Teaching is difficult. Teachers — especially the great teachers, they just don’t receive enough credit. I have actively been teaching a non credit pharmacy technician class the past 8 weeks, while also performing Preceptor duties for 4th year Pharmacy School students.
What have I learned while doing both simultaneously?
Obviously the biggest difference is that teaching in the community pharmacy is a more hands on experience in that there’s real life scenarios and people versus teaching in the classroom where there’s only the lecturer, student, book, and white board/chalk board to convey the message.
In the classroom there’s the “audience effect”. You’re lecturing, and you can easily become the only speaker if there’s not a question you give your audience to answer. Thus, you have to exert more of your body and brain energy into focused segments to convey an effective message.
This burden of energy expenditure being on the speaker/lecturer can be lightened only by actively engaging the student by using the white board, computer, or book to create examples and questions of real life scenarios.
Energy expenditure while teaching in the pharmacy is reduced in comparison to the classroom. The drugs, the patients, the real life scenarios are there to be be used as living examples of why the student must study physiology, pharmacology, infectious disease, pharmaceutics, and so on and so forth.
The student can easily view the drug by going to the shelf. They can learn the pharmacology and use of the drug by simply looking at the package insert that comes with the drug. They can observe the practicing pharmacist or pharmacy technician and learn from their behaviors, movements, speech, and thought process in working together as a team to produce the appropriate final product. The examples do not have to be created in the pharmacy — because the examples are there to be observed, studied, learned, and memorized for the present and future use with patients that day and the days ahead.
This accumulation of knowledge by the pharmacy student and pharmacy technician while on externship can produce a foundation of knowledge for how to talk, when to talk, when not to talk, and when to act.
First point… Good teaching isn’t a lecture, it’s a conversation.
Second point… Good teachers find common ground with the student — so that the thoughts expressed by the teacher can be easily understood by the student.
Third point…Good teachers find out what their student’s baseline of knowledge is. By understanding their current knowledge or lack thereof — the Good teacher can elevate and motivate the student to an appropriate and/or desired level of competency.
Conclusion — I have a long way to go in becoming identified as one of the “good teachers”. However, I’ve identified these three points too consider while playing this role.
The Dispense As Written Codes that I use regularly in my practice are:
DAW 0 = NO PRODUCT SELECTION INDICATED
DAW 1 = SUBSTITUTION NOT ALLOWED BY PRESCRIBER
DAW 9 = SUBSTITUTION ALLOWED PLAN REQUESTS BRAND
Why is this important?
Dispense as written codes are important in billing/filing claims correctly to a patient’s insurance plan. Claims must be billed/filed correctly so that patients receive the appropriate drug products at the correct price.
For me… DAW 0 is used most of the time (this holds true for most pharmacists), while DAW 1 is used sparingly; a drug example for those who are not Pharmacists as to when a Pharmacist uses DAW 1 is seen in the case of prescribing Brand Name Synthroid. Prescribers often write for Brand name Synthroid instead of Levothyroxine because this drug has a Narrow Therapeutic Index (NTI). Due to the NTI, formularies often include both the Brand and Generic products on their formularies so that patients receive appropriate pharmaceutical treatment for their thyroid conditions.
If you’re interested in reading more about NTI, please visit the FDA’s website and review the powerpoint “Quality and Bioequivalence Standards for Narrow Therapeutic Index Drugs.”
DAW 9 is increasingly becoming popular and being put into place by Pharmacy Benefit Managers (PBM’s). Typically generics have been dispensed because the generic product is the cheaper alternative when compared to the brand name product. However, increasingly manufacturers have been offering PBM’s rebates for the monies that they pay the pharmacies on the drugs cost.
In short…even when prescribers write a prescription and sign Product Substitution Permitted — the pharmacist must dispense the brand name product for the product to be covered by the patient’s insurance. This is done by changing the computer DAW code from a 0 to a 9.
So you may be asking, “how is it more profitable for the PBM’s to have higher priced drugs on their drug formularies?” I found a great article published by NCPA entitled “PBM Revenue Streams and Lack of Transparency”. The article is a quick read and outlines why Brand Name products continue to be on formulary even when a generic competitor enters the market.
