KOMUNIKASI DAN

KONSELING
Prof. Dr. RA. Oetari, SU, Apt.
INTERACTING WITH
PHYSICIANS
Building rapport
Reason for calling
Preparation before calling
Communication consederations
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
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
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 solutin 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.