Brian Webster

• —— CHAPTER ONE ——•

“Almost all the growth that’s available to you exists when you aren’t like most people.”  — Seth Godin, Tribes

 

On learning

Everybody learns. We’ve done it passively since childhood. Even the most hard-headed among us can be broken in by experience. When it’s hot outdoors, we venture out in short sleeves. When the climate control at the office makes us shiver, we learn to keep a handy sweater at our desk. When the tax bill leaves us gasping, we seek out possible deductions. We learn constantly to adapt to our environments, our circumstances, our general place in the world.  We do this because we are human. Life does not award us extra credit for being human.

The greatest rewards require more effort. We accept this wholeheartedly as students pursuing entry into the university program of our choice and while working toward the degree or certification that will spring us forth into our careers. We in the healthcare profession accept that certain paths require even more of us, through undergrad and then graduate degrees, residencies and the raft of licensure exams that certify us. Why do so many of us stop there?

Chet Holmes, the late corporate motivational expert, asserted in his book The Ultimate Sales Machine, that “only 10 percent of the population has what’s called ‘the learning mindset.’ These are people who seek out and enjoy learning. The other 90 percent of the population will not look to improve their skills unless they have to as part of their job requirement.” 

Our careers do not award us extra success for learning only what we are required to in the course of practice. In truth, a career as a pharmacist is quite rewarding in and of itself and I do not mean to suggest it is not. But I would like to put forth that there is much more one can do with a PharmD degree than dispense medicine. 

Why this book?

I am writing this book for the bright and aspiring minds with limitless potential to make a truly transformational impact on healthcare in the U.S and/or abroad. The book you hold now is for those who feel they can do more, be more and experience more in their personal and professional lives; those who want more than what is readily handed to them at the given moment; those who want to work smarter and reach higher levels of success in whatever path they choose to take; those who appreciate that the responsibility of reaching the peak of their career does not rest on the shoulders of anyone but themselves. 

If you are curious about non-traditional roles in healthcare, this book is for you. Even if you decide to stay on the traditional path, you will have learned new skills for setting meaningful goals and holding yourself accountable to those goals. Further, you will find greater peace of mind in knowing you’re not pigeon-holed into a permanent career path.  You will be certain that you are making the choice for yourself. I am writing this book to give you a sense of empowerment, a jolt of energy, a beam of hope that lifts you up and fills you with the mindset of “Damn it, I can do this!”

To be clear, this is a motivational book written specifically for my fellow travelers in pharmacy. It is not a book about the practice of pharmacy. I will not discuss benzene rings, chiral structures or “drug allergies to everything but dilaudid.” With this writing, I hope to liberate your mind so that you end up with a better appreciation of what’s available to you professionally and a proven methodology to pursue and catch the goals you set.

None of this is complicated science, nor should it be. The concepts I will cover in these pages are as simplistic as they are time-tested. On the page, it looks easy. But the ability to follow through and execute these beautifully simplistic ideas is what separates great achievers from the masses. The onus is on you to begin living these lessons.  It is not enough to simply know them.

The considered career

Take what you gain from this book as a separate course to anything you learned in pharmacy school. I am not hurling stones at the education pharmacy schools provide around the career path. I have found that most offer fantastically refined, advanced educations on everything it takes to be great at the practice of pharmacy. However, once you’re out of school a few years and curious about pursuing an alternative path with a PharmD, you realize your education hasn’t been designed for that.  

The pharmacy education is not incentivized to teach students about long-term career pathways. It is aimed at placing graduates in jobs. Schools are required, for accreditation purposes, to report their job placement figures from the previous graduating class the year after graduation. They are not required to submit any type of career satisfaction metric, long-term or otherwise. Nor should they be. This leaves you, the individual, to fend for yourself in gaining the extra knowledge, motivation and sources you need for even greater fulfillment.

It is understandable that most young pharmacists do not take time for personal growth and reflection. There is a deserved sense of accomplishment that already comes with earning a degree, securing a well-paying job and easing into the career while buying a home, starting a family and etcetera.  By the time most pharmacists begin to reflect on their careers, it is often after years of mounting frustration with the entry-level situation they worked so hard to get. People change. You might change. A day could come when standing on your feet for 8 to 12 hours and dealing with the occasional aggravating customer no longer suits you. Many pharmacists remain for 10-15 years in positions that, when or if they do leave, are quickly filled by eager recent graduates. 

