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The Importance of Messaging and Public Image

Big news recently hit the email inbox. Pharmacists are now able to administer medications, including vaccinations.

I’ll let you read that again to let it sink in…

This puts us on brand-new footing because we are now able to lawfully prescribe, dispense AND administer medication. The possibilities stemming from this announcement have not even begun to be explored, however, we should back up for a second.

HOW do we convey these changes to the public? HOW do we create demand and value for our time? HOW can we leverage this in our dealings with other health professionals?

The actual performing of these new tasks is fairly academic; we receive the proper training or direction, do some repetition to iron out the kinks, and gain confidence with our own clinical styles. It’s the buy-in from other stake-holders that often drive the promotion and uptake of these services. The mere availability of a service means nothing if the consumer doesn’t know to ask for it. If we don’t have support in our practice areas from other sectors of the healthcare system, ultimately patient care may suffer.

As a couple of examples, I point to minor ailments and flu shots. Both are necessary and in many ways overdue. In the case of the former, it will significantly cut down on waiting room visits and allow for more resources to be allocated to major ailments. In the latter, the hope is that more people will have access to the vaccination causing infection rates to drop among the collective. The issue I personally have is in the messaging or ‘talking points’. I’ll try a multiple choice quiz:

1) A patient is exposed to the media promotion for minor ailments, either through the provincial announcements, print or tv advertisements. He/she seeks out a pharmacist with what expectation?

      a) a review of their medication profile (for free) to see what options they have.

      b) a refill on an expired or finished prescription (with applicable copay).

      c) a prescription of their choosing because they self-diagnosed through one of the internets and know exactly what they need (with applicable copay)

      d) an assessment of their condition and recommendation (assessment fee regardless of referral, OTC, or Rx therapy)

2) A patient hears that pharmacists will be able to give flu shots in the fall through a media release. Which scenario best describes the reaction?

      a) Great news, now I don’t have to wait at a doctor’s office. 

      b) How much will it cost me compared to a doctor’s office or flu clinic?

      c) No thank you, I don’t believe in vaccinations. I’ve heard they cause autism.

      d) Wow, now my pharmacist can screen appropriateness of my medication and give it to me in one visit! If I have questions, the drug expert is able to answer them immediately while I get the shot!

Sadly, I reckon the d) answers are few and far between at this moment but hopefully the tide will turn. The point is, the opportunity is so much broader than simply minor ailments and flu shots. We are now able to assess and take responsibility for patients’ health. Any further services that fall under our scope, be it therapeutic substitution, adaptations, emergency fills, performing lab requisitions, etc, all require ASSESSMENTS as a foundation. Similarly, the ‘flu shot‘ is only one small benefit of the fact that we are now able to ADMINISTER medications. This could grow to include all injectable meds (travel vaccines, biologics) or even oral meds down the road (in institutional settings).

If we are able to promote our expanded scope properly, with long-term potential mixed in with short-term wins, we have a shot to be among the most accessible AND versatile health professionals out there. As a consumer, I want to believe that our value to the healthcare system is more than ever before.

Are we sending the right message?

Disclaimer: The views and opinions expressed in this article are those of the author(s) and do not necessarily reflect the official policy or position of any agency, employer or affiliation.
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Time

      Time has come up a lot in recent months. Will we have time to administer injections? Do medication reviews? Assess for minor ailments? Will we have time to do all of these things and still have good relationships with our patients? All of these questions are legitimate and require careful thought to ensure solutions are realized and sustainable  for everyone.
      In thinking about these questions, I have been pondering the concept of time. Specifically our time as practitioners. For example, in the run of a day at many community pharmacies, there is not a lot of spare time. We could be at work for eight hours or more and are often running  from the time our shift starts. We run from one end of the counter to the other, answering the phone, ringing people in, counselling, recommending OTC’s. Unfortunately, it’s often difficult to have an extra minute to eat, let alone administer a flu shot.
      When I do have that extra minute, I try to spend it with my patients. I take an extra minute to talk to a mother about her son’s ADHD.  Perhaps the diagnosis was thrown at her and she doesn’t understand what is happening to her child. All it may take is three extra minutes and she leaves with more knowledge and comfort than when she arrived. Maybe you choose to spend it with a patient who has depression and has finally gotten up the energy and nerve to ask for help. Or perhaps with the elderly lady who can’t understand why her doctor has her on a stomach pill when she hasn’t had gastrointestinal problems for years.
      All of these little minutes add up. It may not seem like much, but I truly believe they cultivate our relationships with patients. Now we are faced with a changing scope of practice. When this expanded scope first came on my radar, I was scared. I was nervous that my relationships with my patients would suffer. Now I realize that I could choose to be scared and not do anything, which does no one any good,  or I can take the little minutes I have with patients and form them into an appointment to administer a flu shot, do a medication review or an assessment. I believe it will strengthen our bonds with our patients. Just because I’m giving a flu shot doesn’t mean I can’t ask the mother about her son’s ADHD, or the man about his depression, or the lady about her stomach. We can ask these questions, and we will, because they are still our patients and it is still their time. We’re just squeezing a few more services into it. Let’s face it- in the end, it’s just multi-tasking. And pharmacists are champion multi-taskers.
      We can do this.
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A Whim

I went into the profession of pharmacy on a whim. I always thought I wanted to be a paediatrician. I loved kids and loved helping people. I thought those two things melded perfectly into being a doctor for children. I envisioned having a super cute office filled with stuffed animals and clouds painted on the ceiling. It was going to be perfect…

Fast-forward to my first year of undergraduate sciences and Dalhousie University. I hated everything about that year. I hated going to classes with hundreds of other students. I hated that the professors had no idea who I was or what I could become. And I hated the exams. Very high pressure, very low expectation. Generally awful.

