What pharmacy can learn from other professions.

To the Editor: Paul Hawken said, “All is connected…no one thing can change by itself.”1 The face of pharmacy is changing as the healthcare system itself changes. With the recent opportunity of reimbursement for cognitive services through Medicare Part D MTMS legislation, to the ongoing battle for the pharmacy dollar from the consumer with free or $4.00 generic prescriptions, to more pharmacies becoming full service healthcare centers and providing onsite clinical assessments, the evolution of pharmacy is rapidly morphing. These new opportunities are a mixture of good and less than good ideas for pharmacy as a profession. When thinking about other professional areas, what could pharmacy learn from others? More importantly, as pharmacy educators, how can we integrate different professions' thinking into our curriculum? Legal and Accounting. When was the last time you walked into your lawyer's office or your accountant's office, unannounced, without an appointment, and asked for immediate service? The answer to that question is most likely never. Nearly all other professions require appointments for consultative services. Pharmacy is one of the most trusted professions in the world; however, can we purvey quality services prn with unknown prescription dispensing demands, particularly in community practice? With MTMS now established, pharmacists should begin considering fee-for-service consultative appointments. It firmly establishes professional value with customers and provides the opportunity for uninterrupted, higher quality service for the patient. As educators, the more opportunities during IPPE and APPE we can expose students to regarding professional services by appointment, the more students will feel empowered to initiate this type of model into their practices after graduation. At Butler, we have brought in pharmacists performing such services by appointment and exposed students on community practice rotations to their ideas and thoughts, as we do not yet have enough sites for all students to experience such practice opportunities. Public Relations and Advertising. If you have ever had the opportunity to meet with a public relations or advertising representative for hire, the first thing they would show you is a portfolio of their work. With continuing professional development now on the horizon, there is every opportunity for pharmacists to begin providing the same to potential employers – a portfolio of their work. This could include not only a CV, but writing samples, a hero file with letters of recommendation, any certifications or classes taken (both CE and non CE), and annual performance reviews. Any recruiter will note that documentation in site will be much more tangible for visual learners and hiring managers. The method to integration of this portfolio idea into the curriculum could best be served by providing outside professionals with more experience in writing portfolios that share their ideas with pharmacy students. This could easily be integrated into a professional practice course or an Introduction to Advanced Pharmacy Practice Experiences course. Sales and Marketing. Pharmacists are in demand. The average student graduating still receives multiple offers for employment upon licensure. Students therefore do not have to market themselves actively for a job after college. Also, the major pharmacy chains are battling over pricing of prescriptions rather than focusing on high quality service or providing other ancillary services to their customers which in turn develops a unique market position for their companies. What if pharmacies took the Steve Jobs' approach to providing excellent, unique appointment-only service as a separate section within the retail store? Many Macintosh computer owners will never go back to a PC simply because of the unique genius bar service that is provided by appointment at each and every Mac computer store. Pharmacists and students need to understand they are selling themselves each and every day. Everyone has a unique brand. In the new economy, it is not the product, but the customer's experience that will make the inedible mark and keep the customer over the long term. Also, many pharmacists are incentivized for generic substitution. What if pharmacists proactively presented new generic switches to nearby physicians as a value-added professional service? We have addressed these issues at our institution with a new seminar series program that addresses marketing of a community-based pharmacy by bringing in pharmacists that have actually performed sales and marketing practices within their communities and offered discussions with students currently on community practice rotations about such practices. Teaching and Education. Theoretically, all pharmacists, not just pharmacists in academia, are educators. Not only do we have to learn a lot of scientific details, but we also have to be able to communicate those ideas back to the customer at a level relevant to the customer. All pharmacists can learn from reading and studying great educators. To be a great educator means that one must also be a great life-long learner. Moving beyond just continuing education to a broader scope of customized continuing professional development will provide more educational and intellectually challenging areas for pharmacists to master and in turn better serve their patients and profession. Also, as pharmacy educators, are we teaching our students how to teach others? Each pharmacy school should offer an academic rotation within advanced pharmacy practice experiences (APPEs) and require it for all students. Preceptors in this arena are easy to find, for they are teachers at schools of pharmacy. Coaching. Life coaches, wellness coaches, and business coaches are everywhere. In order to establish and foster long-term relationships with patients and retain business, pharmacists should focus on preventative services and coaching their patients around wellness rather than just discussing the treatment issues at hand with a prescription. Pharmacists are trained on how to help their patients create a wellness plan, a medication plan, long-term disease management plans and even diet and exercise plans for better health. At Butler University, we have APPEs for students in the campus wellness center called Healthy Horizons and directed by Dr. Carrie Maffeo. During this APPE, students check blood pressures, body composition, and perform other tests that expose them to the opportunity to coach patients in the realm of wellness without simultaneously focusing on dispensing. Entrepreneurs. Entrepreneurs tend to have a great combination of vision, technical knowledge, and ability to get things done. These are qualities from which any profession, including pharmacy, can benefit. Pharmacy used to be an entrepreneurial profession with independent community pharmacies being the rule rather than the exception in practice. However, we need to hold on to the entrepreneurial mindset firmly for future generations of pharmacists, as creativity and right-brained thinking will be the new commodity for employers in the years to come. At Butler, we have provided opportunities for students to not only create new over-the-counter products in the self-care course, but also assign them to “sell” their products to the class. Students need to understand the creative process in projects that not only allows them to break the ice among their team members, but more importantly, teaches them the creative process and the ability to think outside the box. Artists. Finally, each and every one of us has the ability to be an artist in whatever profession we have chosen. The common thread among all artists is passion. In The Reinvention of Work, author Matthew Fox explains, “Jobs are to work as leaves are to a tree. If the tree is ailing the leaves will fall.”2 He goes on to state the definition of the word job came from the Middle English word gobbe, which meant lump. Whereas, “work is about a role we play in the unfolding drama of the universe.” We need more rock stars in our profession. We should see them in the media, on television, on radio, online – talking about drugs and all the amazing pharmacology that we can best explain…no other profession provides as much training on pharmacology. According to Fox, by sharing our work, we share “part of our display, part of the parading of our beauty” in the universe. Our work is beautiful. Every university that has a communications department, television channel, or radio station along with a school of pharmacy should host a program with pharmacy students discussing hot topics in healthcare. This exposes them to media challenges and therapeutic challenges simultaneously. Students must be able to think on their feet and effectively communicate, as all in media must do. Pharmacy can learn a lot from other professions. The examples above are few of many others from which we can learn. By connecting to other professions and extracting their best practices, we have further opportunity to elevate ourselves. As we change, develop, and morph as a profession into the new millennium, those with the audacity to pioneer new and better ideas will ensure a profession that will not only evolve, but endure. Erin Albert, PharmD, MBA College of Pharmacy & Health Sciences Butler University