Ensuring HIPAA compliance has been likened to navigating
a minefield of potential violations. Even with the best of
intentions and work ethic, a single lapse in concentration or
judgement may be detrimental to one’s employment if it re-
sults in a breach of HIPAA law. Having an understanding of
the regulations and the
challenges that go
along with them may
help us avoid costly
mistakes.
The Health Insurance
Portability and Ac-
countability Act
(HIPAA) is a federal
statute enacted in
1996. This complex
series of rules provides
standards for manag-
ing healthcare data and
incorporate the provi-
sion of privacy of Pro-
tected Health Infor-
mation (PHI). It ap-
plies to healthcare agencies and
healthcare personnel and providers
having access to individually identifia-
ble health information records such as
physicians, nurses, pharmacists, health
insurance companies, etc. HIPAA rules
are enforced by the Office for Civil
Rights (OCR) and include all forms of
this data - electronic, paper and verbal.
HIPAA is further defined by a set of
rules:
The Privacy Rule – sets national
standards for the use and disclosure of
PHI.
The Security Rule – outlines safe-
guards that must be implemented to
protect the confidentiality, integrity
and availability of electronic PHI.
The Breach Notification Rule – requires affected individ-
uals to be notified that their PHI has been compromised,
as well as notifying HHS and in some cases the media.
The Act contains five
titles (sections):
HIPAA Titles I,
IV and V – protect
coverage of health
insurance for indi-
viduals who have lost
or changed jobs or
who have pre-
existing conditions.
HIPAA Title II –
applies to processing
of electronic
healthcare transac-
tions and requires
organizations to en-
sure patient health
data is stored, ac-
cessed and transmit-
ted in a manner that
is compliant with federal privacy regulations.
HIPAA Title III – applies to general medical care.
If data contains one or more of the 18 HIPAA Identifiers, it
is considered PHI. Identifiers 1 -3 encompass patient names,
dates such as birth, death, admission, discharge, and patient
location. Identifiers 4 – 11 include numbers – phone, fax,
social security, medical record numbers and even vehicle
license plate numbers. Identifiers 12 – 18 include technology
identifiers such as email addresses, medical device serial
numbers, fingerprints, full face photographs, and any other
unique identifying numbers or codes. PHI can be shared in
many formats—for example medical records, bills, clinic
schedules, emails to or about a patient, and verbal exchanges
that may be overheard. Speaking about or with a patient in a
public area is subject to PHI regulations, and if a non-private
setting is unavailable, a quiet voice should be used. Be
HIPPA: A Minefield Filled with Good Intentions
A Publication of Neil Medical Group, The Leading Pharmacy Provider in the Southeast
July/August 2019
PHARM NOTES
Volume 22, Issue 4
Continued on page 4
Inside this issue:
HIPPA: A Mine-
field Filled with
Good Intentions
1
Battling Cancer:
The Journey
2-3
Conclusion:
HIPPA
4
Sjogren’s
Syndrome
5
The Importance
of Soft Skills in
Healthcare
6-7
Neil Medical
Group Contact
Information
8
Battling Cancer: The Journey
Page 2
PHARM NOTES
When most people hear the word cancer, we immediately
cringe and think the worst. Cancer is a scary, intimidating
word. I’m sure everyone has been affected by cancer in some
way. Some of us have their own personal experience with can-
cer or have had a family member or friend diagnosed with can-
cer. Cancer has been around for a long time, but it seems every
time I turn around I am hearing about someone new that has
been diagnosed. I have had many family members diagnosed
with cancer. A very close first cousin of mine, age 34, was
diagnosed with breast cancer last year. She went thru chemo-
therapy and then had a double mastectomy. Everything
seemed to be looking good after her surgery. Her scans came
back negative; no cancer seen. Then about three weeks later
she started having headaches, neck stiffness and vision prob-
lems. It was first suspected that she had meningitis. Her spinal
fluid was tested and cancer was found in her spinal fluid. Can-
cer was in her spinal fluid and tissues around her brain. The
physicians gave her two months max to live. My cousin passed
almost two months later. She didn’t quite make it the two
months. She went thru a lot of pain and suffering. Cancer in
the spinal fluid is very rare. Can you imagine getting this kind
of prognosis, especially at this young age?
