KOMUNIKASI DAN KONSELING

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

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 therapydecusion-making.Pharmacist can meet with local physicians to:

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.

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 wont 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 youre 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 (pertimbangan)

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. Dont try to play doctor, and dont 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 (kemungkinan)
When a physician refuses to take your recommendation to change an order, dont 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 solution you propose. Make a copy for the patient and a copy in your files. Your communication to the patient wont 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.