Examples of using DAW 9 in my practice (Generic Drug — Condition Treated)
Dexmethylphenidate ER — ADHD
Diazepam Rectal Gel — Seizures
Methylphenidate ER — ADHD
Budesonide Respules — Asthma
What’s the effect on people and the market?
In my practice this leads to a major consultation point…
- You and/or your family member is on a drug that insurance is requiring that Brand Name be dispensed (DAW 9). I’m not sure if your local pharmacy carries the Brand Name or Generic product. Thus, it is imperative that you contact your pharmacy days in advance to ensure this product is in stock when you attempt to refill your medication. If you don’t call ahead of time, this could potentially delay when you receive your medication, which could lead you to become non-compliant with your medication(s).
The reason that this is so important…
- Finding the medication for your patient is important…but ensuring that your patient has access to this medication is just as important. If they can’t obtain or access the medication, then you can’t ensure their compliance on the medicine. And non-compliance ultimately can lead to hospital readmission.
- When patient’s transition from an inpatient admission to being discharged to the outpatient setting, prescribers are often unaware of what’s on or not on the patient’s drug formularies. This can lead to confusion and delay and/or impede discharge planning which can potentially lengthen their hospital admission.
DAW 0 versus DAW 9 seems like such a trivial issue, but the increased prevalence of this small change can impact our patient’s compliance and can drive up the cost for providing healthcare.
If you have Questions related to this topic? Please feel free to leave a comment.
The interview begins—and you have already reviewed the candidate’s resume’. They meet all the qualifications, and even have some excellent references. You hire the candidate, and around six months to one year later after their up and down performance you and the employee decide that it’s best to part ways.
So what happened? The interview went well…check. The references seemed to be great…check. Yet, once the candidate got the job — they had a fatal flaw that was impossible to overcome.
They just didn’t seem to care.
They didn’t care about the customers, didn’t care about their daily performance, didn’t even seem to care about their evaluations… Which ultimately meant that the product they were serving up to your loyal base was average at best. They had just enough good days to make you think maybe it would work out, interspersed with enough bad days to make you shake your head.
It’s pretty weird when you think about it. And naturally, you have to feel a bit disappointed. Typically, I’ll even replay their interview over in my mind; trying to figure out what I missed during my evaluation. Going through this process forces the manager to ask themselves what checkboxes are the most important to be checked before making a commitment to offer the candidate a position.
A few days ago, a colleague reminded me of her words on the hiring process prior to me taking on a management position. She’s held multiple management positions. And she said, “when you hire someone, find a person with good customer service…if the person has good customer service, you can typically work around some of their deficiencies…”
I would add to her statement — that the job candidate’s deficiencies can even be remedied with appropriate teaching and training. So, then the manager must ask themselves, “am I a good enough teacher/trainer to remedy the candidate’s deficiency or do I currently have someone on staff that can be an appropriate educator/mentor for the job candidate?”
I don’t know of any degrees/diplomas to my knowledge that are being conferred by colleges and universities in the field/study of CARING @ WORK. Thus, what questions could be asked to determine if a candidate meets your standards? I guess… you could simply just ask the magical question, “do you care… or will you care? But, unfortunately you will most likely just get a canned answer.
So I suggest going through what-if scenarios with your candidate using a diagram for what you consider to be right and wrong answers for each of your scenarios. This I believe is the best method for gaining a little more insight into determining if a candidate truly possesses the traits required to serve your customer base.
Learning how to write in plain English has been one of the most useful concepts I have learned. Effective written communication is a business litmus test. If done well, it can help the business professional build their personal brand.
Plain English is defined in Wikipedia as being…
A style of communication that uses easy to understand, plain language, with an emphasis on clarity, and avoidance of complex vocabulary.
Personally, this has been extremely important to me in the following areas:
- Writing business emails to convey a message the reader can easily understand.
- Writing incident reports to convey a message that anyone could understand.
- Designing business correspondence to customers regarding new services.
- Designing operations & workflow management forms to ensure quality employee performance that leads to better customer service.
Thus, out of respect to the the art of writing in Plain English this is the conclusion of this blog post.
So…what do you do for a living?
