It is with real pride and deep appreciation that I accept the obligations and opportunities embodied in becoming President of this Association.
I am well aware of the many difficulties which pharmacy faces today, for my life has been dominated by the profession of pharmacy for fifty years, and I can assure you that this new undertaking for the coming year is not taken lightly.
A review of the presidential addresses and reports of the past presidents shows that each president was vitally concerned with the problems confronting pharmacy during his term of office.
We have challenges on all sides; to meet these we must face all of them boldly.
It is not my intention to expound abstract discussions at length. Rather, I am concerned specifically with the present and the future.
We have problems in pharmacy, so let us scrutinize them carefully and do our utmost to solve them. We have not the energy to spare in bemoaning our situation in general, nor do we have any expendable energy for petty bickering among ourselves. We need every ounce of energy we can muster collectively to meet our obligations to the profession and to society.
The most popular word in our language these days is "crisis." But may I suggest that a crisis may often become a blessing in disguise. My own feeling has always been that a "crisis" is just another way of saying "a challenge." And in the final analysis, who ever accomplishes anything unless he is challenged to do it? Why not show a united front in pharmacy? If we really mean business, I believe we can turn this so-called crisis into an opportunity for progress which is virtually limitless in scope.
Of course, we educators in pharmacy represent just one phase of the total profession. We are not going to make the world over, all by ourselves. But we can and should put our own house in order, and thus our influence can have profound effects upon our colleagues in the retail, wholesale, manufacturing and other phases of the profession.
We have many, many good points of which to be proud, but too few other people know of them. Therefore, I think our first approach should be one of public relations.
We cannot hope to be respected unless we earn and demand respect.
I would like to see our Association undertake a definite and consistent campaign to publicize pharmacy in a dignified and professional manner. I would further like to see each school in the Association assume responsibility for good and consistent public relations in its own area of influence. Many of our institutions have public relations counsellors upon whom they can call for help. I think we should share our experience with each other, so that all may profit.
We must think of the future. It cannot be otherwise. Thinking of the present against a background of serious interpretations of the past turns the mind to things ahead. Perfection, nothing less, sought patiently, must forever be our goal.
Public relations is a means of creating understanding and good will toward our field, thereby increasing the public appreciation for the professional services offered by pharmacists.
The courage and clear thinking required to calculate risks successfully and to set an aggressive course has for its objective a greater respect for the field to which we in the general pattern of pharmaceutical education are committed.
Most disturbing, however, is our apparent forgetfulness of the necessity of evaluating ideas of all kinds in attempting to arrive at valid new ones or in attempting to put old ones to good use.
Valid ideas result from the combined efforts of a number of people working hard at the business of arriving at ideas.
Public relations is nothing new. Throughout history people have worried about the problem of getting along well with one another. Public relations as an organized approach, however, is relatively new, and has enjoyed a rapid and dramatic growth over the past several years. Business, industry and educational institutions have been among the leaders in implementing public relations programs.
An eminent public relations counsellor describes public relations in terms applicable to pharmacy: "Public relations is a vital tool of adjustment, interpretation, and integration between individuals, groups and society. Public understanding and support is basic to existence in our competitive system. To know how to get along with the public is important to everyone."
In simpler terms, public relations is doing a good job and receiving credit for it. We all have public relations, good or bad, whether we know it or not. Through good public relations planning, it is possible to present knowledge upon which the public can make its decisions concerning a group, an institution or an individual. A great amount of public information is gained through mass media. A great many of the public's attitudes and actions are based upon this mass media information.
Such information must be accurate, must follow predetermined lines of thought and must bring to bear upon the public a heavy impact. To do so, it must be organized and channelled. Public attitudes must be analyzed and evaluated. Policies and procedures must be identified with the public interest.
Pharmacists generally have maintained good public relations with their customers. Pharmacy schools, too, have good public relations within their communities. This public relations is carried on in almost as many different ways as there are individual pharmacists and pharmacy schools. Such public relations, however, is localized, and lacks the impact necessary really to tell pharmacy's story.
The Association needs an overall public relations program to provide policies and procedures on a nationwide scale. These policies and procedures would serve as a guide for localized and community public relations. We have done a good job in training young men and women to become pharmacists; we have brought to the American people better medicine and better health through better pharmacy; we are an important section of the health team. Few people, however, outside of the profession, know these things.
