Are You Really Helping Patients? (Part One)

I expect every pharmacist agrees they should be “helpful” when dealing with patients, but what does that really mean?

If you asked 100 pharmacists, you’d probably get dozens of different answers. As an organizational consultant, I can understand this poignantly. We’re also supposed to “help” the organizations we serve, but that means something different to many consultants.

Here are 3 ways pharmacists “help” patients:

• Instructing: We give the patient the information we know they need in order to safely and effectively take their medications. If patients don’t behave appropriately, we can blame it on their inattention or ignorance.
• Empathizing: We try to feel what the patient feels, followed by a rational discussion of why those feelings may impede their medication therapy. If patients don’t respond to this, we can blame it on their unwillingness to deal with their emotions.
• Connecting: We simply let the patient know we’re available, give them phone numbers or e-mail addresses, and wait to hear from them. If we don’t, we can blame it on their aloofness or apathy.

I’m willing to bet you’ve seen some or all of these types of “helping” in action, and you’ve probably seen them fail as often (or more often) as they succeed. Perhaps we instruct, only to learn the information wasn’t wanted or needed. Perhaps we empathize, only to find out the patient sees empathy as patronizing. Perhaps we connect, only to learn the patient doesn’t understand why she should value your help.

Even in the short counseling window we have, we can do better. Edgar Schein, a well-known organizational consultant and professor, suggests helpers engage in what he calls a “humble” kind of helping.

To help in this way, we must consider what we may not know:

• What are the actual motives of both the pharmacist and patient?
• What do the pharmacist and patient expect from this help? Is there trust?
• Does the patient have the knowledge to follow the helper’s recommendations?
• What value does the patient place on the help (other than monetary)?

Schein calls this “accessing our ignorance.” By doing so, we can quickly determine what the patient really needs (or thinks he needs) from the helper at that time. By honoring the patient’s initial motives and expectations, the pharmacist can build trust and mutual understanding, which can then enable the pharmacist to guide the patient in helpful ways. Often, this can be done with a quick series of questions, beginning with a statement like, “I’d like to take a few moments to be helpful to you today. Can you tell me the best way I can do that for you?”

I’ll conclude with an example to consider.

Donna, age 35, is in your pharmacy receiving a new script for sertraline 50 mg. She’s casually dressed but appears fatigued and her emotions are blunted when you fill the script for her. You’re concerned she may not have a grasp on what this medication will do and how it will affect her.

How will you help her? What questions will you ask? What do you not know?

In my next article, we’ll revisit Donna and see how the “humble” approach to helping can lead to useful interactions with your patients.