Playing nice in the sandbox: Tips for

enhancing the physicianpharmacist

relationship
Share This Page
May 21, 2014
Career Manager By Megan Keller, PharmD
A

My day started with a physician who came into my office shaking a paper. The pharmacy faxed me again
stating Ms. Smith should be on an Angiotensin-Converting Enzyme (ACE) Inhibitor because shes
diabetic! She is not diabetic, shes on metformin for polycystic ovary syndrome, which I included in the
directions and I have already told them this twice over the phone, said the frustrated physician.
Ouch.
Two sides to the story
As a pharmacist with ambulatory and community practice experience, I see both sides of the physician
pharmacist relationship. Working in a physicians office, I live the day-to-day frustrations with the
physicians such as pharmacy messages with no information, repetitive faxes, duplicate refill requests
(despite already being addressed), and constant interruptions. This all happens when I only have 15
minutes to see a patient and Im already an hour behind.
I understand where community pharmacists are coming from. I know what it feels like to have
prescriptions backed up with patients staring through the window as if I am a zoo animal and have a
physician call on hold while quickly trying to finish logging the controlled substance prescription in my
hand. And of course, the controlled substance count doesnt match. Oh, and now the physician is giving
me a piece of his mind on the phone.
More alike than you think
One thing I can tell you is that physicians and pharmacists are more alike than we realize. I bet you the
physician on the phone hasnt had lunch yet either. I bet you they are tired and burnt out, and
overwhelmed too. I have no doubt that a pharmacist has zinged them a time or two, which has made
them biased. You have probably had similar experiences with physicians, and in the big picture, we all
want the same thingthe best care for the patient.
Tips from my physician colleagues
With tensions often running high between physicians and pharmacists, I asked the family physicians I
work with how community pharmacists could improve physicianpharmacist relationships. They had the
following suggestions:

Delivery is key. You are a well-educated colleague on the health care team. As long as everyone keeps
whats best for the patient in mind, there are no ego battles. Start with the problem you want to talk about, state
why this problem concerns you, and then offer a solution. Try this: I was thinking about Mr. Smiths case and I

feel/think that we could help his ____ by doing ____ so how about ____? Also, avoid telling a patient: You
should be on XYZ instead try: Ask your physician about XYZ.

There is no I in team. No one likes to be told what to do or how to do it, let alone both. If you keep the
team in mind and the goal on the patient, then you can minimize problems as much as you can.

Reach out. Building a better physicianpharmacist relationship comes with time and working together.
Starting with face-to-face introductions (i.e., doctor detailing, building a relationship with the office manager, etc.),
find out what physicians see as issues that pharmacists could potentially help with such as complex patients with
lengthy med lists, patient education, or resources. Eliminating problems is a way to build trust with physicians.

Be professional. Avoid putting the physician in a bad light over an issue with their patient. Errors should be
handled in a professional manner that does not make the patient think less of the physician and vice versa if
there is a misunderstanding with the pharmacist.

Be personable. Personalize any correspondence rather than form letters. This takes time, but we
physicians will pay more attention.

Be flexible. Every physician has different preferences on how they would like to be contacted. Reach out to
physicians in your area to find out what works best for them and tailor your communication to fit those needs. Be
sure to observe nonverbal cues when face-to-face and pick up on their tone when speaking on the phone or in
person.

No one likes to be on hold forever. If you unable to take the call right away then ask for an extension
number to call the physician back at. When making calls, physicians are typically by the same phone for a short
duration.

Be the bigger person. Avoid making assumptions like this doc always yells, check your bias before
communicating, and avoid taking it personally. You cant go wrong with being the bigger person and resisting the
urge to give in.

Implement and earn respect

We need to continue to earn physicians respect by striving to make every interaction a positive one,
especially in difficult situations. I encourage you to be a leader for the profession and pick one of these
tips to implement in your practice. Remember to always live by the Golden Rule: Treat others how you
want to be treated. It applies to more than just playing in the sandbox!
Thank you to the physicians at Doctors Hospital Family Practice for sharing their thoughts and time.
Megan Keller, PharmD, is Director of Clinical Pharmacy Services at Doctors Hospital Family Practice in Grove City,
OH, and an Assistant Clinical Professor of Pharmacy at the Ohio Northern University Raabe College of Pharmacy.