The Opportunity Cost of Waiting

A recent report published by Harvard Medical School highlighted the following patient cost in attending a medical appointment:Total time involvement….121 minutes; which broke down to Travel time….37 minutes and Clinic time……84 minutes.
Within the clinic time segment, only 20 minutes was spent with the doctor.
Those figures, extrapolated to represent the entire US population amounted to 2.4 billion hours annually with $52 billion representing opportunity costs.

In these days of tight economic pressures facing community pharmacies, I reflected on the wasted opportunity costs involving pharmacy patients waiting for prescriptions to be dispensed, and how that time may be better managed.

Many pharmacies squander the opportunity of a waiting patient when a question is often asked, on receipt of a prescription, “Do you have any other shopping to do while we dispense your prescription?”

What is usually implied is that the patient might like to visit the supermarket to fill out the surplus time that may now constitute an inconvenient waiting period for that patient.
Why send them to an opposition business?
Why not capitalise on their time within the pharmacy?

For the sake of a simple comparison, if we assume that the US time involvement for a doctor appointment was similar to the time involvement for a patient presenting for a prescription plus an adjustment for population (US=319 million, Australia = 23 million) the opportunity cost for Australian pharmacies is $3.75 billion.
You can adjust this figure by calculating your own time estimates for an Australian prescription patient.
The aim of this exercise is simply to demonstrate the enormous $ value opportunity that a waiting prescription patient represents and identify how a community pharmacy may invest in this opportunity.

Recent work by the PSA in documenting the concept of improving a community pharmacy as a health destination, points to the fact that forward pharmacy helps to establish a focus of interest for a consumer and that pharmacist access helps to satisfy consumer need.
This is not a new concept, but PSA have taken the steps required to document this claim.
However, this research needs to be extended in two areas.
The first is to establish a “home” for the forward pharmacist so that the umbilical cord attached to the dispensary is cut, ensuring that the forward pharmacists are free to become patient-centred and in fact, have to provide a completely clinical function to justify their existence.
If a home is not established, the pharmacist will always migrate back to their original home represented by the dispensary.
There has been hesitancy by community pharmacists to create this essential investment, because it also means further investment in clinical program revenue to cover the cost.
This is where PSA has to develop its thinking and future research.

With 73 percent of community pharmacies now “flat-lining” on their bottom line net profit return, the tipping point has arrived and most community pharmacists remain unprepared as to how they handle future directions.

The second area of investment relates to the patient opportunity that exists in the patient waiting area and how functional this can become as an extension of patient service and a higher dollar return from each patient.

i2P has done a lot of research in terms of pharmacy design and patient comfort, also systems to improve work flows that increase capacity to spend more staffing time per patient.
We have concluded that ergonomically designed chairs that are padded and have arm-rests that assist patients to go from a seated position to a standing position are essential for the expanding and ageing patient demographic.
More space and improved design is also required so that the waiting area can become a counselling area for finished prescriptions. Plus, with additional furniture elements resembling a coffee table, so that finished prescriptions and associated paperwork can be comfortably displayed.
One additional feature for the “coffee table” may be a tablet computer device fixed to the table surface that can provide access to the pharmacy online catalogue products as well as drug and condition information-all designed for direct patient access.
Staff can productively train patients to access the information required that can build sales and knowledge that can translate to patient value – which then supports the forward pharmacist.

Designing an integrated coffee shop waiting area requires a high degree of planning, particularly privacy elements, such as free standing sound-absorbent panels, pot plants etc.
It may well mean that an interview that commenced in the waiting area may have to move to an interview room if privacy becomes a concern for the patient.

Coffee shops are themselves a destination point with a strong social element.

Properly adapted to a community pharmacy environment they can create a more informal but acceptable component in making a patient feel central to a pharmacy activity and at the same time enhancing the health destination concept.
A patient who feels like a patient will be more likely to enter into a paying relationship for any advanced services as they experience the welcoming culture embraced by this special patient engagement.

There are a handful of Australian pharmacies that have embraced a coffee shop concept as part of their offering.
I have observed that the pharmacies I have personally made enquiry of appear to be busy and profitable.

Previous articles appearing in i2P have stated that PBS as a product is at the end of its life cycle and from a marketing perspective is a commoditised product, now fast becoming a loss leader that has now adversely impacted on a total pharmacy environment, such that a large number are now confronted with their own tipping point and will be forced into taking action, before facing some form of financial collapse.

It is better to evolve using existing space and inventory as leverage, to something different, but acceptable to your patient base.
The concepts outlined in this article will demonstrate to your patients that you are making positive change that may just provide an incentive for a patient to stay with you, rather than move on to one or more shopping environments that provide a motivating stimulus different to your offering.

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