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6 Current Obsessions

August 23rd, 2014

1. Big Black Delta. After listening to the latest album, I went over to their Faceplace page, where I saw a bunch of black cat photos. Now, I love them even more. Caution: they have a kind of retro 80s sound.

2. Water.  As in, will future generations have enough?

3. Assessment of learning, particularly in the realm of entrepreneurship.

4. Failure. (I just can’t let this one go.)

5. Spain. For obvious reasons.

6. Tiny spaces. As in, I want one.

When Will Water Become the New Oil?

August 22nd, 2014

Waverly STEM PrincessToday, I’ve been thinking a lot about…water.

Much like health, I think we all (myself included) take potable water for granted.  We just flip on the faucet and assume it’s going to pour out and be safe to drink.  The assumption that we’re always going to have it around in this fashion is…disturbing.

Just look at this article out of Detroit about their water problem.  If you saw on the national news the other night, Lake Mead is at a record (14 year) low, and this is a source of water for several states.  Meanwhile, in Arizona just this week were floods.  Even right here where I hang, Indiana, the state chamber put out a rather disturbing report on water and how it ties into our economy.  This is happening right here in OUR OWN country, my peeps! Not the middle of the desert on the other side of the Earth!

Now, for those of you thinking – wait a minute, we’ve got the oceans – keep in mind that is salt water.  Less than .5% of the total water on Earth is potable.  Desalinization is still cumbersome.

Friends, mother nature is tricky.  While we fight over oil in many countries, I’m pondering how long it will take us to start globally fighting over another precious resource that we are taking for granted, water.  This scares me.

There’s a major educational opportunity here.  If we can train the next generation to preserve water and treat it as the very precious resource that it truly is, we can slow down this massive drought of ignorance.  I’ll admit it – I AM IGNORANT when it comes to clever ways to preserve water – so I looked it up! Here are some thoughts:

1. CDC has some thoughts on making water safehere.

2. The Alliance for Water Stewardshiphere.

3. Study Dr. Elinor Ostrom’s work on commons – including waterhere’s a bit on it.

4. 25 Ways for Preserving Water in Homes and Yardshere.

5. Water conservation at the community levelby Penn State.

Water is absolutely essential to life.  Without it, we and the creatures we share this planet with will die.  I don’t mean to be gloom and doom, but I am worried about this problem, as it becomes more apparent to me.  If I just get you to think about this for a minute or two (or more, as I have over the past couple of weeks) I think we could all make some serious positive changes…not only for ourselves, but for future generations.

Is Social Media Use an Ethical Professional Obligation for Healthcare Professionals?

August 20th, 2014

PrincessPiperSTEMPrincessI was lucky enough in May to attend Mayo Clinic’s Social Media Residency Program.  First, as an outsider, I was impressed that ALL Mayo employees were welcome to attend the residency program.  But second, I’ve also subsequently been lucky enough to watch their blog from afar since the live training (or, rather, they push their blog to my inbox every morning, which is one of the few things I actually read on a regular basis in my inbox).

An interesting comment was posted recently by Lee Aase, the Director of the Social Media Center at Mayo, where he stated the following in this post:

  • “…social media should be recognized as tools health care professionals are expected to use, and that effective application of social media is part of professionalism.”

I’m going to let that sink into your brain for a second, especially if you are a healthcare professional.

While I can’t speak to what they are teaching students in other healthcare programs, I can tell you that in pharmacy, professionalism is front and center.  In fact, in the ACPE 2016 draft guidelines (of which pharmacy schools are held to as our accrediting body), professionalism is all over the draft guidance document and standards.  Here are just a few draft standards that are applicable to professionalism and social media:

  1. “3.2 Education – The graduate [pharmacy student] must be able to educate all audiences by determining the most effective and enduring ways to impart information and assess learning.
  2. 3.6 Communication – The graduate [pharmacy student] must be able to effectively communicate verbally and nonverbally when interacting with individuals, groups, and organizations.
  3. 4.4 Professionalism – The graduate [pharmacy student] must be able to exhibit behaviors and values that are consistent with the trust given to the profession by patients, other healthcare providers, and society.” (ACPE 2016 Draft Standards)

Next, watch this video (which I believe is also in Lee’s talk above).  The item that blew me away in the video is that one college has altogether stopped sending email to students.  Wha…?!?

If you bundle all this together – in order to educate and communicate as a professional, you have to go where the audience is – right?  If that’s true, and social media is now the predominant platform where people get their news, share their lives, and learn about society – shouldn’t pharmacists as professionals therefore be right there in the middle of social media land?  Do we have an ethical, professional obligation to be there?

