, I’m not saying that in a scaremongering way. But most of our systems are not designed for a really sharp, large increase in the need for respiratory support or infection support. That’s not what we’re designed for. We practice for when there’s a really bad plane crash, we practice for blackouts. We practice for all those things. But this is something that comes around hopefully, historically anyway, it only comes around once in a generation, that’s a good thing. But it means we may need to, at the moment, look and say; the decisions we make in the next few weeks, is economy going to win? Is health care going to win? Are we, as a society, going to pull together?

AC: That’s three very different competing questions.

It is my personal opinion that we are no longer seen as retail, that it will be way more consulting rooms, way more delivery to home.

Ade Stack

AS: Totally different. And really, what society wants and what health care wants won’t always be the same. Like society may say we want a St Patrick’s Day parade. We, in health, cannot, in my opinion, have St Patrick’s Day parades. It’s actually obscene to think of it, where it could put many of our most vulnerable people at risk by having mass gatherings. It’s not the people who go to a St Patrick’s Day parade. It’s when they go to visit a granny two days later and they’re healthy with a little sniffle and suddenly we have caused this. So, these are decisions, some of them are economic, and it isn’t as simple as open or close schools. Because where are all my staff gone? Because 80 per cent of my staff if, you close the schools tomorrow, and particularly because we have a grow your own culture, we have a lot of single parents. This is not as simple as open or close schools

We have to start saying economy can’t be the only decision. Society will have to make compromises because this is not a normal situation.

Covid -19 and the future of healthcare

AC: The Covid-19 virus and what we’re going through at the moment is obviously an external shock. Looking at the sector, and the whole health system, as it develops over the next number of years, you’ve clearly thought a lot about both technology and how it can enhance the user experience. You’ve seriously looked at the whole empathetic delivery of that service. What do you see? If you had a crystal ball and see pharmacy and pharmacies in 20 years time, where do you see that going?

AS: I don’t think it will look anything like what it does now. I think there will be a decision made. It is my personal opinion that we are no longer seen as retail, that it will be way more consulting rooms, way more delivery to home. If you look at France. France pays pharmacists to consult at basically euro a minute. We get no consultation. We’re paid to dispense. And in reality, borderline people would say that there’s a financial incentive to sell. There is no financial incentive for my team to sell. That’s not what we do. That’s not who we are. And I’m very comfortable with our model. It’s contrarian. It’s not the market.

You can have your own business because you think you’re going to make more money that way. Or you can have your own business because you think the way it’s being done could be done better.

Ade Stack

AC: And it’s profitable.

AS: I guess. The kids still have food and are going on holidays. If the flights still go. I’m comfortable with it. I can go to bed at night saying we’re not a brand, we’re an ethos. And I have to be able to stand over the decisions we make. And my decision I made 20 years ago is we are not a retail pharmacy and I’m very comfortable with that.

AC: That was a very brave decision as a young woman starting up her own business. You’ve described it as a contrarian view. A young woman or man, anyone starting out in that position standing up and saying, I’m going to do something that’s actually quite different to what is the proven model that’s there at the moment. Where did you get that inspiration?

AS: You can have your own business because you think you’re going to make more money that way. Or you can have your own business because you think the way it’s being done could be done better. And I was the second. So, after the first year, our accountants who are still my accountants, said you need to stop doing this. You’re burning money. And we did burn money, but it was my money. So, I went from my little Barbie doll two-seater sports car to a Proton from Malaysia and burnt money.

But, suddenly, we found there was a small market for it. And that market has grown and grown. And I’m really comfortable with that. I didn’t want to have a business so that I could have a fast car. I was willing to sell my car. And I’m really comfortable that what we did. To see an opportunity for people who are in nursing homes who weren’t getting specialised care. Private hospitals, intellectual disability patients in sheltered housing. And that’s where I have a real interest, because if we can help their compliance and help the staff compliance, we keep them healthier. And I really enjoy that.

AC: And it’s still viable as a business.

I think in Ireland, our problem is that most businesspeople don’t share their skills with the wider community. They only use them.

Ade Stack

AS: It’s still viable. There may be people out there with larger profits. There may be people with larger turnovers. But I only have to be comfortable in my own skin. I repay the bank. We’ve never defaulted on loan. My staff, I hope, know that we’re trying always to pay them well and pay them justly. And for me, that’s what matters. I don’t want to be the biggest. I want to be the best.

