I recently met a competent and hard working experienced pharmacist manager when working within a busy retail chain. I told him what MUR Evangelism was about. Although he was impressed with the message, a lot of his views gave made me think extremely hard about another perspective- the dark side. He was given a Pharmacy Manager of the year award by his company this year. When asked by head office about his secret, his reply was surprising. He wasn’t implementing any additional services and didn’t do any MURs. His secret was to provide a quick and efficient dispensing service for his patients. Infact his turn over had increased by 30%. Why? Simply because patients wanted a quick service. ‘If you have a quick service and your owings are kept to a minimum then word of mouth will bring you business. No marketing, no additional services, just quantity of scripts' were his words. Infact although he did think the nature of MURs was valuable for patients, he believed that the way it had been implemented was flawed. His take was simple,’ If you spend 15 -20 minutes in a consultation room in a pharmacy that does 13000 items a month then you will lose customers. People want speed of delivery and no owings… get this right then the rest is just extra. Infact he believed this so much that he will refuse to do any MURs. His fear was that if he did any then it would be expected from him from his line manager and no additional support would be provided (no funding for an ACT or 2nd pharmacist) On reflecting during the time I was there I realized that he spent 15 minutes talking to me on this subject and between 12pm and 2pm we only saw 4 customers with prescriptions. So I beg the question, are people looking at MUR targets akin to eating an, overwhelming, whole elephant of 400 as opposed to eating a, manageable, bite of an elephant of say 2 a day. In my opinion with the latter view this is achievable.
I noticed another barrier was his mindset. He felt that his training never equipped him with counseling patients and being clinical. His expertise was related to extemporaneous dispensing, a skill that was now redundant. He was previously a superintendent pharmacist of a multiple, a proprietor, and now on a good salary as a pharmacy manager of the pharmacy local to his home. He had 4 years to retirement and felt that he had achieved everything he wanted, he did not want to take on any other role. On observing him, I felt that his impression of MURs was that of a clinical review and that he lacked confidence in his counseling skill in the consultation room. Yet outside the consultation he was brilliant, and he applied his clinical background well when communicating with patients. Infact what I saw time after time, he counseled patients, reacted to their queries and essentially did MURs every day as a part of his job. He was an MUR evangelist. He needed as much clinical skills do an MUR as a pharmacist would do in dispensing. I found it striking how perception of an MUR becomes different to the interaction with a patient we have every day. The truth is MURs is what we have always been doing, except we are now typing them up and doing them in consultation rooms. Incidentally when I carried out MURs with many of the patients, the feedback was that they loved this pharmacy because of it was efficient and the pharmacist manager was knowledgeable and was approachable! So the moral of the story is that what you think are your strengths are different from the strengths that the patient believes you have. If you are approachable and have confidence in what you say then patients will take that you are a good pharmacist. The key to an MUR is for you to have the skills to warm to a customer. It’s about building a relationship with them.
COMMENTS
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Very good article. Building relationship is at the heart of MUR. However, we have to the deliver the warmth to our customers from the heart otherwise it is meaningless. In other words, we must genuinely be interested in our patients' or customers' medication. If we only pay lip service to the service, then the patient will see through. Perhaps we need to remind ourselves who a patient or customer is: A patient or customer is yourself when you are not at work.
