Comments on Steve Jobs Commencement Speech

If you have't heard Steve Jobs commencement speech on youtube, I recommend you watch it.

The take-aways from my viewpoint are:

1. Don't go to college if you are not benefiting from it.

2. You are more motivated to learn if you have the choice -- and are not made to do so.

3. Sometimes your greatest failures lead to your greatest successes.

4. Doing what everyone else does will not lead to greatness.

5. Live each day as if it is your last. Because one day, it will.

What should every person know about money?

I still read magazines. I mean real magazines, made of paper, that you can buy at a news stand. One of my favorite magazines, Men's Journal, asks famous people (like Gene Hackman) questions about life such at "Have you ever cheated death?" or "What's the best cure for a heartache?". I like to answer the questions myself before I read the celebre-answer.

This month, they asked "What should every person know about money?". Here's what I think.

Money is a way of keeping score in life -- just not a very good one.

People with more money tend to be considered more successful in life than those without. Still...

"Money" is to "life" like "hits" are to "baseball".

In baseball, the team with the most hits tends to win more often. Not always, because it's possible to get a lot of hits and not score any runs.

And in life, it is possible to fail with a big pile of money, just like it is possible to succeed with little money.

The key is to find better ways of keeping score. Count the number of your friends. Total the number of times you help someone each day. Tabulate the smiles you cause.

Don't ignore money, but don't make it your only scorecard for success.

Crack dealer "Freeway Rick" is intrinsically motivated

This morning, I was listened to a Planet Money podcast interview of Freeway Rick Ross, a former big time drug dealer who talked about the economics of dealing illegal drugs.

Most of the podcast dealt with how making drugs illegal, also made them highly profitable, thereby leading to unintended consequences like violence and crime.

One striking admission by Freeway Rick was his joy in doing the job -- i.e., intrinsic motivation. Rick said, "I loved it...I felt like I was powerful...It was every man's dream to be free...I'd rather be doing that than anything else, almost."

Rick talked about how engaged he was in his job. He enjoyed cooking the drugs. He enjoyed the status it gave. He enjoyed being in control.

Of course, Rick's experiences and his view of the world are quite different from the average pharmacist, but we can learn from Rick.

To be intrinsically motivated, we need autonomy in our jobs. Autonomy encourages responsibility and meaning. We also need to maximize periods of "flow". Flow is a state where you are so engaged in your work that you lose track of time. Flow occurs when we challenge ourselves to achieve goals that stretch ourselves (but not so much that it leads to frustration). Finally, we need to seek mastery of what we do. Mastery encourages feeling so control and achievement. Rather than seeking to master the market for illegal drugs -- we need to master the medication use process for our patients. This journey toward mastery gives us a goal to work toward that can sustain us when our jobs dissatisfy us.

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 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.

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?