Satisfaction and meaning in pharmacy

I am in my fourth decade of pharmacy. Through the years, rarely have I interacted with colleagues who were satisfied with their professional efforts. Though this has always bothered me, I have had only vague ideas about its source.

Defining the problem

We start out with early successes in math and science, coupled with an outside stimulus that identifies pharmacy as a worthwhile idea. Next, we need to possess a type of intellect dominated by qualities of organization and capacity, one that can retain vast amounts of very specific pieces of knowledge. Then, we must show a specific kind of confidence and intellectual independence that can take knowledge and initiate its application in new situations. And last, our personality should include the characteristics of focus, drive, and stamina, which will see us through an extended period of challenging academics.

By the time we begin our professional life, we are by definition focused, confident, driven people with extensive intellectual capacity - finely tuned specialists who are expert at working independently on very complex problems.

Autonomy

Autonomy involves making one's own choices. Our profession is deeply committed to law, policy, and procedure. We are rewarded for how closely we follow these and penalized when we deviate.

At our first job, we are placed in a highly structured environment and given routines with lists of very specific tasks to perform. Even though later our tasks may become more elegant, they remain specific and assigned.

Problem-solving

A clearer, more complete definition of this idea might read: "Engaging the full power of your creative problem-solving ability as an integral function of your daily responsibilities." This means studying questions and problems, and then creating the best possible solutions.

There is a great difference between being fully occupied intellectually and being fully engaged creatively. The first can be applied to doing the same difficult computations thousands of times. The second involves applying all your knowledge and experience to new and different problems.

In the course of our careers, we do not move up a ladder of ever-increasing challenge or complexity. The tasks that occupy us at the end of our careers are often very much like the ones we performed at the beginning.

Effort and reward

One of the features of our profession is the almost flat advancement structure. While we come into the profession at a high rate of pay, there is little upward movement after that. There is no reward for additional education, experience, or specialization. Ours is one of the few professions where there is no proportional monetary compensation for investing 40 years in becoming widely skilled and highly proficient.

Conclusion

Let's look again at at earlier statement:

By the time we begin our professional life, we are by definition focused, confident, driven people with extensive intellectual capacity - finely tuned specialists who are expert at working independently on very complex problems.

It is my observation that we use very little of the ability we have. The very nature and structure of our profession limit us. When we have little autonomy, when we perform repetitive tasks for most of our careers, and when there is little relationship between effort and reward, is it any surprise that we have questions about the value of what we do?

Mike Lahr is a clinical pharmacist with Salem Regional Medical Center in Oregon. He can be reached by e-mail at mikelahr@aol.com
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