Taking Time to Understand the Question

If your community pharmacy practice is anything like mine, you are constantly being asked questions by consumers. Historically, the pharmacist has been a trusted individual in any town. Regularly, questions of all sorts are asked, and answered. Many times these questions have nothing to do with pharmacy; however, we seem to take the time to do our best to answer them. Being a trusted individual in the community is good for business.

In particular, I am interested in discussing questions we field about pharmaceutical care. Some questions are relatively simple, such as, “Where are the cough drops located?” We will usually answer this without breaking stride, perhaps a quick smile and a couple words about where to locate the cough drops.

Other questions require a bit more discussion. When a patient comes and asks “What would you recommend to treat my cough?” we will need to spend a little more time and ask the patient a few questions of our own. We may ask whether it is a dry or wet cough or perhaps we may ask if they have a fever or how long the cough has been going on.

My point is not to elaborate on how we counsel patients about cough therapy. More importantly, I feel it is important to emphasize that all day long, we are being confronted with questions from patients. We need to be prepared to decide, on the spot, which questions we can simply answer, and which questions require a few moments of interviewing the patient.

Just the other day I had a phone call from a nice little old lady who had been to the dentist for some work. She was calling with a scenario and a question that did not immediately make sense to me. Initially, she asked me if we stocked Norco 7.5 in our pharmacy. Initially I hesitated, due to the fact that someone was calling to check my inventory on a schedule II medication.

Rather than just pass it off as a drug-seeking-individual, I took the next step to understand who she was, had she been to my store in the past, and why was she calling me to check my inventory. She explained that she had already called 4 other pharmacies and none of them stock Norco 7.5. This confused me just a little because the generic for Norco 7.5 is quite common and most pharmacies do stock this medication.

After having satisfied my concern that this truly was just a concerned patient looking for her medication, and not a drug-seeking-individual, I felt comfortable discussing the inventory issue with her. We talked about which stores she had called, specifically what she had asked, and how they had answered her.

After this short 2-minute discussion I went on to assure her that yes, we do stock the generic for Norco 7.5 in our store and we would be happy to work with her if she wanted to come in and present her prescription to us. I explained that we would need to evaluate the prescription prior to filling it; however, if all was appropriate, we would be happy to take care of her.

She immediately went on to say that she wanted what the Doctor had ordered. She didn’t want any generic medication. Again, this was confusing to me. I asked her if she understood that the generic medication is the same thing as the trade name medication. I briefly explained the FDA generic approval process and that she could look all day in our small county and never find the trade name product. Furthermore, if she did find the trade name Norco 7.5, she would need to pay cash because her insurance would not pay for it.

She was very grateful for the clarification. She asked me why none of the other 4 pharmacies she called had taken the time to explain to her that the generic medication was the same as the brand name medication? After that discussion, I stated that we would be happy to take care of her, or, she could call on her regular pharmacy and ask them if they stock the generic for what she is looking for.

Later that day she came to our store. She appreciated that we had taken the time to understand her question and was now transferring her prescriptions to our pharmacy.