We all have our canned answers to describe ourselves to the strangers that ask us this question. So…I suppose for a moment, pause and reflect upon the answers you have given throughout the years.
Think of those times you were hesitant to state your job title; and also think of those times you were proud to state your job title. Consider the times you were either happy, sad, or indifferent when someone asked you “what do you do for a living.” One thing is for certain; professional competence, college diplomas, jobs, and socio-economic status do not correlate to happiness, fulfillment, and satisfaction.
We are all on a wave but each person’s wave has different lengths. Being self aware and cognizant of this fact provides each of us with small boosts to our emotional intelligence score.
The dreaded “first impression” can certainly have different outcomes when you’re able to live in the moment of a conversation instead of replaying canned questions and answers.
If we agree that human beings are much more than job descriptors and titles; consider your own life story…
If someone had to introduce you in front of an audience; would you expect them to come to the microphone and blurt out your job title and degrees… then walk away from the microphone and sit back down?
Maya Angelou famously said, “At the end of the day people won’t remember what you said or did, they will remember how you made them feel.” Ultimately, that’s what this blog post is about.
When you meet people for the first time, please let the experience be organic. Leave the canned answers and questions in the pantry closet. I have learned from my own personal experiences that this is an important concept to apply in my life. By making this small decision, it has allowed me to not blindly box people into categories or groups—because everyone has their own story to tell.
When you meet a person for the first time, consider this… those diplomas, job titles, and trophies on the mantle are simply short highlights to the various chapters that fill a person’s unfinished book of life.
Take home statements…
- You do have a life outside of your career…reciprocate this truth when meeting people for the first time by not immediately going for the “what do you do for a living” question.
- Throw the canned questions and answers in the garbage. They will help your conversations be more refreshing and organic.
- Instead of asking people what they do for a living, ask instead, “can you please tell me about yourself?” This allows people to have a moment of reflection. They then have an opportunity to decide if they would like to tell you their personal story.
Author, Sam Blakemore, August 4, 2017.
You don’t have to be a manager to run into circumstances that make you want to claw your hair out. Managing conflicts in the retail market space is like pouring a cold cup of water in a glass during the summertime. What I’m trying to get at folks, is that you’re going to have to learn how to deal with the emotions of your staff, your customers, and your family, and most importantly yourself.
First, I would like to come clean… I can be the worse at dealing with conflict. I’ve yelled and kicked many garbage cans.
Any person that is passionate about their craft strives for excellence; and if excellence is not achieved there will be frustration.
Before we get into managing conflict…Let’s consider the following:
- On a scale of 1 to 5; how do you manage stress?
- Who do you talk to about your stress?
- What is your outlet for your stress?
- When was your last vacation from your work?
- Do you actively take time to de-stress during your workday?
- Have you considered quitting your job due to stress?
- How often do you raise your voice in a day, a week, a month?
- How is your family life; do you spend enough time with friends and family?
- How is your sleep? Have you been getting enough rest?
I bring up those questions to lead into how conflict arises. Conflicts arise with much more earnest and ease in times of stress and exhaustion. To ensure you’re at your best; make sure you at least attempt to take care of your daily needs. Eat lunch at an appropriate time, step away for a 15 minute break to clear your mind, or take a brief walk to get away from the office.
Back to conflict! Haha…
When facing conflict with customers, employees, peers, or even family— the first thing you should do is pause. The second step should be to gather your thoughts. The third step should be to listen before speaking. Pause, gather, listen.
What does it mean to pause you ask? The pause should be intentional. It helps you to refocus your energy into not speaking. Oftentimes I’ve found that immediately speaking, only pours fuel on a “gasoline conflict”.
Gather… To gather means to collect your emotions, your feelings, your worries, your fears, your anxieties. Conflict is an adrenaline rush. Having someone out the blue, just begin yelling or cursing can be a shock to your nervous system. Thus, gather yourself and consider why you’re standing presently in conflict. The pause allows you to actively choose to gather your thoughts and emotions.
