Dec 2, 2017
Pharmacy Leaders Podcast
“Organizing your leadership road in 2018”
What you can expect:
How do you refer me?
Anyone who struggles with pharmacology or the Top 200 Drug Names, please refer them to my audiobook Memorizing Pharmacology: A Relaxed Approach
Today’s Episode focus: External Expectations
1 Obliger tendency
2 Obliger tendency in the pharmacy profession
3 Obliger solutions
Four tendencies mnemonic QUORA
A[person who understands external expectations]
Recommend the GretchenRubin.com quiz
NAPLEX vs APPE
Difference between P1to3 years vs P4 year
Analogy to Shut up and Write PhD groups
Residency vs Family
Residency vs No residency - obliger
Residency Showcase not the “Resident to be” showcase
Story about my wife’s new side business with Rodan and Fields
Solutions - Both/and not either/or mindsets
Mailbox money side hustle instead of extra job
Story about UMAB gym job
Who do you want to be with, not what residency do you want to get
Spouse’s time for a side hustle
Four tendencies for everyone
Spouse, kids, boss, employees
The Date night unbreakable appointment
The Writing appointments
1 What is the obliger tendency?
2 How does the obliger tendency show up in the pharmacy profession?
3 What are solutions to the obliger tendency for pharmacy professionals?
ASHP in Orlando
Other publishers and podcasters
Friends on this episode:
Welcome to the Pharmacy Leaders podcast with your host Tony Guerra. The Pharmacy Leaders podcast is a member of the Pharmacy Podcast network. With interviews and advice on building your professional network, grant and a purposeful second income from students, residents and innovative professionals.
Okay. Welcome to the Pharmacy Leaders podcast. Normally, I have a guest, but I'm going to be transitioning here. I'm going to interview with Todd Eury and talk about that transition. But, I wanted to kind of reintroduce myself and talk about the things I'll be talking about here in late 2017 and 2018. So, what I wanted was just a short sentence to explain what it was that I'm going to do with this podcast, and it came to me early this morning while I was at the gym, kind of how things come, but I want to help you organize your leadership road in 2018. So, whatever it is, whether it's career, whether it's second income, whether you're a student, what are the challenges that you're having and how can we help you with those. And the way that I'm going to do it is, I'm generally going to interview someone who is some pharmacy leader and it doesn't have to be a formal position. They might be the best at something that they do. Also, I'll try to give advice where I can. I've been in the profession for 20 years and I've had really good success with some second income, especially with self publishing. I'm probably one of the.... I might be one of the most purchased, self published audio books on Amazon right now. That didn't go through any kind of a formal publisher. Now, I do have another book that's coming out with a formal publisher or a nationwide publisher, but again, so it's something that you can do and I can tell you how to do that from beginning to end. And then, we're going to talk about your professional network and brand.
How do I refer you? I understand as a student, you're kind of figuring things out in P1, P2 year, but as you get towards that P3 year and you're looking at those APPE rotations, what is it that you are going to try to get better at? Some people are extremely sure of what they're going to do. They're going to do manage care residency or critical care residency or they're going to do an MBA or they're going to be in community pharmacy or independent. And, I don't necessarily like that those tags come along with a place because that's another place, it's not you. What is your brand? How would someone refer you is really what a brand is asking you. So, if I think of someone like Tyler Dalton from Auburn, I immediately think nutrition. Same thing with ____, but I also think nutrition and I think small town pharmacy, independent pharmacy. Same, I guess, with Tyler Dalton as well. But, I should be able to, in one sentence, encapsulate how you would want me to refer you because I do run into a lot of people and a lot of people that might be able to help you. How would you refer me? Anyone who struggles with pharmacology or the top 200 drugs, especially if they are a second language speaker, English isn't my first language, refer them to my audiobook ‘Memorizing Pharmacology’ or ‘How to pronounce drug names’ or ‘Goodnight pharm’. I'm coming up with another one. That's going to be a little bit more advanced for NAPLEX and NCLEX, those types of exams later. But, the interviews, the advice and the professional network, how to build that up?
