I don't know the future but...

There are a lot of blow hards who predict the future of pharmacy.

Since I was a student, educators and leaders have been saying that pharmacy needs to change. It needs to move from a drug-centric focus to a professional-service-centric focus. Well, we still focus on the drug product.

And we may be product-centric in the future. I don't know.

But I do know that change will occur. One of the reasons is illustrated in this website which totals up the cost of various elements of each taxpayer's tax bill.

Health care's portion of the tax bill is 24%. That is unsustainable.

We can't afford to continue doing things the way we always have. Taxpayers -- including you and me -- will not stand for it.

The only question is, "How will pharmacy change?"

The answer is......beats me.

Google's guide to better bosses

The New York Times had an article today describing Google's plan, code-named Project Oxygen, which sought rules for building better bosses.

If these rules are generalizable to other settings, like pharmacy (and I think they are), pharmacists can learn from them.

One finding is that professionals want a boss with technical skills. These technical skills help in advising the team and when pitching in to help as needed. Having and using technical skills helps the boss retain credibility with the team and show that she cares.

The other finding is that technical skills are much less important than people skills -- ranked eighth of the eight skills measured.

These findings are consistent with my experience which is that pharmacist managers can help relationships with staff by rolling up their sleeves and helping out from time-to-time.

However, helping out too often can take the pharmacist manager away from their other job -- managing people. And ultimately, managing people is much of what managers add to the team.

Pharmacist managers who can't juggle the competing technical and people skills will ultimately hurt the team.

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.

The Problem of Pay for Performance (P4P)

Linking the performance of health care professionals to their compensation is a good start but unlikely to work alone in changing behavior. Health care professionals will continue their current behavior because of some of the following reasons.

They don’t know what they are supposed to do to change.
They don’t know why they should change.
They don’t know how to change.
They think something else is more important.
There are no positive consequences for them to change.
There are no negative consequences for them not changing.
They are rewarded for not changing.
They are punished for changing.

If the health care system does not provide what professionals need to change, they will not change or they will change in undesirable ways. Compensation will not make a significant difference. Pay-for-performance schemes cannot replace the other changes necessary for improving the quality of health care -- they can only support them.

How to win friends and influence people

If there are any more people out there that read books, I highly recommend Dale Carnegie's "How to Win Friends and Influence People." It is easy to read and offers some basic insights that can improve the effectiveness of any health care professional.

What I still remember after reading it a couple of decades ago is that the way to to become likable and credible is to stop talking about yourself. Instead, listen to others. Ask them about their favorite subject -- themselves. That may not be the case in all people, especially in cultures that don't like to bring attention to themselves, but it is for most people.

You might say "Duh!", that is so common sense. And you would be right. But we often forget or get into the habit of making everything about us.

And in our tweeting; Facebook; me-me-me society, we often spend more time focusing on ourselves than on others.

Read the book. Dale Carnegie is still relevant to human interactions today.

Which is more important -- a good process or a good outcome?

In the long run, a good process will be more likely to result in better outcomes over time.
Let's say you want to hire a new employee.  You can get lucky once or twice with a poor selection and hiring process, but over time your luck will start to fail you.

The problem with good luck and bad processes is that it can be hard to tell them apart.  Thus, an incompetent person who does not know what he is doing can be labeled a genius because of some short term good luck.  And once labeled a genius, it can be hard to recognize or admit a person's incompetence until major damage has occurred.

Therefore, it is essential to employ good processes in order to achieve good outcomes.

How to manage Generation X

A blog in the Harvard Business Review Website Titled "Managing and Motivating Employees in Their Twenties" gives some excellent recommendations for managing people in their 20's.

Advice includes a number of basic recommendations like "ask frequent questions", "give them personal attention", and "wear authority lightly". My question is, "Why haven't the other generations demanded the same type of treatment? It seems to me that these are basic ways of motivating and managing anyone -- not just 20-somethings. Why have we learned to accept poorly communicated management expectations, abuse of power, and demotivating managerial practices? I say, "Right On, Generation Y!"

Why pay-for-performance in health care will probably not work

Daniel Pink describes my viewpoint about the science of motivation exactly!!

You will probably not believe him, but he presents what we already know about motivating ourselves and others. The evidence is clear. We just don't use it in the practice of pharmacy and health care.

Can motivational posters motivate?

The short answer is "yes". Despite the large number of "demotivational posters" available on the Internet which make fun of motivational posters (and rightfully so), motivational posters can help motivate in the following ways.

1. When an individual uses the poster to remind herself about aspirations and goals. A classmate of mine in college had a motivational poster above his desk titled "Justification for Higher Education". This poster showed an expensive beach front house with a five car garage filled with expensive autos. He is now a successful entrepreneur who I envision has a house similar to that on the poster.

2. When the motivational poster communicates a message that is accepted by team members. Motivational posters only work when they are consistent with the beliefs of those being motivated. They cannot change cynical or pessimistic viewpoints in the workplace.

3. When the motivational poster reinforces the message of a trusted leader. Without trust in the leader, the message of motivational posters will probably be resisted and mocked. However, if the team trusts the leader, the message communicated by motivational posters is more likely to be seen as credible.

The image of pharmacists need improvement?

Although pharmacists are one of the most trusted professionals, their image in the minds of the public is weak and poorly defined. Google the phrase "pharmacist are" and you will get the following output. I think that this indicates some work we need to do to project a more positive, stronger image.

Common Sense

Students often complain to me that managerial problem solving is just "common sense."

In truth, common sense is not really all that common in actual work situations, because common sense is typically based upon mental models that are not tested or examined. Common sense also tends to disappear in times of stress and emotion. Common sense also does not work well for complex problems.

In real life, we don't have time to use our common sense, so we just wing it and suffer the consequences.

Bad Management Kills!

People don't typically think about true costs of poor management in health care settings. But bad managers kill people!

They do it by making it difficult for physicians, nurses, and pharmacists to serve their patients. Bad managers waste the time of people they manage. They cause distractions, waste resources, and hurt productivity. They reduce the performance of health care professionals with unnecessary paperwork, meetings, interruptions, and aggravation.

Let's get rid of bad managers in health care and save lives.

How do pharmacists succeed in helping their patients?

In an earlier post, I asked the question, "Why don't pharmacists do more to help their patients?" It provided a list of many of the reasons why pharmacists are doing much less than they are capable of doing for their patients. I now suggest reasons how so many pharmacists succeed in helping their patients.

They have a clear personal mission to help their patients.
They take ownership of their practice setting.
They accept responsibility for their patients' health.
They keep up to date with the best methods for helping their patients.
They think nothing else is more important than helping patients.
They are more motivated by the work itself, rather than the rewards that are offered by their employer.
They have balance in their life which prevents personal problems from getting in the way of helping patients.

Why don't pharmacists do more to help their patients?

Pharmacists could be doing much more to help their patients to achieve optimal health outcomes. According to a book by Fournies titled "Why employees don't do: what they're supposed to do and what to do about it," many pharmacists don't do all they can to help patients because:

They don’t know what they are supposed to do help patients.
They don’t know why they should help patients.
They don’t know how to help patients.
They think something else is more important than helping patients.
There are no positive consequences for them helping patients.
There are no negative consequences for them not helping patients.
They are rewarded for not helping patients.
They are punished for helping patients.
They are not and will never be capable to help patients.
They have personal problems which prevent them from helping patients.

That brings up a related question, "Why do so many pharmacists do such a great job helping patients when they have so many excuses not to do so?"
What motivates them to overcome the barriers present in many practice settings?