Eiffel Tower — Texas Style

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I work as a coverage pharmacist for an oncology clinic here in Texas. We have sites all over the state. This week, I’m working in Paris. Yes, there is a Paris, Texas. Actually, there are a lot of towns in Texas named after European cities. If you cannot afford to go to Europe, just come to Texas and buy a bus ticket.

It will be 2 years next month that I have been working as a coverage pharmacist. Many people first ask me what it is like to be a traveler, and then tell me that they can’t do my job. The truth is, I’m starting to think like them. Each site that I cover has its own personality, and its own way of doing things. I hate that I have to know so many different ways of doing the same tasks that is mandated throughout the entire company. I also have to deal with many different types of personalities from the staff, and with that, comes drama. I have not dealt with so many petty people before. Finally, the last minute schedule changes make it hard to make and keep plans, and have somewhat of a social life.

With that said, I DO love my job. I have met so many amazing people throughout the company. Like this week, the technician I’m working with took me around town and showed me the Eiffel Tower. I learn about different regimens used in different populations, and spread ideas that other sites have implemented successfully. For example, when I have my own site, I want to put cartoon stickers on the chemo infusion bags, so the adult patients can smile when they see the stickers. Getting chemotherapy is tough enough; such a small gesture makes a BIG difference. And yes, for the most part, I am appreciated for covering the site. Most of the pharmacists that I have covered know that their site is in good hands when I am there.

It is hard to be appreciated, and find joy in your job, especially in pharmacy. There are so many negative aspects that just beat a pharmacist down: irate customers/patients, phone ringing off the hook, impolite representatives from the physicians’ offices, insurance companies and reimbursement cuts, mountains and mountains of paperwork, being compliant with state and federal rules and regulations, mounting tasks from management (who are not pharmacists and really have no clue how the pharmacy is run), drug shortages, rising costs of medications, and so forth. So why are we in pharmacy in the first place?

Just remember WHY you got into your field, whether it be pharmacy or something else. Did you make someone smile today? Did you utilize your skills and make an important intervention? Did you pop some bubble wrap next to a nurse’s ear? Oh wait, I did that today. Remind yourself that it was YOU that did that: brought a smile to someone’s face, made a huge intervention, pop some bubble wrap, etc. Because of YOU, someone’s life got a little better and brighter. For that, you should be really proud of yourself.

I wonder if I can find some Texas style crepes …..

Desperate Makes You Stupid

I was following up with someone the other day. He is a recent grad, who has been looking for a pharmacist position for a long time now. I had asked him what had changed since the last time we had talked. He said that he had talked to some of his friends and classmates who were managers, and hire for their companies. They had given him the advice of keep applying to different positions, that it’s a numbers game. Anyone who has the least amount of understanding of today’s pharmacist market knows that this is the WORST. ADVICE. EVER. I had asked him how his friends got their jobs, and he said through fraternities and people they knew while in school. So basically, they gave him the most generic advice that they didn’t follow themselves. I was following up with someone the other day. He is a recent grad, who has been looking for a pharmacist position for a long time now. I had asked him what had changed since the last time we had talked. He said that he had talked to some of his friends and classmates who were managers, and hire for their companies. They had given him the advice of keep applying to different positions, that it’s a numbers game. Anyone who has the least amount of understanding of today’s pharmacist market knows that this is the WORST. ADVICE. EVER. I had asked him how his friends got their jobs, and he said through fraternities and people they knew while in school. So basically, they gave him the most generic advice that they didn’t follow themselves.
I tried to give him advice that I DID use myself, and I gave my own experiences. I am not ashamed to admit that I got my current position through a personal connection. My friend J had worked for this company as PRN for over 20 years, and she knew the Executive Director for Pharmacy really well. She told him to give me an interview, and luckily, he liked me and hired me.
Anyway, I digress. I told the recent grad that I got my current job through personal connections, his friends got their jobs through personal connections, and nowadays it’s not about WHAT you know, but WHO you know. Of course, the recent grad didn’t take my advice. He even told me he is studying to take the license exams for the neighboring state because he saw that there were jobs posted there.
However, I do understand where he’s coming from. He’s desperate to find a job, ANY job. I was there, too. There were times in my pharmacy career that I was out of a job, and I had to borrow money from friends and family so I could pay rent, and not be homeless. I hated selling my possessions, just so I could have money to eat. I remember what it was like to be that desperate. And desperate makes you stupid.
Desperate makes you think that you can’t get any good job, so you have no choice but to accept anything that is out there, even if you KNOW you will not be happy there. Desperate makes you stubborn, and you end up ignoring the advice from those who have been what you have been through. Desperate gives the feeling of panic. Desperate makes you do the same actions over and over again, yet you expect different results. DESPERATE MAKES YOU STUPID.
I know that the pharmacy market has been really tough, especially as of late. And yes, it is very easy to become desperate. But you can take certain steps to increase your chances of getting a position, even if it is used as a stepping stone to get to the position you really want.