On a better note, I know a lot of people who had cancer and
were cured of the cancer. Usually the key is finding the cancer
early on. Many cancers have a high chance of cure if diag-
nosed early and treated adequately.
Cancer is a generic term for a large group of diseases that can
affect any part of the body. Cancer does not discriminate. Can-
cer does not care what the age, gender, or skin color is. One
defining feature of cancer is the rapid creation of abnormal
cells that grow beyond their usual boundaries, and which can
then invade adjoining parts of the body and spread or metasta-
size to other organs. Metastases are a major cause of death
from cancer. Cancer is the second leading cause of death glob-
ally. About 1 out of every 6 deaths worldwide is due to cancer.
Approximately one third of deaths from cancer can be linked
back to behavioral and dietary risks including: high body
mass index, tobacco use, alcohol use, lack of physical activity,
and low fruit and vegetable intake. Tobacco use is the most
important risk factor for cancer and is responsible for about
22% of cancer deaths. Late stage presentation and inaccessible
diagnosis and treatment are common.
The most common cancers are: lung, breast, colorectal, pros-
tate, skin and stomach cancer. The most common causes of
cancer death are cancers of: lung, colorectum, stomach, liver,
and breast. Cancer arises from the transformation of normal
cells into tumor cells in a multistage process that usually pro-
gresses from a pre-cancerous lesion to a malignant tumor.
These changes that occur are a result of the interaction be-
tween a person’s genetic factors and 3 categories of external
agents that include the following - chemical carcinogens such
as asbestos, components of tobacco smoke, aflatoxin (a food
contaminant), and arsenic; biological carcinogens such as in-
fections from certain viruses, bacteria, or parasites; and physi-
cal carcinogens such as ultraviolet and ionizing radiation. Age-
ing is also a fundamental factor for developing cancer. The
incidence of cancer rises dramatically with age, most likely
due to a build-up of risks for specific cancers that increase
with age. The overall risk accumulation is combined with the
tendency for cellular repair mechanisms to be less effective as
one grows older.
Between 30-50% of cancers can be prevented by
avoiding risk factors and implementing existing
evidence-based prevention strategies. The cancer
burden can also be reduced through early detec-
tion and management of patients who develop
cancer. Modifying or avoiding risk factors can
significantly reduce the burden of cancer. These
risk factors include: lack of physical activity, al-
cohol use, tobacco use including cigarettes and
smokeless tobacco, being overweight or obese,
unhealthy diet with low fruit and vegetable in-
take, ionizing and ultraviolet radiation, urban air
pollution, sexually transmitted HPV infection,
infection by hepatitis or other carcinogenic infec-
tions and indoor smoke from household use of
solid fuels. Tobacco use is the single most im-
portant risk factor for cancer. Tobacco kills ap-
proximately 6 million people every year from
cancer and other diseases. Tobacco smoke has over 7,000
chemicals, at least 250 of these are known to be harmful and
50 are known to cause cancer. Tobacco smoking causes many
different types of cancer including: cancers of the lung, esoph-
agus, larynx, mouth, throat, kidney, bladder, pancreas, stom-
ach, and cervix. Second-hand smoke has also been known to
cause lung cancer in non-smoking adults. Smokeless tobacco
causes oral, esophagus, and pancreatic cancer.
Page 3
Volume 22, Issue 4
Dietary modification is also important for cancer control.
Cancer of the esophagus, colorectum, breast, endometrium
and kidney are linked to obesity and being over-weight. Di-
ets high in fruits and vegetables help protect against many
cancers. The risk of cancer also increases as the amount of
alcohol increases.
