Discourse Community Analysis: Pharmacy The profession of pharmacy is an ancient and honorable practice dawned from the beginnings of civilizations for the betterment of mankind. In ancient times, the pharmacists, or “medicine man,” provided insight into the betterment of health, and thus were deemed as valued members of the community. They held positions of power and had influence in major decisions for their respective townships. The evolution of medicine has come a long way, from humble beginnings of establishing which plants were to be used for medicinal purposes to genetically tailored medication. Pharmacists, more specifically community pharmacists, are the health professionals that are most accessible to the general public. Nowadays, it seems like there is a pharmacy at every corner or block in the city, and at least one in every town.
They are the only healthcare professionals that are accessible without appointment, while providing a variety of services such as medication therapy management, pharmacotherapy, and prevention services. Along with the management of prescription medication, pharmacists can advise patients on exercise, diet, and over-the-counter medications, such as vitamins and supplements. The pharmacists’ core values are created with the patient’s best interests in mind, and are exemplified through how accessible the pharmacist is. Because of advancements in medicine and technology, the way pharmacists communicate with patients and other healthcare professionals has changed dramatically, adapting to new laws and regulations which may alter the role pharmacists have with patients and the healthcare team.
The prescribing and use of prescription medications have skyrocketed over the past 20 years. “The total number of prescriptions filled by all Americans has increased by 85% over two decades, while the total U.S. population has increased by only 21%.”1 More than half of Americans regularly take a prescription medication, as well as over-the-counter drugs such as vitamins and other dietary supplements. Now more than ever, pharmacists in all practice settings are needed to help regulate and combat this overconsumption of prescription medications.
Inadequate levels of health literacy, the degree to which individuals have the capacity to understand basic health information, impedes the public’s ability to make healthy decisions. Pharmacy, in its modern form, is the health profession that bridges chemical science and health science in order to ensure the safe and effective use of pharmaceutical drugs through clear communication modes. It is the pharmacist’s duty to ensure the patient completely understands the medication, as well as how to take it.
Because of this surplus of prescription medications, on top of how accessible the pharmacists have become, pharmacists were forced to adopt more efficient means of communications. Luckily, this influx of new patients and prescriptions came around the same time as major technological advancements within the healthcare industry. New pharmacy software, email, and online prescription services revolutionized how pharmacists communicate: between each other, between other healthcare professionals, between patients and their insurance providers. Joan Kim, a licensed pharmacist for over twenty years, has witnessed, first-hand, the evolution of communication within the pharmacy.
Prior to this new technology, “there was no real-time billing, everything was dial-tone, everything was slow, everything was manual…there was nothing but phone lines and fax. That was it. Technology allows for a “paper trail,” there is no discrepancy between the pharmacist and doctor.”2 Online means of communication makes the lives of all members of the healthcare team easier. Implementing technology within the pharmacy can not only help pharmacists deliver better care to their patients, it can also drive improvements in their clinical, operational, financial, and regulatory compliance performance.
Modern modes of communication are not perfect, as there are some drawbacks when implementing these modern forms of communication within the pharmacy. For pharmacists that have routinely been using pen and paper to write down patient information, adopting a new communication is a feat in itself. There is a dramatic learning curve, especially for older workers and patients, who may be reluctant to change their current processes. For the staff, workflow is disrupted, which results in temporary losses in productivity. This loss of productivity may potentially lead to mistakes, which can lead to losses in revenue. Another possible disadvantage of technological communication is that it may impede the ability to build personal relationships between the patient and healthcare provider. At times, the healthcare professional may spend time inputting patient information into the system, meaning there is less time to interact with the patient. While this may be true, the benefits of information technology certainly outweigh the costs.
The use of information technology improves healthcare by increasing adherence to drug guidelines, reducing medical errors, and monitoring patient data over a longer period of time effectively, which may not be feasible with the traditional pen and paper way. Pharmacists are willing to take on this challenge of adopting this new system, regardless of the costs, as the patient’s well-being is at the forefront of the pharmacist’s mind. Within the healthcare realm, there is an incredulous amount of technical terminology and jargon that pharmacists, as well as physicians and nurses, utilize in order to streamline communication and understand patient information better and is not merely background noise. Standardized communication between professionals helps healthcare professionals document information easily, as practitioners deal with many patients everyday. Abbreviations such as ‘QH’ and ‘BID,’ which stands for ‘take every hour’ and ‘twice a day’ respectively, allows for doctors to send prescription instructions to the pharmacy quickly. This terminology, while difficult to understand at first, can accurately describe the condition of the patient and what treatments are needed.
