When I was driving on campus recently, I observed the demolition of a cafeteria. Heavy equipment was ripping out sections of the building, and I could see everything being trashed by heavy equipment buckets.
If my father had been with me, he would have bellowed about wastefulness and suggested that someone should have removed the useful fixtures, shelving, and probably hundreds of light switches and other items before the demolition. Toward the end of his life, he occasionally mused about America becoming a "disposable society," preferring to scrap the old and start from scratch, whether it be a building or a television set that goes on the blink. My dad's generation characterized such a practice as wasteful, born from a spoiled and impatient new generation that wants its needs met immediately.
I thought about recycling and pharmacy and what Dad might have said if I had asked him whether recycling applied to pharmacy. One's general obsessive-compulsive urges have applied to recycling for decades, with the implementation of unit-dose packaging to avoid waste. Using the term euphemistically, however, recycling in pharmacy, or its absence, could embody "reengineering" processes and rolesresurrecting historical pharmacy practices that were abandoned in the name of progress, or even "retooling" pharmacists to assume new responsibilities.
Perhaps the most significant contribution that we as pharmacists have abandoned from the old days is customer service. Decades ago pharmacists knew their patients and were on a first-name basis with the doctors with whom they collaborated. Undoubtedly, this philosophy was fundamental to the value we added to the medication-use process. In hospitals, we have come a long way in terms of physician collaboration, but we have still lost our customer focus. We have standardized, modernized, automated, and sterilized so much of what we have historically doneall in the name of progress, cost-consciousness, and "improvement." It has become far too common to make our customers, whether patients or providers, fit into our standardized processes, with little "wiggle room"for refinement based on individual needs or preferences.
We as pharmacists need to revisit our customer satisfaction philosophy and openly discuss as team members how we might restore our customer service strength. Can't pharmacists be able to make exceptions to "standardization," based on the situation? One's first reaction might be that, if 1 exception is made, we will lose control of our ability to serve all. Is that really true, or do we hide behind rules to make our own lives simpler?
I have often found that, if I take 1 extra minute to understand a unique need and to determine whether there is an opportunity to go the extra mile, I can resolve most difficult situations. On some of these occasions, I can actually do what I was asked about? and I usually improve a relationship when I do. On other occasions, I cannot meet an expectation or preference, but I rarely damage a relationship if I try (even unsuccessfully) and am courteous and sensitive to my customer.
I think we can improve customer service without significantly compromising efficiency. Shouldn't this be the topic of discussion at our upcoming staff meetings?
Mr. McAllister is director of pharmacy at University of North Carolina (UNC) Hospitals and Clinics and associate dean for clinical affairs at UNC School of Pharmacy, Chapel Hill.
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