Episode 204: A pharmacist’s mind should be treated like a factory, not a warehouse

In this episode, I’ll discuss why A pharmacist’s mind should be treated like a factory, not a warehouse.

Your mind as a warehouse

Treating your mind like a warehouse means you fill it with facts and knowledge, hoping to recall it at a future point. This is a great method to use for exact sciences.

But the science and practice of pharmacy or medicine is far from exact. Each patient represents a unique combination of history and disease states. While some scenarios are more common than others, you could never memorize exactly what to do in every possible patient care scenario.

Your mind as a factory

Instead of a warehouse, I think of my mind as a factory. A factory where the raw material of information and observation is made into the product of answers and solutions.

More important than remembering facts about medications is knowing when and how to apply these facts to impact the life of a patient.

I’ve always called references like Lexi-Comp or UpToDate the “3rd half of my brain.” I rely on these references for exact details like half-life, bioavailability, and volume of distribution. While I know some of these facts off the top of my head from repeated use, I could never hope to remember all of this information about every medication.

Application to patient care

To be able to apply these facts to patient care, I concentrate my brainpower on learning the underlying mechanism of action of medications and how they can be used within the pathophysiology of disease. I discussed how I use pathophys and mechanism of action in detail back in episode 78.

One great example of this concept in action is with octreotide and sulfonylureas. If you are just memorizing indications and doses for these medications separately, you would never connect the two. But the mechanism of action for sulfonylureas is to cause increased insulin release from beta cells, and for octreotide it is to inhibit insulin release from the pancreas. So in the setting of sulfonylurea overdose, with profound hypoglycemia from the endogeous release of insulin, it makes perfect sense that octreotide can serve as an antidote.

You can access more examples of how to correlate pathophysiology with the mechanism of action of disease in my free download area at pharmacyjoe.com/free (it’s download #7).

Application to pre-rounding

Treating your mind like a factory can be applied in other areas too such as pre-rounding in the ICU. I’ve seen many ICU pre-rounding sheets that look like warehouses of information – with spaces to write down every single lab value and medication that is listed from the computer.

If you are going to treat your mind like a factory, you don’t want to copy-paste from the computer to a pre-rounding sheet.

Instead, I make the purpose of my pre-rounding sheet facilitating problem-solving. I’ll write basic information on my pre-rounding sheet, like the name and day of therapy for the antibiotics that the patient is on. I’ll think about the dose, frequency, indication, and renal adjustment too, I just don’t need to write all that information down.

If I notice a problem and come up with a solution in my “factory” such as the antibiotic needing renal dose adjustment, then I’ll write down what to do on my pre-rounding sheet so I can make the recommendation during rounds.

What are some examples you have of why you should treat your mind like a factory and not a warehouse? Leave a comment below.

Editor’s note: As best I can tell this is the first published use of the “mind as a factory” concept.

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If you like this post, check out my book – A Pharmacist’s Guide to Inpatient Medical Emergencies: How to respond to code blue, rapid response calls, and other medical emergencies.

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