We all know that in the average pharmacy, we are short changing the pt that come to us to have their prescriptions filled and help them manage their medical needs. Let’s be realistic, if you are working 12-14 hr shift with the normal missing breaks and you are averaging to verify 40 +/- Rxs/hr …The true volume will have peaks and valleys of that “average” which can be 50% +/-
Time and again… we repeat the mantra.. “we need to be paid for our time and knowledge … separate from the product…” we found one opportunity… vaccinations and what did we do.. shoot ourselves in the foot again.. Give vaccinations on demand.. instead of starting to have appts for the RPH’s time.. establishing the perception that we are not like Pavlov’s dog… ring a bell and we come drooling to provide another product/sale. And we wonder why we are treated like we are fast food workers… maybe because we are functioning like fast food workers ?
Maybe if we tried to help patients better understand why they are talking the meds that they are taking and try to address any side effects that they are having… Here is a new app that non-fast food Pharmacist can use to help patients… http://www.pharmacy.purdue.edu/ptrqol/
We claim that we have pts.. but do we really… think transfer gift cards.. everyone with three brain cells holding hands.. knows they don’t work at getting pts to move their Rx business. Do we ever ask for the pt to bring their previous Rx history so we know what we are doing.. NAH .. we just ask about drug allergies. Hey it would take time.. to put all of their Rxs into the system to worry about drug interactions.. doesn’t fit into the “metrics”. So lets admit it.. for the most part…we have CUSTOMERS .
Now that we have established the type of people that we are dealing with… we have traditionally failed to try to educate the “person with money at the register” what to expect from the pharmacy system.. You know what you can do.. you know what you can’t do… if you don’t educate the “person with money at the register” what level/type of service they can expect.. GUESS WHAT.. they establish their own expectations.. and when they get pissed when you miss their expectations.. you give them a gift card to reenforce that their expectations are not unreasonable.
Let’s look at how we can help fewer pts better.. without putting a strain on the bottom line. Take my favorite patient type – chronic pain pt – your typical chronic pain pt takes a ton of meds.. a recent survey stated that 51% believe the Rx dept staff think that they are a “drug seeker”.. A new person walks up with a opiate Rx for more than 30 doses.. how many people are going fake a control Rx for 30 doses or less ?
Many see a “drug seeker”.. the wise RPH’s will see a cha-ching .. why do you want someone getting a bunch of opiates and nothing else from you.. it will be the odd chronic pain pt that takes only one-two Rxs.. develop Rx dept policy… we don’t fill controls ..unless we fill all of your meds.. That one policy will eliminate a lot of your questionable control Rxs… that takes staff time and probably not add a penny to the bottom line.. If the pt agrees to bring all their Rxs… all you need to do is treat them like any other pt with a chronic condition.. and you do your best to have their meds on hand.. when they order them.. or tell them you need a week’s notice to order for them.
GUESS WHAT.. you have started to build a PRACTICE..
Next step…start working with all your pts with chronic conditions that take a lot of meds.. work with them to get all of their meds filled on the same day every month. You now have one phone call from each pt for refills… you fax all the refill requests to their doctor at one time… they end up checking out all their meds at one time.. most likely.. they will increase their compliance.. you get more business..
How much time do you think that you will save.. having to deal with a single pt once a month.. as opposed to 1-2 times every week? You might have time to talk to pts about their meds.. maybe you can educate these pts to think ahead for getting their refills… or you know when they are due to get refills.
BY GEORGE… don’t look now.. that “pharmacy practice” is sneaking up behind you… it might even over take you.. you might actually get involved in PRACTICING PHARMACY rather than acting like a fast food worker.. That is unless you don’t really like interacting with pts and would rather be like a hamster on a wheel.. keep running and getting no where.
Filed under: General Problems
Yes, you really do have to “train” your patients. Oops! I forgot. They don’t teach how to manage a pharmacy counter in school anymore.
Thanks for the shout out, Steve.
Charles “Doug” Hepler (for the younger set,t he guy who coined “pharmaceutical care”) argued quite persuasively that we have to go out there and provide care whether we get paid or not. Becasue that is how we define ourselves as professionals. We have to condition the patient to expect more, and then they will want it, and they will ask their employer to pay for it. (this is highly condensed). We didn’t. Now we reap the rewards. But if you can’t help every patient (and that’s too true for words) you can make a promise to yourself to pick ONE patient out of the stream each day that needs something more. Then maybe ONE patient an hour. Remember the story about the guy throwing starfish back into the ocean? “made a difference to THAT starfish. You know who they are. And you will feel better about yourself for doing it.