I have an out-of-town guest who forgot to bring his medicines along.

He normally fills his prescriptions at a small, locally-owned pharmacy so was able to call up the pharmacist that he knows by name and she was able to get a week’s supply of his medicines transferred here with no problems. The conversation had the tone of asking a friend to do a favor.

Had he normally transacted with a major chain, that too would have been an easy process with a centrally-linked database able to pull records and process a refill without an issue.

The issue would have come in with a mid-size pharmacy — without the intimacy of a personal relationship or the technological capabilities of a national company. The organizations in the middle have neither advantage and find themselves competing — and lacking — on both ends of the spectrum.

It is tempting to play the middle ground since it doesn’t require the courage to leave one segment of the market behind. But long term you’re better off choosing one end of the scale and leveraging all the advantages that come with clarity.

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