The news hit me like a ton of bricks: "All EasyCare pharmacies will be closing beginning Aug. 20. All active prescriptions will be transferred to convenient ..."

What? Just like that? Yep. A small group of 11 pharmacies in central Massachusetts — all connected to Reliant Medical Group — is closing its doors.

Sadly, this sort of thing happens all the time. But these pharmacies were close to home and staffed by folks I know and pharmacists I have worked with in the past. The challenge to maintain profitability in retail pharmacy suddenly became even more real.

I'm no stranger to the profitability problem of retail pharmacy. I have managed pharmacies for both large chains and small independents for most of my pharmacy career.

I know what it is like to develop a detailed business plan, carefully strategize every cent spent on marketing, calculate and control every cost. It's hard work. Those who think they can put up a pharmacy and start making money overnight better hope it's a long night, because profitability often takes a long time.

I don't know all the details about how Reliant Medical Group (or parent company Atrius Health) planned to grow their pharmacy business. They may have had great advisors and seasoned experts involved. But in today's market it takes extraordinary effort to keep your pharmacy P&L in the black.

The following five factors are just some of the most significant profitability problems that pharmacies face today:

1. Margins

Smaller margins mean that it will take more prescriptions this year to make the same amount of money you made last year. Some of this problem is self-inflicted as pharmacy chains began racing to the bottom with generic prices — even to the point of giving away certain medications for free.

Prescriptions have become loss leaders. But the expansion of PBM control and mail-order pharmacy has made it even harder for pharmacies to squeak out a profit.

2. Cash flow

Many independent pharmacy owners open their pharmacy doors without considering the impact of cash flow on their business.

Since most of their prescription business will be billed through insurance, they will be stuck waiting 30, 60 or even more than 90 days to get payment for their product and services. That means the same customer may come in and fill an expensive medication three or four times before the pharmacy ever gets paid for the first bottle.

3. Staffing

Pharmacies aren't staffed by volunteers. Pharmacists, pharmacy technicians, book keepers, front store managers and cashiers all will want a paycheck. And the cost of staffing involves all the employment expenses and benefits that go along with that.

This is why many owners often find they have to work all the hours themselves and are sometimes reluctant to hire enough help because of the significant expense involved.

4. Hours of operation

The push for pharmacies to be open longer hours and more days creates a profitability problem. Patients like the convenience of being able to pick up their prescription at 8:30 p.m. or Saturday afternoon or even Christmas day.

But longer hours means more staffing and often involves employees "working" when there is really little "work" to do. Owners are paying the perception of convenience to win patients and their prescription business.

5. Service and software fees

When you own or manage a pharmacy, you quickly become aware of the multitude of fees, licenses, service contractors, organizations and individuals who can put their hands in your pockets. Some of this can be controlled, but much of it cannot.

You need software to run your computers, and software requires support. You need insurance. You will have utility bills and compliance fees and membership dues. These all add up quickly and make getting your pharmacy's head above water more problematic than you might have thought.

It pains me whenever I hear that a pharmacy has to close its doors. It means patients, who have come to appreciate the relationship with their pharmacist, now have to look into starting over again with someone else. It means pharmacists, technicians and others have to start looking for work in a market that is less than favorable.

And it probably means that someone up top had to make a hard decision that he or she knew would impact the lives of many families.