1) USE YOUR CONNECTIONS! Reach out to old colleagues, supervisors, classmates, professors, etc. Social media has made it really easy to find and connect with people from the past. I use Facebook and LinkedIn a lot. LinkedIn also tells you connections of connections, so if there is someone you know that knows a hiring manager or employee of a company you would like to work for, don’t be afraid to ask for a referral.

2) If you are still in school, talk to your professors and preceptors. Ask them what the likelihood of their companies hiring new grads is. We recently had hired a new grad for a PRN position based on one of the pharmacists’ recommendation, as she was his preceptor. Make sure you stay in touch with the preceptor, even after that rotation is done.

3) JOIN LOCAL ORGANIZATIONS! APhA and ASHP are the biggest pharmacy organizations, but they also have state and city chapters.  There are also non-professional organizations out there that could be beneficial. There is a Meetup group here called Dallas Health Entrepreneurs Network, which looks at looking at healthcare from a startup perspective. Even personal Meetup groups can have professional benefits. I have met a few pharmacists through various personal interest groups. If I ever want a job change, I have a few people I can call.

4) If all else fails, talk to pharmacy recruiters. They are able to give you posts of where the need for pharmacists is (remember, they get paid for your placement). Yes, most will be in rural areas, but it will get you the experience needed, until you’re able to reach out to pharmacists in your desired location. Who knows, maybe the area you were dreading to go to may be the best move for you personally. I thought I would never leave Illinois and move to Texas, but now Dallas is my home.

If you could take away just one thing from this post, it is to just reach out. Don’t try to find a job, any job, on your own. Avoid being desperate, and if you can’t avoid that, then avoid being stupid.

Time to head to the gym. I’m desperate to work off the brownies I had for lunch.

Moving On Up

My coach and mentor posted on social media that he had turned in his resignation at his current position. He is giving up his full time position as an anticoagulation pharmacist at the VA to become an entrepreneur full time. I am very excited for him and his journey, and I am very happy that I get to see him from the sidelines. A, you’ve been successful in your endeavor so far; I know you’ll go on to create more opportunities for yourself and for others.

When I read that post, it got me thinking about my own pharmacy journey, as well as my general life path. Am I truly happy with where I am right now? The answer is yes and no. I am very lucky to be in a job that I love. To be honest, I love my job most of the time; there are some times when I hate it. I have a job where I am challenged mentally, my schedule is normal business hours, I have great rapport with the physicians and nurses, the patients are grateful for my help and expertise, my colleagues and managers are always there whenever I need them, and the technicians I work with are extremely hardworking and loyal. Seems like every pharmacist’s dream job, right?

So why am I not truly happy where I am right now? There are so many reasons. The first reason is the direction that pharmacy is heading towards right now. There are too many players in the pharmacy game, and most of them are not even pharmacists. We are constantly fighting with the PBMs (pharmacy benefit managers; these are the companies that take care of the prescription insurance claims). Most of the medications dispensed in our pharmacies are high cost anti-cancer medications, they cost $5,000 to $20,000 per month. So of course we are fighting for reimbursement, and the right to dispense at our pharmacy, instead of forcing the patients to use their mail order specialty pharmacies. It gets REALLY hot here in Texas (we’ve already had several days in a row where the high has been over 100 degrees), and leaving medications out on the porch in this heat, or in a non climate controlled area, is just a waste of money, time, and resources (if a medication gets too hot, it can lose its efficacy). Patients then can get unexpected delays in their treatments, or their out-of-pocket costs are too high. This is especially true for Medicare patients, who are exempt from taking advantage of copay cards or other assistance from the drug manufacturers. It does break my heart to see patients unable to get their medications because they cannot afford it.

