Understand the Culture in Which You Practise Hyperthermia: Are ...

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in conversation B E C O M E A N E F F E C T I V E P H A R M A C I S T Understand the Culture in Which You Practise Lionel Laroche, Ph.D., P.Eng. During one of the advanced workshops for preceptors on Managing Cultural Differences, one Canadian preceptor (Jim) related the conversation he had with his Middle Eastern intern (Ali) at the end of his internship. Jim: What was the most memorable moment of your internship? Ali: I think it was when you were filing some paperwork on the third day of my internship. Jim: What do you mean? Ali: You were completing some papers and I was watching you from the back of the pharmacy. At one point, you crumpled a piece of paper and threw it into the blue box. The blue box was full, so the paper fell on the floor. You leaned down, picked it up, and put it on top of the pile in the blue box. A few minutes later, you threw another 14 pharmacyconnection • July/August 2009
piece of paper into the blue box which again fell on the floor. You got up, picked up the blue box and emptied it into the blue bin at the back of the store. Jim: What made this moment memorable for you? Ali: In my home country, as a pharmacist, you would have called one of the pharmacy employees and told them to empty the blue box into the blue bin. The fact that you got up and emptied the blue box yourself was a complete surprise to me. I realized at that point that being a pharmacist does not mean the same thing in Canada as it does in my home country. In most parts of the world, being a good pharmacist requires a solid knowledge of drugs -- their impact on patients, their side effects, their potential interactions -- and of the health care system and how to get paid for the work performed (the technical part of the job). It may also require a clear understanding of how to interact appropriately with patients and explain to them how to take their drugs in the most effective way (the interpersonal part of the job). When pharmacists move from one country to another, they may find that their work is similar. But there can be differences in the technical and interpersonal areas of practice. There are differences in the technical areas because different diseases occur at different rates in different parts of the world. For example, diseases that pharmacists in Zimbabwe have to deal with these days, such as cholera or malaria, are not commonly found in Canada. Meanwhile, influenza is far more common during the winter in Canada than in Zimbabwe. Obviously then, Zimbabwean pharmacists have to know about drugs for tropical diseases that many Canadian pharmacists will encounter only very rarely, and Canadian pharmacists need to know vastly more about flu-fighting drugs and vaccines than their counterparts in Zimbabwe. There are also significant differences in the way medications are paid for around the world (by the patient, by private medical insurance, by public health insurance, etc.). Pharmacists coming to Canada from other countries must deal with differences in the interpersonal areas of practice as well. Being a good manager (in that pharmacists manage pharmacy assistants and employees), a good employee (in the case of pharmacists who report to a pharmacy manager), or a good service provider requires that they behave in a manner appropriate to the cultural context. As a result, people who have completed their pharmacy studies outside of Canada and the United States and come to Canada to practice, need to learn how personal interactions are managed in a Canadian pharmacy practice setting. Experience with both the International Pharmacy Graduate (IPG) program of the Leslie Dan Faculty of Pharmacy, University of Toronto, and its mentoring program, and the preceptor workshops for the Ontario College of Pharmacists, shows that most pharmacists handle differences in the technical area more easily than in the interpersonal area, for a very simple reason: they expect them. Indeed, most pharmacists are aware of the existence of these differences. In addition, pharmacists are interested in, and enjoy learning about, new diseases or new drugs, which makes overcoming these differences fairly easy. By contrast, pharmacists encountering a difficult culture, at least initially, experience difficulties in the second area of differences, namely, interpersonal communication. In order to deal effectively with these differences, pharmacists first need to be aware that they exist. They are not usually discussed in pharmacy textbooks, and may be difficult to discern. Successfully dealing with them requires time, patience, practice, and feedback. Let’s take a simple example: the smile. In the Canadian retail sector, the smile is absolutely essential. The number-one criterion by which North Americans evaluate a store is “Did the employee smile at me when I walked into the store?” This finding applies to pharmacies and pharmacists as well. Contrast this situation with countries like Germany or France. Germans say that they smile only when there is something to smile about. In Paris, smiling at a stranger, especially one of the same gender, is likely to make that individual think something like, “What is wrong with this person?” In other words, a pharmacist coming from a country where smiling at strangers is not as important or encouraged as in Canada will likely have to learn to smile when customers enter the pharmacy. Learning such behaviours often takes time and requires a conscious and deliberate effort in order to reach pharmacyconnection • July/August 2009 15
Page 1 and 2: July/August 2009 Understand the Cul
Page 3 and 4: contents Prescription Delivery Regu
Page 5 and 6: editor’s message Della Croteau, R
Page 7 and 8: lueprint, which is similar to the c
Page 9 and 10: Proposed PharmD Program Update Coun
Page 11 and 12: Systems to Comply with the Regulati
Page 13: Larry views his MMT practice as an
Page 17 and 18: coroner’s report Coroner’s Inqu
Page 19 and 20: • not understanding weather condi
Page 21 and 22: health canada advisories & notices
Page 23 and 24: s Cosmetic Pesticide Ban The new le
Page 25 and 26: pharmacy technician Q&A Susan James
Page 27 and 28: pharmacyconnection • July/August
Page 29 and 30: inspectors’ corner Professional I
Page 31 and 32: The Invisible Environment The invis
Page 33 and 34: (b) failed to provide the College w
Page 35 and 36: in this case to require him to incu
Page 37 and 38: focus on error prevention Ian Stewa
Page 39 and 40: laws & regulations Drug and Pharmac

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