Pharmacists have teleprompters for brains (revisited)

We've gotten better at prescribing. Here's why.

At the end of 2022, I wrote about our flashy soon-to-be new authority in Ontario and offered a solution to help us transition our thinking style from checker to initiator as we became prescribers. It went like this:

All pharmacists have at least one thing in common: we passed a few multiple-choice exams.

Remember when your classmate said he would know the answer when he saw it listed in the options? He was right. And this was the first clue that pharmacists have teleprompter brains.

In a multiple-choice exam, the student is prompted with clues of the problem and the answer. Information is right in front of them and all they have to do is select it. This was a key driver influencing the way the pharmacists’ brains work, by receiving prompts and choosing the best path because the brainwashing and mental manipulation did not end there.

After hundreds of multiple-choice exams, we entered practice where we were prompted with prescriptions and products to review (e.g., compliance packs, stock bottles, drug charts and guidelines to follow). In these environments, the answer is in front of us and we are prompted to evaluate based on what we see (teleprompter-like), as oppose dto invent a plan from scratch (prescriber-like).

This is not bad

Teleprompting is simply an environmental model that has worked a deep mental trench, a habit. Of course, there are many pharmacists successfully working outside of dispensing roles, but stay with me.

Relative to the history of our profession, only more recently have pharmacists been pushed to invent from scratch through prescribing. This is a new mental model, where we use the same analysis but then move on to create the solution instead of select it from what is presented in front of us. We will no doubt be great at this new way of thinking but it will require practice.

It is like playing piano without sheet music, inventing instead of following instructions. Mentally, we will need to be comfortable asking for permission less and leading more. To bridge this gap while we put in our practice time, we can develop templates and workflow that build on our current thought model.

The solution I suggested was a compilation of prescribing templates that are modifiable in a Word document that you can save to your computer. Simply print off the page needed, complete your assessment, and it doubles as your prescription and documentation.

I called it RxDeck and there were no software, training or subscription fees. Since pharmacists enjoyed it by providing a solid solution for systematic prescribing workflow and thorough patient care without red tape, it was worth updating with the new minor ailments being added to our authority as of October 1, 2023.

Introducing RxDeck version 2.0

Not only does RxDeck v2 have the added six minor ailments in Ontario, but it also contains other templates that have served pharmacists well over the past decade such as templates for injections, communicating with prescribers and geriatric medication reviews.

Let our new-aged practice begin, as more and more pharmacists migrate from using teleprompters to inventing harmonies without sheet music.

You can Explore RxDeck2 more here. Let me know what you think.