Pollution of water, air, and soil with carcinogenic chemicals
contributes to the cancer burden to different degrees depend-
ing on the geographic location. Exposure to carcinogens also
occurs from the contamination of food, such as aflatoxins
and dioxins. More than 40 agents, mixtures, and exposure
circumstances in the working environment are carcinogenic
to humans and are classified as occupational carcinogens.
Exposure to all types of ionizing radiation, from both natural
and man-made sources, increases the risk of various types of
malignancy including leukemia and many types of solid tu-
mors. Risks increase when the exposure takes place at an
early age and also when the exposure amount is higher.
To prevent cancer people may: increase avoidance of the risk
factors previously listed, vaccinate against HPV and Hepati-
tis B virus, control occupational hazards and reduce exposure
to ionizing radiation including occupational or medical diag-
nostic imaging. Vaccination against HPV and Hepatitis B
viruses could prevent 1 million cancer cases each year. When
identified early, cancer is more likely to respond to effective
treatment and can result in a greater probability of surviving,
less morbidity, and less expensive treatment.
Early diagnosis consists of the following steps that must be
integrated and provided in a timely manner: awareness and
accessing care, clinical evaluation, diagnosis and staging,
and access to treatment. Compared to early diagnosis, cancer
screening is a more complex public health strategy that man-
dates additional resources, infrastructure, and coordination.
When planned effectively, appropriately financed and imple-
mented, screening can reduce deaths from cancer and, in
some cancer types like cervix, can also reduce the risk of
developing cancer.
The main goals of cancer diagnosis and treatment programs
are to cure or prolong the life of patients and to ensure the
best possible quality of life for cancer survivors. The most
effective treatment programs are those that: adhere to evi-
dence-based standards of care, are provided in an equitable
and sustainable way, and are linked to early detection and
accurate diagnosis and staging.
The first step in the management of cancer is to establish the
diagnosis based on pathological examination. Obtaining a
tumor sample is done by having a biopsy or aspiration that
may require an intervention such as an endoscopy or an im-
age guided procedure. Laboratory and pathology medicine
services are essential to accurately analyze and interpret pa-
tient samples, which guides the diagnosis, treatment, and
management of the patient. It is then critical to determine the
stage. Staging is used to help guide treatment options and
estimate a patient’s prognosis.
Cancer treatment requires consideration of evidence-based
options, which can include more than one of the following:
surgery, radiotherapy, and systemic therapy. Cancer treat-
ment services require a strong health system to ensure treat-
ment is high quality, safe, effective, and accessible to all can-
cer patients.
After active treatment for cancer, a plan can be developed to
monitor patients for cancer recurrence or spread. This follow
-up is also useful to manage health problems related to can-
cer diagnosis or cancer treatment and assess for development
of other types of cancer. These services include tests and/or
routine examinations and are vital to manage the conse-
quences of cancer diagnosis and treatment. In conclusion, try
to limit your risk factors in order to decrease your chances of
cancer.
Article by Stephanie Joye, RN, BSN, CRNI
Nurse Consultant, Neil Medical Group
Page 4
HIPPA: A Minefield Filled with Good Intentions…….………...continued from page 1
PHARM NOTES
mindful when discussing health information with a resident
when they have visitors in their room. HIPAA protects infor-
mation relating to a patients LBGTQ status as well.
Access to PHI is only permitted when this information is need-
ed for legitimate business needs and to fulfill a job function.
Access to electronic PHI should only occur with a provider’s
own log-in credentials. It is considered a violation to access
records out of curiosity such as looking up information about
friends, co-workers, public figures or for malicious intent.
Patients have rights to their information under HIPAA that
include receiving copies of their records, accessing their actual
records, requesting records are corrected if they contain inac-
curate information, and requesting restrictions on disclosures
to their records. To ensure electronic security of PHI, it is a
good idea to log out of computers or electronic charts when
not using the information, never share passwords with others,
use a strong password, and have computers set to time-out
when not in use.