I’m not going to push it and say that social media management should be part of mandatory healthcare curricula just yet.  That may be too revolutionary for today.  But, I will say that I think we need to go there.  I’m there personally, as I’ve been part of the inception of the Social Media Dames Unconference Series in Indiana (which, by the way, tickets are now on sale for the November 20, 2014 event in Indianapolis here.)  It’s now more than “hide your Facebook profile” when it comes to professionalism, social media, and the internet for healthcare pros.  If we are truly trying to keep costs low, educate, communicate and be true helpers of public health and wellness of society at large, shouldn’t we go where the masses are?

I’ll leave this for you to ponder today…

 

The Pastophor

August 19th, 2014

I’ve had my design thinking hat on this week about some other things…which had me thinking tonight about the following:

Why do physicians prescribe drugs?

The physicians are diagnosticians, from my understanding.  But why should they get to pick the “best” drug for a patient, when:
a. they don’t necessarily know what else the patient is taking, (and yes, there are some very fatal and very nasty drug-drug interactions out there to be worried about)
b. they didn’t have as much pharmacology training as an actual pharmacist, and
c. they typically don’t know what’s on the patient’s preferred formulary for their prescription benefit plan.

Common sense aside for a moment, I dug around history tonight to understand what the origins of this split between the physician as prescriber and the pharmacist as dispenser happened.

I’m still not totally sure, to be honest.  But, the one thing I stumbled upon was the pastophor.  This was, in ancient Egypt – a physician and pharmacist in one.  The pastophor diagnosed, treated and prepared medicine for the patient.  They were allegedly “highly respected” in society and pharmacy, or the preparation of medicine, was considered a specialty within medicine.  (I found that here, on page 25.)

Now, let’s flip over to NPR, where tonight, I also saw an interview with a cardiologist about his new book, basically about the problems with our healthcare system in the U.S., inter alia (and no, I haven’t had a chance to read the book yet).  Part of the interview talks about some docs (NOT ALL) ordering excessive diagnostic tests for patients.  Now, of course, we have a few laws called Stark and Antikickback that don’t allow docs to be vertical marketers anymore.

I guess through reading part of the first reference above, pharmacists in England couldn’t get their act together (meaning they didn’t have standards of education and experience established), which led to physicians making the call on drugs, and having licensed pharmacists (rather than snake oil salesmen or untrained chemists) fill the prescriptions instead.

Here’s my bottom line: I’m inconclusive here.  It kind of makes sense (at least from a design thinking perspective) that the doctor may be great a diagnosing the patient, then putting on paper or ePrescription the diagnosis – then handing the DIAGNOSIS over to the pharmacist INSTEAD of the drug, and letting the drug expert decide on which drug is best/cheapest/on formulary for the patient…?  Maybe? Perhaps?

There’s probably more history here that I’m missing.  But I still am haunted by the why.

However, if nothing else, we learned about the pastophor in this post.  Believe it or not, there are actually some pharmacist-physicians out there in the universe this very day.  Maybe THEY can shed some light on why physicians get to prescribe drugs, but pharmacists have no say in the best drug for the patient…?  When I run into one the next time, I’ll be sure to ask…*

(*OK, technically, pharmacists can prescribe a few drugs on their own, based upon different state laws.  Also, pharmacists may be able to prescribe through something called collaborative practice agreements.  This is a step in the right direction.  And I’m not saying that all physicians are terrible prescribers in this post either.  What I’m questioning is WHY the system is the way it is currently – and should it REMAIN that way?)

Getaway

August 18th, 2014

Boonsboro  So, this weekend, I escaped to WVA, VA and MD.  Specifically, I stayed in Nora Roberts’s B&B, The Inn at Boonsboro.  As one of my friends put it, we like to support fellow writers.

But, in this weekend getaway, I also visited Antietam and surrounding places to learn a little more about our history as a country – which, as you know, isn’t all warm and fuzzy.  However, I also found a few surprises along the way this weekend, which are the following:

1. Small towns are in some cases – alive and well.  Boonsboro isn’t a large city; however, it’s booming.  There were tons of people around, and the Inn I believe was at capacity.  I like to see that small towns are still thriving in this super-hyper-linked crazy era we live in.

2. Writers support other writers.  Nora’s husband owns the bookstore across the street from the Inn.  The room of her books was truly prolific; however, that didn’t impress me as much as her table of OTHER authors’ signed books for sale.  I dug that she and he support other writerNoras.

