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are not alone in focussing on this topic as many of the health professions
are becoming concerned that their members are having trouble passing
on information to patients in an appropriate manner ie communication
has become the name of the game. It is interesting to read reports
on medical malpractice cases where the complaint often is not on
the standard of care but on lack of effective communication after
the accident. Covering up facts and hiding the truth has often been
the reason a case proceeded when an open disclosure and apology
might have satisfied the victims and prevented litigation.
Last
year consultant pharmacists were all been sent a special "Communication
and Concordance module" by the Australian Association of
Consultant Pharmacists (AACP) to assist them in the medication
review process. Much of the information found in module seems
self evident but that does not mean it has no relevance. There
are some very good tips on communication techniques including
verbal and non-verbal communication, building relationships with
patients and communication with "difficult" people.
We've all seen these before but it does not hurt to have them
reinforced in a concise manner. I'm not necessarily an advocate
for the AACP, but I have to admit that this module has much going
for it. Currently my section of DVA taking part in a workshop
on public speaking and I was interested to see that much of the
AACP module bears a striking resemblance to what we are discussing
in the workshop. It seems that gaining the trust and attention
of a group appears little different from gaining the trust of
a single patient or doctor and is just as important if you want
to communicate effectively. Remember, communication is a fragile
process; if you change it only slightly, you can distort its meaning.(AACP
module)
McDonough
and Doucette (J Am Pharm Assoc 41(5):682-692,2001) write on how
to develop a collaborative working relationship between pharmacists
and physicians, much of which depends on good communication. I
was interested to see the comment that in the initial stages of
such a collaboration most exchanges are initiated by the pharmacist
and that it is only later that doctors begin to make the first
move. It is thus imperative that communication breakdowns are
avoided or the whole process can be stalled. The authors write
of the different aspects of communication within the process and
how it should support movement toward the collaborative working
relationship. Face to face visits provide opportunities for the
two health professionals to become comfortable with each other
and to develop relationships based on trust and respect.
This respect is an integral part of the medication review process,
not only with doctors but also with patients and community pharmacists
(if the consultant pharmacist is not associated with the patient's
own pharmacy). The ability to communicate appropriately becomes
imperative for the on-going health of the Domiciliary Medication
Management Review (DMMR) programme if potential benefits are to
be realised. Remember that communication is a fragile process
and must be nurtured, especially by our profession.
We have worked too hard to become recognised as responsible health
professionals, having a significant input into patient care, to
blow it with communication problems. The medical profession jealously
guards its role as the primary health educator, complaining that
pharmacists can scare patients out of taking their medication
with excessive information!
We walk a fine line, being required to give CMI to patients but
having to temper this so that medication is actually used.
Communication is the name of the game!
Even
our medical colleagues are questioning their communication skills.
Dr Jacqueline Maxmin, in the latest British Medical Journal, questioned
"Do we (doctors) hear our patients?"
She wrote of her partner's terminal illness, and how the medical
teams did not appear to hear his concerns, and seemed unwilling
to discuss his deteriorating prognosis.
Listening
skills have always been an important part of health care, diagnosis
being very dependent on hearing how the patient describes the
symptoms. Active listening is something we all should employ when
trying to determine what OTC to recommend or when counselling
on a new prescription item.
Counselling must be given in a language the patient understands
or it becomes a waste of time.
In short, it is in the best interests of the profession to ensure
that we, as pharmacists, communicate effectively with our patients/customers/doctors
and anyone else with whom we may come into contact. The trust
that we pharmacists currently enjoy in our dealings with the community
has, in part, been a result of many years of effective communication
with our customers and colleagues.
Communication is not only the name of the game it is also the
means by which pharmacy can maintain its image as a responsible
provider of health care.
Please don't blow it folks.
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STAFFORD