Of course, staying ten or more years in the same job since graduation can continue to be rewarding and fulfilling. The key difference is that you must know what you are choosing, even passively, by opting to not pursue other roles. Do not remain in an entry-level position by assuming it is all that’s available. If you choose to stay there, stay because you want to, because you’ve looked at the other options and decided they’re not for you. You did not work this hard to get where you are and feel trapped in it.

The worlds of healthcare and pharmaceutical care have evolved so much over the past decade. In healthcare, reimbursement models such as accountable care organizations, bundled payments and clinically integrated networks have come to the fore. More specifically in pharmacy care, specialty pharmacies, medication therapy management companies and more have come to dot the professional landscape. Yet for the most part, the career path we’ve exposed to pharmacy students has remained rather static. 

I also was guilty of limiting my options. When it came to fending for myself in college, I did not pursue any extracurricular education around my chosen career path. Like many others, I allowed tunnel vision to light my way forward, so the education I got on careers was limited at best.

At pharmacy school, I believed that once I graduated I’d be a candidate to work either in a retail/community pharmacy setting (Walgreens, CVS, etc.) or spend 12-hour shifts filling scripts at a hospital.  I spent a summer working for a large retailer and decided rather quickly that was not for me. Though I understood retail pharmacists made substantially more money, I felt I needed a different environment for any kind of long-term success. 

Without giving the notion much thought one way or the other, I put in for a residency based on the advice of a mentor I have great respect for. He told me, unequivocally, that if I wanted to pursue a career in hospital pharmacy, a residency was the way to go. I got lucky.  That turned out to be a positive experience for me, though I wasn’t sure what a residency entailed when I first took it on.  I just did it.

I want to inspire bright people to pursue, to continue to pursue, or to love already being a PharmD.  It is the best healthcare degree available.

A recurring theme throughout this book will be the difference between ‘pharmacy’ and ‘pharmacist.’ Understand, once you graduate from pharmacy school, the word “pharmacist” does not appear anywhere on your diploma. When I talk with students and even practicing pharmacists, I often must repeat this fact until it sinks in: the word “pharmacist” is not on the diploma. Why is this distinction important? Because as wonderful as being a pharmacist can be, it is not the only thing you can do with your PharmD. There are many other options you can explore with a pharmacy degree in hand. 

This difference is more than semantics. It amounts to a philosophical shift in your self-perception and what is possible for your career. If you continually see yourself with a pharmaCIST degree, you will mentally wall yourself off from other paths you are capable of exploring. But even being aware of other paths won’t necessarily be enough to set you well upon them. This is why I have developed the Vision, Direction and Accountability system, which we will discuss more at length later in this book.  I’ve seen the V-D-A system work. Conversely, I’ve seen people, including myself at times, fail without putting it into play. While nothing in the world is fool proof — build a better system, along comes a more maladroit fool — the Vision, Direction and Accountability principle is one of the best systems one can apply to living their dreams.

It also doesn’t hurt to have a PharmD. Let me explain why it is the best degree.

• First, pharmacists are continually ranked as one of the most respected professions. In the most recent Gallup survey of Honesty/Ethics in Professions, pharmacists ranked No. 2, sandwiched between nurses at No. 1 and medical doctors at No. 3, with 67 percent of responders rating our ethics as high or very high. 

[[ http://www.gallup.com/poll/1654/honesty-ethics-professions.aspx ]]

• Second, very few professionals — even among other healthcare practitioners — understand pharmaceutical science and its practical applications.  There is real power in this.

• Third, from a business perspective, pharmacy is a green pasture. For example, the Affordable Care Act (also known as “Obamacare”) is creating new delivery models that boost pharmacy’s role.  The rise of ACOs (accountable care organizations) is one such model.  We will cover more of them later in this book.

• Fourth, whatever the job market for pharmaCISTS, pharmaCY jobs are plentiful. The website, www.pharmacymanpower.com is a great tool for evaluating the pharmacist job market, whether nationally, by region or by state. However, it only showcases traditional pharmacist jobs and rarely, if ever, the numerous other careers anyone with a pharmacy degree can pursue.

