Somebody
observed to me the other day after a series of conversations: 'I see you refer
to your patients as customers'. I responded by saying that I use the terms
interchangeably but I more often use the term customer for most of the patients
I see in my pharmacy simply because they don't seem like patients. I thought nothing
of the interaction until I was having a separate discussion with another of my
colleagues who works in the hospital. He was adamant that I should use the term
patients. I have given this a great deal to thought and this is what I think:
I
disagree with my hospital colleague, and will continue to use the term customer
and patient interchangeably. The most important determinant of which term I use
is the person in front of me, because there is a
noticeable difference in how a primary care and a secondary care patient
perceives themselves. After all, a great deal of our customers in the community
might not perceive themselves as 'ill'. If we are going to connect with
our customers in a meaningful way, we must look for clues from them as to
how best to refer to them. We can usually pick this up through non-verbal
interaction or even on the basis of how the interaction is developing. A
successful community pharmacist will be able to do this seamlessly. It is only
when a patient (or customer) feels connected to us, that they will begin to
open up to us about the underlying reasons why they are having problems with
their medication. Have we ever wondered why some of our customers will discuss
issues which they will not or cannot raise with their doctors?
So what
is the real skill of community pharmacist:
I
described a lack of confidence in my article to the Transitional Committee (link ). Maybe the real skill of the
community pharmacist is the ability to build a lasting relationship
with the customer or patient to such an extent as to be able to influence
their medicine-related decisions. It goes without saying that a good
knowledge of medicine is imperative. Because of the emphasis on lasting
relationships, the community pharmacist should not be bound by the
straightjacket of certain terms. A pragmatic approach to problem solving is
desirable provided this is achieved in a professional context. The community
pharmacist's skill is in his ability to have a meaningful conversation with a
patient one minute and a customer, the next.
Now, if
we combine the medicine-related information we can glean from the medicines use
review process with the treatment objectives of the doctors and other allied
professionals, then we have a powerful mix of an effective healthcare strategy
which will benefit our society. The NHS will be better and the nation will be
healthier.
Case
Studies: Who is
the customer and who is the patient?:
Mrs P J
comes to the pharmacy and asks to speak to the pharmacist. The pharmacist
offers to conduct the conversation in a private area but Mrs P J says it is not
that private and is happy to talk to you over the counter. She describes having
a cold sore and require the pharmacist to recommend a product.
The pharmacist
presents Mrs P J with a range of medicines for cold sore but she asks the
pharmacist to recommend something. The pharmacist chose aciclovir as his most
preferred option. However, Mrs P J considers all the product in front of her
and picked penciclovir contrary to the pharmacist's preferred option.
The
pharmacist then advise the patient on how to take the chosen product
appropriately. When Mrs P J had left, the counter assistant, who had over heard
the conversation, said: 'I wonder why patients behave like that, why ask for
the pharmacist's advice when they are not going to take it'.
The
pharmacist said to the counter assistant: 'That is not a problem. The customer
had a choice of products which are effective for cold sore. It doesn't matter
to him (the pharmacist) which one she picked provided he was available to
provide the right advise as to the appropriate use of that medicine'. The
customer is probably more likely to use the product she chose.
' Maybe the real skill of the community pharmacist is the
ability to build a lasting relationship with the customer or
patient to such an extent as to be able to influence their
medicine-related decisions'
Case 2:
A Mr M P
visits the pharmacy and asks for a quiet word with the pharmacist. The
pharmacist takes the patient to the consultation room.
Mr M P
said: 'I'll just like to check what I have just been told by my doctor with
you. My doctor tells me that my CRP is slightly raised after a blood test and
that I shouldn't worry. I have polymyalgia and I am concerned that my symptoms
will come back. Do you think I should increase my prednisolone dose?'
The
pharmacist explained to Mr M P that although CRP may indicate an underlying
inflammation from polymialgia, it may also be due to infection. CRP is not a
specific marker. Then Mr M P offered that he had suffered a series of infection
lately. The pharmacist moved to re-assure the patient that this may be the
reason why the doctor is not too concerned at the moment. Things will probably
settle when the infection is cleared. If however the pain of polymyalgia
recurs, he must let either the pharmacist or the doctor know.
It was
clear to the pharmacist that this was the re-assurance the patient was seeking
and he (the patient) was very grateful for the input.
----------------------------------
So I ask...who is in front of
you? A patient or a customer? you decide...
