The Patient Proposition

I am wondering if there are any pharmacists out there who have ever created a written proposal to recruit patients to your practice.
The reason I ask is that so many pharmacists in their communications with each other or with other health professionals, talk in terms of having “customers”, with the word “patient” appearing spasmodically in any given conversation.
Pharmacists are often ambivalent in the sense that part of their professional role involves logistics and the holding of a suitable product inventory – the same elements that underpin general retailing.
So it is not surprising that retail thinking can overshadow professional thinking, nor is it surprising that the drift into a wider landscape of retailing occurs when the professional component comes under pressure, generally through government regulatory change or other health professional competitive initiative.

If you think about the basic premise surrounding customers and patients you will note that:
“The customer is always right.”
But: “The patient isn’t necessarily right.”

A patient is someone who arrives by referral (by other health professionals or by existing patients of the pharmacy) or by an independent “walk-in” to a pharmacy, and all come with a “duty of care” legal requirement.
Part of that duty of care involves an obligation for a pharmacist to mentor a patient so that they can take personal responsibility for their own health, and in the process acquire sufficient knowledge to engage in self-care.
It also involves collaboration with other health professionals so that a patient may be referred when you have reached the limit of your professional competence in a particular aspect of health.

The marketing pressure created by franchised market groups, also major wholesalers, can alter perception and clarity for pharmacist direction, because these entities want to generate sales of products and require a pharmacy to have a strong and expanding customer pool to sell commoditised products to.
There is nothing wrong with that aspiration provided the management skills within each pharmacy are strong enough to sustain an optimum balance of prescription sales to total sales, and for a stable community pharmacy, prescription sales need to be 45-55 percent of total sales.

To highlight the inappropriate use of the words customer/patient you only need to refer to the headlines of a market group pharmacy media release for a recently announced new professional service:


Surely the above is a patient proposition?
I2P has no problem with the screening scope of the service being offered, even though it has been criticised by doctor groups publicly.

But surely that service should form part of a “patient” proposition.
Here the market group thinks only in terms of “customers”, and uses that descriptor in place of “patient.”
And if that patient proposition becomes a written document that can be communicated to patients and other health professionals, I am certain that pharmacy patients would enjoy being recognised as patients and that the patient proposition explains the full benefits on offer.

While that process will not eliminate doctor criticism, it will reduce it.
More importantly, a documented patient proposal will help to deflect media misrepresentation and would reinforce patient confidence.

Consider also the process of a patient beginning their journey by initially making an appointment with a doctor (or other health professional).
Although some doctors dispense samples and even sell products, their professional environment is minimally merchandised.
A patient within that environment is treated as a patient and the patient “feels” like a patient.
The second leg for that patient’s journey may be a pharmacy.

Unless the design of that pharmacy is one that welcomes patients and has an internal space dedicated to patients, with each space carefully crafted and designed to stand out from all other spaces, formal recruitment of patients may suffer.

A patient may lose their aspect of feeling like a patient (and immediately begin to feel like a customer) if the interior is not well-designed to attract and clearly compete for patients.
In other words the core business of pharmacy may appear to a consumer as a graft-on to the apparent basic commercial business that visually occupies the major space and often has product discount signs in great profusion.
This is an area devoted to customers –and  there must be a balance!
The more a consumer feels like a “customer” the more price scrutiny will be undertaken by that consumer.
So convert them to a “patient” seeking value in quality health services.

For a pharmacy to function as a patient envisages it, patient needs should be addressed first to maintain the patient’s feeling of “patientness”, and in that state they will not be negotiating prices – only services value.
When patient needs have been addressed the patient can then become a customer and the total consumer leverage will be utilised with the result that the pharmacy has satisfied a patient and a customer – sequentially or simultaneously.

The patient content of a pharmacy is the real measure of a successful mix of professional services and so must be the major KPI for all pharmacy practices.
But unless you have some efficient recording system you will not know your total patient numbers and their individual preferences – nor will you attract patient collaborative offers from other organisations seeking to value-add to their own health initiatives.

To sustain patients you need to be able to communicate (on a range of levels) any professional offering.
For this you will need to have basic contact details (including email address) and have some understanding as to what health offerings might appeal, through the establishment of an accurate patient profile.

We are not talking about a complex system here, and we are also talking about a process that franchised groups will ever get down to.
This is why we advise that a complete review of your franchise should occur and a decision taken to reduce the fee component surrounding unnecessary services and apply the monies released as part of an internal professional services budget.

To create a balance between customers and patients requires a consistent marketing process, with the marketing budget slanted towards the creation of patients.
As a starter for a patient proposition, all you need to do is design a booklet that illustrates your complete pharmacy professional offering to a patient – a catalogue of services with a full description of each, including ancillary services such as same day prescription deliveries, credit facilities and Internet consultations – and anything else that is significant in terms of what a patient may value.

Price incentives may also be a feature of a patient registration where a number of free services are available or a special price reduction may be available say for an initial consultation.
Or the price discount may be attached to some flagship programs such as pain management, stop-smoking or diabetes support.

A range of pamphlet handouts must also be prepared that describes in detail what a pharmacy patient may receive (in health value terms) for each single, branded service, and part of this pamphlet needs to have a contact detail form for new patients to complete.

A new patient profile then needs to be established utilising a cloud system plus the facility to access existing information systems such as dispensing data.
All this detail needs to be available remotely utilising computer tablets (or similar equipment) so that patients may also be able to be serviced from external locations (e.g. at home, after hours).

The initial patients will be pulled from the customer pool generated by commercial retail marketing activity.
Conversion of customer to patient will be performed by trained pharmacy personnel utilising the written materials described above.
This constant application provides the tool to maintain or adjust the best customer to patient ratio that suits your style of practice.

Showcasing the entire professional system must be a range of privacy-regulated spaces that are presented using designs of shape and colour to make that particular area stand out from all the other competing activities in the pharmacy setting.
And at the same time promote an image of quietness, privacy and confidence.
Above all, the pharmacists attached to these spaces must be engaging and patient-focussed and they must not appear as add-ons to the dispensing space competing for the same resources.

There are unique methods of displaying professional spaces and i2P has researched a number of different approaches that will form content for a future article.

Meanwhile, the pharmacy professional services background needs to improve its visibility (through infrastructure and marketing systems) to provide primary care patients with a valid alternative over the high-cost, long waiting time for the average GP patient.
Also developing is an increasing number of GP’s using their legislated gatekeeper role to manipulate patient preferences towards a more dictatorial offering e.g. by not treating patients who may have elected not to have all the vaccinations as promoted by the Australian government in their vaccination program, as a “for instance.”
About one quarter of Australian GP’s are already thinking in these terms if not yet ready to implement in practice, as yet.

With appropriate infrastructure and well-designed professional services, pharmacies could, at a minimum, provide a check and balance alternative that would build increased satisfaction levels for new pharmacy patients.

It will also attract more continuous criticism from the medical fraternity.
But that will be easily deflected by building a professionalism that can be favourably compared – and that must be the nightmare keeping the AMA executive awake most nights.
i2P notes that since this article was commenced, medical critics have forced AMCAL to hold back the delivery of the Strokecheck service until a further review occurs.
There will be a continuing medical pressure for all new pharmacy initiatives.
Get used to it!
But at the same time ensure that all criticism is taken on board and addressed, taking the view that your service must stand all tests to survive, and be accepted by a pharmacy patient with confidence.

Then watch the movement in the annual polls, taken as a measure of integrity and trust, increase dramatically.

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