Improve your physician collaborations

Mike Boivin will be presenting at Pharmacy U Vancouver on October 22, 2022.

Clinical practice guidelines and regulatory colleges both recommend interprofessional collaboration. But, even knowing this collaboration can enhance patient care, many pharmacists struggle with enhancing relationships with physicians in their community.

“For interprofessional collaboration to work, pharmacists have to make every effort to meet physicians in person,” explains Iris Krawchenko, pharmacist consultant and family health team pharmacist from Hamilton, Ont. “We have to get out of the pharmacy and look for opportunities to develop relationships with physicians in our community. It is virtually impossible to develop long-term meaningful relationships with physicians through fax communication and telephone calls. Continuing education events or local rounds are a great way to meet some of your key prescribers. We have to remember that physicians can be important enablers; their awareness and support of our scope and abilities are crucial to our practice.”

Start small and ask, not tell

Pharmacists should start with a targeted approach. “I recommend that pharmacists start small with targeted solutions for physicians,” advises Heather Foley, family health team pharmacist in Temiskaming Shores, Ont.

“It doesn’t have to be complicated; it is about finding the low-hanging fruit where physicians can benefit from your expertise.” Iris agrees, “Start with your key prescribers and the physicians that tend to be more receptive to your recommendations and simply ask the question that if I can help with one thing in your practice, what would it be?” Iris stresses that “by simply asking where they need help with patients’ medications, we have acquired valuable insight on what our starting role can be.” 

Start with one thing and make sure you deliver

Both Heather and Iris stress starting with something that addresses the prescriber’s needs to improve patient care and then deliver it well. Iris suggests, “Pharmacists try to be everything for everyone, but in the eyes of the physician this can be overwhelming. I would recommend you start with one issue only – non-adherence, for example – and then use it as a springboard for other collaboration opportunities.” Heather emphasizes that “you need to under-promise and over-deliver. If you promise you are going to do something and don’t deliver, you have essentially eliminated future collaboration opportunities.”

Be confident and engage the physician

“It is important that you are confident when you meet,” Iris explains. “You should not make assumptions that they know what a pharmacist does. By addressing strategies to improve their patient care needs focusing on their needs, you greatly increase the potential for collaboration.” 

Heather adds, “Find something you do well and own it. If you are confident that you can address a specific issue, let the prescriber know. Many physicians will have no idea what happens to their patients when they enter your pharmacy.”

Don’t let it die

“Have a strategy, start small, evaluate it, modify it and look for the next opportunity,” says Iris. “Collaboration is an ongoing process that can be constantly adjusted to meet the changing needs of patients and prescribers.”

She adds, “If the collaboration works, you can also use the same strategy with other prescribers in your community. Physicians may be more comfortable collaborating knowing what you have already done for other prescribers.”

Always focus on the patient

“I see a major role for pharmacists to help to reduce some of the complex patient burden on primary care physicians,” says Heather. “Physicians are the diagnostic experts, they are accountable for making the right diagnosis for a patient and developing a treatment plan. Pharmacists can have an important role ensuring that the treatment plan is implemented and constantly adjusted to reach the treatment goals. Having another set of eyes following up after diagnosis will reduce the burden on physicians and ultimately improve patient care.” 

Tips to ensure successful collaboration

1. Have a strategy. “You shouldn’t go into a physician meeting discussing everything you can do for his/her patients. It is important to have a starting point, implement it and then work collaboratively on ways to build on this success.”
2. Have an opinion. “Many times physicians will receive faxes from pharmacists stating ‘please advise’. If you don’t offer an opinion on drug therapy, how can a physician trust you to take on a bigger role?”
3. Customize. “A fee-for-service physician may have very different needs from one who is salaried. Always ask his/her primary needs and mutually look for strategies to address these needs.”
4. Be there when they need you. “As you start collaborating with physicians, they usually start to rely on your input regularly. Being able to offer timely advice can make you an exceptionally valuable resource for physicians in your community.”
5. Know your limits. “Know your strengths and weaknesses. Focus on your strengths and how they can be used to address your prescribers’ needs.”