AUGUST ,Edition # 31, 2001

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In the fourth article in this series, concerning the establishment of a consultant pharmacist practice based in a community pharmacy, I will be looking at the roles of the Consultant Receptionist and the Forward Pharmacist.
The model I am constructing is an idealised one, but based on the objective of being able to charge a fee for service, not reliant on a government subsidy.
As other writers in this newsletter have commented, many attempts to have pharmacists charge a fee for a service have failed, because they did not differentiate their service sufficiently, brand it, and market it as a product.
While I will eventually get to types of services and specific marketing strategies for consultants, I have utilised existing pharmacy services and the staff involved as a "directing force" to lead in, and sell consultancy services.
This becomes the basic marketing strategy.
In so doing, I am more clearly defining the role of each person involved, their educational requirements and their function in relation to the total services offered from a pharmacy, but specifically, consultant pharmacy services.
So we have already defined the "Primary Practice Assistant", the "Dispensary Technician", the "Forward Pharmacist", the "Consultant Receptionist", the "General Consultant" and the "Specialist Consultant".
I have endeavoured to illustrate the physical model using a floor plan, which I vary with each article.
Because each article in this series builds one on the other, it would probably be a good idea to review previous articles. The links at the foot of this text will navigate you to the appropriate locations.

The "Consultant Receptionist" was identified in the first article, but we did not touch on the type of person required. Ideally, this should be a nurse, who is a person comfortable in communicating with other health professionals, particularly medical practitioners.
In their role of being a nurse, they are the primary persons to have "hands on" contact with patients, within a hospital setting and in a community setting. Patients, doctors, allied health professionals and pharmacists feel quite comfortable dealing with nurses in their traditional roles.
Who better, then, than a nurse, to provide the initial contact to a consultant pharmacist service, whether a prospective patient, medical practitioner or other health professional?
If the nurse comes with management/secretarial skills, hopefully acquired from working in a medical practice, then you are able to capitalise (and learn) from a highly trained person. If the nurse also comes with other practical skills (wound dressing, midwifery etc), then he/she will be able to be integrated into the general consultant space referred to in the floor plan below.
It may also be possible to provide vaccination services if the nurse comes with practitioner status.
It is my belief that consultant pharmacists will need this type of nursing contact to provide a communications conduit to other professionals, to effectively reach out and explain what they are providing and how they propose to do it.
This resource also offers potential for expansion into a range of community based, integrated health services (such as Hospital in the Home), which I will elaborate on in future articles.
You are referred to the extended floor plan below:

Private Room		Paneling separating private room and open consoling area is opaque and floor to ceiling i.e. patient cannot be seen from dispensary.
Entrance Area	Open Counseling Area with Privacy Glass Panels. (This area for general consultant use and nurse use)	Forward Pharmacy Desk	Dispensary (Technician's area)
			Bench
	Reception Desk
Reception area is completely open, with a chest high opaque panel and a soundproof glass extension, separating it from the dispensary. A soundproof glass panel separates reception from counseling and a floor to ceiling opaque panel is installed between the counseling area and the private room. Forward pharmacy area may be separated from the reception desk with a soundproof, free standing, portable panel. The receptionist will be a nurse experienced in running a general medical practice, and who comes with additional skills that can be utilised within the consultant pharmacist service model		Location for sales assistant, designated as Primary Care Assistant Information Desk FRONT SHOP AREA