Perhaps you can see no necessity for telling pharmacy's story to the public. If you need an example, look at the American Medical Association and its problems over the past few years.
Physicians were treating their patients as they had always done, and got along well with them. Medical schools were turning out physicians as rapidly and as well-trained as possible. There were no problems, and medicine in general was snug in the thought that everything was rosy.
Then came the dawn, in the form of "socialized medicine." The public took up the cry for more doctors and better medical facilities, and modern medicine and medical education were in the spotlight.
The public, which had heretofore thought their doctors were doing a fine job, were not quite so sure now. The public had nothing upon which to base its decisions except information in the public press concerning the "socialized medicine" plans.
The A.M.A. fought back, as we know, but it was an uphill battle all the way. Had they been actively telling medicine's story earlier, the task of combatting "socialized medicine" would have been much easier. Had the public been aware of the A.M.A.'s policies -- which in reality were in the public's interest -- the problem would have been much simpler.
Instead, the A.M.A. had to take the defensive position, always a difficult one. 0nce a charge is made, it is difficult to refute without leaving doubts. Had the A.M.A. followed the advice of some forgotten sage who said, "The best defense is a good offense" the difficulties would have been much fewer and more easily treated.
I subscribe to that sage's advice. I believe our Association should adhere to his "good offense" suggestion. I believe our Association should establish a department of public relations at the national level. It should be supported by a budget that would permit modest beginnings toward an overall program. It should be responsible for:
Obviously, such a program cannot be developed overnight, nor will swift public reaction be the result. It must be a long-range development, calculated to educate the public in the ways of pharmacy.
Obviously, too, such a program cannot be accomplished without adequate financial support. Such Support, modest at the beginning to be sure, will of necessity have to increase as the program develops and reaches into new areas.
I would urge that we give this serious consideration; that we as pharmacy educators take the offensive now, as have industry, business, education, voluntary organizations, physicians, and countless others. Then, when problems arise, as one day they surely will, they will be of less magnitude because of sound, well-organized public relations policies and procedures.
I have one additional suggestion, and one which would apply with equal force to the schools of pharmacy and all other professional schools. It is simply this. I believe that part of the training of a doctor, a dentist, a nurse, a pharmacist, a lawyer, or a minister should include formal training in the principles of public relations. The professional man today owes a large part of his success to his ability to get along with people, to interpret his problems to them, to win their acceptance of his programs, and to gain their respect. Many people have natural, almost instinctive ability to learn these things; but others do not. I suggest that a course in public relations, or human relations, or whatever you wish to call it, be a part of the curriculum of every professional school.
As individuals the professional people would benefit; as a group the profession would benefit because of the enlightened direction the professional associations would have.
Our efforts should be aimed at developing a greater appreciation of what pharmaceutical education means to the public and how it operates to their benefit.
People are little interested in the operation of a pharmacy school, but they do want service from the pharmacists in their communities. The schools and colleges of pharmacy have been progressively preparing their students to render these services most efficiently.
If we are going to measure the position of pharmacy and pharmaceutical education in the public mind we must at least entertain the idea that it rates very high. It must rate high in the mind of the teacher, and in the minds of our students. If they are not motivated at the time of admission by an inherent desire to progress in the educational pattern, then they must be motivated while in school. This motivation can be successfully carried out only by the teacher in pharmacy and by the product of our schools, the pharmacist.
Recently there appeared the report of the President's Commission on the Health Needs of the Nation known as the Magnusson Report. This Commission appointed by the President of the United States consisted of representatives from Medicine, Dentistry, International Association of Machinists, National Consumers League, the Farmer, CIO, National League for Nursing, but no representative from Pharmacy.
In volume one their findings and recommendations are in part:
SECTION 1. There is hereby established a commission to be known as the President's Commission on the Health Needs of the Nation, which shall consist of a Chairman and fourteen other members to be designated by the President:
SECTION 2. The commission is authorized and directed to inquire and study the following:
a. The current and perspective supply of physicians, dentists, nurses, hospital administrators, and allied professional workers; the adequacy of this supply in terms of the present demands for service; and the ability of educational institutions and other training facilities to provide such additional trained persons as may be required to meet prospective requirements
c. The problems created by the shift of thousands of workers to defense production areas requiring the relocation of doctors and other professional and the establishment of additional facilities to meet health needs.
e. Current research activities in the field of health and the programs needed to keep pace with new developments.