Also, it's kind of tragic to me how the school loans are getting so big. I do listen to the other podcasts and hear that it's around a 160,000 average, but what I'm seeing people go in, I'm seeing their pick up about 200, a little bit more than that. So, I also want to talk about some second income strategies that you can do as a student, as a resident and as a practitioner. But, what would I talk about when I have this kind of first re-introductory episode? And, I thought about this and I wanted to think about the most impactful thing that happened to me in 2017 or the most impactful advice that I got, and it came from a book about external expectations. So, when I do an advice, podcast or if it's just me talking, I’m gonna be very structured about it.
And, there's going to be three points that I'm going to make, and this book that I read and listened to was called ‘The four tendencies’ and it's by someone named Gretchen Rubin, and I believe it's just like that ‘gretchenrubin.com’, and she talked about the four tendencies and I'll get into the four tendencies in a little bit. But, what I'm going to talk about in this episode is a specific tendency that's specific to me, also to my wife and I believe to most or many health professionals because it tends to be one, where you do for others and you put that first, and that can cause a lot of problems, but it can also make you a very altruistic person. And, how do you handle that?
So, the first point we'll talk about is talk about this obliger tendency in the four tendencies that Gretchen Rubin talked about in her book. The second thing we'll talk about how the obliger tendency applies to the pharmacy profession whether you're a student, resident or working professional, and then we'll talk about some solutions, some stories that people taking advantage of this tendency and ways to kind of avoid it bringing you down. Now, I'm known for creating mnemonics and memory tricks and things like that. I always struggle to remember actually the four tendencies in the order. I would remember mine and there's always one that I would forget. So, I use the mnemonic ‘quora’ like the website where you type in a question and maybe somebody has answered it before. So, Q for questioner. My little Brielle... I have triplet six year old daughters if you've never heard me before, and Brielle is an absolute questioner. She will keep asking and asking and asking and then when she is satisfied with the answers, then she'll do what it is that maybe you wanted her to do, if she is satisfied with the answers. There's an upholder and an upholder believes that things should be done a certain way and they're going to kind of stick to their guns that way. The obliger is the one that says, “I'll do it for you” and there's something called obliger rebellion, where they kind of fight back after they've taken on too many tasks. So, if you've ever asked someone to do something. They've always helped you out, but then all of a sudden, they just stop and they just seem very angry with you. That might be obliger rebellion.
And then, the fourth is rebel. I don't know if there are any true rebels in pharmacy or “I feel like a true rebel” would in many ways reject college as a curricular answer to something that they should be doing on their own. I'm just not sure, but questioner, upholder, obliger and rebel, and I encourage you to go to ‘gretchenrubin.com’ and take her quiz. I think you have to give her your email address, but it's invaluable for figuring out how you're going to deal with these external expectations. But, let's talk about this obliger tendency as it relates to the pharmacy profession and we'll start with students, then residents, then the professionals.
So, as I have taken on APPE students for the first year and I had taken students from J-term, but I wasn't sure if I would have enough for them to do and things like that and it turned out to be the opposite where we always have more than enough to do. They get to get facing, face to face teaching experience in front of students at community college and it's a little bit nicer because at many of your APPE rotations, you're going to feel like you know very little. At the end of the day, you're going to feel like a failure, you're going to come home and it's going to feel like a disaster that you were supposed to be teaching the patients, but here, you don't feel like you've done anything. And, that’s, I know, a part of the learning process, some of the very clinical ones, especially if you get something like critical care way early or you don't get some kind of internal medicine before the critical care or there's some kind of mismatch between student and site. As far as students go, I would ask how are you doing with your NAPLEX studying, and in the PhD world, the one thing you're never supposed to ask is “How is your thesis coming?” So, I feel like each time I ask them, “How's your NAPLEX studying coming?”, it always is the same. It’s like, “Well. Sort of coming.” And, I wanted to ask them if they were maybe an obliger. Maybe, they put the APPE site above the NAPLEX because they feel like the NAPLEX is something for them. And, what I'm saying is that we kind of put those into two different boxes that all these sites and all these APPE rotations are supposed to prepare you for the NAPLEX, but that's not exactly true. You are actually in much better position to pass a six hour multiple choice exam when you had all your classmates, when you were there in the classroom and you had that support. Without that support, now we're in a lot of trouble, and now, we're in a position where maybe we're not going to get the kind of support that we really need because now, we're in... essentially, many of the APPE students are wandering homeless. They have a place to stay, but they don't have anywhere permanent. They don't have a routine. Each APPE rotation is different, the hours are different. So, the routines that they had worked for their whole lives to build up since first grade have now just been thrown to the wind. So, it's very much like going from high school to freshman year where you've got all of this freedom, how do you make it so that you'll do something? And then, as an obliger at work, you'll do what work wants or the APPE wants and then at home, you'll do what your family wants, and then there's very little time for you to study for the NAPLEX, turning into kind of a disaster at the end. So, we'll talk about solutions in a little bit, but when I think about students, that's the first thing I think about. It’s that their school work and then the NAPLEX becomes secondary to the needs of other people and other organizations, and we want to make sure that we're aware of that if we are an obliger, like I am, like my wife is.
