..Information to Pharmacists
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Your Monthly E-Magazine
SEPTEMBER, 2003

NEIL JOHNSTON

Management Consultant Perspective

I Am So Tired

I wonder if anyone has stopped to think about the culture of pharmacy?
Changes in culture affect people profoundly and may give a reference point as to how pharmacists are thinking and feeling these days.
I am personally experiencing feelings of profound tiredness, which I do not believe are simply derived from the onset of old age.
In disussions with other pharmacists, I have found they are experiencing the same feelings.
All of these pharmacists could be regarded as highly successful in their chosen profession of pharmacy, but they are all espousing uncertainties in the diverse challenges that are arising from multiple sources.
They are all excellent managers, but never before have they had to adapt to the numerous and rapid changes that have been inflicted by government and its agencies, the industry, and the profession itself.

They have no difficulty managing each component of change separately- it is simply the difficulty of being confronted with multiple components simultaneously.
In short, they are in the middle of a culture change beyond their immediate control.
They are being "globalised"

Culture used to signify the high moral standards demanded by the membership of a group of people.

It has now taken on a totally different meaning, in that it now pertains to whatever habits prevail.

This aspect has been accelerated by the process of globalisation, where a global "new" monoculture is seen to take over from previous "old" cultures and their inherent standards.
It is a process that creeps up on you, and overwhelms the individual totally.

It could be said that never before in the history of the world has so much cleverness been used in so much stupidity. The cleverness is derived in the creation and manipulation of markets, media and power.
The stupidity manifests itself in the destruction of community, responsibility, morality, art, religion and the natural world.

What this phenomenon induces is a feeling of being powerless, of being numb, having a lack of inspiration and a feeling of there being an uncertain future. Faced with this, people become gloomy and depressed, experience fatigue and tiredness, and withdraw into trivial or sensational distractions.
Alternatively they can develop addictions to money, power or drugs.

This phenomenon can now be observed in all walks of life-politics, culture, civil administration, the media, science, education and even the law.

When we feel powerless we feel "dumb"
It is no accident that the above processes are now said to be "Dumbing Down" procesess.
This has led to the introduction of a new word "Dumbocracy", which is defined as the "rule of cleverness without wisdom".
Dumbocracy has, as its cardinal rule, to look at only the short-term gain; never what may be the ripple effects further down the pathway, and its effects on other people.

It is a bit like the industrialist ripping out old-growth forests for financial gain, but choosing to reside in a natural bushland environment for personal lifestyle enhancement. Eventually, the industrialist runs out of bushland and becomes "hoist in his own petard", but only after rubbing everyone's nose in it before he reaches that point.

You only have to turn on the television to experience "dumbing down" at its most banal.
The Americanisation of Australian (and most of the world's) culture, expressed in art forms such as film and music, illustrates a dominance of American popular culture that is progressively displacing and destroying all other alternative or native cultural influences.
What we see instead is a cultural landscape of consumerist uniformity that has been manufactured by the mass media and business interests.

Is this what has happened to the pharmacy profession?
Are we becoming homogenised and pasteurised so that we may better be globalised?
It would explain why we may have feelings of anxiety, because we are more easily manipulated in a "globalised" format.
And because we are more easily manipulated, we never stop running.
Is this why I feel tired?
Have I been "dumbed down" to the extent that my intellectual input into my daily affairs is minimalised because I am on the end of a "string", such as a computer program?
The clever end was in the design and writing of the program.
The dumb end, requiring no wisdom, is that I must slavishly follow the dictates of that program if I want to achieve my reward e.g. a cheque from the Health Insurance Commission.
Is this also why I experience minimal job satisfaction?

This "dumbing down" process is undermining old values and is creating a degradation of knowledge and cultural literacy. At the very least, knowledge gives the power to say no and the ability to give reasons for a rejection.
But this is a form of discrimination!
And this is politically incorrect!
The whole point of an education used to be to teach discrimination-to discriminate between good and bad art, good writing and bad writing, good science and bad science etc.
Our education system, as a whole, tends to be aimed at the lowest common denominator, and is creating, on a mass basis, a generation whose minds are more empty than open.

How does this all come about?

Well, you only have to look at the advertising and public relations industry to provide some of the answers.
The "spin" as it has become known, has created a system to generate desire, needs and wants which are then attached to specific cultural "commodities".
Advertising is very seductive and is intended to evoke desire.
Every technique or ideology is focussed toward this outcome.

Advertising serves a master that is rooted in capital, the market, commercialism and consumerism.
It creates propaganda for these ideologies in an indirect manner, that is dangerous (because it is not obvious) and bends every message and ideology towards its own purposes, blurring the line between truth and fiction.

Consider the "spin" on recent Australian events-Children overboard; the intelligence estimates used to generate and justify a war with Iraq; the "new" drugs reported on television news programs that turn out to be old drugs with new approved indications.
These are just a few examples, for we are surrounded, and being drowned, in a multiplicity of advertising and PR messages.

Advertising creates a climate where luxuries become necessities that people must acquire to maintain their status.
Advertising is all about the manipulation of human beings.
It responds to people identified only as "consumers" and its relationship to its audience is purely based on their ability to consume.
The values and perceptions created within the advertising industry, enter the culture and influence people in their daily living, their relationships and their values.
There is no question that advertising is successful, but in a way that is not generally understood.
It has made consumption and possessing, an indicator of social success.
Advertising emphasises pleasure and gratification, rather than restraint and repression and has created an expectation of entitlement; thus an intolerance of any frustration or delayed gratification.
This now pervades Australian and most western world culture.
It values change for changes sake which tends to be superficial and showy, rather than mature or integrationist.
It tends not to enhance life, and creates a lack of fulfillment and emptines, as the promise of advertising is not kept.
In short, it is corrupt.

As editor of this publication I get to read all the articles by the writers before they are published.
In particular, I was struck by content of articles submitted by Ken Stafford, Karalyn Huxhagen and Heather Pym.
Each struck me as a commentary, in varying degrees, on the "dumbing down" of our profession.
Karalyn highlights some of the manipulative practices of drug manufacturers, who utilise different drugs under the same "brand" and develop consumer advertising which manipulates both pharmacists and consumers.
Ken Stafford discusses some of the problems of manipulation by the medical profession and Heather Pym talks about the "joys" of cognitive services and the lack of practitioners (which I perceive as an indirect outcome of educational and professional manipulation).

What to do?

I do not have the answers, except that it does require a constant revisit and affirmation of those positive values that embrace our profession.
It requires good leaders to promote such values.