Commission has one major objective--
"During this crucial period in our country's history it will make a critical study of our total health requirements, both immediate and long range and will recommend courses of action to meet these needs."
The commission met first on January 14 and 15, 1952, and made four fundamental decisions which guided the commission policy throughout the year. The one important to us is number two:
"To reach no conclusions until we have beard all the evidence which could be assembled in the time available and to scour the country to find the experts and unearth the studies which would supply us with basic data."
On page 3 this report also makes the following recommendation:
"The physician leads the over-all effort, but as one member of a well-trained team comprised of dentists, nurses, technicians, and many other professional health workers. Only through such joint endeavor can the whole range of services be delivered."
To be most effective the health team must achieve a smooth continuum of care, -- embracing promotion of health, prevention of diseases, diagnosis, treatment and rehabilitation, -- all of which is constantly improved through education and research.
The report, volume one, page II, reads:
"Physicians, dentists, nurses, and auxiliary medical workers are the indispensable and irreplaceable core at the center of the provision and distribution of medical care. . There is no substitute for the skilled surgeon, the precise dentist, the trained resourceful nurse. Good Health Service is never mechanical; it stems from the educated mind, the warm heart and the practiced hands of our many health workers."
Pharmacy as a profession is not mentioned in its rightful place.
In one summary of the report the statement is made
"far less than necessary is spent for preventive care, and expenditures for drugs are high relative to expenditures for other medical care."
The implication here is definitely not correct.
In volume two, page 240, the following statement appears:
"The individual who is interested in promoting his health can take one of several courses. He may seek information from newspaper columns or magazine articles, both good and bad. These are probably the most popular sources of health education. He may purchase vitamin pills, cold medicines or tonics at the corner drug store."
In volume four, page 29, the emphasis is placed upon "Life-saving but expensive drugs" and on page 33 of the same volume is the statement:
"catastrophic drug bills which drain the family purse at the same time that other emergency expenses pile up."
In a review of the bibliography the only references made to the field of pharmacy are as follows:
Under the caption- "Drugs and Medicines" the following are listed:
At a panel discussion on training of paramedical personnel, according to the printed report, Dr. Robert P. Fischelis was the only representative of pharmacy who participated.
At a joint panel on Research and Education of Physician, Dentist, Nurse and Paramedical Personnel, there was no representative from Pharmacy.
No pharmaceutical official agency appears in the list of organizations providing technical information and assistance.
In the printed list of witnesses the only names of persons and organizations who presented or filed testimony at the regional hearings conducted in eight major cities are David Bitner, President of the Pennsylvania Pharmaceutical Association; Dr. Ivor Griffith, President of the Philadelphia College of Pharmacy and Science; and Herman Winkleman of the Retail Druggists Association of Greater St. Louis.
I believe this emphasizes the need for a powerful public and professional relations program. I have offered the foregoing in support of my contention.
We have had the Charters Survey and the recently published Pharmaceutical Survey. We have had many reports, contributions, the Pharmacy Curriculum Committee of the A.A.C.P. reports, and "The Pharmaceutical Curriculum," but have we taken full advantage of all findings to bring pharmacy where it rightly belongs on an even keel with the other health professions?
A veritable revolution in medical education occurred in 1910, with the publication of the Flexnor report, which led the way to sweeping reforms in medical education. Certainly the findings of the Pharmaceutical Survey should, in fact must, accomplish the same in Pharmaceutical Education.
More than thirty paramedical specialists have evolved including such diverse groups as medical laboratory technicians, X-ray technicians, dieticians, physical, occupational, and speech therapists, medical record librarians, social workers, clinical physiologists, hospital administrators and many others.
The training required for these fields ranges from one year of study after high school to two or more years of post-graduate education.
Thus the improving standards of training in most paramedical fields not only gives increasing assurance of competence and technical reliability but also attracts more applicants to training institutions.
