Coming Around, Slowly and Surely

In October 2014, I wrote Logic Applied……nothing new under the sun. in response to Jim Plagakis in Drug Topics. I needed to write the piece as  the once money-making enterprise, being a pharmacist, finally become an issue for reflection – at what price is the salary providing satisfaction in professional and personal spheres of life? As long as the money was good, it seems pharmacists were willing to overlook so much regarding their profession. This does not mean pharmacists do not work hard as I know otherwise. The good pharmacists work long, hard and diligent hours on behalf of their patients.

What the reflection does mean is pharmacists are finally realizing they have  the reasons and power to change their profession in general and healthcare specifically.  Their job is no longer one in which the pharmacist works for one employer for life. People such as Oluwole Williams realized it was not about the legacy, rather it was about thinking what one could do with their experience and knowledge within a specific field. Mr. Williams addressed a number of wonderful and promising ideas in the Dispensed as Written column of which I only could have added Peace Corps Volunteer. And then Kelly Howard wrote 2015: The #YearOfTheRPh, where she explained a very personal situation which changed her for the better.

There is the thinnest glimmer of hope in thinking the pharmacy profession will reach into the 21st Century. More and more pharmacists are seeing the bigger picture and looking at what they can do to create change rather than talking about what should be done. It is inspiring as pharmacy is a field which can change people’s lives. Instead of licking, sticking and filling, pharmacists can provide patients a degree of education and efficacy in the medicinal choices they make. It has been a long time coming and I am thrilled.

Instead of hospitals, insurance companies  and health care institutions defining good patient care, pharmacists now can look at how to use their fulcrum.  Amazingly this benefits ‘patients’ and  students – those who study the sciences. There will be new opportunities and careers allowing people to use knowledge and skills in different ways.

As a pharmacy tech, I am looking forward to being able to work with people who will take an interest in their patients as people and DOP’s who have an interest in more than cost metrics. Clearly Ms. Howard indicated it is time for those in the pharmacy and medical fields to stop being doormats. This is all it takes – one or two people to decide the profession has to change.

As a teacher, I am inspired to see people taking on the corporate mentality. Sharing with others the varied and rich options available through what used to be seen as a stagnated degree is exactly what education needs to see. Teachers, similar to pharmacists, have been licking, sticking,counting and ‘filling’ (in the case of teachers, student brains) far too long.  If the long-standing tradition of pharmacy can change, surely education can progress as well.

Logic Applied……nothing new under the sun.

I have thumbed through Drug Topics magazine forever. My father was a pharmacist; He read the magazine and left it lying around. It was something we discussed as he thought, when I was in high school, I might wish to try out the profession. My father suggested I join the Air Force (he had been drafted Army). All those years ago I just did not feel compelled to study so much chemistry, although in retrospect I wish I had. Biochemistry/biotechnology is the ‘new-new’ thing of my lifetime.

Despite my father trying to convince me of serving my country and obtaining a stellar education via the Air Force, I took a different path. I kept with the science and medicine type themes, earning a BA in Speech Pathology (after leaving nursing right at the beginning of clinicals). I so wanted and needed to see positive outcomes, I left speech pathology for education. My head and heart told me I could apply what I learned as an undergrad and help many students do well. Neuro, learning, behavioral outcomes and more were what motivated me. Watching people slowly be overtaken by declining health, descending into  the depths of hell with the many types of brain damage nature provides (organic and via car accidents, etc.), I had to leave speech pathology.  I went on to be a Peace Corps Volunteer.

My father pursued an advanced  degree in public administration as he foresaw the Kaiser Permanente model to be the future. My father had worked for Kaiser way, way back. He re-invented himself and did things he loved, including working as a consulting pharmacist. He did chart reviews, he   spoke with community members and educated them on everything from how to read up on the medicines they were taking to understanding the difference between a cure and something which treats a symptom (antibiotics vs. other stuff). My father worked with the Red Cross. He wanted to be part of the re-trenching of pharmacy tech programs (more on this in following paragraphs) so he taught pharmacy tech with the INTENTION of getting students into pharmacy school – which he did accomplish with quite a few students.

