CBC.ca | The Age of Persuasion | Season 5: Marketing the Unpleasant

CBC.ca | The Age of Persuasion | Season 5: Marketing the Unpleasant

Pharmacy students are a tough audience.

I constantly search for interesting stories to interject into discussions about marketing pharmaceuticals.

This podcast describes the marketing of things that are not mentioned in polite company.

See for yourself.

It's better than reading!!

Should prescription drugs be insured?

Drugs are so expensive these days that it is getting that only the rich can afford them.

I recently spent over 200 dollars for a small tube of ointment at a pharmacy.  I asked the pharmacist for the generic, and she said, "That is the generic."

I used to think that insurance for prescription drugs was unnecessary.  Now I am starting to argue that it is.  The following presentation from slideshare gives my reasoning.

Should prescription drugs be insured

View more presentations from Virginia Commonwealth University

Why insure health care?

Many people who argue against Obamacare don't know what they are talking about.  The same is equally true for those that argue for it.

To inform those individuals and anyone else who may care, I have developed the following slides which ask the question, "Why insure health care?"

Why insure health care?

View more presentations from Virginia Commonwealth University

Common sense in pharmacy is rarer than you think

Pharmacy students often complain that many of the things I teach are "just common sense."

I typically respond by asking, "if managerial decision making is just common sense, why are good managerial choices so uncommon?"

Don't get me wrong -- there are many excellent managers and pharmacists who make solid decisions day-in-and-day out. However, almost all pharmacists have been on the receiving end of monumental blunders made by co-workers and bosses. In hindsight, many blunders could have been avoided by better decision making processes.

So, how do we improve our decision making?

The first step is do understand the various forms of decisions we face in pharmacy practice.

There are five types of decisions pharmacists face -- legal, clinical, economic, managerial, and ethical. Different inputs and processes go into each.

If we incorrectly identify a problem, we will use the wrong process to solve it. This can result in poor solution.

For instance, if we look at all ethical problems using a legalistic framework, we might make decisions that legally justifiable but morally indefensible.

Identifying knowledge which is "common" in common sense requires a detailed understanding of all five processes of decision making -- legal, clinical, economic, managerial, and ethical.

I suggest that most students and many pharmacists need more knowledge and training to successfully apply common sense to pharmacy problems.

Nurses are the only essential in health care

I know nurses. My mother was a nurse. My sister is a nurse. My brother is a nurse. My sister-in-law is a nurse. My niece is a nurse. My other niece is a nurse. And my beloved wife is a nurse.

Nurses can never be replaced by technology.  Machines may eventually replace many of the tasks done by doctors and pharmacists, but machines will never be able to "care" like nurses.   Nurses are the best!!

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Via:Master Degree Online.com

“Procrastination: A hardening of the oughteries.”

I hate hearing students say, "I don't do my assignments until the last minute because I work better under pressure." One reason this is a sore point with me is that I have to grade some of the crap they submit. Another reason I hate to hear it is because I know that procrastination will hurt them in the future.

Procrastination might be one of the most important things that influences the success of anyone including pharmacists. That's the message coming from Piers Steel, author of the Procrastination Equation. Steel says that people who procrastinate are more likely to be poor, put off necessary health care, have damaged relationships, and many other bad things.

I doubt that our students are any worse than earlier generations at procrastinating. The difference today is that there are too many distractions that permit procrastination -- the Internet, cell phones, and 24-hour media.

Success in pharmacy requires individuals to learn to control their tendency toward procrastination. One strategy I have used which made a big difference in my life was removing all games including solitaire and hearts from my computer.

Now I know have plenty of time to find other excuses to procrastinate.

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.

Robots were too late to replace me

One of the reasons I left hospital pharmacy practice was the mind-numbing tedium of much of my daily tasks. I kept thinking, "When are they going to develop robots to do this, so I can find better ways of helping the patient?".

Well it seems that finally have invented such robots.

Too late for me, though.

Can pharmacists be replaced by computers?

In the New York Times recently, the Nobel Prize winning Paul Krugman discussed the mistaken belief that higher education will ensure a good career.

He cited other economists who state that computers will be able to replace anyone who is doing, “cognitive and manual tasks that can be accomplished by following explicit rules.” Computers are much better at doing these things. These are exactly the kinds of tasks that many pharmacists have excelled in over the years and therefore likely to be replaced by computers.

Success in the pharmacy of the future is more likely for pharmacists who are good at jobs that can’t be carried out by following explicit rules — communications, pharmacoeconomics, personnel management, social marketing, and many other problem solving skills that students seem to resist.

If pharmacy students don't want to learn to work with ambiguity, there is another option suggested by Krugman. Most manual labor being done in the U.S. is hard to automate. Therefore, many jobs of the future will be truck driving, janitorial work, and other forms of physical labor.

Its the student's choice.

Attributes of a great pharmacist

A colleague of mine, Laura Morgan, asked students what attributes make a good pharmacist. She then put their responses in a word cloud. This is the result.

At first, I thought "these are great!"

Now, I've changed my mind. I now think the listed attributes indicate a certain level of passivity. I don't see advocate, leadership, innovative, or other proactive attributes. The attributes they list are nice but seem wussy to me.

Why lectures suck

People learn by:
1. listening
2. doing
3. reading
4. talking to other about what they know
5. watching others do something
6. making mistakes and correcting those mistakes

Lectures only utilize (1) listening which is usually tied with (3) reading. That is the way education used to be and still is in many places.

Project-based learning (also called case-based or problem- based) can employ all six of the above ways of learning for students. The problem is that it requires a teacher who is knowledgeable, flexible, creative, and committed to student learning. It also requires much more time from the professor. These things are not always available in pharmacy educational settings.

Watch this video. It clearly illustrates the value of project based learning. But to really understand, you need to apply the method on sayyyy.....a PROJECT!

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.

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.

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?"

Testing is the best way to learn

The New York Times discussed research about the best methods for retaining information learned by students. The study found that students who read some information, and then test their recall of that information, will retain information better (50% better) than simply studying or using a learning method called concept mapping.

Recall of material is essential for pharmacists. It is an educational building block to higher levels of problem solving. I have been increasing the use of little quizzes to test student knowledge prior to class discussion. I think I will do more testing in the future.

Using Marketing Principles in Teaching

Marketing can be useful in many ways. Take teaching for instance.  I segment my students into the following three market segments. 


The first is "dedicated learners".  They are easy to teach.  Just guide them to what they need to know.  They do well in almost any educational environment whether it is lecture, online teaching, or group instruction.  Just give them good content and provide them with opportunities to apply the concepts in problems, discussions, and exercises.  Typically, they already know a lot because by nature, they are learners.  Sometimes, I have to even tell them to back off a bit.  


The next segment is  "skeptical learners."  These people want to learn, but they need to be convinced.  They have been asked to learn a lot hogwash over the years and are choosier in how they spend their time.  They are often older, mature students who have stronger opinions of what is important and not.   Skeptical learners require the instructor to build a persuasive argument for the value of the material and the need to learn.  Once that is done, they are often even better learners than dedicated learners because they fit the ideas into their daily lives.  


The last, and most difficult segment is "unmotivated learners."  For them, learning is not important, so coercive educational strategies are needed.  Rewards and punishments, such as assigning attendance grades, are needed.   Even then, they often do the minimum amount possible unless you can spark their interest enough to turn them into skeptical learners.  


My target market is the skeptical learners.  Good teaching can influence their learning.  My secondary market is the motivated learners who will succeed if I do a good enough job with the skeptical learners.  Unmotivated learners are NOT my target students.  Of course, I will encourage them to engage, to learn.  But time is better spent on the other two student groups.