Where’s the Passion?

My oldest son entered his first year of university this year and it has been amazing to witness his excitement and passion for learning and the drive to achieve his goals.  It has me looking back at my own university days, over 20 years ago, and the ensuing years that have past.  What did I expect from working so hard to be a “pharmacist” all those years ago and where am I now?

I remember what it was like sitting in a lecture hall, in classes I enjoyed (admittedly medicinal chemistry may perhaps be excluded here!)  While it was incredibly hard work, I loved it!  I loved learning the newest drug studies and guidelines for disease management. I also remember those early years of pharmacy practice, fresh out of school, being so excited to get into the real world and apply my skills caring for patients.  Even 25 years ago we were talking about “Pharmaceutical Care” and “expanded scope of practice”.

It didn’t take long however before discouragement set in and I felt stuck in a rut of checking endless prescriptions.  I spent over ten years of my professional career mostly just “doing my job”, and I will admit, slowly drifting into apathy.  I did my job accurately, but I was not passionate about it. I also did the minimum amount of CEUs every year, never remembering the learning or applying it to practice.  One year I even had the College respond to my continuing education submission with the comment that it seemed “ lacking in thought ”  and rather “hastily put together”,  and they were right!  I wasn’t engaged, I had no passion for the practice or for continued learning.

I often complained I didn’t have the time to look after patients properly, however, when I did have time I did not extend myself to proactively engage patients.  I eventually asked myself the tough question:  If I was given the perfect circumstances, all the time I needed, the ideal practice setting…would I be able to do the job I wanted to?  Could I take responsibility for patients medication management, solve drug therapy problems, engage patients proactively rather than waiting to be asked questions?  I wasn’t sure.  I was so rusty from the many years of the prescription checking tread mill that I was hesitant and frankly afraid to step out of the role of just technically checking prescriptions.

I share this rather embarrassing segment of my career as I feel many pharmacists are stuck in their practices.  When I read comments on blogs and have discussions with colleagues at conferences, I hear the resounding theme that pharmacists, even just a few years out of school, have lost their passion for pharmacy practice.  There are numerous outside factors that contribute to this including corporate decisions, government cutbacks, drastic cuts in drug pricing, third party pressures, etc.  But I think we as a profession also need to acknowledge our own contributions to this state of the profession.  Apathy abounded even in the “good” years, in the years where pharmacists were being offered starting bonuses, had shift overlap and high wages.  It’s been decades of pharmacists not stepping into their role, merely talking about how important we are rather than demonstrating it in our pharmacies.

So now we face a time of crisis where artificial intelligence and automation can take over pharmacists role, and the drive towards cheaper, faster and more convenient drug access will radically disrupt traditional community pharmacy.

I don’t claim to have all the answers, or really any at all.  I continue to write and speak and engage colleagues because I’m just not ready to give up.  I’m not ready to retire my white coat and send my patients to the “Amazons” of the world.  Despite it being rather vulnerable to put myself out there in discussing pharmacy practice on a national platform, the dialogue is essential.

Where am I now?  In the ensuing years since that wake-up call I radically changed my practice, and eventually hired on support staff and pharmacists who have the same vision and passion and are willing to practice in an environment I am proud to have created.  Have I encouraged my son to pursue pharmacy as a career?  I will admit that in his earlier years I did, but as he got older and Engineering more suited his interest I was relieved.  I don’t know where pharmacy is headed, it isn’t looking good, but giving up for me is not an option.  I still need to find passion in my work, a reason to get out of bed in the morning, and that reason is the patients in our care and the development of my incredible team that looks after them.

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5 Must Ask Questions About Your Prescription

When you are handed a prescription by your physician or your pharmacist there are many questions you should know the answer to before walking out the door. Below I highlight my top five.

CC Flickr Shared by Rob!

  1. What is this medication for?

This may seem obvious, but countless times when I ask a patient if they know what their prescription is for they tell me they have no idea.  When someone doesn’t know what a medication is for, there is little motivation to take it correctly or even at all.  Most drugs have more than one indicated use.  Know what yours are being used for.

2. What will happen if I don’t take this medication?

This may seem a strange question, but the reality is that over 50% of medication prescribed is either taken incorrectly or not at all.  (Health professionals are a little vain- we tend to think if we prescribe it, you will take it.) If you don’t take your high blood pressure medication, you have a higher chance of having a heart attack or damaging your kidneys.  If you don’t take an antibiotic for a nasty cold…well, really nothing is going to happen because antibiotics do not work for colds.  There are many prescriptions that are unnecessary or could be avoided with “watchful waiting” and there are some prescriptions that can be deadly if you do not take them exactly as prescribed.

3.  When can I expect this medication to work for me?

An important piece of information.  Will it treat my problem/condition in an hour or in 2 months?  Knowing what to expect is essential.  Someone being treated for clinical depression needs to know that the medication they are getting may not start to work for 2 to 6 weeks.  That’s a long time if you are expecting to feel better tomorrow.  Equally important is a person in acute pain to know that the pain medication should start working in an hour or so.  If not, it may need to be adjusted.  And if after 3 days of antibiotics your skin infection is spreading, don’t wait for the ten days of pills to be over.  You need to be reassessed right away. Know what to expect and always ask questions if you are unsure.

4.  What do I do if I have a problem with this medication?

Not all problems or side effects require another appointment.  Many issues can be solved by tweaking the dose, timing, formulation or way of taking the medication.  Sometimes a change of medication is necessary.  Find out what some of the common problems or side effects of your medication are and what you can do about them if they happen.

5.  Can I take this medication with all my other medications?

I find that most patients will ask me about this.  What is often missed though are the non-prescription medications, vitamins or herbal products they are taking.  Patients tend not to mention these as they are often viewed as “safe” and not harmful.  But in fact, there are many vitamins and “natural” products that can interact with prescription medications.  It is important to mention them all.

We all know it is impossible to remember everything your doctor or pharmacist tells you.  And that is where follow-up and communication comes in.  When I see a patient I advise them of any follow-up that is needed or how to reach me for questions. Typically by phone or email, but for more complicated learning I’ll see the patient in the office. Whether your nurse, pharmacist or physician provides you with your prescription, ensure you receive proper follow-up and educate yourself.  You are the person with the most vested interest in your own health.