Residents: The first thing I wanted to talk about was residency versus family, where maybe a resident focuses on the residency and to the detriment of the family, the spouse, the future spouse, something like that. But really, when I thought of obliger in residency, I thought of the obligation to feel like you have to do a residency. There are going to be a number of people at ASHP where I'm going to be on Sunday that don't belong there, not because they're not qualified, but because they feel like they have to do a residency because everyone that they've talked to is doing it. Many of the professors are residency trained and that makes sense because if you're teaching at a pharmacy school, you are residency trained, but it's not until you meet those APPE pharmacists that... especially the non-clinical ones and some of the schools limit that and the accreditation document limits to two non-clinical rotations that there are plenty of jobs out there that have nothing to do with pharmacy and that you don't necessarily need to pass the NAPLEX and we'll get into that a little bit later in another show. But, what I want to kind of come back to is, are you as an obliger... are you an obliger first of all? And if you are, do you feel like you're obligated to do a residency. And, I keep hearing, “Well. I have to do a residency to work at the top of my license.” Well, let me just give you one fact that will maybe put that in perspective. Most of those people that are working at the top of their license are working for someone that's not clinical. So, the CEO, the department chair, whatever it is, they're probably not doing any clinical duties anymore. So, there is a leadership level above that, above the top of the license. So, I'm just saying that only about 53% according to ‘tl;dr pharmacy’ are going to get a residency. So, it's one in two that you're going to get one in the first place and even worse if you're trying to do it and you shouldn't be there. I really recommend ID stewardship’s blog post on that. It was seen many, many tens of thousands of times, I believe, that you should go look and say, “Well. Just before I even start this, is a residency really what I want?” And that's what the residency showcase should be about. It's not the resident... potential resident showcase. It's not about you showcasing yourself. It's about the residencies showcasing themselves and seeing, “Hey, if this is something that is going to be a good fit, maybe it's not going to be a good fit, but I would just go in with an open mind”, especially if you're an obliger.
And the third is professionals. Many times, we're going to feel obligated to work and obligated to family and we're going to be feeling a little bit resentful that that thing that we've been wanting to do, we're not doing. And, this recently happened with my wife. I want to say about two or three weeks ago, where I came downstairs and I talked this on Dr. Richard Waithe’s Rx Radio podcast that she was on the phone, on the laptop and completely ignoring her show ‘Scandal’. Now, when I come down and I see ‘Scandal’, immediately I think, Thursday night, I'm leaving, going to work, going to meet somebody out or something like that because that's her time. And I'm starting to learn what ‘me time’ is. I just never use that term. But I came down and saw that and talked to her and had an interview on pharmacy podcast with her about it, and she said, “Yeah, this is this is really a connection that I didn't realize that I didn't have.” And now, what she does as an independent consultant for Rodan and Fields is something that is for her. It's her time. It's her time to be with her friends, and she is an absolute obliger. She always puts the kids ahead of her things and herself and she'll burn herself out. So, at the professional level, that happens too. She's a career pharmacist. She has been in pharmacy for nine years, worked as a manager for a local grocery store here ___ and then, at the VA. So, again, that obliger coming in. So, what are the solutions? What are we going to do about it?