The biggest reason is that I feel like I’m not doing enough to make an impact in the world. Don’t get me wrong, I love being a pharmacist, especially in the oncology setting. I love the path that pharmacy journey has taken me. I am definitely a well rounded pharmacist, because of my experiences; I do not have a narrow field of vision when it comes to pharmacy, which is a dangerous risk with those who specialize. However, I love helping people realize their dreams or overcoming their limitations. I have helped friends and strangers overcome fears and limiting perspectives, and they’ve had their lives change for the better. But I always feel like I can do …. more. I could help more people realize their potential. I could guide more people to find what their true passion is in life. I could advise more people to take the necessary steps needed to get their dream job. More importantly, I can help MYSELF more by sharing my wisdom and talent so others can achieve their goals and dreams.

I’m hoping to follow A’s footsteps, but in my own journey. A has done incredibly well for himself, but I know that his path is not my path. My path will lead me to my own success and experiences. Nonetheless, words cannot express how grateful I am for A’s guidance in my journey.

Until then, I’ll just keep singing the “The Jeffersons” theme song in my head. For those who don’t know what I’m talking about, here is the link: https://www.youtube.com/watch?v=L09qnRfZY-k

Ch-ch-ch-changes!

In a previous post, I had mentioned that I need to put myself first. Well, I have been trying to do that. I have been *gasp* going to the gym more, and trying to be more active. Did I mention that I HATE going to the gym? The last time I went, I sat in my car in the parking lot of the gym for over an hour, procrastinating, until I finally gave up and went in.

The biggest reason I hate going to the gym, besides the actual working out, is that I have a real fear of people judging me. I do not have an athlete’s body, as most people do while at the gym. I do not lift 200 pounds, like I have seen some of the people do. I cannot run on the treadmill for 30+ minutes. To see people do this is very intimidating for me.

I joined the gym because my friend J convinced me to, and J promised to work out with me. He only worked out with me the first time, and every other time he had an excuse not to go to the gym. He is still very proud of me that I still went on my own, although I will admit that I probably didn’t work out as hard as I could have, because he wasn’t there to push me. I got scared of everyone there judging me, and what I can and cannot do. It stems from the fear of rejection, as stated in my last post.

So, what now? Despite me being intimidated at the gym, I’m still going. Will I ever get over my fear of rejection and intimidation, and just work out for ME? Most likely not. For those that say that going to the gym is half the battle, I say FTS! To me, going to the gym is like, 1/10th of the battle. Convincing myself to not compare my own journey to everyone else’s, and not run away just because I see a very muscular man bench pressing 500 pounds is half the battle. Actually working out is about 40%. I’m hoping that the more I go to the gym, the more comfortable I will be in my own skin, and my own fitness journey. We shall see if that continues.

If anyone else tells me to give up sugar one more time, I will cut that b****.

Fear Has Killed My Career

I have a fear of rejection.

I am definitely a people pleaser. I want to make sure people have a good opinion of me, therefore I will do what the majority says, even if it’s against my instincts, or against company policy. I often want to go with the flow, not against the grain.

That has definitely hurt my career. I didn’t have a backbone. I didn’t stand up for myself, and sometimes I was drowning in work. I would rather have people like me than ask for help. Sometimes, I would stay 2-3 hours past closing just to catch up, so the next crew wouldn’t have a hard time. I would take on more overtime shifts, even though my body would be SCREAMING for rest, to look like I’m a team player. I have followed bad managers and technicians, because I thought they were wiser and more experienced; sometimes I went against company policy because “that’s the way we’ve always done it.”

