Our Professional Responsibility to Our Patients
“Empathy represents the foundation skill for all the social competencies important for work.” Daniel Goleman
Many of us may have heard of a therapeutic relationship, but do we fully understand its meaning and the tremendous impact it can have on the way we practice pharmacy? To be honest, early in my career, I didn’t have a full appreciation for the therapeutic relationship with my patients. At least until the day my stepfather was diagnosed with renal cell carcinoma in 1995 and I became his advocate for all his health care needs.
During that time, I made it a point to:
· know all the medications he was taking
· monitored all his chronic medical conditions
· made clinical recommendations regarding medication changes as his conditions evolved
· and ensured he was fully informed about his health status and medications he was taking.
I promised him I would make sure he was achieving maximal benefits with his medications. That’s when I learned what it truly meant to have a therapeutic relationship with a person. So how can you develop a therapeutic relationship?
A therapeutic relationship is a shared responsibility between a patient and a pharmacist who agree to work together to ensure medications are optimized. In other words, the pharmacist forms a covenant with the patient and promises to do whatever possible to make sure the patient’s medications are optimized—that he/she will keep the patient’s welfare paramount, maintain an appropriate attitude of caring (empathy) for the patient, and use his/her professional knowledge and skills to ensure that the patient is achieving a therapeutic outcome with safe and effective medications.
Once a therapeutic relationship is formed, there is an open, honest, and two-way communication between the patient and the pharmacist. This allows the pharmacist to collect the clinical information he/she needs to adequately assess the patient for any medication-related problems (MRPs) and confidently “intervene” on behalf of the patient when a MRP is identified. The therapeutic relationship instills tremendous professional responsibility on pharmacists.
So how do we apply this concept of a therapeutic relationship in practice? It starts with the patient encounter. At that encounter, even if you have been providing care to your patients for some time, it is important to establish your responsibilities to the patient to ensure medication optimization.
1. Introduce, to both new AND existing patients, about the idea that it is your professional responsibility to help them optimize their medications and that it will require a change in how you work with them as you monitor their response to medication.
2. Outline for patients what will happen during the encounters you have with them when they come to the pharmacy so that the new expectation begins to form.
3. Demonstrate empathy—a caring attitude so your patients feel at ease. Good communication skills utilizing empathetic responding will help build the professional rapport needed for a strong and trusting therapeutic relationship.
4. Discuss with patients the amount of time needed for an encounter depending on their medication needs and the information you need to collect. Utilizing a robust medication synchronization strategy and applying the appointment-based model to your practice provides you the time needed to focus on patients and their medication needs.
5. Use both your and your patient’s time effectively and efficiently so the encounter is productive, and you gather the information needed to appropriately assess the patient’s medications.
6. Ensure sufficient time for patients to ask questions towards the end of the encounter and for you to answer their questions thoroughly.
7. Resolve any medication-related problems you identify during the patient encounter in a timely manner—working collaboratively with prescribers and making relevant clinical recommendations.
8. Monitor/Follow-up with the patient during future encounters, continue to assess their medications for any problems, ensure they are achieving a therapeutic outcome, and help them become informed consumers of their medications.
Establishing this type of relationship with patients builds a trusting and loyal relationship. The pharmacy profession has been commoditized over the years with the focus on the medication product. Our true value as pharmacists is our medication management expertise and ability to coordinate the care of our patients. All of this begins with a therapeutic relationship so you can make every encounter you have with your patients count!
Rovers JP, Currie JD, Hagel HP, McDonough RP, Sobotka JL. (1998) A practical guide to pharmaceutical care.
American Pharmaceutical Association