PILLS AND PEOPLE: No Script for Dialogue
Barbara R Krasner, PhD
Patients Stand Here
Our family pharmacy of over twenty years recently closed - to give way to an anticipated Target store. It was bought out by a drug store in a supermarket where protocol, order and efficiency seem to be the reigning criteria. Both of these stores had and have a mission: to fill scripts prescribed by medical and dental professionals to help people alleviate their pain and illnesses, and to improve and recover their health. Underlying this mission are attitudes, tones, and relational skills. A transition from druggists who know you and your ills, large or small, to a group of pharmacists who are strangers is traumatic in itself. All of them perform functions that impact their customers’ well-being in fundamental and intimate ways. Still it is tough to go from a store that is homey and receptive to a place that feels sterile and distant...where a sign at the head of the “pick-up line” reads, “Patients stand here...” *I am not a druggist’s patient. They are not our doctors’ substitute. A snapshot of the longterm relationship between us and our pharmacy is revealing: We tried to keep track of what we needed and when we needed it. We were told when an unusual prescription took three days to fill. We renewed prescriptions over the telephone simply by identifying ourselves (we both go by the title “doctor”). We sometimes learned that it was too early to renew, that the prescription had run out and we had to contact our doctor to fax a new one to the drugstore, or that our insurance companies were challenging what we ordered. When a physician changed a generic med into a brand name, one of our pharmacists confirmed its accuracy when David picked it up. In short, we counted on a dialogue between us. There was no question about who the prescribing physician was. There was a rhythm to our exchanges. We knew what to expect. We were told about any changes. On occasion, when we missed a beat and
ran out of pills, a pharmacist was typically willing to advance two or three of them until we caught up. We knew where we stood. Trust and integrity characterized our essentially commercial relationship. It is tough to suddenly lose years of longterm understandings between people with whom we have at least a nodding acquaintance or who often know customers, their personal contexts, their medical dilemmas, their insurance companies and their physicians. It is tough to be a stranger in a loud, crowded, bustling, and unfamiliar atmosphere...a context that carries new demands and is a tall order for customers and entrepreneurs alike. Business practices and customer expectations are in reasonable flux at a time like this. A willingness to imagine and inquire of each other can ease the way for everyone. A tendency to set terms and store policies in stone hinders efficiency and a customers’ sense of being heard -whether or not the two parties agree. Our treatment in the drug store in the supermarket is thin, brisk, and courteous - understandable for people without previous contact. Exceptions are two pharmacists who transferred over from the store that closed. Their style is courteous and efficient too. Their interest and engagement are born of longterm exchange. By and large, we have been well served in our new pharmacy, but ordinary bumps and differing undiscussed premises seem to be viewed as our ignorance of the law, insurance practices, the governance of physicians, and a transgression of rules...the pharmacy’s rules. A collision between their procedures and what we are accustomed to seems to lead to dictates and expectations of customer compliance without challenge.