Relationships play a major role in our daily lives, whether it is between family, friends, your boss or your favorite (or least favorite) coworker. In the health care world, the relationship between patient and caregiver is essential in ensuring that each patient receives the best care possible. Recently, a story about a patient being denied her medication from a pharmacist has grabbed national headlines and in turn, highlighted the importance of creating a productive patient-caregiver relationship. A woman who just experienced a miscarriage drops her prescription to the local pharmacy to get it filled. She returns the next morning to discover that not only was the medication not filled, but that the pharmacist on duty decided that filling the medication, which can sometimes be used for abortion, conflicted with his personal beliefs and decided not to fill the medication. He then transfers her medication to another pharmacy, which in turn fills the medication for her. Was the pharmacist right in his beliefs? Should he be fired? Should pharmacists just shut up and fill whatever medication was prescribed? When it comes to healthcare, there is no black and white; no eternally right answers, no sure fire right way to do anything. No decision is ever clear-cut and in essence we use our discretion and judgment on a daily basis, whether patients know it or not. The problem is when that discretion comes under fire, it then has to be defended. Trust is the backbone of health care, patients must trust caregivers and vice versa, but in this unfortunate situation, that trust was shattered. As an ethical professional, establishing trust and effective communication is not only a priority, it’s a necessity. Now let’s start with the facts. Contrary to popular belief, pharmacists are not robots, and companies technically cannot force them to fill or dispense medications. In a sense, healthcare professionals are independent contractors; they may work for an entity but because they are individually licensed, they are free to use their discretion. Many times, pharmacists use this discretion to question medications from a suspicious doctor, question whether a drug interaction is safe, or question whether a prescription is legitimate. However, with this discretion, comes great responsibility. It is not the role of the healthcare professional, to play judge and juror. It is merely our role to be reasonable and to take care of patients. Transparency, compassion, and gaining patient’s trust is essential and unfortunately none of these goals were accomplished in this incident. Compassion for others and empathy for those who are vulnerable must always be considered. In this situation, instead of speaking to the young woman in front of a busy line of patients, the pharmacist perhaps could’ve escorted her to a private consultation area, showed empathy and concern, been transparent about his beliefs and made a conscious effort to ensure she was taken care of. It’s possible that the patient would not have felt belittled or embarrassed and would have been more open to an alternative solution. After suffering a miscarriage, clearly the young woman was in a vulnerable state, so making her recall her painful experience in front of strangers only escalated the situation. My mother, who was a kindergarten teacher for 30 years, always used to tell me, “it’s not what you say, it’s how you say it.” In my experience, I’ve dealt with many patients who were going through various situations and I learned that effective communication solves many problems. Unfortunately, basic communication is a lost art. Because of the lack of the communication, a minor situation was escalated into a national story. In the future, hopefully healthcare professionals continue to foster solid relationships with patients built on trust, mutual respect and compassion.
By Dr. Charles Johnson Pharm. D