So, the first thing I want to take before we even start with the obliger solutions or what to do about getting your own time back is to make sure that we understand there must be both and & either-or. Either-or means either I'm with my family or I'm working or I'm doing something for myself, and that ignores the possibility that there might be a both ‘and’ solution. So, maybe, if you are going to go running, you can listen to the podcast or you can listen to something that's going to get you a little closer to your goal. That's actually why I started ‘Memorizing pharmacology’, the book itself because my students just didn't have time. They were busy. The community colleges, we tend to have students that are working adults. Many times, the school revolves around the family rather than what your life revolving around school is it might be when you're 18 to 22, and it's a real struggle for them. So, that way, it could become a both ‘and’. On the way to the class, they could listen to something that I assign them and the audio also helps if you want to hear it again. So, as far as a student goes in solving that problem with a NAPLEX, the first thing is to get a group and many students reject the group because they think, “Oh. We're going to be in different places.” In this digital age, there's no reason you can't be connected or stay connected, but what you're really looking for is an accountability partner. The funny thing is that if you get two obligers together, the one obliger will oblige to the other that they will study because the other person asked them to and then, the other person will remind them because they asked them to. So, two obligers together actually works really well to get things done, but they can get overloaded very easily. But, that would be my solution is to at least get one accountability partner, and don't worry about studying together right now about content.
The other thing is if I had the... RxPrep seems to be the common book or Kaplan, I would actually rip the first five chapters out to make it a smaller book and more portable because the size of that book, it’s unwieldy. It's tough to take around. I would just rip it out and I would just... I would maybe go down to Staples, have it binded for a couple bucks, and that way you have a small book or even divide it into, you know, seven pieces, something like that. Just so it's more manageable, maybe one for each APPE rotation or something like that in terms of studying. The other thing is that many students, even in APPEs, I did this. I burnt myself out working 70 hours a week sometimes, usually 60, where I would go 40 hours on the APPE. Then, I would go to maybe even the same chain at a different location and work for money for 20 hours a week and I was exhausted. What mistake I made was, it’s that I thought, “Well, to get a job, I'm going to have to continue to work as a tech”, but the one job that I saw that should have been the job that I had was, on campus at the University of Maryland, the gym is actually on, I think, the ninth or tenth level of a parking garage, and every time I would go in there, there was a student and they were doing their homework and they were just checking people in. Now, whether that person made three or four dollars an hour less than I did, all they did was check people in and their homework. I came home exhausted because I had the APPE, then I had patients at work. What you want is a job where you can do your own stuff and to not really worry about the money as much. Now you're saying, “Okay, well. I'm in fourth year. I can just get hours every once in a while”, and that's where the side hustle comes in that we'll talk about later in further episodes and second incomes come in. If you listened to me, I’ve talked a little bit about my book, but I'm going to get really into it and how I did it and talk about all the numbers, but right now, this year's income from the ‘Memorizing pharmacology’ and the other books will pay for just about any pharmacy school in the country for a year's worth of tuition room board and all that stuff, and I'll tell you exactly how to do that. But the solution to the APPE, to the NAPLEX, is to get in a group and then, we'll start talking about some other opportunities, employment opportunities that maybe you could do that don't make you more tired-er... or more tired, right.
And then, the last is... the second is the resident. When your spouse is going to become a resident and my wife and I ended up being resident-resident couple, but let's say they are resident, you’re a student, then that's the time to start your side hustle because as soon as they're not resident, then they're going to want your time back again, and then you might be working full time or you might switch roles. So, establishing something that is yours that connects you to people that you want to be around and that gives you mailbox money, that income... Well, it's really inbox money, where you just get an e-mail that says Amazon has deposited X number of thousand dollars into your account and thank you very much.
On the professional side, that kind of third group, I think I would love further to know the four tendencies for my children. I kind of have an idea of who they are in terms of that. We definitely have a questioner. We have a rebel and I think an obliger. But, I ask my APPE students, and they don't have to if they don't want to, but they've done Strengths Finder. But, what I want to know is how do they match expectations. So, if they're an obliger, I know from my own personal experience with my spouse that I have to be really careful to continue to ask, “Am I giving you too much?” because they'll continue to say, “Yes, I'll do it” and I don't know if it's too much. So, I'll continue to monitor and make sure that I shouldn't be taking things off their plate, adding too much to them. Something that I would also recommend if you have employees, for sure you'd want to know how they handle these expectations, and just because someone's a rebel doesn't mean it's a bad thing. It just means that you're going to have to deal with that a little bit differently. Go to the Gretchen Rubin book, she’ll explain it to you. She does a fantastic job going through very thoroughly each of the four tendencies.