Education was a great fit for me. I taught for many years – formally, informally, public, charter/public, private, corporate. Each day I always found one ah-ha and it sustained me. I left the classroom/corporate (formal setting) about eight years ago for tutoring and consulting work in ed-tech. The first four to five years were difficult. I was not willing to compete with the shills who promised all parents they could ‘brain train’, teach their child to read, etc. as it was not true. It took awhile to define myself (I was NOT a snake oil salesperson) and clarify there are times when some students do indeed have deficiencies which can not be overcome with what we know currently. I had to admit failure where failure was due, own it and move forward.   From this time period, I  learned how to write tight, effective IEP’s and 504’s. I learned how to have conversations with parents, teachers and admin which actually matter instead of being vague, noncommittal and wishy-washy. I have many accomplishments of which I am thrilled as I have, and continue to, change lives for students and families.

Simultaneously the Silicon Valley folks taught me something completely different – failure was absolutely necessary. Essentially Silicon Valley reiterated what I knew about scientific method. Failure was indeed the answer. Only through failing could you see what you needed to do differently and better.  In Silicon Valley, you are not worth much if you do not take a calculated risk and fail. Confirmation bias is quickly obliterated if you learn to work in and with people from Silicon Valley. I have, by complete accident, had the pleasure to work with some of the brightest talent in Silicon Valley who do and make things which matter. I take calculated risks regularly.

Along the way I obtained my Pharmacy Technician’s License. I did this as I love traveling and living abroad. It gave me hope to know between being a pharmacy tech and tutoring, I could travel, come back to the states, land on both feet and function. Not so. A pharmacy tech license is the equivalent of Gr 9-10 Algebra and chemistry/bio. Everyone told me to cold cock the test (including my father who stated I could do it with one eye covered and a hand behind my back). I was afraid. I took a course. Holy moly. I began to understand some major problems, the least of which is who takes responsibility for what.

Pharmacists created the pharmacy tech program and  never intended for it to be a pathway to pharmacy, dental, med or nursing school. It was meant to alleviate pharmacists of the non-thinking portion of their job. With this in mind, a pharmacy tech is little more sophisticated than working any other repetitive job as the pharmacist still carries the responsibility for the ‘final product’. I know as much about sanitation as I would working in a restaurant and learned more as a science teacher. Since the threshold to train pharmacy techs was so low and the pay little over minimum wage, it did not encourage the right kind of people to come into the program. More often than not, pharmacy techs are underutilized since the program (aside from how the military trains pharmacy techs) is deficient on so many levels.

It could be said the pharmacy tech program in the U.S. is an abysmal failure of everything from logic to creativity to improving healthcare. It failed at launch and has slid downhill ever since.  It was created by pharmacists and  should be re-configured into something valuable, useful and appropriate.

All of this led me to wonder about the article by Jim Plagakis in Drug Topics from September 2014. He addresses the issue of legacy pharmacists, those who are highly paid with no more room to go upward without a career change or pursuing something different. If pharmacists are worried about losing their prestigious place in the dog pile, they should be doing something more akin to what Dr. Atul Gawande does outside the surgical suite. Even though Dr. Gawande has stated over and over he is near or at the top of his game, he finds something new to pursue with excellence on behalf of patients.

Pharmacists have reached the point in time where they need to drop the stance of having ‘earned their keep’ (the equivalent of tenure for teachers) and actually do something above and beyond. Find out what is happening in Silicon Valley regarding ACA (don’t be afraid – there is this amazing place with a med school called Stanford and another place called UCSF with a pharmacy school in the area). Along the way, it would be great if pharmacists thought about improving the pharmacy tech program so they could actually train responsible people looking to pursue a medical career. Create a step-ladder for people to go to pharmacy, medical, nursing and dental school. I would imagine a pre-med student who  worked as a compounding pharmacy tech and was intellectually engaged by the pharmacists would be a shoe in for an outstanding medical program and/or biotech.  According to everything I hear on NPR, we are desperately short of doctors.

Comparing  ‘legacy’ pharmacists to tenured teachers  not only weakens the argument, it begins a strange comparison which benefits neither teachers nor pharmacists. Using the word legacy does nothing to change the connotation. Very few professions in todays 21st Century stay constant. Stagnation or inertia is when some one chooses not to move.

The legacy my father left was very genuine and real. Education was seen not as a mere accomplishment, rather a continuous expectation. One did not stop learning by being ‘done with school’.  He earned the Governor’s Award for Volunteering in IA while he was cycling through various cancer treatments . He volunteered regularly on an exhibit (Iowa Roots, Global Impact: The Life and Legacy of George Washington Carver) which he felt could re-invigorate scientific thinking. Most of all he helped me embrace change as real, necessary and of the utmost importance for succeeding in life.