What became of my decisions? If I didn’t rest, I made more mistakes, potentially killing the patients. If I went against company policy, I would be thrown under the bus and punished, because it was ME that knowingly went against company policy, despite everyone else doing it. If I stayed late to help the next crew, I was never appreciated for my hard work; sometimes I was criticized for taking too long to do my work. I was called during my time off because the supervisor or technicians just assumed that I would come in and work, despite my personal plans. In every situation, I didn’t advance in my career, and I sacrificed a lot of time and effort to colleagues and employers that just didn’t care what I did for them.

I would like to say that I grew a pair and started to stand up for myself, but the truth is, I am still very much a people pleaser. My fear of rejection is still real, and it does affect my pharmacy career, as well as personal relationships. I wish I had a better game plan on how to stand up for myself, without making anyone mad, but in all honesty, that is just not possible. I know I will go crazy if I try to please everybody; in my mind, I do know this, but I still try to please everybody. There are times that I still stay late to help either the current staff so they can get out earlier, or to help whoever I am covering for. I have taken on more projects that my area managers have given me that are outside my generic job description. I keep telling myself that I am passionate about the projects, and I’m not sacrificing a lot of my personal time and effort; plus, I will gain some valuable skills that eventually will help me in the future, both personally and professionally. I do buy lunches and treats for the technicians that I work with, as it is not easy to work with a coverage pharmacist. I tell them it’s to thank them for their hard work, but in reality, I do it so they will like me more.

I have learned a few tricks, though. I have learned NOT to go against company policy, just because “we’ve always done it this way.” The potential risk, especially to the patient, is just not worth it. I have also learned to listen to my instincts. If someone tells me to do something that just feels wrong, no matter if it is a manager, or a technician who has been there a really long time, I will not do it. Yes, I do get in trouble initially, but more often than not, my instinct was right. When in doubt, I have learned to ask someone I trust for a second opinion before making a choice. No one is weak by asking for help.

I still have a very real fear of rejection. I have started to take the steps to manage it. I hope that eventually, this fear will stop killing my career and other life endeavors.

 

My Love Life and My Work Life

I have been crying over a guy who has made it clear over and over again that he will only see me as a friend. I met up with another friend, who asked me why I was letting my emotions get the best of me. My second friend, whom I will call J, very bluntly told me that I shouldn’t be chasing a guy that doesn’t want a relationship with me, and that I really should focus on myself. J then asked me, if I’m not happy in all areas of my life, then why would anyone want to come to me for help?

I was taken aback by his by his question. I answered back, saying that I’m a career coach, not a love coach, and I’m already doing great things in my career. He then pointed out that my emotions have affected me in my career. Looking back at my career, I saw that he was right. I was doing well in my career when all other parts of my life were going well. When I wasn’t happy with one part of my life (in most cases, it happened to be my love life), even though it seemed like I was doing well in my career, I didn’t feel happy in it; I felt either restless or stuck, or stressed.

When I first talked to my coach, we didn’t even talk about my career. We talked about my love life, or more specifically, lack of a boyfriend. We spent the entire hour finding ways to improve my chances of getting a husband. I felt better after a while, and I was doing almost everything in the game plan laid out for me, and that is when I had become excited about becoming a career coach myself. Now, I am still boyfriendless, but to be of better service to other people, I really do need to focus on myself.

With that said, I really am trying to be happy in all parts of my life. Tomorrow, J and I are going to the gym to sign up for the membership, and I’ll be calling J to go to the gym with me. By day, I am a floater pharmacist for a specialized company, so I know it will be hard for me to go to the gym at the same time every day. Also, I love meeting up with people in the evenings, so I either have to work out in the  early morning or late at night. These sound like excuses, and they absolutely are. I hope I can overcome my excuses otherwise I’ll get a good butt kicking from J.

What about the first friend, the one I have feelings for? The truth is, I don’t know what to do about him just yet. One complication is that I am totally in love with his dog (dogs are like children, right?), and I REALLY don’t want to leave her. He is a good friend. Some friends have told me to just cut off ties and move on, but some friends have told me to save the friendship, as he does make me happy, and he’s really a good guy. Both choices have pros and cons, so I have to follow my heart, and see which is the better choice. Until then, I will follow J’s advice and work on myself.

