Deep Work and Why My Job Sucks

deep work focus

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Have you heard of deep work?

Apparently, the ability to do deep work is highly correlated with job satisfaction for those of us being paid for our cognitive services.


I’ve been doing a lot of work over the past two months

Whereas I usually average about 35 hours a week of work, I’ve been doing closer to 50 lately.  Don’t get me wrong, I’m not complaining here!  I’m taking the opportunity while it’s available.

I wish I could get overtime for those extra hours I’m putting in.  However, working two jobs to get it means I miss out on that feature.  That’s ok though, because, being per diem affords me a lot of other perks.  

Anyway, with the extra hours I’ve been putting in a lot more drive time than usual. Which means I actually have time for podcasts (my normal 10 minute commute is great, but, no podcast time).  I’ve been binging the Hidden Brain podcast for the last two weeks.


Topic of today was “deep work

My best summary for what deep work is, is, the ability to do highly focused work with no distractions.  This is opposed to “shallow work” or things that require little real attention.

Points that were touched on:

  • The thing of real value these days is in human cognitive capital. Our ability to think. 
  • This is going to be even more valuable in the future as automation replaces our “shallow work.”

It got me thinking… do I ever get to achieve deep work in my job?

Based on the general concept of what was presented, I would have to offer a BIG FAT NOPE in response.

My primary practice setting is retail pharmacy.  I honestly can’t think of many other professions that require the amount of focus and attention to detail that are juxtaposed with the inordinate amount of interruptions and requirement to multitask.

Retail pharmacy is by its very nature completely at odds with the concept of deep work.

And we wonder why so many retail pharmacists aren’t exactly excited about their JOB

My observations here are built on informal personal polls and anecdotal evidence such as Facebook forums and sites like “The Angry Pharmacist.”

There are many retail pharmacists that love their profession and some of the work.  BUT, I can’t name one in a traditional retail setting that I know that loves their JOB.

Of course, as is the case with many professions, what we learn in school has little to do with what we actually do when we get to work.  Pharmacy is no different here (at least in the retail setting).

In a hospital setting and some of the evolving clinic based roles, I could argue that many pharmacists are actually doing what we learned in school an in a somewhat similar fashion as we were trained.

I think I achieved deep work states while in school

I would focus on my studies.  Go to a quiet room with no cell phone or computer.  Just me and the material.  Ok, actually, I was more of a coffee shop with headphones kind of person, but, if I had to study at home, I did do what I describe above.

Real life in the real retail world

I can tell you, that, in no way, shape or form did I intend to enter a “customer service field.”  But, that’s what it is.  In customer service, especially when people can see you, customers do not expect to wait for you to finish your thoughts.  And deep thoughts?  Ha!

Deep work isn’t really possible when you’ve got someone staring you down from 15 feet away.  There are six phones are ringing.  A drive through alarm is buzzing.  Someone is yelling “Dr. call on line 3” while another staff member is yelling “consult at window 2!”  All while you’re desperately trying to finish (safely) checking the prescriptions of someone who was promised that they would be ready in 20 minutes… 47.36 minutes ago.

Oh yeah, and the prescriber dosed something wrong, but, because they get time to do their deep work in their office, they’re unavailable right now to take a call to clarify what they were trying to do.

In retail pharmacy, we’re largely herding cats

It wasn’t until I actually started working that I realized how little time there was going to be for my brain to process any information.  In a retail pharmacy you’ve scarcely put out one fire, haven’t even had the time to document an occurrence or a note, before your attention is pulled in 4 more directions.  Usually, your attention is already being pulled elsewhere in the midst of trying to put out said fire.

Mindless is not the correct way to describe it.  Far from it in fact.

We are expected to catch the mistakes of all those working around us at 100% accuracy.  Pharmacists are expected to assess the whole patient and their medication file as well.  We are expected to be super focused.

The work certainly isn’t easy either.  Most nights, except for a particularly “interesting” interaction with a customer (more likely bad than good), I can’t really say what I did all day.  There’s not much memorable about it.

It’s just not an environment that facilitates deep work.  Honestly, it’s not an environment that encourages much higher cognitive processes.

And, it’s not near as as safe as it should be, if people really wanted to think about the likelihood of mistakes when attention is pulled in so many directions.

Most root cause analysis of mistakes in pharmacy identifies distractions as a cause in roughly 50% of drug related errors.  Yet, apparently it is common (and measured) for pharmacists and technicians to be interrupted as much as once every two minutes.

Unfortunately, many of the suggestions given for reducing distractions (see the link above) are frankly, impossible to implement in a retail pharmacy.  Timing of interruptions? Yeah, we’ll let the customers know we’re only available for 10 out of every 60 minutes.  A “no interruption zone” for the order entry staff?  Order entry staff?  One person does order entry, fills the prescription, then sells it to the customer in 20 minutes or less!