As you already know, paramedical workers are persons other than physicians, dentists, and nurses who are engaged in the investigation, treatment and prevention of disease and disability and in the promotion of health by virtue of some special skills. In such a list in the President's Commission report, Pharmacists are listed as tenth, placing medical laboratory technicians, X-ray technicians, dieticians and nutritionists, physical therapists, occupational therapists, speech therapists, social workers, clinical psychologists and even midwives ahead.
In connection with public and professional relations, the need for a brochure has long been recognized. The committee appointed by the Executive Committee to prepare a suitable brochure has devoted a tremendous amount of effort and work in preparing it. The preliminary report appears to be quite long and it has certainly covered many of the facets of pharmacy. Certainly it will not be too long for any person seriously concerned with the problem of selecting a career. I believe, though, that a brochure is necessary which will appeal to the prospective student and to the parent. I also think that more thought should be given to our college bulletins so that they can more accurately portray the curriculum to the student. As presently constituted, the bulletins are built up with a vast amount of material which is purely academic and can in the main be interpreted chiefly by committees on admission, registrars and administrative officers.
We all know that communities have taken measures to protect the health of their citizens.
As Public Health practice has expanded, have the skills of the pharmacist been recognized and used to the fullest extent?
After all, what is Public Health? It is defined as "The science and art of preventing disease, prolonging life, and promoting physical and mental health and efficiency through organized community efforts."
If this is public health, and I believe it is, should pharmacists be mentioned specifically with physicians, nurses, etc., as a component of the core of public health personnel, or be mentioned as one of the special groups which also participate, such as dentists, health educators, laboratory workers, nutritionists, social workers, statisticians, and veterinarians?
The World Health 0rganization, a specialized agency of the United Nations, is the directing and coordinating authority in the international aspects of health. It provides technical and advisory services in many phases of Public Health, in which is included standardization of drugs. Are we represented?
Should the curricula of pharmacy schools embody some specialized training required for public health activities?
To seek justification for the inclusion of a course in Public Health in the already crowded curriculum of a school of Pharmacy, we might address ourselves to identifying the place of the pharmacist in the field of Public Health.
First of all, the pharmacist is a professional worker in a field which is included in the general classification of the health sciences. Within this field, he may be classified as a co-worker with the physician. As such, he becomes an active member of the so-called "Health Team." Traditionally, like the physician, the pharmacist has been largely concerned with the materials of curative medicine. However, during the last three or four decades, the shelves and especially the refrigerator of the corner drugstore have come to be occupied by an increasingly higher percentage of materials whose use is directed to the preservation of health and the prevention of disease. For example, I direct your attention to vaccine points and other sera and vaccines and even to the ever-present vitamin pills.
Furthermore, we find an increasing number of pharmacists rendering direct service in the public health field as employees of health agencies, official or voluntary, especially those charged with responsibility for the care of the indigent sick. Others are serving the state or federal agencies concerned with regulation and standardization of drug products. In fact, in the broadest sense, any professional function performed by the pharmacist which is not a direct service to an individual but rather an organizational service to the public or groups of individuals takes him into the field of Public Health as it is broadly conceived of today.
In this category of service, we cannot escape the unofficial (and often involuntary) function which the pharmacist performs in the field of health education. We must recognize the fact that, as a professional person supposedly informed on matters pertaining to health and easily accessible to the general public, the pharmacist is the logical target for requests for all sorts of information on health matters. Some of this he has been taught to refer to the physician but to a great many questions he can and quite properly should provide an authoritative answer. Whether he likes it or not, he will find himself called upon for an opinion as to the danger or usefulness of fluorides or chlorine in the town water supply, the control of pests, the local school health program, the need for a new hospital and countless like matters.
It seems to me, therefore, that it is incumbent upon us, as educators, to equip the graduate in pharmacy to perform, as intelligently as possible, in the field I have briefly and imperfectly sketched. Certainly, the least we can do is to provide him with a background of knowledge as to the modern concept of Public Health-its organizational structure, history, functions and development -and either tell him or allow him to draw his own conclusions as to his place as a pharmacist in it.
Finally, in this connection, let me dwell for a moment upon an educational by-product that need not necessarily be related to the professional functions of the pharmacist. By providing an introductory background in public health, we have created an informed citizen. Progress in public health depends upon an intelligent understanding and leadership among the population whose health is being furthered or protected. A professional background need be only incidental to this understanding and this capacity for leadership but the ability to comprehend and the power to THINK about health problems is fundamental to it. The preparation of our students for community leadership as citizens is probably as significant as their training as professionals.