3. In order to understand the future, we have to study the past.  We visited two national parks in the area, one with another monument to Washington.  It had a walking path up to the monument, along with historical points along the way of Washington’s life.  To study great future leaders, we have to understand great leaders from the past.  And as much as I prefer the future to the past, I know I need to keep reading and learning about history, in order to not repeat the bad stuff, and re-do the good stuff.

4. Heed the advice of the locals.  Josh was our waiter the first night at the restaurant in town, and he gave us advice on all the spots to see.  We did all of them, and were glad we did.  Pay attention to what the locals say – they don’t mislead.

AntietamflowersatInnCrawfordsphoto(3)

Your Career is a Garden

August 14th, 2014

photo(6)It’s funny how the universe has a way of working out.  Just as I begin this post, a new connection on LinkedIn sends me an article I’m quoted in (I had no clue it was out, nor do I recall being interviewed for it) but it has a quote in it from yours truly that is totally apropos to this post, which is in part the following sage advice for your consideration:

Gone are the days of treating your career like a ladder.  Treat your career instead like a garden.

First, careers aren’t linear anymore.  They zig, zag, go 360, and move around all sorts of crazy non-linear pathways.  People get laid off, quit, or choose to opt out of the workforce altogether for various reasons.  People also jump back in–reinvent themselves in new industries by utilizing and maximizing transferable skills.  A ladder is straight, with usually only one directional option.  Ladders really don’t cut it when describing one’s career anymore.  There’s more than one way!  Besides, the 40 hour work week with ONE employer is dead.  Over.  So over, we need a new word for over.

Instead, think of your career as a garden.  First off, have you ever witnessed an extraordinary garden? Apart from the beauty and gobs of hard work behind the scenes to make it beautiful, they rarely have only one flower in them.  The best gardens have vegetables, herbs, and flowers of all kinds.

As I begin writing my new book about Multipationals, (yes, I’m declaring that a word, right here and now) or people with multiple careers advancing at the same time, I realize that the most fascinating and interesting people on the planet now treat their careers not like ladders – but like gardens.  They look for opportunities that might be a little different from what they currently do, but the new opportunities heighten or intensify their existing expertise and skill set.  In the meantime, they weed out the “junk you don’t want” – as I was so eloquently quoted in this article unbeknownst to me today.  I’ll also be discussing this with my friend, Abdul-Hakim Shabazz on his radio show Friday evening 8/15 at 6 pm in Indianapolis on WIBC.

Gardeners painstakingly weed out the stuff they don’t want in the garden.  They constantly evolve the garden into its magnificence over time.  They foster the plants they love in the garden.  The seasons, temperature, and care all can change the garden as well, just like our lives.

One of the hardest jobs I see as an educator is preparing the next generation of students for this new garden-like or portfolio-like approach to career development.  No one in school ever taught me how to look for pockets or varieties of career opportunities in the same space and time – I had to figure it out for myself, and I’m still struggling with optimization of it.  But now, through my writing and teaching, I’m going to investigate how these amazing multipational career gardeners are managing it, as they will own the future, so I can help the next generation of rock stars shine.

Mark my words.  Or mark my nasturtiums…!

Who’s the Other Half of Your Eutectic Mixture?

August 13th, 2014

This post is brought to you by an old memory that hit my nose when I walked in home tonight–and from pharmaceutical preps lab a few decades ago.

Sometimes, when you mix two solids, you can form a liquid at room temperature.  It’s called a eutectic mixture.  Several substances can do this.  But for us pharmacists, the #1 classic eutectic mixture is…wait for it….camphor and menthol.

That is, when you mix two solids–camphor and menthol–at room temperature together in certain proportions, they melt together and form a liquid.

I always thought this was magical chemistry.  Even in the very practical and downright scary pharmaceutical preps lab–where everything was serious.

If you’re a solid (OK – if you’re one of those theoretical physicists out there who thinks were all made up of waves – set that notion aside for a moment) and ask yourself – who melts you?  Who’s the other half of your solidness that makes you form a eutectic mixture?  It could be a best friend, or significant other, or maybe even a pet.  Whatever.

I just want you to pause and think about this magical chemistry for a moment in your life.  If you are truly lucky enough to have someone in your life who does this to you – I’m giving you permission to maximize your time with them.  Get gooier.  Melt.  Because–this life won’t last forever.

For those of us who don’t have a melty magical half–there are other things to melt with.  Books.  Writing.  Other passions.  Find them.  Get gooier with those too.

It’s important to find things that melt you.

