Pharmacists know too well the ongoing challenge of bridging the gap between being a clinician and a healthcare provider in a retail setting, where patients see themselves as consumers and have high expectations – not to mention high-levels of skepticism about service and advice.
by Rose Patodia
To gain insight into this new type of consumer, pharmacist Rosemarie Patodia spoke to retail and pharmacy business expert Jim Danahy to find out how pharmacists can build trust and establish valuable long-term relationships with Boomers, a powerful demographic with unchartered influence and wealth.
The Boomer generation is a hugely important group of people – the largest single demographic market, in history. As customers, what makes them unique?
Their gravitational force in economic terms is especially significant. And Canada has one of the biggest Baby Boomer generations in the world as a percent of total population.
With Boomers, it’s about their life as a whole. They were the first, well-documented, self-possessed, inwardly focused, generation. So they are keenly interested in themselves, particularly their health.
What’s the difference in their attitude compared with other demographics?
They weren’t born with technology, they’re the generation that created it. They may not be as good at it as digital natives, but make no mistake, Boomers are incorporating a ton of technology into their daily lives.
They have wealth. They have influence … in their personal lives and their professional lives. (It’s important to) recognize that Boomers are arriving in your pharmacy with a whole lot more going on than hypertension. And you better understand what the treatment aimed at hypertension could do to impair their real-life goals.
Because woe to the health professional who thinks that this person is going to dutifully carry out your instructions if it is going to interfere with their plans. That’s something to take into consideration. Goal alignment is the key to adherence with these patients.
“You will never own the loyalty of a boomer. You will earn it.”
How then do you teach pharmacists to cultivate and navigate their relationship with a Boomer customer?
In our training, we introduce pharmacists to the ‘patient walk.’ The facilitator will get a member of the group to stand up and they walk across the room together, holding a three-foot rope, to simulate typical pharmacist-patient encounters. The idea is that it is the pharmacist’s duty to keep the rope slack with the customer. You maintain a strong connection without dropping it or making it too restrictive or tight. We constantly ask ourselves, ‘Is the rope slack?’
If the patient kicks up the pace and jumps into homeopathics or traditional Chinese medicine, for instance, what pharmacists usually have a tendency to do is drop the rope. This is the is the challenge of patient-centred care. We wouldn’t judge or drop patients who struggle with smoking cessation or weight loss programs: We don’t drop the rope; we stick them and help them, especially through setbacks.
Boomers look at alternative therapies more often than older generations. They’re going to drop their pharmacy if pharmacists say they aren’t going to work with that. The thing about this demographic is there are a lot of them, so it stands to reason that they represent a significant chunk of your complimentary medicines, or at least non-traditional. It’s important to understand that Boomers often walk in into a pharmacy with specific questions or having already made choices. And our role is to guide and support their health choices.
You have talked about the importance of “moments of truth” and the challenges of maintaining the connection between customers and pharmacists. Can you expand on that?
Those moments of truth are what differentiate pharmacy from other healthcare professionals. Like it or not, community pharmacy is a blend of healthcare and retail. Canadians can choose from more than 10,000 locations to access pharmacy care and we need to be aware of that.
A Boomer walking into the pharmacy, with a pre-disposition toward probiotics or traditional Chinese medicine, is not going to relinquish those views just because somebody with letters after their name says she or he doesn’t offer that care. Often, this is when the rope is dropped or it gets hot and you have strain in the relationship. Then, it runs the risk of becoming a commodity or transactional relationship only. But when you follow them and build on this moment, you are working to keep that rope slack.
It’s really easy, even within earshot of a customer to ask, ‘Did I drop the rope? Can I keep the rope slack?’
If they get the notion that we’re there to follow their life and help extend it, they will accept us and want to work with us as a member of their team. That’s a win.
When you’re dealing with chronic illness, for instance, especially when people have lived with it for a long time, there are drug therapy problems and issues related to effective regimen.
Our team anecdotally speculates that 50 to 60 percent of patients’ drug therapy problems aren’t resolved because they haven’t been in a quality, well documented care plan relationship. There’s an opportunity for us to play a role in resolving those issues, but the relationship has to be there first.