Safeguarding PHI requires ongoing vigilance. Hard copies of
records and documents should be filed away or covered up
when unattended (paper MARs during a med pass). If com-
puters containing PHI are in an area that makes them visible to
other patients or visitors, a privacy screen should be used. If
electronic MARs are used, ensure the privacy feature is ena-
bled on the computer screen when unattended. Documents
should be promptly removed from fax machines and copiers.
When disposing of PHI it is important to provide safeguards
also. It should be disposed of in a locked bin or shredder or if
electronically stored, authorized methods for securely destroy-
ing should be in place. There are situations where patient au-
thorization is not required: for example, disclosing PHI to oth-
er healthcare providers for treatment purposes or for reporting
required under federal law, by court order, or per state law.
HIPAA permits “incidental disclosures” as long as reasonable
safeguards are in place. Unfortunately, these occur even under
the best of circumstances, however they are not considered
breaches and do not need to be reported. These are usually
minor instances of being overheard by a passing visitor or resi-
dent during the normal course of performing one’s job duties
in one’s designated work area. However, discussions contain-
ing elements of a resident’s PHI with a coworker in a common
area such as a facility cafe would not be acceptable, nor would
leaving a voicemail containing PHI about a resident on their
home phone without their consent. Even though unintentional,
the following examples are considered “unauthorized disclo-
sures”: faxing, emailing or mailing PHI to the wrong number
or address; giving paperwork containing PHI to the wrong res-
ident; losing/misplacing paperwork; sending unencrypted
emails or text messages containing PHI; losing a laptop con-
taining PHI data; having ones log-in to electronic charting sys-
tem compromised; and posting any comments or pictures on
social media that may contain PHI. If a suspected incident has
occurred, employees are obliged to report the details to a su-
pervisor immediately.
What are some of the consequences of a privacy breach? Fi-
nancial consequences in the form of civil penalties and fines
ranging from $100 to as much as to $2.5 million have been
known to occur, not to mention litigation costs. These penal-
ties may be imposed on an institution and/or employee violat-
ing HIPAA. Disciplinary action resulting in job termination is
often likely for an employee responsible for the violation –
even if unintentional. The reputation of both the institution and
employee may be damaged, and there may be an emotional
cost to the victim of a privacy breach. Malicious or intentional
violations may be subject to criminal penalties.
Tips for maintaining compliance:
Ensure resident is accurately identified preferably using
two or more unique identifiers such as DOB, photograph,
etc.
Verify the identity of the recipient of someone requesting
PHI – such as someone claiming to be a law enforcement
officer, someone from the medical examiner’s office, and
various outside vendors that may request information.
Ensure emails containing PHI are encrypted when sent to
a recipient outside of the company network and avoid
placing PHI in the subject line of an email. Use extreme
caution when entering the recipient’s email address to en-
sure correct email address is used. Consider password
protecting any attachments containing PHI.
Avoid using a personal cell phone or camera to take pic-
tures of PHI and avoid transmitting text messages contain-
ing PHI.
Use extreme caution and heightened judgement when
posting any information on social media (Facebook, Twit-
ter, LinkedIn, Pinterest, Instagram, etc.) that pertains to
one’s workplace, even if it seems harmless – “when in
doubt, leave it out!”
Ensure paper records are not removed from the facility or
copied without administrative permission, and ensure they
are stored in secured areas.
Avoid leaving PHI on a telephone message and don’t as-
sume a spouse or relative is entitled to know information
such as resident’s appointments, diagnoses, test results etc.
In conclusion, adhering to HIPAA regulations requires ongo-
ing vigilance, mindfulness and training. Do not hesitate to
contact your supervisor or employer if you have any questions
or need to report a concern. It may end up preserving a job, a
reputation, and in some cases an entire organization.