 

 

Assessment, cont.

August 12th, 2014

Upon further cogitation today, perhaps I was a little harsh on the twin, Assessment, from my post yesterday.

What I really meant to beat up was standardized tests.

There are other forms of kinder, gentler, and probably more useful assessment.

Case in point: reflection.  Reflection now happens in my day job in ePortfolios by pharmacy students.  They are to write about their rotation experiences in their ePortfolios, on top of providing evidence of projects and items they learned about during their rotations.  So, ePortfolios serve two functions: 1. proof of learning and 2. reflection of learning (through writing).

I love writing. (I should think that’s rather obvious here at this tiny blog.)  What I never really pondered before this week was that I think a reason why I love writing so much is that I have the opportunity to reflect on what I’m learning in this crazy life.  And, I love writing even more because I can bring others along with me on my learning journey.

That’s probably also why I’m rabid about trying to get as many students engaged in writing and publishing before they leave college as possible.  To write–is it divine?  That may be a stretch for some (trust me, it’s downright painful even for me on things I don’t want to write about but sometimes HAVE to write about).  But–it’s a form of creation. Expression. Understanding.

Give me a writing assignment.  Maybe skip the standardized test…that’s the most peaceful way I can leave assessment.  For now.

Is Assessment Assumption’s Evil Fraternal Twin?

August 11th, 2014

You know what they say about assuming things…it makes an @$$ out of you and me.

Even though it may appear that assessment is the exact opposite of assumption in many ways, I’m starting to wonder if they are really more closely related than we think.

Lately, I’ve been a little obsessed with assessment – probably due to my stronger obsession with failure.  Failing, if done right, is an opportunity for one to assess what went wrong in a failure, come up with some alternatives, and try to correct it next time when confronted with a similar opportunity, right?

Well, maybe.

If you listen to all the gurus in higher education talk about assessment – the staple in their toolshed they always want to run to first is the standardized test.

PSAT. SAT. PCAT. LSAT. MCAT. GRE.

These letters should strike horror in most of us who dared to go to graduate school.

The gurus SAY these tests can predict future success in graduate school.  But frankly, I’m not convinced.

Maybe I’m biased, because also candidly – my standardized test scores were terrible.  I took a PSAT, had a lousy score then, had a lousy SAT, and even had a terrible LSAT.  And yet, here I sit with a college degree and a law degree.

I’m just here to ask with this post – are we measuring the right things when it comes to assessing success (and for that matter, failure)?

Where are we measuring the following 21st century skills that are IMPERATIVE for our future leaders?

  • The ability to work in a wildly differing team in college?
  • Where and how are we measuring creativity?
  • Where and how are we measuring the ability to solve a real-world problem with a creative product or service that works in the real world (NOT a simulation)?
  • Oh, yeah, and make that product or service with LIMITED RESOURCES by crowdsourcing…
  • Are we assessing a student’s ability to go out to Google, find relevant and reliable information on a subject to curate the best stuff on a subject?
  • Are we measuring how wild their solutions (and for that matter, how many) solutions a student can come up with to solve a problem?
  • How and where are we assessing leadership? (And NO, SORRY, that’s not taking Strengthsfinder or Myers-Briggs and calling it a day. Knowing yourself is just part of becoming a leader.)
  • Where are we assessing how a student builds and fosters a disparate global network?

I’m not sure ANY of the stuff above is assessed on ANY of the standardized tests above.  But, we know our students and employees of the future need these skills.

To put this into the ether: why aren’t our standardized tests changing for assessment of 21st century skills?

Hmmm…..

I’m headed off to ponder this.  But don’t worry – I’m NOT going to create yet another standardized test to try and solve it. Promise!

The Gray Zone of Corresponding Responsibility

August 11th, 2014

If you’re in healthcare, you probably already know all about corresponding responsibility, a legal doctrine.  In Indiana right now, it’s particularly a sticky wicket, because pain management responsibilities between physicians and patients has also elevated.

At the day job, we held a continuing education program at our annual Pharmacist CE program in June in Indianapolis.  Thanks to the panelists, we also put together a couple of case studies from this panel discussion and Drug Topics was kind enough to give it the full attention this topic deserves.

Even though the author is long-winded, it warrants a reading.  And thanks to Drug Topics for giving us wiggle room to make this a feature in their latest edition.

Last, what you don’t see in this article is how well all the panelists worked together to put both this panel and the article together.  I certainly did not do this alone.  And in the era of interprofessional education front and center, the folks on this panel made it a true pleasure to work with them.  Thanks!