JUNE,Edition # 27, 2001

In my last article (follow this link) I touched on qualities that are required to be a successful consultant, and that it was time to develop private practice, not requiring government subsidy.
Points made included the fact that a consultant was proactive in solving problems, and to be successful, you had to position yourself where you were not involved totally in reactive processes.
As dispensing is a highly structured, reactive and continuing process, a consultant will simply not flourish if he/she is involved within dispensing in any capacity. External to the process is where the consultant needs to be positioned.
In simple terms, to be "looking over the fence".
From that vantage point you gain a perspective, and problems are a little easier to see.
Because you are out of the production line you have the mental space and time to visualise solutions.
While a consultant's time has to be managed in the overall, a significant proportion of assignment time has to be unstructured. Most unstructured time will be preparation time i.e. the time required to research a patient's problem, prior to or immediately after, a client/patient interview.
The most important ingredient to be found in unstructured time is creativity, and in the last article, it was determined that creative people shared the common traits of challenging assumptions, recognising patterns, seeing things in a new way, make connections, take risks, take advantage of chance and construct networks.

Challenging assumptions is daring to question what most people take as truth.

It was once assumed that the earth was flat and that the sun revolved around the earth, also that evil spirits caused disease. The thinkers who challenged these ideas were scorned and ridiculed by their peer group.
If we accept concepts without ever questioning, we may never see the alternatives available to us.
When small children ask "Why?", they are demanding explanations for what we often accept without questioning.
They are practising, in their own way, the same independence of thought that is an essential quality of a good consultant pharmacist.

Recognising patterns is perceiving significant similarities or differences in ideas, events or physical phenomena.

In searching for patterns, we attempt to give form to the world.
Detecting patterns in the unknown is a way of creating order out of chaos. Sigmund Freud observed patterns of human behaviour to try and understand the human psyche.
Astronomers watch the sky to find patterns of motion that help us understand the universe.
Gregor Mendel, crossbreeding sweet peas in a monastery garden, observed patterns that led to a new perception about heredity.
In the same way, consultant pharmacists will see patterns within the problems of their patients.
By comparing patterns, the best versions can be isolated, given form and promoted. Even the patterns in unrelated types of patients can reveal and suggest new methods that can be adapted for patient benefit.

Seeing things in new ways is seeing the commonplace with new perceptions, transferring the familiar to the strange and the strange to the familiar.

When artists give the impression of a subject, their perceptions of familiar forms can provide an illustration which some could call strange, even outlandish.
Looking at this page, most would see it as words to read, while others would see it as a collection of millions of electronic "dots".
A photographer, when taking a sectional close-up of a familiar object, converts the familiar to the strange, and in the process can reveal a beauty and complexity not normally discernible to the eye.
When consultant pharmacists use this component of creativity, they begin a thinking process "out of the square". To develop this thinking process a consultant must allow unstructured time, generally outside of the business environment, in a relaxed and calm atmosphere.
"Think-tanks" are an extension of this process, where groups of consultants can interact with each other in a non-threatening manner. When one of the group, often in jest, throws in an outrageous suggestion, the door is opened for others to pick up on the concept and convert this line of thought to something tangible, in a form that none of the individuals would necessarily have developed by themselves. It is this peer group interaction that has been denied to pharmacists in their normal embodiment as dispensers. The result has been negligible growth in professional thought and activity.

Making connections is bringing together seemingly unrelated ideas, objects or events that leads to a new concept.

Making connections can be likened to that moment in a mystery story when the author suddenly allows the link between two episodes or characters to become apparent.
Edward Jenner noted that the disfiguring disease of smallpox never affected milkmaids.
By making the connection that milkmaids became immune by being exposed to the milder disease of cowpox, he derived the principle of vaccination.
Guttenberg took the idea of woodblock printing, used for playing cards and pictures, and thought of making blocks of letters of the alphabet.
The result was movable type.
Many inventions are seen to be, or are derived from, a parallel in nature e.g. sonar navigation is almost identical to the way in which bats navigate by sound. Consultant pharmacists, who are able to make a connection, develop new principles.
In the process, they give them form and substance.
This new "thought product" can often be packaged and sold as a service support over a wide range of clients, recovering research costs in the process.
It may even be possible to market the product to other consultants, who can adapt and customise the idea in their own environment.