Article by Dianne Higgins, PharmD, BCGP
Regional Clinical Manager; Neil Medical Group
Page 5
Volume 22, Issue 4
Sjogren’s Syndrome Sjogren’s syndrome (SS) is a slow progressing, chronic auto-
immune disease in which the moisture producing glands of the
body do not function correctly. With upwards of 4 million
Americans suffering from the disease, SS is one of the most
prevalent autoimmune diseases. Nine out of ten of those af-
fected are women. Despite its prevalence, Sjogren’s syndrome
is often under-diagnosed and the symptoms are often associat-
ed with other illnesses. SS can occur alone or in association
with other autoimmune diseases, most commonly rheumatoid
arthritis and lupus. This condition can affect people of any
age, but symptoms typically appear between the ages of 45
and 55.
Sjogren’s syndrome is an inflammatory disease that most of-
ten affects the tears and saliva glands, though it can affect
many different parts of
the body. The exact
cause of this condition
is unknown, but it is
known to be an inflam-
matory autoimmune
disorder. It is theorized
that white blood cells
infiltrate the glands that
secrete fluids, such as
the salivary glands in
the mouth or the tear
glands in the eyes.
These white blood cells
damage the glands, re-
sulting in dry mouth
and dry eyes, the hall-
mark symptoms of the
condition. SS is categorized as primary or secondary. Primary
Sjogren’s syndrome occurs in patients with no other rheumatic
diseases, while secondary Sjogren’s syndrome occurs in pa-
tients who have another rheumatologic disease, such as lupus
or rheumatoid arthritis.
Patients with this condition may notice irritation or painful
burning of the eyes. Dry mouth, swelling of the glands around
the face and neck, and swallowing difficulty are common.
Most of the symptoms and complications of Sjogren’s syn-
drome are due to decreased tears and saliva. Patients who ex-
perience dry eyes are at increased risk for infections of the eye
that may result in damage to the cornea. Patients with dry
mouth are at increased risk for dental decay, gingivitis, or oral
yeast infections (thrush) that may cause pain or burning. Addi-
tionally, patient may experience episodes of painful swelling
in the salivary glands around the face. Additional parts of the
body can be affected. Pain or stiffness of the joints with mild
swelling, rashes on the arms and legs, and inflammation in the
lungs, liver and kidney may occur rarely and be difficult to
diagnose.
Diagnosis of Sjogren’s syndrome is suspected if (1) the patient
presents with eye and/or mouth dryness, (2) eye tests reveal
inflammation, (3) mouth evaluation reveals dry oral mucosa,
and/or (4) patient’s serum reacts with immunoglobulins auto-
antigens. Biopsy of the enlarged gland may be necessary to
rule out other conditions. Blood tests can reveal abnormalities.
Erythrocyte sedimentation rate is elevated in about 70% of
patients with this condition. About a third of patients have de-
creased red blood cells and about 25% have decreased white
blood cells. Though blood tests cannot confirm diagnosis of
Sjogren’s syndrome, they can be extremely helpful in leading
to diagnosis. Diagnosis of Sjogren’s syndrome is based on all
the information obtained by the
physician including symptoms,
physical exam, and all test re-
sults.
No cure is currently available
for Sjogren’s syndrome. Treat-
ment of Sjogren’s syndrome is
aimed at relieving the bother-
some symptoms associated with
the condition while limiting the
potential for chronic damage
that may result from impaired
secretions. Dry eyes are typical-
ly treated with artificial tears
applied regularly throughout the
day. Anti-inflammatory eye
drops, such as Restasis, may be
needed to increase tear produc-
tion. If corneal ulcerations are present, eye patching and boric
acid ointments are recommended. Drugs that are known to
decrease secretions such as diuretics, antihypertensives, anti-
cholinergics, and antidepressants should be avoided if possi-
ble. Plugging or blocking of tear ducts can be used in severe
cases to increase moisture of the cornea. Dry mouth symptoms
can sometimes be alleviated by drinking water, chewing gum,
or using saliva substitutes. To stimulate secretions, pilocarpine
or cevimeline, may be prescribed to improve symptoms. Pain-
ful, swollen salivary glands can be treated with analgesics and
warm compresses. If necessary, doctors can remove stones in
the salivary glands. Early diagnosis and treatment are key to
preventing long term damage to major organs.
