“I am an old man and I have worried much about things that have never happened.”
Mark Twain

In 1990, the year I received my pharmacist’s license, there was no such word as compliance. HIPPA did not even exist. Medicine policed itself based on high moral and ethical standards.

Obviously things have changed.

As a result of regulatory increases and the possibility of immense fines, health care organizations have had no choice but to implement “policies, procedures, and standards of care” to fully define “expectations” that are designed to minimize or eliminate the number of citations received from the regulatory agencies.

This sadly, has lead to the creation of an “us versus them” mindset. Not only between the regulatory agencies and the health care organizations, but also within the organizations themselves.

The hospitals, clinics, and medical facilities have had to hire auditors, compliance officers, and policy administrators to oversee the creation and implementation of all the rules and regulations.

These people have a tough job.

They have to make sure the facilities they work for are operating to the letter of the law, and they receive considerable resistance from the field workers who have their own pressures and stresses.

Everybody involved has two main goals: Optimal patient care and maximum job security.

But they go about it from different paradigms.

Some are patient focused.

Others are policy focused.

At the end of the day, everyone wants the same thing.

We all want to know that we did our jobs well and that we will continue to be able to feed our families and pay our rent.

Most of all, no one wants to be sued; by the government or anyone else.

Simple enough, right?

Wrong!!

Why?!?

Because of that amazing four letter word that starts with F.

FEAR changes everything!

Whenever the auditor finds a discrepancy in documentation, they have to “write the field worker up”.

This happens because:

• They need to justify their own job so that they too can stay employed.
•  They need to PROVE to the regulatory agencies and the courts that the organization is indeed taking steps to maintain compliance. And, of course,
•  Like it or not, the rules are the rules. And they MUST be followed.

When a field worker like me gets written up, it creates an AMAZING RANGE OF EMOTIONS, ALIBIS, AND JUSTIFICATIONS that in a normal situation wouldn’t seem appropriate.

Back to fear.

After you get written up a certain number of times for “documentation violations”, you begin to fear for the safety of your job and by extension, your livelihood.

If your not careful, you begin to view the auditors and compliance officers as “the enemy”.

The reality is “the enemy” is trying to keep the facility open and protect the patients every bit as much as you are.

It is really a fascinating dynamic.

Many field workers get so frustrated with certain auditors that they change jobs hoping that the new facility won’t be “as strict”.

Others go back to school to change professions altogether because they cannot take the constant stress of having someone relentlessly looking over their shoulders.

But here is what I’ve chosen to do:

“I FIRED MYSELF!!”

Ever since I did, I love my job whether I get written up or not!

“Wait, WHAT?!?”

Well, sometimes the smaller the violation, the scarier it is because you’re thinking “Wow, if they would write me up for forgetting to write a diagnosis code on the order, would they just plain fire me if I made a more serious error.”

Of course, the obvious answer is simply to be perfect in the first place so you don’t have to worry about it right?!?

In lieu of my inability to achieve perfection, I have always tried to implement as many systems and processes to help me become as accurate as possible.

Inevitably, details occasionally slip through the cracks.

The last time I found myself filling out a “performance improvement form” I found my eyes to be full of tears from frustration and my heart to be beating much quicker than normal.

My cheeks were hot and my ears were burning.

“What if…” I thought, “this leads to me being fired?!?”

I love my job, and the life I have created, but sometimes I don’t feel safe because of all of the rules, regulations, and moving parts involved with keeping it.

(Honestly, the fear of hurting someone as a pharmacist is daunting enough on it’s own; without all of the regulatory pressures.)

Suddenly, and without warning, in the midst of my tears, I had a vision.

I envisioned myself actually being fired.

I simply thought: “What if this WAS it?!? What would happen THEN?”

I closed my eyes and really tried to experience that future in my mind.

You know what, it was okay.

I realized that if I was fired, I would create some sort of plan for moving forward, and I would move forward.

In fact, I felt a feeling of relief.

I finally understood that life was holding me hostage because of the lifestyle we live, the things we can buy, and the places we can go.

I understood something else as well.

Nothing life has to offer is worth the price of worry.

If I were diagnosed with a terminal illness today, would I even care about my job?

I would care about my friends that work where I work, but the job itself will go on whether I am there or not.

All at once, I was overwhelmed with a feeling of unshakeable peace.

I was fired in my mind, and I had moved on.

I finished filling out the form and did the only thing I could do next:

“I fired myself!”

I decided simply that at some time in the future, I would be fired, and that I was okay with that.

I look at death the same way.

Sometime in the future (like it or not) I will die.

I can either live fully and play all out until that day, or I can waste my life worrying about the inevitable.

As soon as I fired myself, something wonderful happened.

I began to see every day that I am still actually employed as a bonus in the same way that I view every day that I wake up in the morning as a gift from God.

Not only am I now living completely FREE, but I really enjoy my job and I am so much better at it.

You see, pressure and stress hamper our performance.

Wise competitors think only about what they want and refuse to think about what they don’t want.

Since I’ve already been fired, I don’t have to worry about it anymore.

I’ve sold all of my “stuff” (in my mind at least), so now I don’t have to stress over whether or not I will be able to keep it.

Every day I have my passions is a bonus day.

Consequently, I enjoy my “things” more than ever before.

Now, I can easily focus on enjoying my job and my life to the best of my ability, and I have become a much saner, much happier person.

Ever day is a gift, and if we do it right, it remains that way.

Make a decision today that life will no longer hold YOU hostage and I think you will find that a better version of you will emerge.

Make this one decision, and I promise that the sun will shine brighter on all the remaining days of your life.

Thank you for your time and may God bless your future!!

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