PLEI Perspectives: Returning to Our Roots Will Ensure Our Future

For more than a year now, the Pharmacy Leadership and Education Institute has enthusiastically contributed a number of articles to Pharmacy Times.

While not an exhaustive list, we have explored what the future of work might mean to our profession; how our educational system is at least partially evolving to help change the mounting costs, pressures, and information that pharmacy students need to deal with; how the very definition of leadership is changing; and what we collectively can do to help shape the future.

These issues and opportunities have been presented in an open and perhaps more brutally honest manner that some would like. Our desire has been to open the needed, but perhaps unwanted and uncomfortable, realities of our current world.

We feel these discussions have been taking hold and are combining with other pan-professional activities to take us toward a desperately needed tipping point. Critically important to us was what happened at the most recent American Pharmacists Association annual meeting. We applaud the conference organizers who dedicated valuable time and energy around what we’d term “getting back to treating the patient and not the disease.” While the praise for these efforts is handily deserved, so might the criticism that they are falling short of where we feel we need to go.

A “return to the patient” is something we’ve discussed in other forums so we won’t repeat those discussions. What we would like to do is to provide a higher-level take on how vitally important this will be for our profession and for our patients, as well as our longevity in the health care arena in the future.

First, there remains ample evidence that patients are being underserved or inappropriately served by the health care system generally and pharmacy specifically, primarily by disconnecting them as human beings and regarding them as data points. In other words, we are treating the disease and not the patient.

Removing the focus on the patient, as a living person, induces more fear and trauma into his or her already stressed state. Life is full of stressors and trauma to begin with, which can precipitate or complicate the very conditions we are trying to treat. To increase their trauma is not only against our professional foundation of “do not harm,” it is unethical. While this might appear to some to be a dire situation, we see it as a golden opportunity for pharmacists to provide holistic patient care models for the system in new and vitally needed ways.

As the most accessible of all health care professionals, what we do and how we do it are areas that can be modified that would bring the biggest corrective bang for the buck (ie, in helping patients feel supported and connected to the most progressive and advanced system in the history of medicine).

Next, we know that patients enter into our settings full of hope as well as confusion and, perhaps, desperation. We serve an utterly critical role, therefore, in how they view their own power (ie, in the past that brought them to us, in the moment of our first encounter, and how they will view their role going forward). The worst thing we can do for them is to perpetuate a victim mentality with the belief that they need outside sources of expertise to “fix them.” We have an opportunity to help them realize that they have always had a say, and actually a profound influence, in their life, which they may not have realized, nor capitalized on.

A related opportunity is to help them see that they may have inadvertently contributed to their problems, but that the future is not doomed to repeat the past. How many of us, though, are comfortable with, let alone able to, facilitate these delicate conversations? How many of us are proficient in self-management principles and are able to foster new habits in the few brief seconds we have with patients? These questions are actually moot because there are ample resources that can be accessed so none of us in the health care chain can claim the lack of opportunities to learn new skills and grow ourselves personally and professionally. Related to this, if we espouse the mindset that we are fully capable and even called to save people, we are feeding into the “leading by doing disease” that further disempowers patients and clinicians alike.

The strongest, broadest, and most long-lasting activities we can provide are actually those that are the very foundational basis of our profession. No, we’re not talking informatics and biological regimens, and we’re not talking traditional small molecule therapeutics or even compounding. What we’re talking about predates most naturopathic and homeopathic remedies. Our roots go all the way back to when we were mostly able to only empathize, sympathize, sit and cry or laugh with someone, and let them know that their current state, their value, and their future are worthy of our time.

Way back in antiquity all we could do was sit around the fire and be with one another. We were connecting on the heart level, as well as the head level. Connecting with what was happening in the moment with what brought us to that moment, as well as the future that was possible. Connecting our own hopes and fears with all those around us—not just between 2 people, but our people/tribe. Today we call this “witnessing.” Are we ready as a profession to “witness” for our patients, as well as one another?

The modern age has taken us away from these roots in many ways. Yet in this moment we also see opportunities to connect ourselves with others in ways absolutely unseen in the past. For example, with our newfound knowledge of the human body and disease, we can address pathophysiological issues with clarity and specificity instead of best-guess approaches. With computing systems that provide us with a collective insight, we can explore possible solutions to our problems in ways undreamt of in the past. With communication channels that provide us with the ability to literally see one another across the entire expanse of the globe, in real time and with a quality level where we can almost see the happiness and dread in each other’s eyes, we can provide high-touch health care to nearly everyone with the need.

Returning to our roots does not mean abandoning the advances that have been made over the last 500 years or so. It means recapturing, reemphasizing, and remembering the profoundly influential humanistic characteristics of our profession while we openly embrace the cutting edge scientific and technical capabilities.

Teaching this during pharmacy school, weaving it into practice standards and policies on governmental, business, and association levels, and living this daily with our patients will jettison our role in the health care chain to where it can and needs to go, carrying us all to unimaginable highs.

Gary Keil, PhD, RPh, is a board member of the Pharmacy Leadership & Education Institute, national program co-director at Beautiful Mind Strong Body Center, LLC, and coowner of Evolutionary Health.Eleanor M. Vogt RPh, PhD, is a health sciences clinical professor at the University of California San Francisco School of Pharmacy. Dr. Vogt’s career spans positions within academia, clinical pharmacy practice, the pharmaceutical industry, health policy and planning, regulatory affairs, and patient advocacy.