“Field of Dreams” is one of my favorite movies.  If you haven’t seen it, it is about the vision of the main character to build a baseball field in the middle of his corn field with the belief that players from the past, including Shoeless Joe Jackson, would return to play.  Many characters in the movie think the main character, Kevin Costner, is crazy but he builds the ball diamond and of course, the players return and spectators from all over come to his field, in the end saving his farm from bankruptcy.   

What is interesting when applying this to pharmacy practice, is that there are so many pharmacists out there who are unhappy with their profession and how they are practicing, many of them managers and even owners, but change seems insurmountable and frightening because this is just how we’ve always done things, and simply imagining doing things differently seems impossible, even crazy.

When I started my pharmacy practice 8 years ago (after 17 years of being a staff pharmacist) I had a somewhat foggy vision of what I wanted it to be.  I was mostly unhappy with the care I was providing to patients due to systemic and cultural factors in the pharmacies where I worked, and knew that things could be different.  Over the years since then I have developed a practice I am proud of, a fluid one, as we grow and adapt all the time, continually striving to improve, but where the goal is a practice my team and I are proud of. 

When I travel across the country discussing practice change and patient focused care I sometimes hear, “Well Carlene, easy for you, you have your own practice.”  Yes, I certainly do, and all the sleepless nights and uncertainty that came with that responsibility.  As a matter of fact, my first day open, eight years ago, I had a pharmacy owner from a neighbouring town stop in and tell me it was a “terrible time” to start a pharmacy because of the immense government cutbacks we were facing.  He had a point.  It WAS a terrible time, and not much has changed. Challenges just keep coming pharmacy’s way year after year. 

But what was the alternative?  I wasn’t going to retire in my 40’s, so it was either continue to practice in a professionally unsatisfying manner, or take a risk and work towards what I hoped would be a rewarding second half of my career.

Now I know many pharmacists are stuck with little power to change their situation, and obviously not every unhappy pharmacist can open their own pharmacy, but every pharmacy in the country is managed by a pharmacist, and these managers and/or owners shape the practice they are managing.

If we truly want change it starts with us, in the trenches, creating a culture centered on patients and demonstrating pharmacists as essential by optimizing drug therapy and solving drug related problems, thus improving patients’ quality of life.

It is truly sad that so many of our students enter practice with high hopes and in a few short years are disillusioned because they must conform to the culture in the pharmacy which they are employed, generally being at the end of an assembly line doing mostly technical work.

It takes vision and a strong team leader to shift practice and shape culture, but ultimately pharmacists and technicians who find their work meaningful are happier.  When staff are happy it filters down to how they interact with patients.  Patients are drawn to this type of care when they experience the value of engagement with their pharmacist.  I’ve seen it in my own practice and in others across the country when pharmacists put their energy into shaping practice this way. 

Change is possible.  There are amazing pharmacists out there who would love to be part of a forward thinking, patient centered practice, and so many patients falling through the cracks who truly need pharmacist care.  If you build it they will come, and the professional satisfaction from looking after patients in the way we were trained to will make all the difference, and perhaps it’ll “save the farm”.