When we think of negotiation in pharmacy, we often picture a pharmacy owner/manager or a corporate executive from a large chain negotiating reimbursement contracts for pharmacist services. While these types of negotiations are important, there are other much more common negotiations undertaken by pharmacists and pharmacy managers every day.

Most transactions and communications involve negotiations of some sort, including motivational interviewing of patients, as well as negotiating with employees for their requests, and with your supervisor for certain work/practice conditions and salary. Additionally, pharmacists negotiate on a frequent basis with physicians regarding patients’ pharmacotherapy, in addition to possible protocols for collaborative working relationships (CWRs).

In the journal Sociology of Health and Illness, researchers discuss interprofessional negotiation in the midst of health providers playing a so-called ‘general practitioner-pharmacist game.’ The authors claim that despite a mutual interest in optimizing the benefits of medication for patients, the general practitioner (GP) and community pharmacist (CP) often work in isolation from one another, both physically and figuratively. Sources of tension include pharmacy's ‘shopkeeper’ image, traditional medical hierarchies, and potential encroachment on professional boundaries.

The study employed qualitative interviews of 20 GPs and 23 CPs located in geographically and demographically diverse areas. The interviews were based on a set of ‘unwritten’ rules, termed the ‘GP‐pharmacist game’, which involves the concept of ‘face‐work.’ Key rules of that game include the pharmacist avoiding blaming the GP, using discretion in front of patients, and balancing the necessity and frequency of the communication. The researchers argue that while adhering to the ‘GP‐pharmacist game’ may avoid conflict and ‘get the job done’, it may also constrain efforts to meet wider health care policy aims of a more collaborative relationship.

In their study conclusions, the authors discuss how pharmacists often move things along by employing avoidance as a conflict resolution strategy. While no one conflict resolution strategy is best at all times, pharmacists should generally seek collaboration (win-win) rather than concede, refuse to acknowledge the other party’s arguments, or even compromise (win-lose). This way, the ultimate benefactor is the patient.

Collaboration is often appropriate even when negotiating with other stakeholders in pharmacy, including peers, supervisors, employees, and health plans. All pharmacists negotiate, and pharmacy managers must be especially adept at negotiating with various stakeholders, and pass on their negotiating skills to other pharmacy employees.

Additional information about medication therapy management and management functions can be found in Pharmacy Management: Essentials for All Practice Settings, 5e. You or your institution can subscribe to AccessPharmacy to access the textbook.
 

Shane P. Desselle, RPh, PhD, FAPhA, is Professor of Social/Behavioral Pharmacy at Touro University California. He is author of Chapter 1: The “Management” in Medication Therapy Management and Management Functions in the textbook Pharmacy Management: Essentials for All Practice Settings, 5e.

REFERENCE

Bradley F, Ashcroft DM, Crossley N. Negotiating inter-professional interaction: playing the general practitioner-pharmacist game. Sociol Health Illn. 2018;40:426-444.