Pharmacist-physician collaboration: A ripening synergy

Share your thoughts: Scroll down to post a commentCollaboration between health professionals is increasingly a topic of great interest. With the new and existing models of care and new payment options for physicians (and possibly pharmacists), the continuous evolution of primary health care is at the top of most health policy agendas—all for priority implementation.Transitioning into this highly supportable framework of teams and collaboration is happening in most patients’ circle of care—ready or not!Frankly, we should be more than ready. It's past time for physicians and pharmacists in typical community practice to resolve current inefficiencies. From a physician’s point of view, pharmacists and pharmacy issues place significant demands on our time while providing care to patients, and may even be considered an interruption to the flow of care. Another faxed renewal, another special authorization and another interaction query? Where did that med come from? Callback requests: unspecified, repeats not noted or filled? Their blood pressure is too high? Sorry, whose?From a pharmacist’s point of view, identified drug therapy problems need to be communicated with physicians on a daily basis. We realize we add to their workload but why won’t they talk to me, fax me or call me back? Why has the patient called me four times in the past hour for a clarification they need from their physician? Although this adds to a pharmacist’s busy and unpredictable day, it is all about providing patient care.In our case, a lot of these daily stresses and “add-on” times have decreased or disappeared since we've developed truly collaborative relationships between physicians, the family health team pharmacist and area pharmacists. Whether or not your province offers government-sponsored primary care teams, such as the family health teams in Ontario, here are four key practical steps that we've found make collaboration work:• Regularly scheduled face-to-face meetings are an investment in time for productive conversations. They improve our understanding of each other’s work circumstances, professionalism and scopes of practice. We use them to share clinical information and understand how the pharmacist, for example, uses it to help manage the patient. We also use these meetings to determine methods of sharing information.• Jointly attending continuing education programs.• Jointly developing patient education or care programs (hypertension, diabetes, seamless care, immunization and osteoporosis are some examples of what we've done so far).• Getting to know each other. Playing golf or having a purely social evening have helped build trust and that translates into improved collaboration back in the workplace. This in turn has made caring for the patient much more effective and efficient.A full appreciation of our pharmacist colleagues’ skills and judgment on clinical therapeutics—not seeing them as human “dispensing machines” or as employees of a bottom line-driven retail outlet—increases our understanding of the value of interacting with them.As well, pharmacists who are deeply clinically engaged understand more about how and when to be a part of the path of care that supports fully informed and effective therapeutic decisions. The issues of access, supply and costs, which are all influential aspects of patient compliance, become less of a barrier when pharmacists are fully engaged.Perhaps most important, we've found that patient experiences change when they understand the pharmacist and physician talk and agree on a strategy of care, dosages, timing and whether or not that certain pain or symptom is medication-related. It's as if our increased levels of collaboration and co-ordination set an example, and their level of involvement in their own care increases accordingly.Through increased collaboration, we have seen the excellence of care that comprehensive and up-to-date information can bring to our patients’ everyday lives. Sometimes we struggle with this target. Pharmacists are a super source of support, with a rich knowledge base and broad drug and therapeutic resources that often go further than what most physicians have at hand.Getting to know and understand each other, having the conversations, seeing how patients value our interactions, accepting good advice and revisions to care plans: these steps all occur along the path to a trusting, invaluable relationship between the pharmacist and physician—a ripening synergy.Natalie Hawkins is the owner of an independent pharmacy in Paris, Ont., and works three days a week with the PrimaCare Community Family Health Team. Dr. John McDonald has worked in Paris since 1976 and with the FHT since its inception in 2006.

Pharmacist-physician collaboration: A ripening synergy

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