Collaboration with physicians improves patient care, revenues

Orlando, Fla.--Pharmacists can collaborate with physicians and other health professionals on drug therapy management programs, pharmacy vaccine programs, practice agreements, and other initiatives, to build revenue streams and improve patient outcomes.

“All the money from the stimulus bill that is being directed to doctors and hospitals to implement electronic records systems - pharmacy has a real unique opportunity now for you to be part of that care team,” Marsha Millonig, RPh, owner of consultancy Catalyst Enterprises, Eagan, Minn., told attendees at the recent McKesson Pharmacy Strategies Conference in Orlando.

Bill Tindall, PhD, RPh, director of Alliance for Research in Community Health, agreed that pharmacists can partner more with doctors’ offices to increase their pharmacy business. “The doctor can’t do it by himself anymore,” Tindall said.

The best way to start working with a healthcare organization is to introduce yourself to physicians and medical groups, Tindall said. Some pharmacies and clinics have already established effective partnerships, which result in referrals of patients from each to the other, Millonig said.

For example, a pharmacist in North Carolina created a relationship with an internal medicine group. “She started going into their practice one afternoon a week, and the physician’s office paid her a consulting fee to work with all the diabetes patients one day a week,” Millonig said. A health insurance provider reimburses the doctor’s office for the pharmacist consulting program.

Forty-five states allow pharmacists to be in “collaborative practice” with physicians and administer immunizations, cholesterol medications, anticoagulation drugs, and other medications, Millonig said. Types of medications that pharmacists are allowed to administer differ from state to state.

Collaborative programs not only prove profitable for pharmacists, but patients generally like them, said Millonig. “Patients want you to coordinate their care with doctors and others. They want their prescriptions filled accurately, and they want courteous and helpful employees who answer questions and solve problems,” she said.

Of course, before these collaborative agreements can be set up, pharmacists need to develop relationships with the physician’s offices, clinics, and medical groups. What are some of the best ways to go about that? One way is for pharmacists to introduce themselves to doctors by calling their offices or asking to meet with them in person, Tindall said.

“It is finding shared goals and values. Focus on the patient first, and never be afraid to share responsibility and power. It is not just about you, it is about helping people,” Tindall said.

Pharmacists and physicians should develop a “supportive culture for things to happen,” Tindall said. “We all have to have a common goal, and a common mission, to move things forward.” The shared goals and values of a successful drug therapy management program, for example, would include “developing best outcomes by reducing medication errors, increasing patient safety, and reducing healthcare costs,” Millonig said.

The pharmacist should find out about a physician’s office or medical group before the in-person meeting, and put some thought into ways to create more value for the office. “Gather information about the types of patients seen there, the patient demographics, and the size of their practice,” Millonig said.

After a relationship is established, it is important for the physicians to see periodic reminders of the pharmacy’s services - such as for flu shots - in the form of e-mails, flyers, faxes, and in-person visits. The other ways pharmacists can “sell themselves” to physicians’’ offices, according to Millonig and Tindall, include:

•  Create a written plan with clear definitions of short-term and long-term goals, and list the values that will be created for physicians.

• Get to know the physician’s practice, including key support staff.

• Start the collaborative relationship in a small way, such as asking the office for referrals to a flu shot program.

• Use the internet and other technology for quick and easy dialogue with physicians. “Provide physicians with helpful information on a regular basis,” Millonig said.

• Build a system to share patient information and contribute to coordination of care

• Present a professional image in all communications.

• Develop joint statements with physicians’ offices to share with the media.

• Volunteer to help with a clinical trial or new treatment protocol, particularly those on drug adherence.