The overall disease course of Sjogren’s syndrome can vary
from very mild to rather significant depending on the timing
of diagnosis. It can take years for the diagnosis of Sjogren’s
syndrome to be completed. Patients need to remember to be
proactive about complications and any changes noticed during
the process of diagnosing the condition.
Article by Erin Taylor, PharmD Candidate
Wingate University School of Pharmacy
The Importance of Soft Skills in the Healthcare Industry
Page 6
PHARM NOTES
To succeed in a professional environment, it is necessary to
possess both hard and soft skills. Hard skills are those that have
been learned through on the job training, college education, or
experience. Soft skills are not so much learned as they are in-
nate to an individual. Soft skills are defined as personal attrib-
utes that enable a person to interact effectively and harmoni-
ously with other peo-
ple. These skills re-
late to aspects of
your personality and
are just as important
to success as hard
skills. In fact, the
soft skills that you
possess could mean the difference between simply having a
career and having success in your career. The healthcare indus-
try requires the employ of both hard and soft skills. There are 7
basic soft skills, and each plays a role in enabling a person to
effectively work as a member of a team. These skills are so
important that certain healthcare curriculums (including nurs-
ing and pharmacy) are incorporating discussions about them
into their lectures. The 7 basic soft skills and their importance
are reviewed below.
Communication Communication is the first of the seven soft skills, and while it
is important to possess in any job setting, it is essential in the
healthcare industry. Consider the number of interactions a
pharmacist could potentially have in one day, spanning from
patients or family members to physicians and nurses. In each of
these interactions, an individual must be able to clearly and
effectively communicate. In consulting pharmacy, it is im-
portant to be able to concisely communicate with a physician
about medication changes and/or optimization. In terms of
patient communication, a health care provider must be attune to
the educational level of the person that they are speaking with,
and adjust the depth of their conversation to ensure that the
information they are communicating is understood.
Another aspect of communication is listening and body lan-
guage. Active listening is important in being able to compre-
hend another person’s level of understanding. The body lan-
guage of the speaker can play an important role in the listener’s
willingness to participate in the conversation. A speaker can
also interpret the body language of the listener to gauge their
interest in the conversation.
Collaboration/Teamwork
The second soft skill is collaboration or teamwork. In the
healthcare industry especially, the ability to work on a team is a
necessary skill. Multiple individuals may comprise a patient’s
healthcare team. In the long term care field, a health care team
can be made up of a physician, nursing, dieticians, physical and
occupational therapists, pharmacists, specialists, and many oth-
er individuals. Each of these individuals must work together to
achieve safe and optimal patient care.
As an example, let’s discuss a patient who is consistently los-
ing weight and not eating well. There are many reasons why
this could be: they may not like the food they are being offered;
they may have no appetite or they may be having difficulty
feeding themselves.
Now let’s consider
what healthcare team
members could help
address this problem.
Pharmacy could recom-
mend medications that
work to stimulate appe-
tite, and a physician
could write the orders for this. A dietician could recommend
additional foods that the patient may tolerate. Occupational
therapy could help the patient with feeding. In order to deter-
mine how best to treat the patient, all of these healthcare pro-
fessionals must work together.
Adaptability
Another essential soft skill is adaptability. This is the ability to
change based on the needs of the situation you are in. It can
also mean being willing to compromise to reach a solution.
This skill can be demonstrated by showing openness to an al-
ternative way of doing things, or being willing to take on tasks
that might be outside of your comfort zone. Adaptability is an
indispensable skill for both work and life.
