KOMUNIKASIDAN

KONSELING
Prof.Dr.RA.Oetari,SU,Apt.

INTERACTINGWITH
PHYSICIANS

Buildingrapport
Reasonforcalling
Preparationbeforecalling
Communicationconsederations
Contigencies
Involvingthepatient
Pullingthingstogether
Summary

INTERACTINGWITH
PHYSICIANS
Theprimaryreasonpharmacistscallphysiciansisthat
somethingiswrongoraproblemneedstoberesolved.
Becausethesecallssooftenbeginwithaproblem,they
canstartoffinanegativeoradversarialwayandtrigger
defensivenessinthephysician.Butskillfulpharmacists
canturnthesenegativesintopluses.Theprovisionof
pharmaceuticalcarerequiresacollaborative
relationshipwiththephysicianarelationshipinwhich
egosaresetasideandthefocusisonpreventingand
solvingdrugrelatedproblemswithintendofproviding
thebestpossiblecareforthepatient.

BUILDINGRAPPORT
Youcanbuildrapportwiththephysyciansbefore
youneedtocallthemaboutpatientdrugrelated
problems.Ifyoudoseeyourselfasahealthcare
providerwithpractice,thenmeetingwithlocal
physiciansisavitalstepinbuildingrapportand
allowingyoutobemoreeffectiveindrug
therapydecusionmaking.Pharmacistcanmeet
withlocalphysiciansto:

 Informthemofnewserviceofferingandyourdesireto
worktogethertobenefitpatients.
Encouragephysicianstodiscusswhatserviceswould
assistthemintheirpractice
Discusschangesthataretakingplaceinpharmacyin
generalthatcouldleadtobettercareforpatients
Updatethemonnewdrugdevelopmentswithinspecialty
areaoringeneral.Providingphysicianswithunbiased
informationaboutnewproductscanbeveryusefulfrom
bothanefficacyandcostperspective.Itcanalsoelevate
yourstatusasapharmacistandthatoftheprofession.

REASONFORCALLING

Untreaedcondition(s)
Improperdrugselection
Dosagetoohigh
Subtherapeuticdosage
Adversedrugreactionsandsideeffectsthatcannot
betoleratedorwontgoaway
Druginteractions
Unnecessarydrugtherapy
Complianceproblems

OTHERREASONS
Inabilitytoreadorinterpretaprescriptionorder
Requesttochangeadrugandsuggestionforatherapeutic
alternativebecauseaproductoutofstock,aspecificbrand
isnecessary,orthepatientcannotaffort,isallergicto,or
hasnotbeenhelpinthepastbythepriscribeddrug
Refillauthorization
Requestforadditionalinformationaboutpatientforyour
database
Physiciandetailingorcounterdatailingtointroduce
importantnewproductornewservicesinyourpharmacy

PREPARATIONBEFORE
CALLING

Havethenecessaryfactsready,includingyour
recommendationandrationale
Havealiteraturecitationready,ifpossible
Knowwhatyouretalkingabout(identifyyourself,the
patient,involved,theproblemyourrecommendation
Getsufficientinformationfromthepatient
BepreparedtousedSOAP(SubjectiveandObjective
Information,Assesment,andPlan)
Alwayshaveanalternativerecommendationreadyin
caseyourinitialrecommendationisnotaccepted.

COMMUNICATION
CONSIDERATIONS
Focusshouldbeonattactingproblemsorissues.Keepthe
focusoftheconversationonsolvingpatientproblems,noton
pointingoutthatthedrugtherapyprescribedisappropriate.
Makesureprofessionalboundariesarerespected.Donttryto
playdoctor,anddontsecondguessthedoctor.Ask
questionsandshowinterestinthepatient,notbeingright.
Mentallyandemotionallypreparefordifferentconsequences.
Whatwillyousayifyouaremetwithresistance,anger,
belligerence,attemptsatintimidation,orrefusal?Towhat
extendareyouwillingtopersistandnotbackdown?

 Useacombinationofinformationexchange,
assertivenessandeffectivelistening.
Fortelephonecommunication,bepreparedtotalk
toanurseormemberofofficestaff.
Use4Fcommunication:Iknowhowyoufeel.I
feldthesameway,too.ButIfoundinthe
literature,andstayfocusedontheproblem.

Providesguidelinesforcontacting
physiciansinpersonandbytelephone
Statewhoyouareandthepurposeofthe
call(bepleasant)
Statetheproblemandrecommended
solution

CONTIGENCIES
Whenaphysicianrefusestotakeyour
recommendationtochangeanorder,dont
continuetoargue.Simplytellthepatient
whathappened.
Identifyalternatives,ifpossible

INVOLVINGTHEPATIENT
Apatientprescribedanappetitesuppresantbyaphysicisn
whodoesnotknowthepatienthashighbloodpressure.It
isimportanttoinformthepatientthatyouneedtocallthe
physicisntreatingherhighbloodpressuretodiscussthis
newmedicationandthereasonforthecall.Ifthepatient
askedyounottocallherphysician,itwouldbeimportant
tonotdispenseanymedicationthatcouldharmherandto
putinwritingwhattheproblemisandwhatsolutinyou
propose.Makeacopyforthepatientandacopyinyour
files.Yourcommunicationtothepatientwontbe
communicatedtothephysicisnincorrectlyorincompletly.

PULLINGTHINGS
TOGETHER
Pharmacistphysiciandialogueindicatehow
preparation,focus,andinterpersonnalskill
canmakeagreatdealofdifference

SUMMARY
Itisuncomfortableforpharmaciststocall
physiciants,sincethenatureofthecallisthat
thereisaproblem.
Wellprepared,skilledpharmacistswho
focusonpatientproblemsratherthanon
prescribingproblemscanturnthesecallsinto
opportunitiesforprofesionalcollaboration
andcooperation,ratherthanconflict.