Taking risks is daring to try new ways or ideas, with no control over the outcome.

Creative people are people willing to take risks.
They are not afraid of being wrong and are willing to try the "long shot".
Others might consider this process a form of gambling, being foolhardy, or just plain mad. If the long shot comes off, these "others" will then attempt to bask in the reflected brilliance of the success.
Columbus, Magellan, Drake, Cook and other seafaring explorers, took fearful risks when they set out on long voyages to unknown shores. Besides the dangers from storms, sickness and other misfortunes, they believed they risked encounters with sea monsters, supernatural powers and that they may even fall over the edge of the world!
Alexander Graham Bell risked new ventures, even after his success with the telephone. Some, like the iron lung, worked. Others, like the photophone, did not. The most successful of consultant pharmacists will have experiences similar to those above.
The risk of venturing into the unknown involves the potential loss of professional reputation. If, on balance, after completing all the relevant homework, the "gut feel" is to go down an unknown pathway, a consultant must follow instinct to a natural conclusion.
Personal and professional growth will be the outcome and most certainly, a satisfied patient, who has observed you going into battle on their behalf.

Using chance is taking advantage of the unexpected.

The creative person is open to chance.
Pasteur once said, "Chance favours only the prepared mind."
For myself, it seems "The harder I work, the luckier I get".
Jackson Pollock used chance in painting his canvases.
Charles Goodyear discovered the process of vulcanising rubber by chance. He had been experimenting with various chemicals, trying to make raw rubber usable. By chance, he carelessly dropped some raw rubber against a hot stove and instantly recognised that heat was the solution to the problem.
To be able to take advantage of chance, you must first of all be engaged in some meaningful pursuit.
Constant experimentation with a consistent focus of thought produces an environment in which chance may occur.
When an opportunity presents itself, you are able to marshal all the surrounding components to complete the jigsaw.
Put another way, a consultant pharmacist must always be investing in some form of research.
Research is the intellectual capital of a consultant pharmacist, which is reimbursed through a patient/client fee structure designed to cover this overhead (see previous article on the "thirds" approach to an hourly fee structure).
A consultant who does not conduct some form of ongoing research will run out of information to sell (information has a very short shelf life), will not be able to justify his/her fee, and will be continually outperformed by the competition, already positioned to take advantage of chance, and turn the unexpected to profit.

Constructing networks is forming associations between people for an exchange of ideas, perceptions, questions, encouragement and introductions.

A net is stronger than its separate strands.
Letters, personal meetings and discussions in different environments stimulate ideas.
In Paris, in the 1920's, an international group of artists and writers gathered, and were nourished by each other's work: Picasso, Hemingway, Fitzgerald, Joyce, Stravinsky and Stein.
The work of scientists is shared worldwide. They overcome the barriers of language and culture.
Consultants who do not construct a network are destined never to succeed and will simply "wither on the vine".
A network must encompass many personalities and embrace as many different aspects of the concept of consultancy as possible.
This enables a "holistic" process to develop.
The stimulus that follows from sharing ideas, asking for constructive criticism and receiving assistance in delivering services for a profit, is directly proportional to the effort you put into your end of the network.
This process eventually leads to trusted associateships, strategic alliances, investment partnerships…all designed to deliver a secured clientele with ultimate consultant pharmacist success.
A basic formal network has been established through the Australian Association of Consultant Pharmacists (AACP). By itself, membership of this organisation will not guarantee success.
It is the more informal, personal, local and regional groupings, all networking with each other, that will develop the ideas and practices that will actually work to ensure the survival of consultant pharmacists.
New ideas and practices fed to the AACP for sanction will ensure that consultant pharmacy becomes a vital and energetic segment of the pharmacy profession.
Is the AACP up to it?
Only time will tell, but members should revisit its structure periodically to decide if it is complete i.e. does it represent an organisation looking at consultant pharmacy in its entirety, and is it creative?

The development of private practice, providing a fee structure independent of government subsidy, must also be allowed to flourish and provide a balance to government directed services.
Not all pharmacists have the memory of practising in a completely free environment, gradually converted to a government-dominated environment.
Those who do remember, have the responsibility of explaining to the rest, that a dominant government partner is not the most creative way to conduct a professional practice.
Nor is it the most profitable.
Ends

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