KOMUNIKASI DAN KONSELING

INTERACTING WITH PHYSICIANS

 INTERACTING WITH
PHYSICIANS

 Building rapport
 Reason for calling
 Preparation before calling
 Communication considerations
 Contigencies
 Involving the patient
 Pulling things together
 Summary
INTERACTING WITH
PHYSICIANS
 The primary reason pharmacists call
physicians is that something is wrong or a
problem needs to be resolved.
 Because these calls so often begin with a
problem, they can start off in a negative or
adversarial way and trigger defensiveness in
the physician.
 But skillful pharmacists can turn these
negatives into pluses.
 The provision of pharmaceutical care
requires a collaborative relationship
with the physician
 -- a relationship in which egos are set
aside and the focus is on preventing
and solving drug-related problems
with intend of providing the best
possible care for the patient.
BUILDING RAPPORT
 You can build rapport with the physycians
before you need to call them about patient
drug-related problems.
 If you do see yourself as a health care
provider with practice, then meeting with
local physicians is a vital step in building
rapport and allowing you to be more
effective in drug therapy decusion-making.
◦ Inform them of new service offering and your
desire to work together to benefit patients.
◦ Encourage physicians to discuss what services
would assist them in their practice
◦ Discuss changes that are taking place in
pharmacy in general that could lead to better
care for patients
◦ Update them on new drug developments within
specialty area or in general. Providing physicians
with unbiased information about new products
can be very useful from both anefficacy and cost
perspective.It can also elevate your status as a
pharmacist and that of the profession.
Pharmacist can meet with local
physicians to:
REASON FOR CALLING
 Untreaed condition(s)
 Improper drug selection
 Dosage too high
 Subtherapeutic dosage
 Adverse drug reactions and side effects that
cannot be tolerated or won’t go away
 Drug interactions
 Unnecessary drug therapy
 Compliance problems
OTHER REASONS
 Inability to read or interpret a prescription
order
 Request to change a drug and suggestion for
a therapeutic alternative because a product
out of stock, a specific brand is necessary, or
the patient cannot affort, is allergicto, or has
not been help in the past by the priscribed
drug
 Refill authorization
 Request for additional information
about patient for your database
 Physician detailing or counterdatailing
to introduce important new product or
new services in your pharmacy
PREPARATION BEFORE CALLING
 Have the necessary facts ready, including
your recommendation and rationale
 Have a literature citation ready, if possible
 Know what you’re talking about (identify
yourself, the patient, involved, the
problemyour recommendation
 Get sufficient information from the patient
 Be prepared to used SOAP (Subjective and
Objective Information, Assesment, and
Plan)
 Always have an alternative
recommendation ready in case your initial
recommendation is not accepted.
 COMMUNICATION
CONSIDERATIONS
 Focus should be on attacting problems or
issues. Keep the focus of the conversation on
solving patient problems, not on pointing out
that the drug therapy prescribed is
appropriate.
 Make sure professional boundaries are
respected. Don’t try to play doctor, and don’t
second-guess the doctor. Ask questions and
show interest in the patient, not being right.
 Mentally and emotionally prepare for
different consequences. What will you
say if you are met with resistance,
anger, belligerence, attempts at
intimidation, or refusal? To what
extend are you willing to persist and
not back down?
 Use a combination of information
exchange, assertiveness and effective
listening.
 For telephone communication, be prepared
to talk to a nurse or member of office staff.
 Use 4F communication: I know how you
feel. I feld the same way, too. But I found in
the literature …”, and stay focused on the
problem.
Provides guidelines for contacting
physicians in person and by telephone

 State who you are and the purpose of the

call (be pleasant)
 State the problem and recommended
solution
CONTIGENCIES
 When a physician refuses to take your
recommendation to change an order,
don’t continue to argue. Simply tell the
patient what happened.
 Identify alternatives, if possible
INVOLVING THE PATIENT
 A patient prescribed an appetite suppresant
by a physicisn who does not know the patient
has high blood pressure.
 It is important to inform the patient that you
need to call the physicisn treating her high
blood pressure to discuss this new
medication and the reason for the call.
 If the patient asked you not to call her
physician, it would be important to not
dispense any medication that could harm
her and to put in writing what the
problem is and what solutin you propose.
 Make a copy for the patient and a copy in
your files.Your communication to the
patient won’t be communicated to the
physicisn incorrectly or incompletly.
PULLING THINGS TOGETHER
 Pharmacist-physician dialogue indicate
how preparation, focus, and
interpersonnal skill can make a great deal
of difference
SUMMARY
 It is uncomfortable for pharmacists to call
physiciants, since the nature of the call is
that there is a problem.
 Well-prepared, skilled pharmacists who
focus on patient problems rather than on
prescribing problems can turn these calls
into opportunities for profesional
collaboration and cooperation, rather
than conflict.
 Kondisi yang tidak dilakukan. Seorang pasien
memerlukan terapi obat tetapi tidak
menerima.
 Pemilihan obat yang tidak tepat. Pasien alergi
obat tersebut atau pasien mempunyai
kelainan ginjal atau hepar.
 Dosis yang terlalu tinggi. Dosis salah,
frekwensi, durasi atau interaksi obat atau
penyimpanan yang menurunkan dosis.
 Efek samping yang tidak bisa ditoleransi.
 Terapi obat yang tidak perlu.
 Tidak bisa membaca resep dokter
 Masalah lain : produk sudah tidak beredar
Questions