The hope of healthcare, Part 6 – proceed until apprehended

When last we met, we were examining the importance of agency and how there are times when we need to be reminded of the agency we have to improve things around us. I mentioned how I pulled my team into a conference room in Alexandria to remind them of the agency they had to improve. 

Today, we are going to build on this idea as we continue to consider pharmacists as the hope of healthcare.

While we all know we can improve, not everyone does. Why do you suppose that is? How can it be that we can have the opportunity, the ability and the capacity, but some do not improve? 

Perhaps the answer lies somewhere in the confidence spectrum? Perhaps the answer lies somewhere in the patience spectrum? I tend to find that the answer often falls somewhere in the permission spectrum. When you consider the systems and processes we all work in, doing something outside the norm may seem a little uncomfortable, or even not allowed. This is the way we have always done it, and this is how we will always do it. Personally, I find this way of thinking very frustrating, and also very limiting.

The truth is we all have a wide range of things we can do that are defined by some existing system, regulation or statute.  If pharmacists are the hope of healthcare, we need to find these areas and proceed until apprehended. We need to go until something changes.

In 2006, I was training a group of pharmacists to do comprehensive medication reviews and as part of that class, I was surveying the group to see who might or might not be interested in providing immunization services as that was beginning to become a thing in those days. During one of the breaks, one of the pharmacists, Rich, came up to me to say that he was interested and that he had been giving injections at his pharmacy for many years already. I probably had a surprised look on my face, so Rich continued by explaining there was nothing that prevented him from providing these injections, so it was just part of the services he offered at his pharmacy. Rich was proceeding until apprehended. Once the state statute and regulation changed, Rich was going to have to adjust his practice to be sure he was following the rules.

I imagine you have some experience similar to this. You have a patient present and you can tell right away that the patient believes the prescriber has provided you with a lengthy discourse on what was going on with the patient and you would therefore know all of the ins and outs. I specifically recall a gentleman presenting early in the morning saying something to the effect of, “I suppose you know why I am here.” I did not. No clue whatsoever. 

I believe there is an important idea to consider here: We are all working to create the healthcare system that so many people believe already exists. 

Many years ago, I came across a statistic that said within healthcare it takes about 20 years for an innovation to become common practice. Granted, I am sure some things take longer while others happen more quickly. But for the sake of this mental exercise, let us at least entertain the idea that some innovation will take half that time – about 10 years. Proceed until apprehended. It has to start somewhere. And it has to keep going.  

No matter what area of pharmacy you are advancing today, I encourage you today to keep going, to proceed. It will take time, it will take skill, it will take persistence, and it will be worth it.

I believe there are certain skills that we all need to advance whatever objective we are pursuing. We will look at that when we meet next. Until then, proceed until apprehended!

Until next time

Jesse McCullough, PharmD

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