It was during that year that I met my best friend. I knew her from high school but we weren’t very close at that tenuous time in our lives. She was the only person I recognized in my first year chemistry class and we gravitated towards each other so we wouldn’t have to sit alone in a giant classroom of freshmen. We became fast friends and during the first few months of term she revealed to me that she was applying to pharmacy school, as many in her family had done before her. She said I should look into the program. I did just that and found it to be exactly what I wanted. It meant I could be in the health professions, have a well paying job and a large amount of knowledge. It also meant I didn’t have to go to school for 12 more years or mop up blood. Both of those items were extremely appealing.

And so, my friend and I worked vigilantly to get into pharmacy school that year. We got in after our first try. The two of us (along with another good friend who had been trying to get in and was successful) celebrated that June when we found out we were in the same class.

As I went through my pharmacy degree, I was so thankful. I LOVED the programme. I couldn’t wait to start new courses. I thrived on the stress of studying and learning and absorbing. And when I wrote my licensing exams, I felt Dalhousie had prepared me as best any college could.

I started working as a staff pharmacist in 2009 and to this day still love this profession. On a daily basis I help customers. I help them find toilet paper and hair brushes. But I also help them with getting their milk to let down after they’ve given birth to a beautiful baby boy and are terrified he’s not getting enough to eat. I help them with their addictions and blood pressure. I help them with their blood glucose meters and their hearing aids. I help them when they feel no one is listening. I hug them when they lose a loved one. I help them with their health, both physical and mental. That is what I signed up for when I became a pharmacist. And I love every second of it. Even if it started as a whim.

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The Quest for Job Satisfaction – Choose Your Own Adventure

What does job satisfaction mean to you?

-Really-

Have you ever thought about it? Is it the wage you earn or the vacation you accrue? Is it winning arguments with colleagues or landing that huge business opportunity? Is it directing a team or nurturing individuals in their roles? Are you proud of work accomplishments?  Is it the value you provide to the operation/team/public?

Is it all of the above?

True job satisfaction doesn’t seem to follow a formula or template. If it does, I certainly have been looking in the wrong places. My personal adage is simple and goes something like this:

Job satisfaction is not something that anyone can give to you, be it the boss, your colleagues, or your friends. You have to want it, you have to recognize what adds to (or subtracts from) it, and most importantly, you have to feel it.

The quest part represents the fact that we never stop growing, and therefore the source of your personal job satisfaction may evolve over time. Tasks or responsibilities that were once daunting start becoming less of a challenge. The environment you’re in may shift and offer new and exciting opportunities of which you may want to take advantage.

The new pharmacy landscape will offer plenty of potential niches to fill, ledges to reach for, wide open spaces to explore, and peaks to ultimately summit. This quest, should you choose to accept it, requires an open mind and an awareness of current personal or logistical limitations, as they may impact the first direction you choose to go. You may also need a few things:

1) Mentors – folks you look up to and make you think. It’s in their nature to push you places you may not go otherwise.

2) Leaders – Provide a vision for where pharmacy is going. Well-respected in the community and among their peers, they motivate and set the tone for how we may approach perceived barriers (i.e. – public acceptance of pharmacists providing flu shots).

3) Supporters – Colleagues, peers, friends, family. This network forms the glue that keeps your aspirations focused and achievable.  If you need a boost, they’re right behind you and really mitigate the negative slides.

4) Resources – Could be people, but more often it is information. Ask questions, read whatever interests you. Whether it’s renal failure or cancer research, mental health or menopause, stoking those passions will provide insight into what really gets you out of bed in the morning.

So choose your own adventure. Just like the book series, take it a day at a time and when you have a choice to make, be convicted and accept the consequences on the random page you end up flipping to. I for one am looking forward to exploring all the possible endings. Are you?

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Inspiration

It comes in many forms…sometimes it can be subtle, sometimes succinct and other times, it bashes you over the head and leaves you in the alleyway wondering what the next step might be.

The pharmacy climate is changing faster than most of us ever thought possible. Legislation has been tabled in many parts of the country allowing pharmacists to make and own drug-related clinical decisions for patients with the intent of allowing quicker access and better-quality healthcare in all practice settings. With these changes also comes a need to adopt a philosophy towards how we approach drug-related problems; we are no longer simply drug experts to be used as a resource or to provide recommendations, we are entering a realm where we are able to assess independently and have final authority on therapy decisions within our scope. Needless to say, many of us are struggling with whether or not we will be comfortable in our new surroundings and/or will we still excel in our roles as consumer expectations change.

The profession of pharmacy has given me plenty over the last 15 years: an education, a lifestyle, growth opportunities, and a perspective on healthcare that alternates between cynicism and excitement. Most importantly, it has provided me the chance to meet and learn from so many fascinating people. Though not an exhaustive list, there are pharmacists, students, doctors, social workers, nurses, NPs, business people, educators, mentors. Those folks are the real reason behind this blog. I truly believe that the answers to every obstacle are already among the group and are waiting to be discovered through engagement and networking.

That said, this site is intended to be a forum where leaders within our profession can provide opinions, commentary, and brainstorm possible solutions to all things known or unknown. There may be debate, and there may be reality checks, but the tone will be constructive and provocative.

Hopefully, we can inspire each other and ASPIRE to become the practitioners we want to be. The tagline captures the attitude: ‘The practice of pharmacy…On your terms…In your terms’.