Epoch-making discoveries and contributions by many hundreds of scientists have opened up vast areas of research in the fields of nutrition, endocrinology, hematology, therapeutics, pharmacology, pathology, and many other sciences. Many examples may be cited in which individuals or groups of individuals conducted their series of experiments to prove or disprove a very simple observation. Inquisitiveness or thirst for knowledge, or a desire to accomplish something worthwhile was in many instances the impetus behind the work which often resulted in important discoveries. These have proved beneficial to all mankind.
The large pharmaceutical manufacturers, with their staffs of pharmacists, pharmacologists, chemists and other workers, prepare the material for convenient use, with proper checks for purity, potency and stability.
The retail pharmacists, as the proper purveyors to the physicians and the public, then dispense these medicaments, either alone or compounded with others. They know how materials differ from each other, their storage, their incompatibilities, their dosage. The constant multitudinous influx of new materials requires constant attention.
While no concrete data is available, I am of the opinion that many teachers in schools of pharmacy, regardless of the areas of instruction, have little contact with the drug store whether it be of the strictly professional type, the community store, the self-service store, or the chain store. Most information at their command regarding drug stores is what has been conveyed to them by alumni or by students working in stores.
The physician serves his internship in the hospital and we are all aware of the fact that he is able to keep intimate contact with his patients. If he is progressive, he translates the trends of his profession to the benefit of his patient. The dentist functions somewhat in the same manner. The same may be said of the nurse. The teacher in the school of engineering in a great many cases is able continuously to keep abreast of the advances in his profession by acting as a consultant.
It appears that many teachers of pharmacy fail to keep a finger on the pulse of what is transpiring in the present-day drugstore.
I have been in contact with pharmacy for fifty years, thirty-five of which have been devoted to teaching. Until the last ten years, I considered it a duty on my part to spend some time in retail and/or hospital pharmacy, if only for one evening a week or a month during the summer time.
When I was in Lincoln, Nebraska, for the District meeting, I visited strictly professional stores as well as the most modern self-service stores. This division into two extreme types of stores in the West shows a trend rapidly moving eastward.
I want it thoroughly understood that my comments must not be construed to mean that I favor a decrease in the number of full-time teachers and an increase of part-time teachers, but rather that there should be more thought given by pharmacy faculties to in-service training. This would apply equally to the teachers of Pharmacy, Pharmacology, Pharmacognosy, Chemistry, or Pharmacy Administration. In my opinion this is a practical aspect which we cannot overlook. The teacher should know what happens behind the counter in the retail store whether it be the corner drug store, the professional type of store or the hospital pharmacy.
Pharmacists are men and women who are liked and respected in their communities. They have personality, good manners, and other human qualifications which are not studied in text books or listed in examinations. These are intangible things that can grow up in almost any course, however factual or specialized, in the classroom of fine teachers and in the every day friendliness of campus life.
Pharmacists must have ability to get along with people, to be honest, to do a sound piece of work, and to respect the good work of others, to be reflective, to understand more each day of things and people and the world around us.
Let us dedicate ourselves to the sound development of the highest standards and ideals of pharmaceutical education. When I say highest standards, I do not use idle words but express a fixed determination to attain as quickly as possible the highest educational standards in pharmacy.
Are we too prone to speak too much about pharmaceutical education and not enough about pharmacy? I do not believe so.
We know that pharmacists are facing constantly changing ideas; that some lack enthusiasm about their opportunities; that they do not always evaluate products. We also know that a new realism in educational techniques is little short of inspirational; and that a good teacher must know how to motivate.
Therefore we must strive for more ideal conditions; we must redouble our efforts to advance our profession. The vitality and health of our profession must be preserved if it is to render the benefits expected of it. Whether the actions needed to achieve this end are popular or not is secondary. We are judged by the quality of our products.
It requires more concentrated attention and effort on the part of the administrator, the teacher and the student to master the vastly expanding area, commensurate with the developments in therapeutics, the newer dosage forms, and the economic aspect.