Remember, a PharmD does not only equal pharmacist. 

It is important to acknowledge, again, that there is nothing wrong with a traditional pharmacist career. It can be a wonderful and continually fulfilling job and I do not intend to degrade or belittle it. But there are other jobs you can do with a PharmD. If you look into them and decide you want nothing to do with them, splendid. But choose to be a pharmacist with your eyes wide open. 

Any of the three traditional pharmacy career paths — retail, hospital or ambulatory care — can offer years of professional, personal and fiscal reward. Whatever path you choose, it is important that, as past ASHP president Sara White noted, “No matter how successful you currently are, it is prudent to periodically assess and renew your career.” (Ref: American Journal of Health Systems Pharmacy. 2008; 65:119-121.)

But how realistic is it to renew one’s career without knowing all the other possibilities it can hold?  As I’ve mentioned, we are rarely taught about the vast array of jobs and careers available beyond entry level pharmacist positions. Sure, many schools will offer the occasional career day. Some invite outside speakers and pharmacists from non-traditional career roles to explain what they do. A few do offer unique coursework aimed at providing exposure to both non-traditional and traditional roles. But in my experience, these opportunities are still too few and far between and the non-traditional coursework usually comes in the form of an elective, not a required class. This perpetuates the current problem that we will expand upon later.

One interesting thing I learned when traveling to pharmacy schools around the country is how few of them have a close relationship with their university’s careers office. This is likely due to the fact there’s always been such great demand for PharmD graduates — and lagging supply —  that most schools could place 100 percent of their graduates and still hear from employers looking for more.  Such high placement rates meant that pharmacy students could skip their university careers office services since a job would already be waiting for them. 

This is not necessarily the case anymore, with the recent Pharmacist Demand Index (PDI) showing that supply has largely caught up with demand as far as traditional jobs go. Now the need for well-managed, well-tended career development skill sets is more important for pharmacy students than it’s ever been.

The following PDI survey was taken in December of 2016:

[[ https://pharmacymanpower.com/ ]] 

My Story

“Try pharmacy.”

That’s the advice I got from Dr. Terry Maris, the Dean at Ohio Northern University’s school of business.  I had applied to three business schools by the time Dr. Maris said those words to me, so there must have been something about me even then that caused others to imagine me in a lab coat and latex gloves.  He wasn’t the first. As far back as 1992, my high school Spanish teacher, Crystal Tuel (Crystal Owens at the time) jumped out from behind her desk one morning and said, “Scott, I know what you’re going to be when you grow up. A pharmacist!”

The Spanish word for pharmacist is ‘farmacéutico,’ by the way.

Naive as I was right out of high school, I was incredibly lucky to have been steered onto an excellent path. Dr. Maris had seen that my grades were good and advised me to start in pharmacy, reasoning that if I didn’t take to it, then business school would be an excellent alternative, a safety net. Had I started in business and then decided to switch to pharmacy, I’d have had to start over from ground zero.  Dr. Maris’ advice turned out to be golden and I’ve had the fortune to be able to thank him for it many years later. One reason I’m writing this book now is to pay forward the good deed Dr. Maris did for me.

What I found most challenging early in my pharmacy studies was learning infectious diseases (ID) therapeutics and I quickly encountered some negative experiences around just that. Instead of shying away from ID, I turned it into my lone career motivation. Going into a specialty out of spite probably is not the most helpful rationale. Still, it’s what I did. I set out to do ID better.  My goal was to be a practicing infectious diseases pharmacist in Charlotte, North Carolina five years after graduation. 

Why Charlotte? My parents had taken me there on a family vacation when I was 12 and I liked the city.

I didn’t realize then how precious it was to have such a clear goal to light my way. I’ve never forgotten the value of it.

Keeping Charlotte, NC topmost in my mind, I applied to residencies only in North and South Carolina, winding up at Moses Cone in Greensboro, NC. During my time there, I was amazed to see how highly respected pharmacists can be after years of building trust in their communities. The pharmacy department at Cone has built an amazing relationship through decades of meticulous performance and sound, effective patient care. The physicians at Cone saw “pharmacy” on your name badge and instantly considered you a trustworthy practitioner until proven otherwise.

