Time is always a factor for health providers, and Pharmacists are no exception.
When time is tight during the patient encounter, education can feel rushed, or rote. Yet when there’s little time, it’s especially important to be thoughtful and strategic about education.
In an interview for “10 Minutes to Better Patient Communication,” Dr. Paul Ranelli from the University of Minnesota College of Pharmacy’s Duluth Campus tells us about one concept that helps him and his students get the most out of their time with patients–even if they only get a minute!
You might catch a minute with Paul yourself–he has a few presentations coming up: October 8 at the Engaged Scholarship Consortium Meeting in Denver, CO, and a keynote on October 24, at the Minnesota chapter of Society for Public Health Education.
And of course, you can listen to his interview right here, and check out the transcript and handy links below.
Photo: Dr. Paul Ranelli and Food as Medicine, Medicine as Food in the photovoice portion of the “To Really See: Exploring the Medication-Taking Experience” exhibit. Photo by Richard Anderson.
Hi, this is 10 Minutes to Better Patient Communication from Health Communication Partners. I’m Dr. Anne Marie Liebel. Today, I’m talking to Dr. Paul Ranelli from the University of Minnesota College of Pharmacy’s Duluth Campus. Dr. Ranelli tells us how he & his students deal with a problem that pharmacists often face during their brief patient encounters. And how education is most powerful when it’s both ways.
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Welcome to the show. Today I’m talking via Skype with Dr. Paul Ranelli. Dr. Ranelli is Professor of Social Pharmacy at University of Minnesota College of Pharmacy’s Duluth Campus. Welcome to the show, Paul!
Well thank you, thank you for having me.
I’m so glad you’re here! You and I know each other because we are both members of the Social Medicine Consortium. I wonder if you could tell our listeners a bit about yourself and what you do.
Okay, I am as you said a Professor of Social Pharmacy, and I am a Pharmacist. I have my PhD in Social Pharmacy from the University of Wisconsin-Madison.
What’s one of the problems in the area of provider-patient communication that you found yourself facing frequently?
Probably I can boil that down to two main areas I focus on in my research, and teaching with students. And it’s two phrases that I use, and that’s: “information gathering” and “information giving.” Pharmacy, since we have, our tradition is we have a medication–a drug to give–and we talk about that. We give information about this drug. What are you going to, how–how you’re going to use it, how you’re going to take it. But we don’t gather information from that patient, enough information to help us be a better giver.
I get what you’re saying. Having been to a pharmacy, right, I expect the information is going to be given to me. Could you talk to me a little bit more about what you mean on the gathering side?
Well, there are–the idea is to bring the patient–the user, the medication user–into the conversation, to make them part of what you need to help them use their medication more wisely or better. I’d like to know what the patient knows already, so if I have to give information, I can fill in the gaps that the things they don’t know already. Or I can check on the things that they they know and see if I need to make some corrections. And so what information do you need?
(Sorry) that sounds like–that’s what I’m thinking–really powerful for the patient. It seems like the information gathering has has a lot to do with your wanting to help the patient.
Right.
And that that’s a very powerful stance to take. But I also get the sense that, as a provider, you feel like you stand to gain from this gathering of information as well.
Oh absolutely! Because it makes me a better giver or counselor about medicines. And I also am developing a relationship with the patient, sort of seeing if we can be in concordance with what they’re thinking, what they know about the medicine. And having them be a partner. And if we can be in concordance, rather than just a–and not like, you would say, an empty slate or an empty bucket of information. And I sometimes call it, like: it’s better to be balanced in gathering and giving, than to be just a jukebox. As if you put money in the Jukebox–used to be a quarter, maybe more today–and then you just spit out the drug information when your music, when your selection comes on. In defense of us as Educators, is that many of our students–that’s what we’re training them to do. Because they’re, they are drug experts in the healthcare field. And they don’t have–we don’t spend enough time in our educational process I think in the gathering.
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And that’s what I was going to ask you. So how do you help your students deal with–it sounds like there would be a lot of obstacles. You’re talking about, kind of, the institutional pressure or the history of the field, as a pressure toward the giving of information. Have you noticed other obstacles to focusing on the Gathering?
Well, yes. Sometimes it’s–a response I get when I bring this concept up is, “Well, we don’t have enough time to do that.” I can say that’s probably true in some cases. However, would I use–I give examples of what you can do in a very short amount of time to make that connection with the patient and gather some information: “What have you and the physician talked about, about this medication beforehand?” Because most of the time in a community setting–which maybe your experience has been mostly in an ambulatory setting–the pharmacist doesn’t have the same information available to them with what happened to the patient before they come into the pharmacy. So,
Oh
Our records are not as–they’re getting better, but there’s not that record-sharing before they come to your Pharmacy. In gathering information, that actually helps you feel more comfortable and confident. I mean, simply put: many medicine have a lots of different uses.
That makes a lot of sense. That’s why–I’m thinking about the information that you have. I mean it took you what–three or four seconds? to ask that
Yeah
The question you know, “What did do and the physician talk about earlier?” or “Have you used this before?” It takes seconds to ask that.
Right.
And the differences in the answers you could get, could mean very different things for the information that you’re going to then give the patient.
Absolutely. Yes, there are times when the time is very brief. And patients, humans, we all have things to do. We have a car to catch. A child who’s not very happy because they’re ill. And it doesn’t make the best environment for communication. So you have 30 seconds. So you gather two pieces of information and you give out the most important pieces of information that that the mother, father, or adult user needs to know about the medicine at that particular point in time. Then you set up a–give ’em a business card– or you set up a time. “Can I call you later?” or “Can one of our pharmacist call you later at home to talk a little bit more about this, or find out how you’re doing on this?” Very simple. That can be done in a minute, 30 seconds.
I’m–you were talking about being conscious of of that person’s situation–the crying child, having to rush to get a bus. Keeping that in mind and being strategic about the important things they need to know before they leave. I like what you said about giving them a card for a time when it’s better for them to talk, so you can go over some of the other information.
Yeah that has worked in my practice. I’m not a practitioner much anymore. I’m an educator now, been at it for a number of years. But in my practice, when I was practicing, those kind of little tips have helped me as a practitioner. And they’re also bringing in the idea that you’re just not a giving machine or information giving machine. Your’re, you’re actually trying to make a relationship with the patient.
Thank you so much for that!
You’re welcome, you’re welcome.
I appreciate your being on the show today.
Well thank you very much for having me
Thanks everybody! this has been 10 Minutes to Better Patient Communication. I’m Dr. Anne Marie Liebel with today’s guest Dr. Paul Ranelli. Thank you again Paul, thank you everyone for listening.