Television, radio and visual aids all have had a tremendous effect on the education of our youth. Educators feel that one of the effects of television is that book resistance on the part of the student is fast becoming an important factor we must face in education. For instance, it is much easier to listen to some one else and to look at pictures than it is ferret out information for one's self.
Pharmacy is a member of the health team and should make itself felt as such. We cannot do this by measuring all things on a dollar and cents basis. There should be no question when a physician asks for a definite item that he gets it. Stressing honesty and integrity must be a part of the fundamental training of the student.
Teachers in such a pattern are extremely important. We are dealing with youth and the impressions we make, in many cases, will be carried through life. Thus it goes without saying, our teachers should have the highest educational and moral standards.
We cannot afford to look backwards. We can only hope to move forward by setting a goal which is difficult to reach and working toward it, though it takes a year, two years, five years, or more.
We cannot afford to overlook the point that the majority of the pharmacists we train remain in retail pharmacy. Therefore, I think that our program should consider first of all, making this retail man the best possible by giving him the finest training available. This is not a local problem but a National one.
Dr. Christensen said:
"The educational system of a profession contributes to a large degree to the growth and advancement of that profession. The primary responsibility for growth and progress and improvement in the practice of pharmacy rests upon the member colleges of the association.
"It is true that to insure consistent progress in the practice of pharmacy each succeeding class of graduates should be a little more capable, each a little better educated and better trained than the preceding class. This can be brought about by a better selection of students, improvement in teacher quality, choice of subject matter and scope of subject matter."
In this I concur.
I have found the following words of unknown origin thought-provoking and want to share them with you:
"A child is a person who is going to carry on what you have started. He is going to sit where you are sitting, and when you are gone, attend to those things which you think are important. You may adopt all the policies you please, but how they will be carried out depends on him. All your books are going to be judged, praised or condemned by him. So it might be well to pay him some attention."
This could well apply to our students in pharmacy.
Pharmacy's perspective must change; whether this be a gradual process or a sudden one depends largely upon the situation and attitudes of the member colleges. Within five years it should be possible for all schools to embark upon an extended program, leading to a degree other than the B.S. which would include a definite division into a pre-pharmacy and professional course, or a pre-pharmacy course as a pre-requisite entrance into a pharmacy school. This should be an objective of the Association and should be accomplished.
The teachers' conference for 1954 should present as many facades as possible in order that the very best may be chosen, as only in this manner can we hope to advance. The preliminary report of the planning committee for the 1954 seminar states that "The 1954 Seminar will unquestionably be more difficult to plan and successfully conduct than earlier seminars." Undoubtedly this is true, but the recommendations are sound and merit consideration by the committee which will be appointed to conduct the seminar. I agree the entire seminar should be as practical as possible; however, there must be some philosophical treatment. I feel that the theme "How to Teach and How to Teach More Effectively" is a very good one.
K.T. Keller, President of Chrysler Corporation, has said
"In this age of atomic energy and other wonders it is easier to glamorize achievement than to explain it or to understand it."
So let me ask the question, "Have all factors been considered and measured?" For when the facts are known, all decisions rest finally on judgment and experience. With experience we can calculate many possible eventualities and with judgment we can lay a course which seems to have the best chance of success and the least chance of failure.
To summarize --- I Believe That:
Recommendation -- WHEREAS, I have been reliably informed that the American Association of College Teachers, the American Association of Medical Colleges and the Association of American Colleges each have committees which meet jointly with a committee of the American College of Public Relations Association to study the problems of public relations in their respective fields.
I therefore, recommend, that a public relations committee on pharmaceutical education be appointed. This committee is to consist of two or three members and the committee is to be instructed to request the A.C.P.R.A. to nominate two or three members of their Association to meet as a joint committee to initiate a study of the public relations problem as it pertains to pharmaceutical education.
In conclusion, I desire to state that I have enjoyed immensely the privilege of meeting with the members of the Executive Committee. I have also derived a great deal of satisfaction in attending the district meetings to which I was assigned.
This gave me a splendid opportunity to observe the thinking of the members of the profession in different parts of the country. As your president, I shall endeavor to do everything in my power to promote the interests of the Association and of the field of Pharmacy. With your wholehearted cooperation I am certain that this can be accomplished.
--Edward C. Reif