Monday, September 28, 2020

The Great Debate: Pharmacy and the Well-Informed Patient

Professor Zubin Austin and pharmacy student Samier Kamar tackle the realities of engaging (and disengaging) the new healthcare consumer.

How do you deal with the well-informed patient: one that is smart, well-researched and comes to you with his or her own opinions and questions?

Samier Kamar4th year PharmD student Faculty of Pharmacy, University of Toronto

The well-informed patient is an asset to healthcare. It’s nice to have someone come in to the pharmacy having done his or her research. It triages the questions I would ask and opens up a dialogue. Pharmacists like to say we are the most accessible healthcare professional – you don’t have to book an appointment; just come and we can answer your questions.

Professor Zubin Austin, academic director, Centre for Practice Excellence, The Murray B. Koffler Chair in Pharmacy Management

I agree. Patients are their most powerful healthcare provider, and an educated patient is going to respond best to the therapies we dispense and advice we give. However, now people are looking online at invalidated sources, talking to neighbours, etc. How do you draw that distinction between a person being well-informed and thinking they are well-informed?

SK

It is a fine line. It depends on how they bring up a topic, whether it’s a means of discussion or argument. Regardless, we have to listen to what they say.

ZA

Yes, first and foremost we need to respect patients. Respect, however, doesn’t mean anything goes. There is a lot of “fake news” in the healthcare world. How do you tell a patient that the thing they believe in might not work?

SK

I think it is multifaceted. It depends on who is in front of me, the generation or the age of a patient …

ZA

I don’t like where you are going with this. I think it’s too easy to say a 60-year-old knows less than a 40-year-old, or a 60-year-old can’t find things 20-year-olds can. People are way more complicated than that. … Age might be an important consideration, but only one of many.

SK

You jumped the gun. You thought I was going to say just because they are older, they have less knowledge or don’t use the Internet as much. It’s the exact opposite. The Boomer category is very informed, but sometimes they think they know better. They have enough life experience and they’ve done their own research, the attitude is, “I really don’t need your help, just give me the medication.”

ZA

They’re busy. Oftentimes, the Boomer generation is taking care of other people. So many are involved in managing their parents’ care, and that is a hugely important role that a good pharmacist can support. Not simply from a medication perspective, but from a system navigation perspective.

SK

Definitely. Boomers have so much power in society, with their kids and with their parents. We need to, as clinicians, prove to them our worth. My advice to them is that when you go to the pharmacy you approach it as you would going to your doctor. Set aside some time to discuss your healthcare needs.

ZA

This demographic is really important for pharmacists and healthcare professionals to pay attention to. If we can keep them well into their 60s, 70s and even into their 80s, the service we are doing for the healthcare system and those individual patients is enormous.

SK

We have to take the initiative. I don’t think patients have to do much, other than open the door to conversation.

ZA

I am glad you raised this point, because from a professional point of view, there are so many small but meaningful things we can be doing differently – introducing ourselves by name, explaining that we are the pharmacist, instead of just hiding behind the counter and only coming out when we are asked a question, then scurrying back. Asking people up front “How can I help?” rather than waiting to be asked. If you have a relationship with your pharmacist, that is going to make it more likely you’re going to say, “This is what is happening with my dad or my child or my husband.” That longitudinal relationship is what’s really crucial.

SK

That’s what makes the well-informed patient such an asset. I hope to uphold the power and strength of healthcare in community pharmacy. That’s why it is important to first listen to the patient. Find out what information they have and discuss it. Say, “Hey, bring the article you have, and let’s talk about it and see whether I think it is correct or not” and make decisions from there.

ZA

I would like to live in your utopian world.

SK

Yes, the caveat being we have to inform them. They may be seeing only one piece of the evidence. We are their coaches and we have to guide them in the right direction. By all means, encourage patients and the public to research more about their health – it’s their body.

ZA

Research more, but be literate about how you are doing it; that’s the key. It’s really easy to find information. But just as we worry about fake news, it’s important to be really critically aware of what you are reading. And that is where we have a wonderfully important role to play in society.

SK

I think we can agree on that!

Originally published in Issue 01 of YouAreUNLTD Magazine.

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