A waste of a good education

Given the level of training that we receive, our education and cognitive skills are largely lost in an this environment where there is hardly a moment to pause and collect our own thoughts.  There is no time for it.  And we wonder why there is so much burnout among pharmacists (and other healthcare professionals).

I would say my scenarios are somewhat exaggerated.  In my case it is, to a point, because I’ve sought better conditions (which are actually getting worse again, on trend with the industry).  But the truth is, this is how the days of many retail pharmacists look.  We might get lucky and have a slower day here and there where we actually have some time to reply one email  without being interrupted 8 times.

That’s kind of sad.  A good day is a day where you can complete one 5 minute task without being interrupted.

But here’s the saddest part:

Deep work is correlated with feeling a sense of purpose and meaning in one’s work.  That purpose and meaning foster a profound sense of job satisfaction and inspire individuals to achieve more than the basics of their job description.

If we can’t achieve deep work in our environments are we missing out on this?

Use it or lose it

The people who don’t practice deep work lose their skill in doing so.  If all you engage in is “shallow,” highly distracted work, you lose your ability for deep focused work.

I would have to say that I have noticed this in myself.  On the rare occasion where I do really need to focus and learn something (or produce something), I have an incredibly hard time focusing for a given period of time.  Is my work environment largely to blame for this?  I spend nearly all of my working days attending to multiple things at once.  Keeping a running checklist of things that I still need to get done.

From the podcast, this isn’t a problem unique to my job setting.  It’s a problem in most jobs.  But I wonder, is the very nature of retail pharmacy opposed to allowing for deep work?  The way it stands right now, I would say very much, yes, it is.

Without some groundbreaking changes in how retail pharmacy is conducted, without a complete shift in the business model, it will only get worse.

I’m hopeful though

I’m hopeful that with the advent of things like Amazon’s purchase of Pillpack Pharmacy along with shrinking pharmacy reimbursement, a work environment more in line with the training pharmacists have received is coming.  Of course, I’m equally terrified, because change is never easy and it’s bound to be a bumpy road.  But something’s got to give.

Check out this article that "predicted" the Amazon and Pillpack marriage and some ideas for what the future of pharmacy might look like: Amazon's Pharmacy.

I would argue that among healthcare professionals, who all suffer from having to do very focused, safe, attentive cognitive work with shifting priorities, retail pharmacists have it the worst.

We’re the “most accessible healthcare provider” …for better or worse.

 

10 comments

    1. As always, thanks for taking the time to comment! I think if most of us sat down to think about it, our deep work states are the most rewarding. That or high energy customer interactions that are specifically based on making someone’s day great.. that could be rewarding too.

  1. Very interesting concept. I don’t know that I really get to accomplish deep work as an ER nurse as there is never a time to work on one singular task. It is running from patient to patient or running a code and doing 7 different tasks. I suppose I do feel more fulfilled on days where I catch an interesting case that requires me to only be with that patient for an extended period.

    1. There is definitely something to be said for the excitement (and lack of boredom) these busy jobs can afford. I don’t think I could focus on deep work all the time. But a balance would be nice! I definitely thought of ER staff when I was considering other medical people in somewhat similar circumstances to my own.

  2. I don’t have any need to be visiting a retail pharmacist. But from my experience helping my mom get her med, I can tell you retail customers are deeply grateful they finally get their meds that will solve their problems. Your are helping another person in need while it may not be deep work, thx

  3. Ooooof that sounds rough. I’m so sensitive to my external surroundings, even the interruptions in my office drive me nuts ? To really get any deep work done I need to go off to a quiet spot or WFH…

  4. As a retail pharmacist for the past 22 years I can definitely resonate with the use it or lose it deep thinking. I feel that all the education I was taught back in the 90’s during pharmacy school has for the most part been lost.
    My main focus now it to make sure the prescription that I dispense matches what the prescriber wrote, that it is a ‘normal’ dose and picture/description of the pills match what the computer says it should be.

    My approximately 5 minutes of counseling every hour is the bare basics, whether the med needs to be taken with or without food, what time of day should I take it, will it make the patient drowsy, etc.

    Oh yeah, now I’m at the time of year that I have to work flu shots into my workflow, but don’t worry about it because it will only take an extra minute to work those in. By the way we need to sell these flu shots for almost nothing and no you can’t bill for an administration fee because most insurances won’t pay for it.

    All I can say is I am glad to be nearing the end of my career instead of starting it. 🙁

    1. The retail situation definitely is not conducive to maintaining all the knowledge we learned or, really, for building much new knowledge. It’s sad. My retail workflow is much of the same. Even if I wanted to do more and learn more, there just isn’t time, and because there isn’t time, the opportunities are not available. I’m trying to transition in to something else while I’m still early enough in my career to want to learn something new and hopefully find a new invigorated sense of worth in my profession. Thanks fro stopping by!

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