Pharmacists an Underused Health Resource

By
George Anderson

For consumers taking
a variety of prescription medications as well as over-the-counter remedies
and supplements, pharmacist counseling can be critical. Still, it’s no secret
that patients choose not to take advantage of pharmacists’ knowledge and
help improve their health in the process.

A
recent report by Los Angeles Times cited a study
conducted in California by the non-profit Center for Health Improvement in
2004 and 2005 which found half of all pharmacy customers 65 and older “waived
counseling either ‘sometimes,’ ‘often’ or ‘always.’"

Consumers have a wide
variety of reasons for choosing not to accept counseling, including a lack
of time, but that’s not an excuse the pharmacists should accept, Steven Chen,
associate professor at the USC School of Pharmacy told the Times.

“Good
pharmacists should almost force themselves on patients,” Mr.
Chen said. “They should definitely never say, ‘If you don’t want counseling,
just sign this line.’ But that happens with too many pharmacists.”

Pharmacists
often feel pressed for time and many do not provide the level of counseling
that they are capable of, according to the Center for Health Improvement
study.

“There’s such a high demand for drugs,” Mr.
Chen said, “and
not always enough staff.”

Anne Burns, vice president for professional affairs
for the American Pharmacists Association, told the LA Times. “You
should choose your pharmacist as carefully as you choose your physician.”

Discussion
Question: How much can a high-performing pharmacist affect a retail business?
Should retailers instruct their pharmacists to be more insistent about counseling?

BrainTrust

Discussion Questions

Poll

13 Comments
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Kevin Graff
Kevin Graff
14 years ago

Having done training work for most of Canada’s largest pharmacy chains, I can clearly state the phenomenal value pharmacists can have on the business. No one is more trusted in the medical community. No one is in a better position to counsel and provide added value (read: sell) to the customer.

Here’s the challenge: most pharmacists don’t engage their customers fully enough to create the type of trusting relationship necessary to bind the customer to the pharmacy, or to suggest additional items. The red herring argument is a lack of time. The real reason normally stems from a lack of skill and comfort level with ‘how to’ engage the customer.

Most pharmacy schools provide little if any training on how to deal with customers so it’s up to the pharmacy retailers to accept the responsibility for developing their pharmacists in this area.

When you do get a pharmacist who truly ‘gets’ what it means to counsel a patient, hold onto them. They’re gold!

Gene Detroyer
Gene Detroyer
14 years ago

I have a prescription that I have renewed monthly for many years. Each time I pick it up, I am asked if I want counseling. Each time I decline. If I needed it the first time, I certainly didn’t need it the last 36 times. Yet, I sign the book saying I was offered counseling and declined. Are these the numbers used in the survey? If so, it isn’t a very good survey.

With regard to non-prescription products, I find the pharmacists extremely helpful. They know exactly where the products are and seem to know what the pros and cons of each OTC product are. I find them friendly, well trained and continue to be surprised at how much they know and how much guidance they can offer.

Camille P. Schuster, Ph.D.
Camille P. Schuster, Ph.D.
14 years ago

If older citizens are taking medicine that they have taken for a long time, why would they want or need counseling? Is it a surprise that they turn down counseling for a medication they take on a routine basis? What impact would the pharmacist have forcing him or herself on the customer demanding more time for a consultation? What impact would the pharmacist have doing a lot of counseling for consumers one-on-one while the line continues to grow with patients waiting to have prescriptions filled or picked up? Is there a way to encourage consumers to want some counseling? Is there a way to provide that counseling in a cost-effective manner? And in the appropriate language?

Anne Howe
Anne Howe
14 years ago

Most pharmacists I see keep their backs to the consumers and communicate only with the consumer facing techs. What a shame and a huge missed opportunity. Even if the tech would query the shopper to offer up the opportunity to pose a question would be a huge improvement in shopper satisfaction!

Len Lewis
Len Lewis
14 years ago

In the inevitable disaster that will be government healthcare reform, pharmacists will not only become a more valuable resource but a competitive advantage.

These people have more knowledge about the drugs they dispense and the potential interactions between drugs than most doctors–certainly more than the new crop of physicians whose people skills are about as good as the guy who changes the oil in my car.

Additionally, pharmacists know more about O-T-C drugs and what they can and can’t be used for than anyone. But you’re right, you have to teach them how to engage customers and not just stand behind six-foot counters isolated from the public. If you don’t, you are wasting a valuable resource.

Doron Levy
Doron Levy
14 years ago

Pharmacists training is an ongoing process and retailers invest huge sums to keep their pharmacists up to date with the best and latest resources. The issue of under use falls on the retailer. Do your customers know what is available to them? Shoppers Drug Mart does a good job of conveying what resources are available to patients. In Canada there is a government push for counseling of patients. The thinking is that pharmacists may be able to ease the burden on doctors by answering questions and providing advice that people would normally go to doctors for.

It’s also important to note that SDM has one of the highest dispensing fees of any pharmacy chain, so these resources could be looked upon as value-added services to justify the higher fee. Retail pharmacies must take it upon themselves to communicate what is available to their customers/patients.