And the last is a boss. You know, a lot of the bosses, I believe, when she talked in the book was about those being that other obliger tendency, the upholder. They know what they want to have done and they kind of stick to their guns about it. It's just a good fit, but in terms of an obliger and meeting your professional responsibilities, but also being faithful to home and to the things that are important to you. For me, it would be my family and spending time with my wife, and the easy solution to that is Tuesday night - date night is simply non-negotiable. Somebody asks me to do something on Tuesday, it's just a no. It's just flat out that one day is just carved in stone. The other thing is that if I have... if I want to do writing for myself and this is for the next book and I really struggled this last year, another reason I want to kind of take you guys on as my accountability partners is that I really struggled writing this next book. I've gotten a lot done this year. Don't get me wrong, but I really am excited about this next book ‘Four hundred drugs in one hundred slides’ basically. It's working in parallel instead of working linearly. It takes advantage of cognitive limits. I'm just so excited about it and I'm only on chapter... around chapter three and there's supposed to be eight chapters to it. So, hopefully, as I'm helping you guys, I also help myself get through that, but what I found really worked was to make a writing appointment, not with myself. I've heard that a lot of times and it doesn't work, but there's a writing center, and I take a class at the local college and the writing center allows you to go four times for 4-one hour appointments. And sometimes, the writing person there is just sitting there and I'm saying, “What do you think of this?” “Uh. It looks good”, and I write for an hour, and to get four hours of writing in a week is phenomenal. So, for me, it's again the obliger has to make an appointment with another person to get their own things done.
So, I've gone over the three big things in terms of somebody who puts others ahead of themselves and the obliger tendency or our tendency to do for others before ourselves, the obliger in the pharmacy profession, how a student, how a resident and how a professional might run into the obliger characteristic and it might hurt them and then some of the solutions that we have. So, on the next episode, either I’ll be in ASHP and I’ll do some interviews, especially I want to talk to people at the posters. I've got some other podcasters I want to talk to, some other publishers like tl;dr, like ID stewardship, and really just want to understand what's going on out there, but mostly, I just want to kind of come back to this mission statement, which is ‘How do I organize your leadership road in 2018?’ and then, ‘How do I organize my leadership road in 2018’, how do I get that next book written because that is the most important thing I should be doing now.
Well. Thanks again for listening to the ‘Pharmacy Leaders’ podcast, and now, if you want to get a hold of me, there's a bunch of ways. The easiest way to do it is to contact me by email, email@example.com is a good email. If you want to find me on Facebook, I'm TonyPharmD1. If you want to find me on Twitter or follow me on Twitter, I'm Tony_PharmD. I think I have something like 7000 followers there. And then, YouTube, I have a channel. So, we're closing on about 9000 subscribers, about 3 million views, somewhere around there. On YouTube and then Facebook Messenger tends to be a really good place to contact me. So, we thank you so much for listening and we will talk about podcasters and publishers and get some interviews and very excited for 2018.
Hey, whaddup. This is Brandon Dyson from tldrpharmacy.com. Why am I interrupting you in the middle of this excellent podcast? Because as soon as you're finished with it, I want you to come to my website, obviously. At tldrpharmacy.com, go find a whole boat load of free clinical guides and cheat sheets. They will save you hours of time and they will make learning pharmacy. And also, our guides are fun. Whether you're a student or a practicing pharmacist, you'll enjoy reading them, I promise. Check out tldrpharmacy.com and get better at pharmacy.
Support for this episode comes from the audiobook ‘Memorising Pharmacology: A relaxed approach’. With over nine thousand sales in the United States, United Kingdom and Australia, it's the go-to resource to ease the pharmacology challenge, available on Audible, iTunes and Amazon.com in print, ebook and audiobook.
Thank you for listening to the ‘Pharmacy Leaders’ podcast with your host Tony Guerra. Be sure to share the show with a hashtag ‘#pharmacyleaders’.