Interacting with Physicians

Inform them of new service offerings and your desire to work together to benefit patients. It is important to explain the benefit of each new service to physicians in a way that emphasizes what is in it for them. For example, let’s say that you are going to develop educational services and sessions for asthma patients. Point out to the physician (particularly general practitioners and family practitioners) that you understand how busy they are and know that often they do not have time to be as thorough as they would like. By providing this service and working collaboratively with the physician, you can keep the patient’s asthma under control so that the patient does not need to switch to a specialist (pulmonologist). One pharmacist sold the idea for a blood pressure monitoring service to a physician on the basis that every 2 weeks he would fax or e-mail the patient’s readings to the physician, along with brief notes. This way the physician, who saw the patient only every 3 to 6 months, would have better information at his disposal.

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 a specialty area or in general. Providing physicians with unbiased information about new products can be very useful from both an efficacy and a cost perspective. It can also elevate your status as a pharmacist and that of the profession.

Pharmacists who cannot meet face-to-face with local physicians can send a letter introducing themselves and their new services. The letter can ask physicians to indicate what services they desire and whether they would be willing to meet and discuss these services further. Whether the contact is face-to-face or through a letter, it helps build rapport and credibility and separates you from everyone else.

REASONS FOR CALLING

Pharmacists usually contact physicians about the following types of drug-related problems:

Untreated condition(s). The patient needs drug therapy but is not receiving it.

Improper drug selection. In addition to a wrong drug for this patient and indication, improper selection could mean that the patient can’t afford the drug or is allergic to the drug, that the drug hasn’t helped or been tolerated in the past, or that the patient has renal or hepatic impairment that makes the drug choice improper.

Dosage too high. The wrong dose, frequency, or duration or a drug interaction could make the dose too high.

Subtherapeutic dosage. This could result from a wrong dose, frequency, or duration; a drug interaction; or storage or administration that lowers the effective dose.

Adverse drug reactions and side effects that cannot be tolerated or won’t go away. This could result from inappropriate dosing or administration or from drug interactions.

Drug interactions.

Unnecessary drug therapy. This could include drug use without a medical indication, addiction or recreational drug use, situations in which nondrug therapy or no therapy is more appropriate, duplicate therapy, or treating an avoidable adverse reaction to another drug.

Compliance problems. These can occur when the patient cannot tolerate side effects, the cost is too high, the dosage regimen is too frequent or complex, the patient cannot swallow or otherwise administer the drug, the patient does not understand how the drug works or how to take it, or the patient does not understand the need for the drug or the severity of the illness.

Other reasons for contacting the physician include

Inability to read or interpret a prescription order,

Request to change a drug and suggestion for a therapeutic alternative because a product is out of stock, a specific brand is necessary, or the patient can’t afford, is allergic to, or has not been helped in the past by the prescribed drug,