A simple example of adaptability would be the following: It is
flu season and as a result, multiple crucial members of the
work team are out sick. In order to make the day flow smooth-
ly, the roles of the sick co-workers must be divided up and tak-
en on by other individuals. A willingness to take on these extra
job responsibilities to ensure a smooth work day is an example
of adaptability. In healthcare, this skill is necessary. No health
related job position allows you to focus on one task at a time;
you must be able to multitask and adjust based on the current
situation. Having the ability to adjust to different situations, or
being adaptable, is imperative.
Empathy
Empathy is the ability to understand the feelings of another
person. In patient care, this skill is particularly important. Em-
pathizing with a patient involves being able to discern a pa-
tient’s feelings regarding their diagnosis and treatment. It
could also mean interacting with a patient’s family members,
and responding to them appropriately and with compassion.
Demonstrating empathy helps to foster greater trust between a
patient and a health care provider.
Empathy can also play a role in interactions with co-workers.
Take for example a co-worker who is having a particularly
rough day; they woke up late and on the wrong side of the bed,
the car wouldn’t start, and they stepped in a huge puddle on the
way to work. All of these things are in addition to the other
Page 7
Volume 22, Issue 4
unknown life stresses they have going on at home. You were
scheduled to have an important meeting with them at 9:30am.
At 9:45am, they still have not shown up for the meeting. You
pass them in the hallway, and remind them of the meeting that
they missed. They apologize and briefly mention the morning
they have had. You have two options: you can say “that is not
an excuse, we need to reschedule our meeting” or you can em-
pathize, saying “I am sorry that happened to you and I under-
stand how that can throw off your day. However, we do need
to reschedule this meeting as it is very important.” Displaying
empathy towards coworkers can help to foster stronger rela-
tionships and make for a better work environment.
Self Confidence
Self confidence is a soft skill that can also translate into hard
skills. It is being able to trust your own abilities and
knowledge. Let’s take for example the placement of an IV. In
school or through training, you received education on how to
place an IV. If you lack self confidence, you may question
your ability to place an IV even though you have had the ap-
propriate training to do so.
Self confidence can also play a role in patient and health care
provider interactions. In order to trust their health care provid-
er, a patient must be confident that the provider is capable of
treating them. If you appear to the patient to be lacking confi-
dence, they may become uncomfortable with their care, and
begin to question your ability to treat them. In terms of provid-
er interactions, it is also important to display self confidence.
Consider the following: a physician asks you, a pharmacist,
for a dosage recommendation for a patient. If you respond and
say “Uh, I don’t know... Maybe 20mg?” how likely do you
think the provider is to take your recommendation?
Having self confidence also allows you to accept constructive
criticism as well as enable you to work better under pressure.
For example, say you are a pharmacist assisting in a code situ-
ation. A physician hurriedly asks you for a dose of epineph-
rine. If you possess self confidence, you are more likely to be
able to swiftly assist the physician. This could mean trusting
your own knowledge of the dose of epinephrine, or being con-
fident enough to know that you need help, and asking some-
one else what the dose is.
Problem Solving
Problem solving is closely related to all other soft skills. It is
defined as being able to recognize an issue, come up with pos-
sible solutions, and implement a solution. Let’s take the previ-
ously mentioned example of multiple employees missing work
due to flu. The problem is that there is a work shortage, and as
a result, patient care could be compromised, or tasks might not
get completed. Possible solutions include delegating additional
tasks to other employees, or attempting to obtain additional
help through other means. The implementation of the solution
would be appointing someone to delegate tasks (a leader), as-
signing tasks to other employees, and then overseeing the
tasks to ensure completion. The need to solve problems can
arise in any position, and the problems can range from being
very small to very large. Regardless of the size of the issue,
being able to identify it and come up with solutions, is a vital
skill.
