As the health care landscape evolves, health care provider roles continue to shift.
Industries recognize the power of collaboration and the strength of communication between different providers; among those, the pharmacist and the physician.
Unfortunately, doctors and pharmacists have historically had strained relationships. In many cases, communication suffers, which can lead to adverse drug events (ADEs), or harm caused to a patient as a result of medication exposure.
It’s worth noting, though, that at least half of these ADEs are considered preventable, resulting from medication errors. The National Prescribing Service reports that six percent of hospitalizations result from ADEs and that the majority were the result of faulty communication.
To address the problems inherent in these relationships, we must begin an honest dialogue about the role each provider plays so we can begin to identify how the two industries can work together to improve patient safety and care.
To begin, I asked my LinkedIn network to share their perceived causes for the disconnect between doctors and pharmacists and to offer solutions that might alleviate these challenges. The frustration was evident in the responses I got, but the optimism for change was, as well.
1. Ensure accuracy of written prescriptions
If your patient uses a pharmacy that isn’t familiar with your handwriting, hard-to-read writing can create an unnecessary step for pharmacists who must confirm your instructions.
Beyond that, ensure that your instructions are complete. Include weight for pediatric patients and include your DEA number for controlled medications.
The National Coordinating Council for Medication Error Reporting and Prevention recommends including a brief indication of medication, where appropriate as an additional level of safety for both provider and patient. Adding “for cough” provides clarity, though the NCC MERP recognizes that some medications may warrant protecting patient confidentiality.
Additionally, physicians could provide an easy means for retail pharmacists to clarify prescriptions or notify doctors of medication unavailability.
2. Help pharmacists stay aware of all medications
Pharmacists can’t always rely on patients to provide all medications they are currently taking, especially those patients who see numerous specialists and doctors.
An accurate drug history prevents duplication of medications, dangerous drug interactions, and drugs can mask existing symptoms and alter the results of some tests such as thyroid.
Because pharmacists don’t have the benefit of charts or lab reports, they also may not have information about patient comorbidities. Additionally, although pharmacists have a great deal of knowledge about medications, they may not be aware of patient intolerance or unstated contraindications.
3. Assume the best about pharmacists (and we’ll do the same for you)
If your representatives discount our concerns with dismissive responses, you’re overlooking our role in the process. If it were simply a case of covering our tracks, responses like, “That’s just how he wants it,” might be acceptable.
Pharmacists seek clarification about prescriptions in an effort to protect patient safety and improve patient care.
At the same time, we understand that when we question a prescription, it can be perceived as questioning your authority. We’ll do our best to choose our language carefully in these situations.
Like you, we want to provide effective, safe patient care. We are part of the solution, but we often feel like we are treated as part of the problem.
Assume that when we contact your office, we’re doing our best to join forces with you in providing the very best patient care possible.
Given that reimbursement according to patient outcomes is a not-too-far-off possibility for physicians, pharmacists can help you provide great care and improve your outcomes.
What collaboration currently looks like
A 2013 study of pharmacists and physicians reported that about 97 percent of providers believe that collaboration between the two groups can greatly improve patient outcomes. Most of the respondents reported collaborating in the past, although about one-third of physicians and one-fourth of pharmacists had never collaborated.
The two groups shared a belief that telephone communication was an effective means of sharing information, and both groups agreed that dispensing medication and working to improve adherence were among the pharmacists’ most vital roles.
It’s worth noting, though, that physicians most often sought pharmacists’ assistance for issues with insurance and authorization rather than medications themselves.
Both groups reported a desire to improve collaboration in an effort to improve outcomes, but both groups pointed to time as the major barrier to collaborating.
How we can improve collaboration
The best first step we can take as providers is to change our attitudes about collaboration. Both camps widely accept that teamwork and communication will improve outcomes and create healthier patients long-term.
Physicians must respect pharmacists as health care providers, and pharmacists must do the same for doctors.
Additionally, both groups can work to educate patients about the importance of providing all their information to every provider. By encouraging open communication and explaining the significance of it, pharmacists and physicians can help patients contribute to their own care.
Because pharmacists and physicians both feel the pressure of limited time, pharmacists can work to limit our communications to those situations that demand it. Physicians can adopt an understanding that pharmacists also struggle under demanding schedules, so we don’t routinely make unnecessary phone calls.
As the medical community seeks to cut costs without sacrificing patient safety, collaboration is the best way to improve our efforts and create safety nets that prevent dangerous mistakes.
Alex Barker is a pharmacist and founder, The Happy PharmD.
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