Within the pharmacy, the two principal players involved with the consultant receptionist will be the Forward Pharmacist and the Primary Practice Assistant.
These will be the people actually giving verbal referrals to the consulting area.
Services are difficult to sell until they are given form and substance.
For example, banks really exist to provide loans.
But they provide a range of "products" such as personal loans, home loans and a range of special purpose loans, each being a variation on the theme.
In this format they are easy to "brand", until with common usage, the "brand name" of the product can almost become generic.
So the intangible service becomes tangible, when given that form and substance.
Developing to the "branded" stage creates communication as to exactly what is on offer.
The more recognisable the brand, the higher the premium on price a consumer is willing to pay.
Branded services are indeed valuable.
So when a patient enters a pharmacy and is greeted by a Primary Practice Assistant, there are a number of services on offer.
If the patient request is relatively simple, the first service offered may be a product to assist a minor ailment. Remember, this assistant is well trained to certificate level and is qualified to handle S2 and S3 medications (N.B.not currently possible-only in my idealised model).
This assistant is also trained to recognise complexity.
If the patient request involves a prescription, basic details may be gathered, with the patient being referred to the dispensing technician.
If the job is a simple one, such as a repeat prescription, then the technician dispenses to the final stage and the patient request is fully satisfied.
If the prescription is for a new item, or the patient requires detailed information about their drugs or their condition, the the Dispensary Technician will obviously involve the Forward Pharmacist in the workflow.
At the point of contact with the Forward Pharmacist, a conculsion may be reached that the patient requires a longer, consultant pharmacist conducted interview at an agreed fee.

However, the patient may have indicated a higher degree of complexity, at the initial contact with the Primary Practice Assistant.
The choices then become a referral to the Forward Pharmacist for some free, but time-limited counselling, or to a paid consultant contact.
If the patient indicates that a more in-depth consultation is required, then an introduction is made to the consultant receptionist, with the "handover" being performed in a discreet, courteous and informative manner i.e a mini case history is supplied by the Primary Practice Assistant.
The patient will have had some pre-conditioning to this process, due to having already read a brochure from the pharmacy, or has had the services explained on a previous pharmacy visit, or may have become interested after some professionally discreet, external advertising or marketing campaign.
The probability is that the patient really arrived after a "word of mouth" recommendation from another satisfied patient.

When the patient is handed over to the consultant receptionist, basic personal details are recorded on a profile form together with details of conditions (current and previous), known allergies or adverse reactions, plus a list of medications/herbals/nutrients taken on a regular basis.
Some information may be required from the dispensary, and for this purpose an efficient intercom system should be uitilised to convey the basic requests, or a computer linked in to the dispensary network.
The patient should agree to this information "mining" from the dispensary, as the consultant may be be an independent practitioner, just leasing the professional space.
Privacy Law due for release on the 21st December, 2001 should be studied to ensure all areas are covered.
Access to the consultant pharmacist should only be by appointment, so that adequate time can be set aside for the interview. This also allows for any research to be able to take place on the patient's behalf, prior to the actual appointment date.
This is in stark contrast to the free service, which is not only free and time-limited, but has immediate access..
Differentiation is complete!
Using the above model, and the procedures it contains, eliminates any potential patient confusion as to what is on offer, and what selection they would like to make.
The pharmacy human resources designated in each formal role should be highly trained and have the right motivation to function as a supportive team.
An emphasis on building relationships with each other, the patient and other health professionals will be a prime and ongoing focus. Formal alliances should be built with any health practitioner or organisation, that would enhance a pharmacy-based service.

So when, as a pharmacist you ponder why you are not being paid for your professional services, reflect a little and determine if you are actually putting the work into physical, educational and human resource development.
Your total marketing effort has always been directed towards a high markup on cost to pay for these services.
Intelligent patients are unable to see why they should purchase their products from you, when Pharmacy Direct offers the same product at a much cheaper price.
Your claim is always that you provided the service and the patient should recognise this and support you.
They probably do for the first contact.
How can you justify high margin repeat business when you do not provide the professional service component with successive sales?
Marketing "value for money" services will take on a life of its own as patients are able to actually see what you are offering.
Maybe even health insurance funds will subsidise your services, simply because it is now obvious as to what benefits accrue to patients.
If you continue to hide your services as extensions of physical goods, the spiral will always be downwards, as non-pharmacy competitors will always be able to undercut your price.
Begin to break the cycle now and rebuild an interesting profession.
For those people wishing to review the earlier articles in this series, please follow the links

Article 1

Article 2

Article 3

Ends

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