Lastly, listen with intent. Your mind will without a doubt be racing toward the hills. This person did me wrong. This person is not right. This person is crazy. Be an active listener in the process towards solving the underlying issues of both your customers and staff. I’ve found that 9 times out of 10 a customer or staff member just needed a moment to be heard. It’s easy to underestimate the value of listening. It’s very easy to want to solve a problem; oftentimes the problems are simple problems that can be solved in 30 minutes or by the end of the business day. The big problems that can lead to conflict often are the problems that have been festering for months.
Conflict is around the corner. But…
- Reflect and honestly evaluate your personal stressors
Next, when presented with conflict:
- Pause and breathe
- Gather your thoughts and emotions
- Listen with the intent to understand
Management can be difficult. As you have read from my previous posts the most important resource of any business is its employees. If a manager is unable to effectively communicate and utilize their employees, he or she will not be managing for very long.
Leverage is a principle often utilized to discuss financial debt in the world of business. Financial institutions and businesses can utilize debt to take on more risks in the hopes of increasing revenue and profit margin. In that same respect the employee and manager utilize forms of “workplace leverage” to ensure status and influence within the organization. Both the manager and employee use various levers to elicit a response.
The manager’s “work place levers”
- Hire versus Fire to influence employee behavior and decisions
- Praise versus Write Ups to influence employee behavior and decisions
- The power to increase salary and dole out bonuses to influence employee behavior and decisions
- Positive evaluation versus Negative Evaluations of employees to influence employee behavior and decisions
- Internal politics with ownership and co-workers to maintain status and position while influencing employee behavior and decisions
The employee’s “work place levers”
- Underutilization versus over-utilization of sick and paid days off to effect management behavior
- Gifts and Praise of management/co-workers to effect management behavior
- Positive versus Negative Evaluations of management/co-workers to effect management behavior and decisions
- Habitually early to work versus habitually tardy to work to effect management behavior and decisions
- Internal politics with ownership and co-workers to maintain status and position to effect management behavior and decisions
I won’t delve to deep into the details of how these actions can be utilized by both the manager and employee; but briefly review each point. Consider the names and or faces of the people that you can associate with each variable. In short, both the manager and employee utilize forms of leverage to elicit responses.
As I’ve mentioned previously, people are as important as financial capital in maintaining a functional organization. For those in management; please take the time to consider these 10 key points to ensure a functional work environment.
- Be upfront and honest about the role each person plays in maintaining a functional business.
- Value the opinion of every member of the team, and actively demonstrate this by listening to their opinions and actively considering these opinions when creating changes within the organization.
- Even in times of disagreement; work diligently to maintain a level of respect for that person
- Focus on the value created for the shareholders when trying to create a unified vision between management and employee.
- Focus on the quality of the product created for the consumption of your customer when trying to create a unified vision between management and employee.
- At a minimum evaluate employees biannually; when evaluating always have a third person involved to witness. This reduces the possibility of arguments and misunderstandings.
- Be respectful of the goals your employees have; most likely they do not want to be employees for life. And that is fine. Work with them on creating a 1 year, 5 year, and 10 year plan so that they don’t feel stuck in a rut.
- Create rubrics to grade yourself and employees; this shows thoughtfulness and reduces bias when grading employees on their abilities.
- During reviews, offer each employee a time to have a moment of reflection. Ask them, “do you have an issue with management, a co-worker, or the organization that needs to be resolved?”
- Practice being able to discipline without bias; this practice helps maintain uniformity in the organization, and builds a level of trust for the employee in relation to management.
You will never be able to keep people completely happy. And following this plan will not eliminate every employee’s discontent. I still implore each manager to have a plan, and stick with that plan during both the good and bad times. Work with diligence to ensure the employees you manage have enough space to consider their place and role in the organization.
We work and work till we are tired. The days and months will pass us by, and before we realize it our most important employees are desiring to leave the organization and often we don’t even see it coming.
Please review my 10 key points; by reviewing these points I hope that you’re able to improve employee satisfaction. It is important that managers ensure that an employee’s concerns are heard. There should be open lines of communication in all phases of hierarchy; ownership–>management—>employee. Communication is paramount to ensuring business success.
A company can quickly collapse under the duress of organizational stress. To prevent this collapse managers must pride themselves on using “workplace levers” in an appropriate manner to maintain balanced scales of power in these “workplace courtrooms” that house office politics in every business and industry.