Why curricular design is not pretty

Curricular design and sausage making are very similar.

Lay out your main ingredients

A bushel of faculty members with different agendas
A fond memory of the good old days of pharmacy education

Add spices and other ingredients

Put people in charge who do not have sufficient training and/or authority to manage the different faculty agendas.
Give inadequate guidance.
Use anecdotal evidence to decide what works and what does not work.

Grind all of the ingredients into a casing and call it a curriculum.

Marketing doesn't hurt people -- people hurt people

I love to read the comics each day in my local newspaper -- yes, that thing that used to be "black and white and read all over" but is mostly just "black and white" now.

One common stereotype seen in comics is that marketers are useless, lazy, carbuncular, and so on. The reason this stereotype is so funny is that it is often true.

Nevertheless, just like with handguns and pitbulls, marketing is only bad because people who use marketing are lazy, stupid, careless, unethical, and sometimes even criminal.

In other words, "marketing doesn't hurt people -- people hurt people".

Marketing is just a tool. And as we know, a tool can be used for good or evil.

People who learn the proper philosophy and practice of marketing can do good and change the stereotype of marketers.

But I won't hold my breath.

Four stages of competence

Young people think they know everything.

Of course, that is a wild exaggeration, but many younger people are more confident about life than they should be. That is because many are unaware about how much they do not know. That knowledge tends to come with age and maturity.

In psychology, Abraham Maslow (Yes, the hierarchy of needs guy) stated that we go through 4 stages of competence.

The first is Unconscious Incompetence where we don't know what we don't know. In this stage we are highly confident in our ignorance.

The next stage is Conscious Incompetence where we realize our ignorance, but don't know how to address it. We have not yet learned.

The third stage is Conscious Competence where individuals understand and know how to do things -- but only with conscious effort.

The last stage is Unconscious Competence. At this stage, competence is so ingrained that it is "second nature" and internalized.

When students in the Unconscious Incompetence stage are taught by professors in the Unconscious Competence stage, it can sometimes be a case where a person who thinks they know it all is being taught by someone who has so internalized his knowledge that he can't teach it every well.

This is not the case in all educational situations but it is more common than desirable.

You don't negotiate? It'll cost you!

National Public Radio recently broadcast a piece about a subject near and dear to my heart -- negotiation. The piece was titled "Ask For A Raise? Most Women Hesitate" and it can be found at www.NPR.org.

My interest in negotiation was peaked after reading the book, "You Can Negotiate Anything" by Herb Cohen.

When I talk about negotiation with my students, I tell them that if they apply the basic principles of negotiation, they will be $100,000 richer by the time they retire. I now realize that I may have underestimated the benefits of negotiation.

According to economist Linda Babcock of Carnegie Mellon University, "by not negotiating their job at the beginning of their career, they're (women in particular) leaving anywhere between $1 million and $1.5 million on the table in lost earnings over their lifetime,"

And women are FOUR TIMES LESS LIKELY TO NEGOTIATE than men. Why don't women negotiate? The reasons are complicated but according to Babcock, "women often just don't think of asking for more pay. If they do, they find the very notion of haggling intimidating, even scary."

Now this is a complicated topic and can't be covered in a single blog post. I will periodically talk about negotiation in upcoming blog posts. Stay tuned.

How pharmacists can become indispensable

The key to survival in pharmacy practice is to never be comfortable with the status quo. If you are a pharmacist, you should try to work toward being indispensible to your employer by doing the following:

1. Be the one the patient asks for when they visit the pharmacy. If you develop a strong patient clientele, employers will see you as an asset more than an expense.

2. Generate business. If you aren't generating revenue, you are generating costs.

3. Don't be a jerk. You have to generate a lot of revenue to overcome the negative impact on your career of being a jerk. Even high earners are dispensible if they are big enough jerks.

The Colbert Report -- Giving a shout out to CVS

Tasing a CVS customer in the parking lot.

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Pharmacy and Beer -- Never Fear

In a previous post titled "Beer and Pharmacy -- Two of my favorite things" I talked about how a Duane Read Pharmacy in New York is now serving BEER. The beer is a microbrew that sounds pretty tasty.

Not to be one-upped by any New York pharmacy chain, Walgreens has introduced their own beer brand called "Big Flats". As made clear in my previous post, I am not against pharmacies selling beer. I am just against pharmacies selling bad beer.

I have some expertise on this topic because Walgreens pharmacies in Chicago used to be my beer supplier back in the 80's. I clearly remembered that their beer tended to get skunky -- meaning that it got stale setting on the shelf for way too long.

I think that selling bad beer can hurt the Walgreens brand. I am not accusing "Big Flats" beer of being bad because I have never tasted it. I do know someone who HAS tasted "Big Flats" beer (see the clip), and he does not think too highly of it.

Word Clouds

I love word clouds. I think they elegantly depict the meaning of complex texts. Attached is a word cloud of my article, Managing oneself: an essential skill for managing others. J Am Pharm Assoc. 2009 May-Jun;49(3):436-443. The word cloud provides some idea of what concepts are important for successfully managing yourself.

What is your personal mission?

On one of the first days in my management class, I ask our pharmacy students at Virginia Commonwealth University is to complete a personal mission statement. A personal mission statement is the foundation for good leadership/management -- you need to establish what you stand for if you want to establish a vision for others.

I have included my mission statement in this post so you will know where I stand.

Placebo effect

Daniel Ariely is a behavioral economist who provides interesting insights into consumer behavior. In this presentation, he describes how placebos provide a real therapeutic benefit.

Really -- Pharmacists are going to need to change

As pharmacy students, many years ago, we were told that pharmacy practice needed to move from a profession that focuses on drugs to a patient centered profession. Since then, pharmacy practice in community settings has continued to focus on selling drugs. And pharmacists and their employers have been highly paid for doing so.

Now it is different.

Really.

Here is why.

Economics.

We can't afford to pay pharmacists to do what they are doing. Over the years, pharmacists made a good living by counting and pouring. Now, the profit margins are shrinking for the dispensing of drugs. And the way to increase profits is to either make up the revenues elsewhere in the pharmacy (on greeting cards and motor oil) or reduce dispensing costs. To reduce dispensing costs, pharmacies need to use more technology such as ATM-style dispensing machines, hire more low paid pharmacy technicians and give them greater responsibilities, prepare drugs for dispensing in assembly line type centralized medication filling centers, and/or find some other way to remove the pharmacist from drug preparation.

So, it is clear to me that pharmacists need to change the way they help patients.

The $64,000 question is "change to what?"

You may not realize it, but it is probably a threat

Pharmacists who supervise others often use threats to influence behavior. They may not mean to threaten, but to the people they supervise -- it is a threat.

Threats occur whenever a pharmacist manager emphasizes rewards or punishments in motivating behaviors. Rewards and punishments are opposite sides of the same coin -- I will punish you, I will reward you, I will punish you by withholding a reward, or I will reward you by not punishing you.

Threats can be strongly worded, “Do this or you will be fired,” or oblique, “If you don’t meet the deadline, I don’t know what we’ll do.” Any threat causes employees to protect themselves.

Pharmacists often carelessly make explicit and implicit threats on employees without realizing the consequences on employee productivity. When employees feel threatened, they may protect
themselves in multiple ways – join unions, avoid the boss, withhold information, organize resistance amongst coworkers, or find a new job.

The take-home point is ---- use threats sparingly and know the potential unintended consequences when doing so.