The New "Coin(s) of the Realm"
The phrase “coin of the realm” originates from 18th-century England in the then-established monarchy’s attempt to recoin or reestablish its currency for the realm. It has since grown into a metaphor that speaks to value within a particular domain, organization, effort, or any other social or economic structure within which the thing of value is sought after and drives prosperity.
The 20th century brought about knowledge as the coin of the realm. Knowing more meant more productivity, better use of time, and an advantage over others. The 21st century brought about the proliferation of computing and the internet, on which knowledge could be easily shared and retrieved on demand, for any piece of knowledge one might seek. Thus, skills have become the coin of the realm rather than knowledge, which is now relegated to being a commodity, with the ability to differentiate oneself to the same degree as corn, gasoline, or fertilizer (which is to say, knowledge no longer differentiates one prospective worker or citizen from another).
SKILL #1: Motivational and Time-Effective Communication Skills
The ability to motivate colleagues and patients toward activities, behaviors, and habits that result in better health from optimal medication use will be a can’t-miss skill set. Add the ability to do it in a time-effective way, and you capture the attention of the teammate, caregiver, or consumer. You will have an evergreen career in health care that always bears value and persists. In a world full of information and stimulus coming from every direction at every moment, connecting human-to-human with engaging dialogue over a short period of time that results in action on the part of others will differentiate you from a person simply reading from the script to no real or durable effect.
SKILL #2: Dual Acumen in Navigation of Existing and Future Business Models of Pharmacy Practice
Pharmacists provide cost-effective—sometimes free—services in all settings of care, but they remain gainfully employed mainly through the buying and selling of medications. Even in health systems, where many full-time pharmacists may never dispense or even be part of the dispensing process, dependency on 340B margins supports most within the pharmacy department.
Yet pharmacists’ ability to bill purchasers (eg, health plans, pharmacy benefit managers, directly from the patient-consumer, or others) is growing, and for early-career pharmacists, there is a high likelihood that a much greater portion of pharmacists—if not all of them—will be fully economically supported through the provision of billable services.
But the in-between will require difficult transitions, from evolutions in human capital (with pharmacists and nonpharmacist helpers) and workflow to evolutions in administration, documentation, and key performance indicators. The ability to understand and navigate how the pharmacy business works now and how it will work in the future will separate those who will lead from those who will follow.
About the Editor in Chief
Troy Trygstad, PharmD, PhD, MBA, is the executive director of CPESN USA, a clinically integrated network of more than 3500 participating pharmacies. He received his doctor of pharmacy and master of business administration degrees from Drake University and a doctorate in pharmaceutical outcomes and policy from the University of North Carolina. He has recently served on the board of directors for the Pharmacy Quality Alliance and the American Pharmacists Association Foundation.
SKILL #3: Effectively Harnessing Artificial Intelligence (Legally, Ethically, and Safely)
We are likely only a few years away from educating the first generation of pharmacists who will not remember a time of practice without an artificial intelligence (AI) tool or agent, or even some artificial nonbiological life. The speed at which AI is emerging is stunning. The scale of knowledge and computing that AI has and will continue to accumulate is estimated in numbers we’ve never even heard of (and we’ve all heard of Avogadro’s number). Using AI to become more agile, creative, industrious, efficient, and effective in the provision of pharmacy practice may end up being the most valuable coin in the pharmacy realm going forward.
And it isn’t just pharmacy, or health care generally. These 3 skills will likely define success and career progression for the foreseeable future. All sectors of the economy and employment will seek these skills out. Better get good at them.
