I’m glad to welcome back to the show Pharmacist and Social Pharmacy Professor Dr. Paul Ranelli. You’ll learn how he encourages his students to see patients as experts, what you can do to improve your next conversation with a pharmacist, and why a deficit perspective on patients is balderdash!
Pharmacists occupy a unique place when it comes to patient communication. I’m glad to welcome back to the show Pharmacist and Social Pharmacy Professor Dr. Paul Ranelli. He was first on the show in 2019 and today he’s back to talk about seeing patients as experts.
Hi everybody. This is 10 Minutes to Better Patient Communication from Health Communication Partners, a health-equity focused education and communication consultancy. I’m Dr. Anne Marie Liebel.
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Hi everybody, I’m live via Skype with Dr Paul Ranelli. Doctor Ranelli is Professor of social pharmacy at University of Minnesota School of Pharmacy Duluth campus. Doctor Ranelli, welcome back to the show!
Thank you and thank you for having me. Glad to be back!
I’m so glad you’re here. You were my first interview and I’m going to go ahead and put the link to that show in for anybody who hasn’t heard it. Please do go listen to it. And dr. Ranelli in that first interview, you spoke about information giving and information-gathering. I wonder if you could give our listeners kind of a quick reminder of what you meant by that?
Sure. Glad to. Those are mine simpleton or fancy words for what a pharmacist does a lot with their medications that they’re given to a patient is giving information about that drug or about that medicine to the person who’s going to be using it. So that’s the information giving. That seems pretty standard. The information-gathering is something I try to emphasize and that’s getting information from the patient, is gathering information to help you be a better Giver of information. So what information does that patient have about their medication taking experiences with this drug, with another drug, with this disease state, with this illness. So I try to divide those in my teaching, with the Gathering it, what you got from gets from your patience and then giving what you give about the drug.
Thanks for that, because I think that was–the feedback that I got from your interview was so strong and so positive. And the thing that people remarked on the most with this idea that of the information-gathering from the patient. Like people, once you said it made sense, but people hadn’t thought about themselves as valuable sources of information for the pharmacist. I wonder if you can tell us a little bit more about that idea of the patient as a holder of valuable information.
Sure, well they’re very valuable to that relationship. I consider them an expert. We may be experts in our clinical and drug knowledge with all the schooling that we get. But that patient is an expert in their life. And an expert in how they take their medicines, or what experiences that they’ve had. And they have a great deal to offer to us. So I try to use that as a way to, you know if you think that there may be an information power differential, well this is the almighty pharmacist with all this drug information and I’m this lowly patient that doesn’t know anything. Well, that’s balderdash! They aren’t an empty vessel. They have data to give to us or information that they can share. You may think, they may think it’s mundane, but it’s not. It’s it’s their experiences that they are bringing to the medication taking experience. It’s the idea of concordance. You want that patient to be a partner. And you are giving them the confidence to be a great partner. That “I want to hear from you.”
And you’re you’re anticipating my next question. And that’s, I ask all of my guests, “what’s the problem or the issue in patient communication that you’re addressing or that you’re facing?” And I just heard you name three or four different kind of problems and issues that get raised in patient communication. The idea of being on the same team together. The idea of a patient having enough confidence in their, in their knowledge to take good care of themselves and to see themselves as a partner. The building of the relationship. The trust issue. I mean, the concordance, you brought that up. There so many issues or problems in patient communication that you are addressing in thinking about the patient as a holder of equal information. The power differential! There you go! There’s another one! So, how have you been encouraging this approach with your students?
We do a lot of role-playing in class. And use techniques of sometimes deconstructing. I sometimes use a technique of deconstructing a patient record, where the students only get the drugs that someone’s taking, not any background information. So then they have to make a history from the different kinds of pharmaceuticals that the person is taking. And it could go in many different directions, there’s not one right answer. That’s the point, there is not one right answer, but it’s interesting to see how many different histories you can develop backwards, deconstructing just from the drug list.
Wow that’s really powerful. I’ve never heard of something like that before, it makes sense just I mean from my outsider perspective. Recently you’ve been working with some more arts-based pedagogy as well. You had a pretty exciting project this past semester. Do you want to tell us about it?
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Sure, I’d love to. We had, we had–the last few years of my teacher in pharmacy school I’ve been working on how to bring the Arts—Theater, Visual Arts, let’s say–into the classroom, but also as a way of teaching. As a pedagogy. A way of explaining this medication use process with with the public, with other health professionals, with students. To have a way to make this richer, these these stories that people have about their medication taking experience. To make them richer. So this spring, I’ve been working with a course with two theater professors at the University of Minnesota where i work. They’re at the theater department and I’m in college of pharmacy. So the three of us got our heads together and had a course called Pharmakon: Performing Science.
And so the students who signed up for the class, had to, we– the function of the class was to produce a play at the end about medication taking experiences. And they had to bring their own experiences to the class. And then we had them read some old Greek tragedies, I presented some Pharmacy history to them, discussing how drugs developed, and how important the gods were way long ago about medicine, then science came in. So they produced, with their own medication experiences and all the history and sociology of medication taking, they produced a play that was for class exercise that was put on at the end of the class for a couple hours.
Just I mean so remarkable so many layers here that that we could talk about: the drama pedagogy. The fact that you’re again centering the patient. Asking people to share their own experiences. You and the other professors layering in your knowledge as ways of thinking about those experiences. Getting students to interrogate those experiences. And then sharing that with an audience!
Who gets to think about, “oh! Wow what does this have to do with the way I think about medication? And pharmacy?”
“And Pharmacists?” And that you know you brought in, you know, religion and science. There’s so much richness here. And I think there’s you know if there is anything that I can link to for our listeners to have a chance to see some of this. It is okay if I do that?
Because I got to watch it, I got to see it live
That’s right, yes
So let me let me finish with it with the question that I that I finish all of my interviews: what advice can you give to people whether pharmacists or patients, considering what we’ve talked about today, in terms of seeing the patient as an as an expert.
So the patient I’d like to you to be kind of assertive and say, “Yes I want to speak to the pharmacist about my medicine.” and also have a question or two in the back of your mind if the pharmacist stumbles a little bit. “Is there something I should be asking that I’m not asking?” You know that’s always a great question. “Is there something I’m missing?” You as the patient helping that conversation go if the pharmacist is a little bit shy. So from the pharmacist perspective, I would like them to come out from behind the glass and be more assertive, and not even wait for someone to say “yes I’d like to talk to you’ but say ‘well what can I help you with about this drug?” “I would like to hear from you about your experience with it, or what you walked with the physician about with it.” So that’s kind of the way I approach this from the student’s perspective and that’s how I would like pharmacist and patients to plan that visit.
Thank you. Thank you for this, Doctor Paul Ranelli. Thank you for coming back to the show, thank you for sharing this with us today.
Oh you’re welcome, my pleasure.
Thank you again to Dr. Paul Ranelli for returning to the show. Be sure to check out the student-produced video on Pharmakon, link in the show notes. Support this series and your own learning with our digital educational products. Available right now on HealthCommunicationPartners.com.
This has been 10 Minutes to Better Patient Communication from Health Communication Partners. Audio engineering and music by Joe Liebel. I’m Dr. Anne Marie Liebel, thanks for listening.