AC: But you’re still expanding, even opening another outlet.

AS: Yeah, we’re opening in Limerick. We hope. But it has to be that it fits our model.

AC: So, if one of the other groups decided to copy your model. Do you think they could succeed?

AS: Everything is copiable. Sure, that’s how everything in life is.

AC: Given the ethos and the empathy?

AS: I don’t know. They may say, we like parts of that. But we’ve had 20 years, we’ve a very low staff turnover. And it’s not just about money. It’s about having flexible time in retail. So, you can drop your kids to school. You can take a two-hour lunch break if you want. That’s quite unusual in retail.

So, for people who still feel like being patient facing, customer facing, we try and say, what would I like? I like dropping my kids to school in the morning and that’s important to me because I never pick them up. So, I think if you treat people the way you’d like to be treated. Unless the other companies are doing that, and many of them, I’m sure are, it’s not that easy just to replicate a business model. It’s about a business community, because all of those are really the people who do the crazy ideas that are in my head.

AC: So, do you consider yourself an entrepreneur? Do you consider yourself a social entrepreneur or a business entrepreneur or is it a combination of both?

AS: I don’t think there’s a difference. I think in Ireland, our problem is that most businesspeople don’t share their skills with the wider community. They only use them. And this is going to be very judgmental thing for me to say, but I think that most businesspeople don’t have a charity. They’re happy to be on three boards. They’re happy to be involved in six businesses, but they don’t see that their talents are really needed in what as a community we really want.

I would challenge anybody who says they’re an entrepreneur to say, why do you only do it for money?

Ade Stack

AC: Is that a challenge?

AS: Yeah, I think it is a challenge. I’m a co-founder of a charity. But before I was before, my son got sick, I was on the board of two of the charities and one was an international charity. One was actually a faith-based charity. Then we got involved in our own because my talents are transferable. So, when we’re talking about corporate governance, when we’re talking about budgeting, when we’re talking about what’s the real need? Collaboration with other charities. That’s something that, in Hugh’s House, we’re really trying to work on.

AC: Maybe give us a little bit of the background of Hugh’s House?

AS: We had a little boy called you Hugh, who was born in 2012 and he lived for eight months. But in that eight months, he changed our lives so much for the better because we spend pretty much eight months in the Rotunda where he got great care. We got home for five weeks with thanks to Jack and Jill Foundation. And every night we hung our head in shame as we walked out of the hospital and saw people sleeping in cars. And even before Hugh died, we said this is not right. Because actually, even for the people who are lucky to live in Dublin, you must be blind if you can’t see them and have ever visited a Children’s Hospital with people in parked in cars.

So, we started looking for a house even before Hugh died. And we now have two houses that operate off Mountjoy Square with 14 rooms for a family, stay for free. And we have a terrible waiting list and we should not have a waiting list. We are a wealthy country. We decided to see that problem and say that Marty and I’s talents, which we have for business, were equally applicable to a social problem which has been there for a hundred years.

When St Ultans opened, which was the precursor to Temple Street, people used to drop their kids and come back three months later, and we now couldn’t imagine that. And now it is, we’ll come back in a week. And now we say we know our children, we know how important it is that they know they’re loved and cared for and that we’re there as part of their getting better. And if even if they don’t get better, even if they’re not fixable, like Hugh, that he was loved every day of his life.

So, I would challenge anybody who says they’re an entrepreneur to say, why do you only do it for money? Why is money the only thing that really drives you in your life? Why would you only put your talents for the coin? Why wouldn’t you go and say who in the charity sector? What problems actually annoy me and maybe keep me awake at night? And why can’t you be part of the solution? That would be my challenge.

AC: Well, I think you’ve lived and breathed that ethos both in the business and in your charity work. And that’s a really positive note to finish on. Ade Stack, thank you for joining me.

*****

The Currency podcast series on Irish business is supported by Investec.

Investec provides a range of solutions, including specialist FX, Treasury, Corporate Finance and Lending services. To find out more about how Investec can help your business, click here.

Investec Europe Limited trading as Investec Europe is regulated by the Central Bank of Ireland. Investec Private Finance Ireland Limited trading as Investec is regulated by the Central Bank of Ireland.