Sunday, June 24, 2012

Another break in the wall of text

Posted by Tom Vassas at Sunday, June 24, 2012

Well my experience with administration has come to a close. Though the past 5 weeks did go by fast in retrospect, there were so many times where I actually wished for another week....but just so I had enough time to finish my projects! The entire rotation has given me a great appreciation for just how needed leadership is in pharmacy.

Most of the topic discussions the past 3 weeks have revolved around the advancement of our profession. Until recently, our roles as pharmacists have been roughly the same for 50 years or so. Pockets of us around the country are experimenting with new forms of service; decentralization of RPhs, patient centered medical home (PCMH), home infusion, specialty pharmacy etc. But this does not represent pharmacy as a whole. If we want other professionals to think "I absolutely NEED a pharmacist" instead of "What can I do without a pharmacist?", the shift in thinking has to come within our own profession and not with legislature or educating others. Complacency is a big hindrance. Many of us know a pharmacist who grouches about a new IT system being put in place, or moving the workflow of an area, or trying a new delivery service. But going into practice, we 'young ins ' need to have high value on changing anything we can whenever we can, because there is always a better way.

Unfortunately, most of pharmacy operates archaically compared to other professions. Surgeons with nanoscopic imaging and laser assisted cutting devices? Well some of us still use baskets and stickers to know where our patient's script is. NPs and PAs offering primary care in highly accessible clinics? Well some of us can't hear with a phone glued to our heads. One of the most pragmatic things to help us as pharmacists is one of the few things that we as a profession love by nature yet don't implement; technology! Bar code administration, secure tube delivery, cart-less drug models, robots, CPOE, EMR, point-of-sale delivery and signature; I could go on but the point is yes some health-systems and pharmacies employ these, but the vast majority don't. The premise is simple; simply our fulfillment and distribution practices, allow technicians to take on more of our old 'busy' work, and both techs and pharmacists can finally operate at the top of our licenses. When you fill our days with work we deem more valuable, the profession advances itself.

A lot of this can lie with leaders in helping us get there. There is already a large gap in age for managers and directors, and with the newest generation of Pharm.Ds entering practice, there needs to be a wealth of us interested in leading. This is not a call for new pharmacists to start getting managerial positions; it's a wake-up call for them to be engaged. This means helping our peers and leaders understand what doesn't work for us, try to fix it, fail, and try again until it works. That drive to do things a better way so you can add more value to your day is what leading is all about, no matter how many letters are after your name.

So I must digress from the soap box to finish with the updates from last post. I was fortunate enough to give an inservice to East Ann Arbor staff about specialty pharmacy. That niche has grown so much I guarantee all who are reading this will be involved in the next few years. But it was suprising how well PCMH and MTM fit with providing specialty service; following up with patients, monitoring labs and compliance, advising physicians on drug choices, DDI (omg so many). Among all that is the super important piece for us to be the shining knight in armor for the MD and patient, in their war with 3rd party payers and PBMs. To understand how to fight that fight, is one way to get the MD to say "What do you mean MY pharmacist isn't available?! How can I work without MY pharmacist!?"

Next week begins my ambulatory care rotation in Canton with Stu Rockafellow. Until then I'll leave you with this; Why on earth has it taken us so long to make changes that seem so obvious?


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