You’ve heard it said “no one cares how much you know until they know how much you care.” This is true in many settings. Physicians need to remember this when treating their patients. They aren’t room numbers (e.g. referring to your patient by the room number he/she happens to be sitting in). They aren’t diseases (e.g. referring to your patient simply by the condition they are being treated for). They’re people. They have names. And they want to know you care.
The same is true in the often hectic and chaotic environment of the average retail pharmacy in the U.S. I was speaking with a friend recently (not a pharmacist) who visited a local CVS (not picking on them) and said to me “everywhere I looked there were just bags and bags of prescriptions waiting to be picked up.” The impression that inevitably is given is that, as pharmacists, we are extremely busy and (presumably) have little to no time for patient counseling or interactions.
I know this isn’t always the case. I know there are pharmacies and whole chains that practice adequate staffing to enable their pharmacists to provide counseling and instruction to patients. But even when that is the case, there is evidence that our “in pharmacy” instructions (amidst the clamor of phones, and registers, and TV’s, and in-store radio, and crying children) only goes so far. Much isn’t remembered. Patients are distracted, and often not feeling well.
This is why I advocate for the implementation of what I call a F.U.P.I. (Follow Up Phone Interview).
The process I use is fairly simple, and can be implemented (in my opinion) even in the busiest of pharmacies. All you need is s 3-ring binder, a clipboard and a simple form that anyone can create on their home computer.
The form has a spot to affix an extra label for any patient whom I identify as a good candidate for a follow-up phone interview. Who are good candidates? Really, any patient could qualify, but in my own experience these patients are especially appreciative of these efforts:
- Patients being prescribed a new medication
- Patients being prescribed an antibiotic
- Patients taking >5 medications daily
- Patients prescribed medications for pain
- Patients prescribed medications for which home-monitoring is helpful (diabetes, HTN, asthma)
- Patients prescribed psychiatric medications for conditions like depression and/or anxiety
How it works:
1. I keep a clipboard in a reasonably handy location near me in the pharmacy. The clipboard has a form onto which I can affix a label for the patient I identify for follow up during the filling and/or checking process. Just print an extra label and attach it to the form. It takes 5-10 seconds max. If that isn’t the case with your software, you could alternatively just write the Rx# on the form in that space.
The rest of this process will vary depending on the unique situation in each pharmacy. But the fundamental idea is that I am ready when that rare “breather” moment comes and I have a few minutes to prepare and make a call.
2. Typically 2-3 days AFTER the prescription has been picked up I make a call to that patient’s home. I prepare for this by quickly reviewing the patient profile. I call the patient and identify myself as “so and so” from “such and such” pharmacy and ask “how are you?” I then remind them that they picked up a prescription for “x” drug a few days ago, followed by a few questions that will vary depending on the patient, the medication and the situation in general.
3. Following the phone call I file the form in a 3-ring binder – the newest on top.
It’s that simple. But the results, in my own experience, have been very positive. Patients, generally, appreciate the concern. I learn about patient care in a way that no text book or classroom can ever compete with. The pharmacy business grows. And satisfaction with my career improves.
I’ve heard all the objections to this process in my 20 years of retail. I’m not suggesting this will work for everyone. I would however like to try and humbly respond to a few common objections to this process.
Objection: I don’t have time.
Answer: I get it. My response is to suggest a total evaluation of your filling process to be sure that you have maximized the efficiency. Ever heard of “LEAN?” Google it. It’s a systematic approach to improving efficiency and eliminating waste. Small improvements add up to big savings. Is there some, even small, improvement you can make that would save you even 5 seconds in the filling and/or checking process? 5 seconds saved per prescription, multiplied by 200 prescriptions, will free up 16 minutes of time per day.
Objection: Patients don’t want to be bothered.
Answer: That is true for some. So pick an easy one to start with. Pick someone who you know to be friendly and receptive. You might be surprised what kind of response you end up getting.
Objection: We don’t get paid for this.
Answer: Although this process could be tailored to target patients for an MTM program for which reimbursement IS possible, that is not the point of this particular process in my opinion. The battle for reimbursement for cognitive services is an important one. I’m not suggesting pharmacists continue to “give away” services for nothing. But generally speaking reimbursement can only follow after we have proved our value.
Anyway, this post is meant merely to raise the idea and suggest a process. It works for me. Could it work for you?
Do you have any similar programs you are doing? Would you be willing to share them in the comments section below? Thank you!!
Last modified: December 31, 2014