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2014 Siegel Clinical Acheivement Award Acceptance Remarks

49th Midyear Clinical Meeting
American Society of Health-System Pharmacists
Anaheim, CA

December 8, 2014

Jack Brown, PharmD
Associate Professor and Chair, Department of Pharmacy Practice & Administration
Wegmans School of Pharmacy at St. John Fisher College
Rochester, NY

Class of 2003

I would like to thank Jerry and the award committee for selecting me for this great honor.

I turned 45 this year and did a fair amount of reflection on my life and I realized that according to actuarial tables, I've already likely lived more than half of it. I also reflected on my professional life path and the decisions I have made over time... it's just then that I realized I was destined to be a pharmacist. How you might ask could I determine that? It's because all the tough decisions, even early on in my life, have been made using the same principles I use to be the best Pharmacist I could be. Many of these principles I learned as a MS, PP then Specialty resident here at OSUMC. I would like to share 4 of these with the residents and younger pharmacists this evening.

The first of these is "take ownership of your decisions". We all know them, people who make excuses or refuse to take ownership for their choices in their professional and/or personal lives. I have found that it's not because they aren't smart or gifted in life, but it's because they are unable to make good valued decisions or are afraid or embarrassed of the consequences of making decisions with limited empirical data.

Well as I say to my pharmacy students and faculty at St. John Fisher College on a daily basis, we need to prepare ourselves for the "grey zone." Think about it, our physician colleagues are not going to ask us questions they can look up in 30 seconds on their iPhone, they ask us questions were there is little to no data and they want us to give them a valued judgment based on the principles of pharmacotherapy, not random facts that we memorized in pharmacy school or in residency. I believe this is analogous to life decisions, if we are grounded in moral and ethical principles and stick to these principles we can sleep soundly at night. Even if these decisions turn out to be inaccurate you can have satisfaction in knowing you did the best you could.

Now as residents and younger pharmacists many of you are not as grounded in principles of pharmacy practice as others who have more experience. That is the whole idea of residency, this time right now, this one or two extra years of residency training not only helps you gain confidence in your practice of pharmacy but instills in you principles of practice that will last your entire professional career. So take advantage of this time and soak it up! OSUMC is a very special place... You have preceptors here to help you as they did me to find your way.

Second, we all make mistakes, use them as life lessons and learn from them. Not just in detail, but look for the larger principle. One of the most difficult life lessons I learned was as a MS resident at OSUMC. I spent many a busy weekend in the IV room checking IV's, preparing and checking chemo and TPN's as many of us did. This was my only exposure to being a practicing traditional pharmacy, the rest of the time I was working on projects and in class. One particular weekend I made a single key stroke error on a neonatal TPN. That simple key stroke error resulted in me programing the device to deliver 100 x the intended amount of Na. This error was not picked up for 3 days and the babies serum Na rose to ~180 mEq/L (high normal is 150).

When I was told I was devastated. I have been through rough times, especially as a young corpsman on the battle field in the 1st Gulf war. You see right about then my wife Kristen and I were trying desperately to have a child and the fact that I put a baby's life in jeopardy weighed heavy on my heart. After my devastating experience making a medication error, I learned that bench work involving hand eye coordination and maintaining long stretches with meticulous attention to detail within a busy noisy area is not an area in which I could thrive. I had no problem with the cognitive stuff, like answering questions in pressure situations and having a passion for clinical practice, research and most of all finding creative ways to address practical problems. I also realized that I needed to be a Pharmacist first, not a manager or a student or even a researcher, but a pharmacist. The truth is I still struggle with this today. I have over 30 direct reports and always try to be there for them and all my students, but I need to still practice in order for me to be true to who I am. That is something I will never give up.

This leads me into my next life lesion: find your way professionally that allows you to put yourself in a position to be your definition of successful. I want to be clear here... Success is a subjective metric that only you can determine with specific granularity. This is something I learned from Jerry very early on in residency and never forgot it. For me ...I'm not a guy who is good at checking medication, that's not my strength. I found this out using reflection as a means to listen to myself and find out where my strengths and passions align. But rather my strength turned out to be working with young pharmacists and pharmacy students to help them find their way.

As an OSUMC MS resident I struggled for many of the reasons I outlined earlier and realized I needed to be actively engaged in practice. It was not that the program wasn't challenging or that I didn't like taking classes and projects, but it wasn't for me at that point in my life. So then I changed to the PP residency at OSUMC. Then it happened! I found ID again... You see in pharmacy school I enjoyed ID and did well in it, but I also did well in other areas as well. But, now it just clicked with me and I had a program director that pushed me to not only challenge myself as a clinician but as a researcher and educator as well. Dr. Goff had high expectations which was what I liked about her. She didn't want excuses, but rather emphasized creativity and gave me the tools to thrive and be successful. That final year for me at OSUMC was a glimpse into what I wanted to do. Have a career filled with challenging clinical practice, meaningful research and work with students and post-doc to help shape their careers like Debbie and Jerry did for me.

The last life lesion I would like to leave you with is to give back. One of my favorite scriptures from the bible is "for those who much is given, much is expected". This means that those of us who are privileged enough to have trained at such a wonderful place, we have to be resolute in our commitment to providing similar experiences for our young clinicians where we practice. I'm reminded of this every day, when I look up from my desk at work and see words "Message to Garcia" on a small green book that was given to me just over 11 years ago by folks that invested everything in helping me find my way. I'll close with a simple thank you to of you who helped me along the way. OH...IO.