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Who Cares About Me?
by Sharon Karina, PharmD Candidate (2018), Midwestern University Chicago College of Pharmacy
As eight years of academic and experiential preparation come to a close, I have had both time to reflect and a serious reality check about life beyond school. Most graduating students worry about managing student loan debt and, in this climate, finding a viable professional opportunity. I am not excluded from this. However, what is even more concerning to me now is advocacy.
Let me begin by being completely honest with you, prior to my APPE rotation at ICHP I knew nothing about and was not naturally interested in advocacy. Pharmacy law, despite the passion of those who taught the course, was not as exciting to me as therapeutics or other classes I thought were more relevant to being a pharmacist. Legislative Day was something I did not prepare for when I went as a first-year pharmacy student, and remained an event I did not attend again because of competing priorities. Advocacy was not important because someone else would deal with it. After all, I needed to focus on studying anyhow.
I was wrong. That takes a lot to admit. I made strategic decisions during school to better my personal and professional growth and, really, just survive at times. Legislation was not remotely a concern - but it should have been. Let me explain my new found knowledge to you.
What I’ve Learned
What is advocacy, anyway? Visions of reviewing bills came to mind. I was not entirely wrong but it is not as mind-numbing as it may sound. Some search results were self-explanatory, such as a summary proposing pricing transparency with PBMs. Yet others, such as the proposed use of cannabis in place of opioids in those with opiate abuse disorder, have been buried deep in an unrelated bill (in this case, a banking bill). More proposed legislation includes allowing nurses to have prescribing rights, omitting pharmacists entirely from the conversation. Those are just three small examples of areas for advocacy and for opportunities to create more jobs and value.
Where I’ve Failed
I realized the same reasons I did not care were the same reasons some of my patients decided they did not need to take responsibility for their health. Let’s explore the parallels with actual statements patients have made to me:
Patient: A higher power/karma will take care of my diabetes, I don’t need to take insulin.
Me: A higher power/karma will take care of pharmacy and my career, I don’t need to do anything.
Patient: My doctor is responsible for managing my high cholesterol and once I take my statin I can eat whatever I want.
Me: My national and state organizations/employer/health system is responsible for advocating for pharmacy and my career, once I join/am employed I don’t need to do anything.
Patient: I don’t believe in cancer screenings, if it is meant to be it will happen no matter what I do so why worry about it?
Me: I don’t believe in politics, if it’s meant to be it will happen no matter what I do so why worry about it?
Why You Should Care
The problem with deferring responsibility to someone else is that your best interests are not being looked after. Employers are not looking to advance pharmacy practice or provide job security or a career trajectory for you, and often address legislation as it affects financial gain. State pharmacy organizations are key to scanning for threats and opportunities for professional action but require immense resources to make a difference. This includes individual pharmacists, pharmacy technicians, and pharmacy students taking the time to find out who their legislators are and introduce themselves. You can weigh in on proposals and, in turn, create a climate where pharmacists are able to prove value in managing patient outcomes and costs. I used to believe that advocacy was the responsibility of IPhA or ICHP, but as it became my responsibility as an APPE student, I realized it belonged to me all along.
After all, who cares about me?