How Retail Pharmacists Improve Patient Outcomes

May 18, 2015

Many students are under the impression that retail pharmacy does not "count" as health care.

It was the first week of her retail pharmacy rotation. She was alarmingly bright, but I could tell as I watched her talk to others that her heart simply wasn't in it.

"Don't you like it here?" I asked at our first weekly preceptor-intern meeting.

She flinched as if shocked by the directness of my question.

"Well, I mean you and your staff are all friendly and nice and everything..." she stammered out softly.

"But..." I said, trying to expose the roadblock obviously sitting between her and a successful retail rotation.

"Well, I just hate this awful feeling that I'm wasting my time here," she replied slowly and very carefully, as she looked down at the table.

I must admit I wasn't expecting such an answer, but it certainly got my attention.

"Can you help me understand why you feel working here is a waste of your time?" I asked.

She said nothing, but took a deep sigh that seemed to last forever.

"Look, I'm your friend, and I want to help you. There is nothing you cannot say to me," I told her in my most reassuring tone.

She looked off to the side and let out, in an almost inaudible tone, "Well, I got into pharmacy school because I wanted to help patients, and all retail pharmacists do is throw bags at people and wish them a good day."

Now she really had my attention!

I remembered my friend, the company recruiter, telling me he frequently runs into students who are under the impression that retail pharmacy does not "count" as health care, and that many students believe retail pharmacists, especially ones employed by chains, "cheapen" the profession with their emphasis on low prices and lack of effective counseling.

After I thanked her for her honesty, I asked her several clarifying questions to make sure she felt the depth of my understanding of the "predicament" she was in.

She felt she was "stuck" in a mandatory rotation that would not further her career 1 iota. One of her professors whom she idolized had led her to believe only clinical pharmacists were bona fide health care providers.

"How many phone calls have you answered this week where the customer specifically asked to talk to me?" I asked, beginning my cross-examination.

"I don't know, I guess a dozen or so..." she responded, shaking her head as if to say "so what?"

"And of those 12, how many of them seemed to be asking me questions about their medication?" I asked.

"I guess all of them..." she answered slowly, as a suspicious look seemed to enter her eyes.

"Where do you suppose I met them?" I asked, trying to close the gap.

After a long pause, she said, "I guess all over, but mostly at the counseling window."

"Excellent! Now, when do you suppose I met each of them?" I prodded.

Her eyes were beginning to light up, and she smiled a bit.

"That's right, over the years and one at a time," I said. "Now, let's move over to the consultation window. When I talk to someone there, what is the first thing I always do?"

"I've been wanting to ask you about that," she said. "Why do you always ask them a question about what is going on in their life?"

"It's called getting their attention and shifting the focus from an instructor to a trusted advisor," I explained. "So, what is the last thing I always do?"

"You always tell them your name, when you are working, and you always ask them to call you if they have any questions," she responded quickly, this time with a gleam of recognition in her eyes.

"How long, on average, would you say I spend with each person at consultation?" I asked.

"About 30 seconds, give or take, but you don't have much more time than that," she answered.

"Sometimes I have less, sometimes I have more," I said. "But the trick is to establish a connection, 1 visitor or 1 phone call at a time."

"So, the follow-up calls and repeat visits are where you really help them out?" she asked.

"It doesn't matter where I'm working, how much I know, or what the letters are that follow my name. Until a customer trusts me, they will never become a patient," I explained. "Customers, and patients are simply people with problems. The solutions to those problems come in the form of other people. We are never really health care providers until we embrace that and build bridges with them accordingly."

"Come to think of it, health care providers are always complaining about patient compliance," she observed. "Maybe they should ask themselves why a patient should trust their advice, if the patient doesn't even know them!"

"That is a very wise observation. Improving patient outcomes is all about relationships built as we can build them, one at a time, given the time constraints we have to work with," I said.

"Fair enough!" she said, and she stood up appearing anxious to head back to the pharmacy department with a new paradigm for work.