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    Balancing good customer service with good patient health care

    The United States may be the world's last bastion of customer service. Inherent in our national psyche is the expectation that when we pull out our wallets to purchase something, whether a product or a service, we have a right to satisfaction. All retailers wishing to succeed in the United States must understand this. Competition follows, by means of any number of techniques.

    Competition makes marketers of us all

    This may be a strange introduction to an article related to the practice of pharmacy, but in many ways practitioners working in retail pharmacies are silently affected by this shift. Many of us who have practiced for many years will remember when a different environment prevailed. As we deal with longer hours, drive-thru windows, bargain-basement generics, and a shift from freestanding pharmacies to supermarket departments, many of us may shed a tear or two.

    Whether you regard it as evolutionary or not, the capitalist system of open markets, in which participants win or lose based on their own ingenuity mixed with a population that has been continually romanced by all who wish to sell to them, has brought about many of the conveniences that we, as consumers, enjoy.

    In medicine, this desire to please has created a difficult proposition for healthcare providers who are also often businessmen. In a pharmacy, at some point, the marketing department decided that the general public needed longer opening hours, drive-in windows, "bargain generic" lists, etc.

    Unfortunately, as with all great or not-so-great ideas, the competitive edge is felt only until your competitors catch up. As can be seen with the above three examples, one has only to drive down the street or look for a pharmacy at 8 p.m. to quickly realize that one has a lot of choices.

    Where does one draw the line?

    The point of this article is to stimulate some debate regarding the positioning of the line that divides good medicine from good customer service. With all rules there are exceptions, and with all decisions there are pros and cons. A good example of this is the loss of a high-volume customer who verbally lambastes the pharmacy staff or brings in questionable prescriptions from multiple physicians.

    Because the State Boards of Pharmacy ask you to use your judgment, your choice not to serve a particular patient may simply come down to a personal decision. Unfortunately, implementing policies that decrease significant prescription volume will also raise flags for those in corporate who look only at the bottom line.

    I have also met numerous physicians who have given up their private practices to do locum work or hospital work because they have become tired of aggressive patients demanding prescriptions rather than seeking medical opinion.

    Competition between providers of health care leads to ingenuity and means that those in a position of power who wish to provide a service to the public have to compete with others, and this, to a certain degree, keeps them in check.

    The problem is that the general public increasingly demands complete satisfaction from every encounter, and this is a subjective thing. To most, complete satisfaction means getting exactly what they want, and that is not feasible and could be downright dangerous.

    Health care is different

    It would seem prudent, therefore, to classify good customer service within health care as being distinct from other areas. It would be measured based on patient safety, law, and empathy rather than on other metrics such as speed and ease of use.

    In retail, store management would do well to leave the pharmacy to its own devices and refer any complaints to pharmacy management. Time and again I have seen a store manager trying to be the customer advocate against the pharmacist.

    Pharmacy management should be in charge of hiring, in collaboration with store management, and I would further recommend establishing boundaries at the onset. This would lead to a unified approach when dealing with unrealistic customers.

    Darius Randeria is vice president of staffing for AHS PharmStat Pharmacy Staffing. E-mail him at [email protected].

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