Have you ever seen an informercial late at night? The announcer is so energetic. They work very hard to make you really want their product. Does this sound familiar?
It slices! It dices! You will wonder how you ever got along without it! What would you pay for this time-saving wonder? $99? $59? What if we told you you could have this live-changing tool for the low-low price of $29.98? But wait! What if we double the offer. That’s two for just $29.98! But there’s more. We will throw in the…
The problem the announcer is trying to overcome is one of resistance. Sure, the product looks great. It might even be unique, one-of-a-kind, and indispensable in most every way. It can be all of those things, but most will still not lift their phone to make the call. Change is hard. And the bigger the change, the more the problem of resistance comes into play.
Pharmacy is at a transformative crossroads. The profession is nearing the end of the reimbursement for product road, and the future will necessarily be different. Many believe that the direction the profession is heading will be a healthcare model emphasizing the importance of outcomes, with a true professional fee and shared savings funding the pharmacists efforts instead of reimbursement for the product. A pharmacy model based on patient outcomes is not unprecedented. Many recent studies have shown significant benefits of pharmacists working to ensure therapeutic outcomes in patients. This has the potential to be transformative. It is also the type of change that can be very difficult .
The resistance to transformative change in pharmacy comes from many different places:
- Pharmacists not comfortable with making clinical decisions either because the lack training or they have allowed themselves to grow rusty from too little practice.
- The payor, be it an insurance carrier or a self-insured corporation, is not familiar with the benefits of the possible transformation. They are unwilling to invest in any new model without knowing up front what their return on investment will be.
- Service vendors, those that provide support to the health care disciplines through software and technology, look at the new models of healthcare emerging and are unsure which models show the most promise.
- The patient also resists change. Many patients rarely see or speak with a pharmacist regularly. Their expectations of the profession are limited to receiving a small plastic vial filled with medication and adorned with a label containing instructions. Changes in the pharmacists activities that increase a patient’s interaction with a pharmacist are an unexpected change.
But transformative change also excites. Our pharmacies have adopted a transformative pharmacy model. It is a model we believe will eventually meld into the future of pharmacy. We have strived to overcome many of the aforementioned problems. We regularly entertain visitors in our practice. Our visitors have included an amazing spectrum of professionals including other independent and chain pharmacists, pharmacy owners, chain pharmacy managers, health-system pharmacists, local business owners, local, state and national elected representatives, insurance executives, members from academia, and service vendors of every type imaginable. After observing the model we use, everyone is excited. It is just like an informercial. Everyone has a favorable opinion and is interested in what is being done. The excitement is almost infectious. Pharmacists are especially prone to wanting to participate immediately. But in the end, few move to pick up the phone and make the call.
But like the late night infomercial, there will always be some that do decide to get up and make the call. The seeds of change are starting to sprout. The largest insurer in our state saw the potential for this model and invested some time and money to study the impact. The results were very, very positive. Today, they are working to create a new network of high performing pharmacies based on this transformative model. Getting a payor on board helped us get some traction elsewhere.
With a payor on board, the next step is getting more pharmacists and pharmacies to commit. We don’t need every pharmacist and every pharmacy owner to commit to change. We only need a few, and Iowa has many pharmacists and pharmacies that are progressive. Addressing patient resistance is perhaps the simplest to achieve. Open communication with the patient before implementing changes goes a long way toward patient acceptance.
As it turns out, the most difficult challenge has been getting the service vendors to buy into a new model. Some of these vendors believe that their current products are adequate for the new model. Others fail to understand the requirements of the new model. There are software and workflow solutions that have been created to support the pharmacist in this new model, but as of now, they not yet ready for commercialization. Getting these tools to the pharmacists who need them is proving a significant hurdle. Given the slow but steady acceleration of this transformative model, it is inevitable that this last hold-out will also start to move.
Change is hard. Transformative change is even harder. But not changing is ultimately the hardest, because failing to evolve dooms one to extinction. Make the call. Make every encounter count!
