You are not the Pharmacist

It has been a difficult week with many challenges, but my strongest memories of the past few days are the conflicts I had with some of my patients.  Some of these clashes left a bitter taste in my mouth, yet all of them managed to leave my emotions in a  state of disarray.  So what is it that makes for these tense and unpleasant episodes?

@Drugmonkey titles his blogsite ‘Your pharmacist may hate you’, and in many ways the title at first sat uncomfortable with me, for it positions itself exactly opposite to everything we as pharmacists stand for.  Now however, I have to acknowledge that the  Drugmonkey has faced the demons inside himself way before I even knew about my own.  Yes, there are times that I ‘hate’ my  patients, and I am now going to be honest and truthful about it.

There are many things that people may say or do, or even not do, that gets under my skin.  Bad manners is one of them.  Another would be not to show your elders common courtesy – get off the chair if there is an elderly lady that needs a seat!  I also  abhor bullies.  If you so desperately are spoiling for a fight, go pick your own size, for one day you will find that you  are actually the ‘small’ man and be on the receiving end of another’s bullying.  But what sets me bristling is  when you try and insult my intelligence! And you know what?  There are people out there that try it on a regular basis.

My problem is that as the professional behind the counter, I am not allowed to be rude and always have to smile.  I have to be polite and try and understand.  Try and help, and always give you the benefit of the doubt.  Our professional ethos has basically rendered us impotent – it has tied our hands behind our backs.

You, the patient, on the other hand, am in need.  Genuine need equals genuine service with a smile – guaranteed.   If your need is not genuine, and your approach is motivated with selfish disregard for those in front of you, you will meet up with a great deal of icy demeanour and most probably leave with your original need unattended.

OK, I have said a lot, please let me illustrate.  Mrs X, 55 years of age, lives not four blocks away from the High Street, comes in to enrol in our prescription collection service and also wants us to deliver her medication on a monthly basis.  So far, so good.  We do these stupid things in order to secure customer loyalty, although the question that begs answering is, if she is in town on a weekly basis, why do we have to deliver? She even comes into the store to come and buy her odds and ends! But here comes the clincher – she wants us to automatically request her repeats for her, because she does not want to have the responsibility of ensuring that she always have stock at home.

Now bearing in mind that the local Boots store got on the wrong side of the local surgery for doing just that and nearly lost all their collection business, and that one of our company’s branches got taken by the NHS to court for the same, I am treading carefully.  If you want your meds, just phone us a week ahead, we will run the script request to the surgery, pick it up again, prepare your items and deliver it to your door step.  But it is important – you must initiate the request – you must authorise us to request the meds on your behalf – every time.  Everyone else does it, why are you different?

But no, she will have none of it.  I explain that in principle it is the same as ensuring that you always have coffee, sugar, milk, bread and even toilet paper at home.  But no, she will have none of it.  She then explained to me her health is actually my responsibility – I make a backward summersault – no mean feat with my body I will let you know.  This is what I mean folks – insulting my intelligence – YOUR health is YOUR responsibility! End of story!

During the recent riots a tweet was circulated that encapsulated this spirit of abdication.  It basically said that today people know all about their rights but little or nothing about their responsibility.  This lady was gobsmacked that I could not understand her reasoning.  Probably as much as I was that she could not understand mine.  The other side of the coin is that I had stated the exact framework of the service we offer, and if she did not find it up to standard, then go somewhere else – I do not want nor need your custom.  Be gone.

Another example is where I had an unnecessarily long conversation with a customer about chloramphenicol eye drops.  She had come into the pharmacy requesting the product by name.  As per usual my staff had tried to go through the questions with her, but listening to the ensuing argument, I quickly entered the fray.  She would have none of these questions.  She wanted chloramphenicol, and chloramphenicol is what I was going to give her.  Fat chance.  I very nicely explained to her that there are  strict guidelines for the sale of this product and that the staff were only doing their job in an effort to protect her health and ensuring that she got appropriate treatment.  I got a blank stare.  Heroically I carried on, by now with the full audience of the whole store.  Asking her, yet again, what her symptoms were, she hauntingly informed me that she suffered from dry eyes.  She agreed with me that her symptoms were not consistent with bacterial conjunctivitis, but stuck to her guns, that chloramphenicol is what she came in for, and chloramphenicol is what she was going to get.

Politely I explained to her that she was totally and wholly mistaken in that regard.  This forced her to finally play the trump card.  (brutum fulmen) Now I have been in this game for just over two decades, and her next move was totally expected.  ‘But my  doctor said I should use it’, she said.  Strange that?  If your doctor prescribes/recommends chloramphenicol for dry eyes, we need to have an uncomfortable talk with  the GMC, but then again I do know that you are lying through your teeth and only played your  last card, because you thought I am gullible and stupid, and will roll over and deliver.  You have just there insulted my intelligence, madam, and have caused me to lose all my respect for you.

Do not play the ‘doctor’ card with us.  If your doctor wanted you to use it, he would have prescribed it, and I would have dispensed it.  No prescription equals no chloramphenicol for you today!  Do the maths, it is actually quite simple.

Trying to play games with any of us, be it your doctor, pharmacist or dentist, avails you nothing.  Be honest, state your problem, do not hide anything from us, and let us help you.  You are not the professional here, you are the patient.  Now please do not bite my head off – I know all about and do subscribe to informed decision making, but if you do not know the indication, side effects and interactions of your medicines, you must allow us to guide you through the process.  It would be unprofessional and even criminal if we were to provide a service detrimental to your wellbeing.

That ladies and gentlemen is what gets my blood boiling.  Do not expect me to be your pharmacist and then insult my intelligence.  durate et vosmet rebus servate secundis

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