Why should pharmacists put the effort into Boomers?
They need our help and they’re worth it. Most Boomers are judging us and we don’t get a lot of time to win their trust. They will toggle back and forth between, ‘Is it gonna to be a one time purchase?’ or ‘Is this someone who is going to be a trusted part of my healthcare team?’ If so, the relationship will deepen.
The sharing is significant and that’s where the opportunity is. Our evidence on this is seven years of significant anecdotal data, but when you win the trust of a Boomer, that’s when you start to see important revelations. You will never own the loyalty of a Boomer. You will earn it.
Can you give an example?
The documented care plan is the key to the relationship, so that each time the patient comes in, or visits, or we’re on the phone together, we’re picking up where we left off, even if it was with a different pharmacist. They have a relationship, perhaps with a preferred pharmacist, but also with the pharmacy itself.
We must be loyal to them. But I’m not sure we should expect loyalty back from them. What we can do is earn trust. And that’s like money in the bank. You can write cheques on it, too (every now and then).
We explicitly ask, ‘What could I do to be better next time for you?’ – even if it’s a small thing. For a Boomer, it personalizes.
What other things can you do to keep the conversation going?
You can certainly talk about technology. Start with apps and wearables aren’t far behind. Boomers are using step tracking apps on their smart phones, plus Fitbits, various smart watches and smart sports wear that can record everything from steps, to heart rate, blood pressure and sleep patterns, but most healthcare professionals are not asking them anything about that. Talking about how and why they use their trackers is a wonderful doorway into discussions about their health goals and important lifestyle motivations.
As a healthcare provider, you can be a source of interpretation and support on these things – especially if you’re wearing one yourself. You’re immediately imbued with the expertise associated with what is important to them.
Quite often we’ll suggest to Boomers that their parents may benefit from wearables. Mom could be a thousand miles away, but she can track and share basic health indicators without being intrusive.
Wearables provide a connection, continuity and hard, useful, clinical data without the need for installing any software at the pharmacy. We can just add the information to the patient notes from whatever system they use.
That’s where proactive, health promotion components starts to show Boomers that you are interested in more than medications and are part of their health team. When we do those things, and document them in a care plan, we convert transactions into sustained, valuable relationships.
It dovetails unbelievably well into pharmacies doing the appointment-based model. Wearables make it really easy to start the conversation for pharmacists who are afraid they’ll have nothing to talk about.
How do you inspire your pharmacy team to meet the needs of Boomers?
Boomers are among your most discerning and demanding patients. The best way to ‘wow’ them is to make better care part of the daily routine.
The pharmacies we work with set aside five minutes each day to reset for patient-centred care: every pharmacy can find five minutes. They run a tightly scripted five-minute staff meeting every day without fail.
In addition to never, ever going longer than five minutes, they review a 90-second drug therapy problem from one of the previous day’s patients. The 90-second DTPs roll-up into 250 time-efficient ‘mini-rounds’ improving the entire staff’s understanding of the most valuable service any pharmacy can provide.
The leader of the meeting asks the full staff three simple questions every day. One is, ‘What worked yesterday?’ It recognizes good performance and reinforces what everyone should keep doing.
The second is, ‘What would unbelievably fantastic have looked or sounded like yesterday?’ The question resets the goal everyone is shooting for each day.
And the third question acts to align the whole team 250 times a year: ‘What one small thing will we do today that will move us closer to fantastic?’ It’s recentres everyone on the patient every day. It’s magical if you do it daily and follow the steps.
Jim Danahy is an expert in retail and pharmacy productivity. He is CEO of AdhereRx Inc., which devises integrated systems to improve patient outcomes and profit acceleration for community pharmacies. AdhereRx is also co-owner of Howe Sound Pharmacy in Gibsons, B.C., a renowned clinical pharmacy, research and training centre, and demonstration site for the AdhereRx System. Danahy is a third generation retailer and the founding Director of The Centre for Retail Leadership at York University’s Schulich Executive Education Centre. He is a member of advisory committees for the Retail Council of Canada and the international licensing trade organization LIMA.