Tell Me Why You Went Into Pharmacy

Dear readers, I would like to know: why did you choose pharmacy as your career?

I actually didn’t choose pharmacy as my career; my dad chose it for me. I am Indian-American, and when I was growing up, we did everything our parents told us to do, including major life choices, like career paths and marriage. It was when the pharmacy shortage was happening. My dad had read about pharmacy, from the job markets to the salaries. He thought it would be an easy choice for me, as I was studious and hard working. My dad had an interest in chemistry, as did I. He even researched the best schools for pharmacy (at that time there were way less schools than there are now). So, being the obedient daughter that I was, I went into pharmacy.

While in school, I HATED pharmacy. Too many things to remember, not enough of a social life. I remember my business school friends getting done early on Thursday afternoons, and they didn’t have classes on Fridays. So they would go out on Thursday nights, and I felt like I was missing the fun (Pharmacy always had 8am labs). I couldn’t memorize everything, and I felt bored in my classes. Pharmacy didn’t excite me, and I definitely was not interested in the “rat race” of being the top student. I did get my pharmacy degree, and went to work.

The first few jobs I had didn’t help my attitude with pharmacy. I had thought about quitting several times, but never did because I wasn’t skilled or trained in anything else. Over time, I gained a lot of skills needed to be a GOOD pharmacist, and my hatred disappeared, and love and passion took its place. I love being a pharmacist now.

So tell me, how did you get into pharmacy? Why did you choose pharmacy as a career? Would you do something different if you could?

Thank you!!

Sense of entitlement?

Yesterday, I had the opportunity to talk to a potential client. She had seen my posts on LinkedIn, and thought I could help her. I gave her 2 hours of my time, and tried to coach her through her situation, while assessing whether she will be a good client for me. In the end, she just wanted to tell me what to do to get her out of the situation she was in, but she didn’t want to do the work that would have propelled her through her career. At the end of the phone call, we were going around in circles, I ended up getting upset and emotional, and told her we would not be able to work together. I think she agreed, but mainly I felt like she wanted me to help her for free, and that she was entitled to my help and expertise.

After that phone call, I felt really rattled. I could not go to sleep (I ended the phone call at 11pm), and I could not figure out why this phone call was bothering me so much. Then it hit me: at one point, I also had a sense of entitlement. When I first got of pharmacy school, I felt like I had put in the time and effort, not to mention the money, to finish pharmacy school; therefore I should have job positions handed to me. When I had the job position, I felt like the problems were not MY fault, so the solutions should just fall beside my feet. When I fell, I fell HARD. I thought I had hit rock bottom in my pharmacy career, when in reality, it was the best thing in my life. It humbled me like no other, and I ended up working harder than ever to get what I wanted. Yes, I have failed in my career, even after I hit rock bottom, but with the newfound sense of humility, I was grateful for all the setbacks, as it propelled me to be farther in my career.

After talking with the client last night, I thought maybe she was acting like this because she was young, but today, I found out I was very wrong. I was covering the normal clinical pharmacist, and working with the pharmacy manager. This pharmacy manager had expected the clinical pharmacist and technicians to do all the work. His excuse was that he didn’t know how to do it; he had only been at that position for about 8 months. However, part of it is a sense of entitlement. He thought that he didn’t have to do as much work, because everyone else will do it. At the end of the day, the physicians, nurses and patients were asking for ME to handle the problems. I seriously felt more like the manager than he. The worse part is that the pharmacy manager is in his fifties, and I’m in my late thirties.

I bring that point up because everyone thinks that only the young people have a sense of entitlement. It is also the older generation. This pharmacy manager is struggling, and definitely is not trusted by his own site. The client is also struggling, and thought she could get me to tell her how to get out of her situation, and she clearly didn’t get that. I have noticed that those that expect others to bail them out will NOT succeed in the long run, even if they get a short win. It bothered me before, because it reminded me how I once was: an arrogant, self-entitled prick. However, I am also grateful for the reminder, as it made me reflected how far I have come, and how far I can go.