Ryan Mathews
Ryan Mathews
14 years ago

Customers trust pharmacists more than they trust their own doctors. The problem is, most retail pharmacists are so overworked they don’t have any time for consultation.

Carol Spieckerman
Carol Spieckerman
14 years ago

While I think that opening up the layouts of most in-store pharmacies would send a more customer-friendly message (the physical barriers to actual pharmacists are so prohibitive, the only thing missing is a big skull and crossbones sign), isn’t it incumbent upon doctors to check for cross-reactions in the first place? Current pharmacy procedures, with the check-the-box obligatory consultation asks, sacks filled with boxes and stuffed with lengthy information sheets sealed with staples that attach yet more paperwork…seem so outdated and wasteful.

I’d like to see that piece simplified, however, I don’t advocate pharmacist consultations being forced on customers. Plenty of prescriptions are embarrassing and I would bet that’s one reason why many customers choose to slither out!

John Boccuzzi, Jr.
John Boccuzzi, Jr.
14 years ago

A good friend of mine who is a pharmacist decided to open his own specialty compound pharmacy 8 years ago. I congratulated him, but asked how he could possibly compete with CVS, Walgreens, and general grocers, especially since he was not going to accept any insurance. He said with customer service. If I was a betting man I would have lost. Not only did his business succeed, it has grown year over year.

I have signed the same note pad most shoppers do when I picked up my prescription that says I do not need to speak with the pharmacist. The primary reason is they look stressed and frankly there is no private area to ask questions.

Pharmacy is a big draw for retailers; in fact one retail executive I met with shared that 80% of people that use the pharmacy in a retail grocer shop the store for everyday items. If that isn’t enough incentive to create the best pharmacy in town, I don’t know what is.

I can only assume my friend will continue to grow his business as consumers look for better service.

Conclusion: There is a huge opportunity for small and mid sized retail stores and chains to focus on their pharmacy and be rewarded for their efforts. When it comes to pharmacy, low price is good, but service wins hands down.

JoAnn Hines
JoAnn Hines
14 years ago

I can’t imagine going to a pharmacy that doesn’t provide counseling as part of its service. For me, it’s an integral part of why I do business with a certain location. I research every new pharmaceutical faithfully, yet I still have unanswered questions.

Perhaps rather than talking about “counsel” it could be phrased like “understanding your medicine,” avoiding pitfalls and mistakes (something along that line) to indicate that expertise is readily available and in most cases, indicated.

Erik Bergeman
Erik Bergeman
14 years ago

I think if you look at the checkout process in most chain pharmacies you will find the culprit. We are all consumers here and we have all been to a Walgreens or CVS to get a prescription. Out of 20 times, how many times have you been checked out by the pharmacist? I would guess for me maybe 1 or 2 at the most (usually it’s an associate because only the pharmacist or a certified technician is allowed to dispense). And of those 2 times how many times have you even been asked if you would like counseling? Even if you were asked, you were probably in a hurry.

One of the key brand promises of a Walgreens or CVS is convenience. If I am thinking convenience when I walk in, which is what their marketing department wants me to think, then I probably will decline even if asked. On the other hand, let’s say I went in for a clinical visit in-store and I happened to get a prescription for my ailment. If asked in that setting, I might actually want to hear the sage advice of the pharmacist because I probably only got about 2 minutes with the nurse practitioner.

Anyway, I don’t really think it’s fair to blame the pharmacist. We are responsible for our own health and if we don’t ask for advice in a situation like this, it falls on us as consumers. We know the pharmacist is there for us and we know he has more knowledge then we do–maybe even more than the doctor who prescribed the medicine. It is our responsibility to use the resources available to us to our best outcome.

Craig Sundstrom
Craig Sundstrom
14 years ago

“Good pharmacists should almost force themselves on patients,” Mr. Chen said.

I know nothing about the CHI – it even seems to have escaped Wikipedia! – but Comrade Chen’s overzealous remarks tend to make me discount anything they might say.

That having been said, and back to the basic question, I’m a little confused as to what role (for a pharmacist) is being advocated here: is it as public health officer or as profit maximizer? What if, for example, a pharmacist knows that a generic on which the profit margin is $2 can be substituted for a proprietary with a margin of $8; should that info be pointed out? I suppose one could argue this is no different than many other money-wasting ideas that salespeople are asked to push, but therein lies the problem: is the pharmacist a neutral professional or a salesperson?

Dave Wendland
Dave Wendland
14 years ago

I agree that pharmacists are the most accessible, trusted healthcare professionals available to consumers. (In fact, last week while moderating a panel of experts on the issues surrounding diabetes care, I cited a report that found patients with diabetes interact with their pharmacists seven times more than their physician.) There is no denying access to care. I also applaud many in this dialogue commenting on the pharmacist’s OTC knowledge.

Now for the bad news: pharmacists don’t have time (and often don’t have the training) to counsel effectively. In my view, counseling is not always about the medication itself but instead, the nutrients it is depleting, OTCs that will make the regimen easier to maintain (thus compliance increases) and associated issues with the specific health condition.

I am hopeful that the pharmacist will become the knowledge center and greatly help our crippled healthcare system.