Last week’s Management Tip built focused on promoting a safety culture and improving the reporting of adverse events. As pharmacists are a key link in the medication use process, they invariably will be involved in and communicate with various other stakeholders in this process. Pharmacists will make recommendations to prescribers aimed to improve patient outcomes, mitigate the likelihood of adverse events, and improve patient safety. As such, it is important that pharmacists effectively communicate with prescribers and that these prescribers at the very least listen carefully to the pharmacist and hopefully implement pharmacists’ recommendations borne from sound judgment, experience, and best evidence.

Luetsch and Scuderi implemented a study employing a novel method of examining pharmacists' reflections regarding past prescriber communications they have had when making recommendations.¹ Those reflections described how physicians demarcated territory, evaded scrutiny, and/or disparaged pharmacists’ professional expertise. Pharmacists perceived limited options in negotiating these experiences and often employed patients in resolving issues that were left unaddressed. They felt frustrated, undervalued and angry after their experiences, and described apprehensiveness in future interactions with doctors. The study authors concluded that although instances of medical dominance by prescribers were relatively infrequent, pharmacists do not seem to be well prepared to counter or negotiate around them.

Pharmacists much approach other health care professionals from the standpoint of patient benefit and altruism. They will never win a ‘turf war’ with prescribers. Pharmacists must be assertive and not passive-aggressive. Even when communicating on behalf of the patient, pharmacists will sometimes encounter resistance, even arrogance and poor judgment. Pharmacists can then look toward various negotiation tools such as motivational interviewing and principle-centered negotiation that focuses on: separate people from problems; focus on mutual interests; invite multiple win-win solutions; and insist that the result be based upon objective criteria. Pharmacy managers can and should lead by example when negotiating with other health providers and educate pharmacy staff to do the same.

Additional information about Ensuring Quality in Pharmacy Operations and Negotiation Skills can be found in Pharmacy Management: Essentials for All Practice Settings, 5e. If you or your institution subscribes to AccessPharmacy, use or create your MyAccess Profile to sign-in to Pharmacy Management: Essentials for All Practice Settings, 5e. If your institution does not provide access, ask your medical librarian about subscribing.

¹Luetsch K, Scuderi C. Implementations to improve medication error reporting in hospitals: A systematic review and narrative synthesis. Res Social Adm Pharm. 2020; https://doi.org/10.1016/j.saph...