I was willing to help that potential client, until I realized she just wanted me to give the answers to her. She wasn’t willing to do the work necessary to make her situation better herself. I wanted to help the pharmacy manager, until I saw that he wanted me to do all the work. I am willing to help anyone who asks for my help, as long as they are willing to take my help and suggestions seriously, and DO THE WORK. Until then, I will be grateful for the many opportunities given to me, and the people who have guided me along the way.

Do Pharmacy Schools Prepare Their Students for Life After Graduation?

My opinion is ABSOLUTELY NOT.

When I graduated pharmacy school, I got a job at a hospital about 3 hours south of my parents’ home. I didn’t even last the probation period. I knew the technical pharmacy stuff, but I had no clue how a hospital pharmacy ran. I had inpatient hospital rotations, but they were with clinical specialists, who weren’t in the main pharmacy; I was hired to be a staff pharmacist. I didn’t know how to treat the technicians, and other healthcare professionals. I didn’t even basic pharmacy rules and regulations! To be honest, I wouldn’t have kept me either.

After that job, I went to work for Walgreens in that area, since my parents’ area was saturated with pharmacists. I thought I was prepared for that job, because I worked at Walgreens as an intern while in pharmacy school, and I had an amazing manager, who became my mentor. Boy, was I wrong! It was the end of the pharmacist shortage, and the beginning of how retail pharmacy is now. I still lacked the skills to be an efficient and effective supervisor to the technicians, and I didn’t know how to deal with unruly patients. Eventually I left Walgreens, and went from job to job, from Illinois to Texas. With each job, I learned valuable skills needed to be a GOOD pharmacist, and ultimately, landed a job that I truly love. If it weren’t for certain skills, I wouldn’t be where I am at now.

I am also a preceptor for students from the Texas pharmacy schools, and after many candid discussions with P4 students, I realize that the future is very bleak for them. Many skills that are vital for various pharmacy settings are not even taught in school. In Texas, it is a state board requirement to have IV certification in order to work in hospital or infusion settings. Yet, most students haven’t even held a needle. Many new graduates are being thrust into management positions. How can they manage a pharmacy if they do not even understand the basics of how the pharmacy is operated? What about interpersonal skills?

Pharmacy schools do an amazing marketing job in telling prospective students about the six figure salary that they will receive after graduation, and the high job placement rate. However, what they do NOT tell the prospective students is that there is an oversaturation of pharmacists in the desirable areas (mainly metropolitan cities), and that graduates take either a position in an undesirable area, or take multiple per diem positions. However, a job is a job, so the pharmacy schools do maintain a high job placement rate. Most of the pharmacy students come out of school with over $150k in debt, so not having a position is not an option for most. Plus, who wants to spend that kind of money, for nothing to show for it in the end?

So, what can we do to help the future generation of pharmacists, besides telling them to not go into pharmacy in the first place? It is obvious that pharmacy schools will not change their marketing strategy to realistic views of today’s job market, nor will they incorporate mandatory classes to teach pharmacy students basic life and management skills needed for after graduation. I learned my valuable skills needed in order to be a good pharmacist through my many jobs, but many employers do not have the patience or desire to teach the new grads these basic life and management skills. Why should they, when they have 10 applicants for even a per diem position?

 What about the current pharmacy students, new graduates, and pharmacists in the market now? How can we help them become GREAT pharmacists? One way is to have a mentor. However, a good mentor-mentee relationship takes YEARS to cultivate. Even then, people change, jobs change, skill sets required change. If the mentee changes, there is no guarantee that the mentor will change as well. What about YouTube videos? Anyone can find any type of tutorial on YouTube, right? There are some things that even YouTube can’t teach properly. There are many books on management and leadership, but many pharmacy students and new graduates will not know how to decipher what information is applicable to them, and how to apply that information in their current or desired practice settings. I recently hired a career coach, and I have seen so many positive changes. Even if my job or circumstances change, the career coach can guide me through those changes, while still making the positive impact. 

There is no one right way to better oneself as a pharmacist; but finding the right solution may take some time. But one thing is clear: one must have the desire to change. We cannot change the market, or the way pharmacy schools churn out pharmacists; but we CAN change what kind of pharmacist we desire to be.