As residents there, we were trusted with dosing protocols on everything from heparin, warfarin and aminoglycosides to antidepressants and even drotrecogin in the intensive care unit.  The people, the atmosphere, the experience could not have been better for a young pharmacist.

After Cone, I moved on to a second residency at Duke through Campbell University. This proved to be one of the most challenging experiences I’ve ever had.  Up to this point in my development, I’d always been tougher on myself than anyone else had been. At Duke, this changed abruptly. Still, the experience turned out to be as helpful as it was jarring. I learned an unbelievable amount in such a short period of time. I owe so much to the preceptors, physicians and fellow residents for the irreplaceable education I gained at Duke.

After that experience, I went back to Cone for a year and then landed at the Carolinas Medical Center/Health-System in Charlotte as the infectious diseases (ID) pharmacist, fulfilling my five-year plan to be an ID pharmacist in Charlotte, NC.

Soon after achieving my first career goal, ONU (Ohio Northern University) asked me to come and give a guest talk on Urinary Tract Infections (UTIs) and I had the distinct honor of bumping my former professor from the lecture. 

During this time, I also started a small consulting business on the side to offer my infectious diseases pharmacy expertise to smaller, regional hospitals that could not afford such a specialist. This particular venture never quite got off the ground, but ultimately led me to Premier, where I spent nine and a half years as a working pharmacist.

It is also where CareerScript was born.

During my time at Premier, I diagnosed myself with a condition I’ll call Career Attention Deficit Disorder.  I am the kind of person who desperately needs change, as I get bored with routine fairly quickly. Where most people like to master a career and then keep change to a minimum, I crave it.  I become restless. I seek change. 

I wanted to do more.

The CareerScript Philosophy

When I left clinical practice, others took notice. 

I began hearing from friends, former colleagues and even schools of pharmacy, all reaching out to me for advice as I started down my own non-traditional career path. This raised the stakes a bit, for I realized that what I thought I was doing for myself, I might also doing for others by showing the way.  This empowered me to learn as much as I could so that I could share it and make it helpful to others.  That’s what this book and the CareerScript website/app are all about: allowing me to distill two decades of learning into a package of information products others can benefit from.

But information is not enough all by itself. It’s not enough to merely be aware of what more you can do with your education and experience. I needed a system to help students, practicing pharmacists and other healthcare professionals actually get onto the alternate career paths they sought.  This is where my lifelong thirst for knowledge in business has had a huge impact.

My passion for business took me to — and through — many books on sales, marketing, strategy and motivation that, frankly, we in the healthcare profession just don’t have time to read during our academic years. I took the principles from those books, applied them to personal growth and boiled them down here for your long-term career benefit. 

Actually, I discovered in those business and sales strategy books many of the same principles I had already benefitted from over the first five to seven years of my career, so the literature served to re-tether me to successful habits I had gradually strayed from.  I took what I learned and converted it into a personal growth and development philosophy of Vision, Direction and Accountability.

Vision, Direction, Accountability

It is my hope you'll look to this book as a personal resource; one that can open your eyes to an entirely new world of pharmacy careers, help you choose the right path and — most importantly — arm you with a proven methodology to expedite achieving your ultimate goals.  I've broken this mission down into three parts. 

• VISION: You must see the field ahead of you before you proceed.  Know yourself and your options before you proceed.

• DIRECTION: You need a map to guide you along the signposts toward your goal. When we want to go somewhere specific, we do not simply set off in the general direction and hope we run into it. It is important to set, document and reach all the smaller goals on the way to your ultimate destination. Doing this makes your quest real by converting wishes into action.

• ACCOUNTABILITY: You must empower others in your life to participate in your success and hold your feet to the proverbial fire. 

When you know where you want your career to take you, what to accomplish along that path and have others to share your goals and accountability with, your chance of success skyrockets almost to the point where you cannot fail. This is a proven system.  I have seen this approach work for others and experienced its power in my own life.  In fact, I am eternally grateful for the authors of those books that helped me formulate this approach and have referenced them throughout the course of this book. If you find this book enjoyable or helpful, then I encourage you to read the others referenced in these pages.