In Part 3 of "The New Pharmacy," Mark Burger takes you through the daily checklist of a successful practice.
Mark BurgerIn "The New Pharmacy: Revenue streams, Part 1," we outlined some of the steps you can take to research the New Pharmacy approach to professional practice. In Part 2, we examined a different way to elicit patient information and analyze physical states. Now let’s go right through the pharmacy door and take a look at some of the nuts and bolts of your daily routine.
Here’s the first rule: Set yourself up to succeed. Pick your patients carefully. Not everyone is your patient. Not everyone wants to participate in their own healing. Not everyone is going to listen. Not everyone can afford your fees - and some won't do anything that isn't paid for by insurance.
Some patients “inhabit their illness.” Some patients have been thoroughly brainwashed. Some patients are too complicated for you to help. Usually these are patients who aren’t honest or are in some type of denial, or are playing a game of “I need attention.” Google “Munchausen Syndrome.” Learn to recognize it. Avoid patients who have it.
This is called triage, and sometimes newly minted, high-minded young pharmacists, eager to serve humankind, find it difficult to carry out. But you can't help everyone.
Spend your time with the motivated patients. Explain that you are not a doctor, so you can't give them a diagnosis, but you are pretty sure you can improve their health. Don't try to be the doctor ... be the pharmacist - the New Pharmacist!
15 keys to the New Pharmacy
The following pointers are in daily use at our pharmacy, Health First! Pharmacy:
1.Train your staff to shield you from involved questions at the register. They should know what your limits are for answering questions at no charge and when those questions suggest a consult. Teach them to recognize the long storyteller and to ask nicely, "What is your question?"
Your employees are your shield. Without them, you will never get your work done. If you don't give them tools for handling patients, they will never get their work done.
2.Develop a good questionnaire, or subscribe to a cloud-based service that has one, with access points for your clients to log in, answer the web-based questionnaire, post their answers where you can evaluate them, and print out teaching docs, graphs, symptom burden lists, etc. [If you want the names of a few applications, e-mail me and I'll send you the links.]
3.Collect a nonrefundable advance on your consultation fees. This guarantees that patients won't cancel on you, wasting your time. The same practice applies to seminars: Collect in advance. No refunds.
4. Keep a schedule that you like (e.g., the maximum number of consults/day and the time of day for consults that you prefer). Post your fees. Offer patients the option of going 15 minutes, 30 minutes, etc. Ask them what they want to do. If they are only willing to give you 15 minutes, do the best you can. At 15 minutes, wrap it up as best you can, or ask them whether they want to go another 15 minutes.
If you've done an honest job of educating them, captured their interest with solutions, shown them that you know what you're talking about, and sold yourself as a caring pharmacist (which you are!), then they are likely to buy enough time to get to the answers with you.
5. Make sure that patients send you their completed questionnaires at least 24 hours before the scheduled appointment.
6. Ask patients to bring in recent labs (from within the previous 6-12 months).
7. Have your staff call patients the day before the appointment to remind them. â¨
8. Give them a clipboard and a pen and encourage them to take notes. It's their health, after all.
9. Consciously develop a skill for "knowing" whether your clients want to hear the â¨explanations or just the solutions (i.e., you tell them what to do and they do it). Using the right approach with patients will save them money and frustration. Also tell them, realistically, what you think you can accomplish in the time allotted to the consultation.
10. Always ask for and document the names of each patient’s primary care physician and medical specialists.
11. Develop a system for taking notes that can be easily uploaded and shared with patient and physician. We use the Smart Pen (aka Echo Pen) by LiveScribe (www.livescribe.com/en-us/smartpen/].
A colleague of mine in Columbus, Ohio, uses a free medical charting system developed by The Ohio State University that lives on the Cloud. He sold his compounding pharmacy, by the way. Many physicians refer patients to him every day, and he spends 8+ hours each day on consults. This will happen to you.
12. Take good notes. Learn how to SOAP (Subjective, Objective, Assessment, and Plan) and use the POMR system (Problem Oriented Medical Record system). It will help you to problem-solve.
13. Don't be afraid to recommend products that you sell or lab tests that you stock. Remember that when a pharmacist suggests a lab or a supplement, it means a lot to the patients. They have a lot of trust for and confidence in your advice. Don't abuse it.
14. Recommend a follow-up in 8-12 weeks. State what you want to accomplish with it and suggest a time.
15. When you get too busy, raise your prices. You will lose patients, work less, and make more money. This is called "market pricing."
You should hear the complaint "Your prices are too high!" or "Will my insurance pay for this?" at least once a week. That is how you know your worth - and know that you are not leaving any money on the table.
Remember: You are "too busy" because you are getting results and the world is beating a path to your consult room.
Next month: “The 80/20 solution ... a case study.”
Mark Burgerowns Health First! Pharmacy and Compounding Center in Windsor, California. He welcomes your questions and comments at Mark@healthfirstpharmacy.net.