Time Management
Having the capability to manage your job responsibilities and
complete all job tasks in a specific time frame is another im-
portant skill to posses. A small example of this would be a
physician in a doctor’s office: they must be able to dedicate
time necessary to address each patient’s concerns, but they
must also balance their time to ensure they see all patients
scheduled in that day.
Time management is also necessary when one is multitasking.
In a typical work day, there are certain tasks or projects that
must be completed. Throughout the day, unexpected meetings
or conversations may also become necessary. Being able to
prioritize tasks to ensure they are completed is an essential soft
skill. The skill of time management can go hand in hand with
adaptability.
The importance of soft skills in the healthcare industry cannot
be denied. Take the following situation as an example: you are
a patient coming into the hospital with a DVT. You are in
pain, scared, and wondering what is going to happen. Your
doctor tells you that you have a DVT, and he is going to give
you some medicine and send you home. Your nurse enters the
room and says “Take this pill. We are sending a prescription to
your pharmacy and you can go home.” You are discharged
home, and pick up your medication but are scared to take it
because you know nothing about it.
Now let’s consider a different situation. You come to the hos-
pital, and your doctor enters the room and introduces himself.
He tells your diagnosis, explains how he intends to treat it and
asks if you have any questions. He then leaves the room, and
consults pharmacy for a dosage recommendation. A pharma-
cist enters your room and explains the medication you are
about to take, including how to take it, possible side effects,
and when to return to the doctor. Your nurse then comes in
with the medication, and explains that a prescription is being
sent to the pharmacy. She states that she hopes you feel better,
and explains your discharge instructions. How is the second
situation different from the first? Which situation would you
want to be a patient in?
Soft skills are largely inherent, however, it is possible to de-
velop these skills. A push is being made for these skills to be
discussed and assessed in all healthcare curriculums. On an
individual level, a person should evaluate their interactions
with others. They should take stock of how they react in dif-
ferent situations, and identify areas for improvement. In the
healthcare industry, soft skills are vital to achieving optimal
patient outcomes. They are also essential in maintaining a
healthy and positive work environment. Arguably, soft skills
are just as important to success as hard skills.
Article by Whitney Schlick, PharmD Candidate
UNC Eshelman School of Pharmacy
PHARM NOTES
Kinston Pharmacy
2545 Jetport Road
Kinston, NC 28504
Phone 800 735-9111
Louisville Pharmacy
13040 East Gate Parkway
Suite 105
Louisville, KY 40223
Phone 866 601-3041
Mooresville Pharmacy
947 N. Main Street
Mooresville, NC 28115
Phone 800 578-6506
To all the Pharm Notes Family,
We’ve probably all been told that TOGETHER you’ll go further, be stronger, accomplish more, and
be more successful. So here’s some food for thought:
At a Midwestern fair, many spectators gathered for an old-fashioned horse-pull (an event where
various weights are put on a horse-drawn sled and pulled along the ground).
The grand-champion horse pulled a sled with 4,500 pounds on it. The runner-up was close, with a
4,400 pound pull.
Some of the men wondered what the two horses could pull if hitched together. Separately, they
totaled nearly 9,000 pounds, but when hitched and working together as a team, they pulled over
12,000 pounds!
We all bring our individual strengths and talents to the
workplace…..but when we can combine our efforts and
work together as a team…..we can accomplish so much
more! It’s powerful….and more importantly….its true.
Till next time…...
Cathy Fuquay
Pharm Notes Editor
Pharm Notes is a bimonthly publication by Neil
Medical Group Pharmacy Services Division.
Articles from all health care disciplines pertinent
to long-term care are welcome. References for
articles in Pharm Notes are available upon request.
Your comments and suggestions are appreciated.
Contact: Cathy Fuquay ([email protected])
1-800-735-9111 Ext 23489
...a note from the Editor
Thank you for allowing Neil Medical Group to partner with
you in the care of your residents!
Burlington Pharmacy
509 S. Lexington Ave
Burlington, NC 27215
Phone 866 937-3857