Are the pharmacists this subservient?

Are we meek and drawn-out? Sadly, I think so.

While it is easy to whine about effects, many people do not dwell much on the causes. I do not know about you, but I cannot remember a situation where someone other than me solved my problems. Pharmacists for a long time had taken for granted their professional status. In Kenya, this profession has been standing on a shaky ground and no one who had the opportunity bothered to lay a good and firm foundation for it. And so predictably, the value of a pharmacist continued to plummet faster than that of a run-down African country economy. This will continue to happen if we do not do something that is far-reaching now and now. Our sense of self-importance will be dealt a big blow because no one else will recognise us by our own terms. We want to be recognised yet we are doing nothing about it; that really disturbs me. May be someone somewhere is trying, but his or her individual efforts are not powerful enough to turn around the profession. May be it is about time we lowered our expectations for a major transformation and concentrate on the few who have a combination of knowledge (it is so needed), attitude and drive that can take us to the next level. Certainly, a diminutive transformation is better than no transformation at all.

Many pharmacists, both in public and private sectors do not lead by example. They delegate their professional obligations to lesser ‘professionals’, and make themselves invisible to those who really need their services. They do not want to dig out and touch the dirt themselves lest they soil their well-pressed garb. They seem not to have an idea where the jewel of their profession is. This is even made worse by the now more alarming knowledge depreciation that, as one pharmacist once joked about, can give you a clue on the ‘pharmacist’s’ year of graduation. I am talking about those oldies, the types who pretend to be subordinates when a new nurse calls on them, desperate for their professional intervention for a poisoned patient or one who has some other drug related problem. And because they have not been practicing enough to build up their confidence and improve their problem solving skills, they do not gain experience, that they should have, with time.

The main problem is that we pharmacists care less about adding value to our practices to remain competitive, and by extension earn respect. We all want exponential increase in earning power, for no value added. Value addition starts from the kind of knowledge you have and are able to retain to be of use to you, what more you can do with your hands and what you are confident it cannot be done (or done well) without you. Value addition develops to what you were not able to do yesterday, but you can do today because of your deliberately thought out efforts. Value addition is about a bunch of you or more considering each of your individual ideas for improving your practice, debating on it in your own conference, whether scientific or not and lobbying for it to be part of your regulators policy and demanding to be paid for it. Value addition of your services will enable you to attract and earn much more from the premium clients. Such clients in our economy are still few, but their numbers can only go up with a growing economy. It is only wise to be ready for higher-end clients, than to lose the priviledge to better-placed competing professions in the era of overlapping roles when the time is ripe.

Those in public sector who seem not to have any job description other than drug supply management can take advantage of that gap to curve their own niche. You can guide infection control committees by going for newer and more technical information on sterility control. From the information, you can develop protocols on what minimum concentration is inhibitory, bactericidal, or sporicidal against a given microbial load. Then ensure that the dilutions of disinfectants or sterilants are as a routine done well to achieve the required disinfection or sterilisation respectively, for all the re-usable sterile instruments without corroding them as they are costly to replace. Remember, those WHO manuals are just hand-me-down guides of do this or do that prepared by someone like you for those who want ready-made information in brains-resource limited settings. You can then compare your own protocols with the standard protocols found in the manuals or guidelines. Believe you me; no one will be more authoritative on such than you will because you took your time to think like the experts. You can also carry out on job studies and be ready to present them in your hospitals continuing education meetings. You can even lead in these meetings and make useful comments to other people’s presentations by reading ahead for a pharmacist’s point of view on the topic. It also insures you against those questions that may catch you off guard.

For those in private practice, create for yourself your own customized patient information leaflets. Do not depend solely on the manufacturers/distributers leaflets, as they are mostly inadequate and have an element of bias. They may even be unavailable for the line of medications you are so passionate about or it could simply be because you can do better. Anything that convinces your clients that you are genuinely interested in their welfare as you are in their money is worth doing. You can even create a special day where you provide health education forums to your patients, especially those on long-term treatment. Such actions will certainly lift you up, and make you enjoy your work more. You could even improve your clinical skills more tastefully than those in hospitals could (since you do not have the benefit of a clinician seeing the patients before you see them at all time) by advancing your education so as to handle the walk-in patients’ problems more competently. The possibilities are endless in this sector for a pharmacist who wants to engage his mental faculties’ full throttle. And please I will always say, love your work or close shop and quit the profession-do not hang in there.

These little things that seem insignificant from far are stifling the dominance we so need in managed health care. Be assured that when a surgeon or any other does not find you useful, or sends a prescription you only to be filled by a dubious character you delegated your responsibility to; it won’t be long before that same surgeon employs such a dubious character to dispense from his office. The surgeon will argue that it does not make a difference anyway, in terms of quality of care to the patient, and for that, the surgeon has a point. Before you know it, all these characters will have fully fledged illegal pharmacies in their clinics, which of course, are not run under the watch of Pharmacy and Poisons Board. This has already happened and many of the medical practitioners are embracing the practice in their private clinics in a reckless abandon. It will happen again, and again, and again.

The question is; what can you do to reverse this trend? I do not think you really want to do nothing. I do not think it is in your interest to carry on as if nothing has happened. I really do not think you will allow yourself to have worked that hard to qualify and let somebody else revel in your turf, not without a fight.

Is that too much to ask?