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

Thinking your glass as half-full can kill you

National Public Radio had a story recently discussing research on how to live well and long. The story described Helen Reichert, a one-hundred-and-nine-year-old woman who lives at home, has all of her mental abilities, and likes chocolate truffles and Budweiser.

Her doctor, Mark Lachs, attributes her longevity, in part, to her "adaptive confidence".

Adaptive confidence describes one's ability to bounce back from life's stressful moments.

"You don't get to be 109 without life hurling a few curveballs at you, and Reichert has had more than her share: bereavement, gender discrimination, medical issues. And after each, she dusts herself off and moves on."

Adaptive confidence is positively associated with optimism. Optimists have been found to live more than 7 years longer than pessimists -- possibly due to their ability to recover from setbacks.

The lesson from this story is summarized by Dr. Levy who says, "So if you're a boomer and you don't think your outlook on aging has any impact on the rest of your life, you might want to brighten your attitude a bit."

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.

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.

This is why the image of PhRMA is so bad!!

Pharmaceutical companies spend significant time and money developing, "The first and only approved FDA treatment for inadequate and not enough lashes," and come up with new diseases like "hypotrichosis."

I predict that there will soon be a series of studies presented at medical meetings showing the burden of Hypotrichosis on society and the cost effectiveness of Latisse compared to fake eye lashes.

“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.