We often discussed the issues surrounding pharmacy practice, but never in a progressive or helpful manner. It's easy to see what's wrong in a situation but we seldom find ways to improve issues or "fix our faces". A particular problem, and one that requires immediate attention is that of the public perception and resulting interaction with pharmacists. Now, many reasons exist for the cause and escalation of this problem but that's a discussion for a different day.
For now let's look at some "common sense" tips pharmacists (and assistants) can implement to improve patient perception and value added/superior (retail) service:
Using the following scenario, notice the type of questioning and the rationale behind each. Much of the work pharmacists do is internal (screening, medication option selection, prescription reviews, dosage adjustments, comorbidities assessments, double checking etc) which can be mistaken for not doing anything at all so to make it more evident to patients, it needs to be voiced and brought to their attention in every way possible.
- don't let a session, no matter how quick, start and end without asking any questions. Questioning shows knowledge (which translates into more respect for the profession) and it opens doors for deeper interrogations on patient history which is required for optimal service and therapy initiation.
The mistake most dispensers make is that when patients request a product by name, they think the patient knows all about it. Sometimes this is true but often it's not. A friend, colleague or family member who isn't a health care professional might have recommended the product without putting much thought into it. It is our duty to check if it is warranted and safe for that particular person.
When a patient isn't "engaged with" they assume they are automatically correct in their selection and the need or perception of requiring counselling is quenched. They might not realise that medicine is potentially dangerous. It always needs assessing, dosage monitoring and contraindication checks. Always remind them that we are here to assist in medication selection amongst other things. Even with repeat buyers (otc or chronic scripts), make sure to inquire about: who is it for? ( even when sent, the messenger's perception of that "pharmacist " will change)
What the need/problem is (establish it if new) and if there are any co-morbidities/ contraindications, allergies etc (dangerous factors to consider before initiating therapy).
For repeat patients, inquire about the progress of therapy, is it helping, any side effects or noticeable changes etc?
All these will let them know that you care, and are able & willing to assist further if need be. Boosting the "fix" to your face!
Scenario Example:
Patient: good day
Medicine's Expert (ME): good day, how can I help you?
Patient: I'd like some Mybulen please.
ME: sure, is it for you or someone else?
Patient: it's for my wife. She's in pain.
ME: where is the pain located and how sever is it sir? Does she have asthma, stomach ulcers or any kidney issues? Is she pregnant?
Patient: hmm it's her neck, she slept wrong last night. No she doesn't have any of those things. But she has diabetes. The pain is average..
ME: alright, because she has diabetes, just be mindful that mybulen has antiinflammatories which further accelerate kidney damage in the long run. Therefore when possible opt for local pain relief such as Voltaren gel or transact patches which bypass systemic absorption and hence renal excretion.
For now I can suggest you take a muscle relaxant combination like Uniflex if you really want tablets but rubbing it with an antiinflammatory gel should be sufficient. It relieves localized muscular pain, avoids codeine which can quickly become habit forming and provides a safer alternative.
Patient: oh wow I didn't know that, thanks a lot. I'll take the uniflex and gel but also give me a mybulen just in case she shouts at me.
ME: ok, just let her know that there are options next time she has pain. She should always inquire with the pharmacist for the best alternatives.
Patient: ok, you've been helpful. Bye now.
Patient thoughts:
*Wow they're really thorough!*
*they checked if the medication is safe for her!*
*they're really knowledgeable*
*maybe they can recommend something for my nom's illness*
*I'll bring my script here next time*
Obviously this scenario is simplified and can escalate or be more complex but the idea is to always be inquisitive. Fix your face, and we fix our profession.
Hope this helps even one person and makes sense. What are your thoughts?
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