The most important purpose of using this medical terminology is to avoid medical errors. Not properly communicating or documenting patient information records may lead to patient risks. An important aspect of providing the best care to patients is to confer with fellow pharmacists on how to be the best healthcare provider possible. In order to gain a further understanding of these new forms of communication, pharmacists can turn to web communities and online forums as a way to communicate and seek advice between other pharmacists and/or patients. An online forum is a discussion site where people can share thoughts and advice about a specific topic in the form of posted messages.
“CafePharma” is but one example of the many online forums specifically dedicated to all things pharmacy related, directed towards future, current, and former pharmacists to share valuable, inside information about the profession of pharmacy, job openings, and personal stories. The website is organized in a simplistic fashion, which makes it easy to navigate for inexperienced forum users. The homepage does have a drop down which helps the user directly go to what he or she is looking for. There is also a Google search engine bar at the top of the site to streamline navigation. Because the site requires no credentials to post, anyone can participate in the forums, which includes patients and prospective pharmacy students. This public access sacrifices credibility for accessibility.
However, while these forums are a great resource for quick information, it does not compare to communicating with patients and other professionals in person as hand gestures and facial expressions are lost within the typed messages. Conferences, such as the American Pharmacist Association Conference, gathers pharmacists all around the country to share their experiences and thoughts on a more personal level, equipping members for their role as the medication expert in team-based, patient-centered care. The goal of the pharmacist is to become the best healthcare provider possible, which in turn will help communicate information and directions clearly and efficiently with the patient, as the slightest miscommunication could lead to dire consequences. Because the health care realm emphasizes tangible results from certain medications and treatments, research is a key component to legitimizing the practice.
Online forums and web communities are not the only resources pharmacists use to research information. There is a plethora of scholarly articles scattered across the internet, and can be found on online databases and website, such as Google Scholars and the American Journal of Pharmaceutical Education. Such articles provide the reader with highly credible research information, requiring evidence that supports claims by referencing sources of information. For pharmacist that have been out of school for a long period of time, academic journals can help promote active reading and keep the reader up-to-date with new breakthroughs in healthcare.
Research studies create evidence for better practice, leading to more effective treatments and ultimately an overall better patient experience, upholding the values of the pharmacist. Patient-centered care is the cornerstone of the healthcare system. Pharmacists want to know if implementing a certain policy has an effect on the patient’s well being and community. The scholarly article “Retail Pharmacy Policy to End the Sale of Tobacco Products: What Is the Impact on Disparity in Neighborhood Density of Tobacco Outlets?” published in 2016, is but one of many scholarly journals accessible on the internet that informs the reader of contemporary policies and issues in a detailed, research-backed manner. The study investigated “whether the CVS Health policy to end the sale of tobacco products reduces the disparity in the density of tobacco retail across neighborhoods.”4 Researchers examined the association between neighborhood sociodemographic characteristics and tobacco retail density to see if the policy affected one sociodemographic group more than another.
The structure of the study, which is divided into eight distinct sections, follows closely with the structure of the scientific method: a question is posed, a hypothesis is formulated, an experiment is created and completed, and the data is analyzed and discussed. The abstract provides a brief summary of the article, often used to help the audience quickly grasp the paper’s purpose. Following the abstract is the introduction, which gives a more in-depth background information about the specific topic of study. The methods of research are initially stated in the abstract, and then more in depth later on in the article underneath the subheading “Materials and Methods.” There is also both a discussion and a conclusion section within the article. The discussion section sums up the data and applies it to real-world scenarios.
In this specific article, while the CVS policy to end the sale of all tobacco products is a commendable population health policy, the data highlights the distinction between population health policy and population health disparities policy. The discussion also highlights any weaknesses or errors that could have skewed the data. The conclusion, similarly to the discussion section, contains a brief explanation of the data, and includes a statement that either accepts or refutes the hypothesis given prior to the experiment. The study is conducted in great detail, along with an analysis of possible errors.
What makes the study professional, credible, and trustworthy to the audience is the comprehensive, professional language, as well as a list of fifty-nine references. The sheer amount of authors that collaborated with one another is what legitimizes and validates the research component of the study. Scholarly articles are excellent sources for pharmacists to research what has been studied on a topic pertaining to healthcare as well as to find bibliographies that point to other relevant sources of information.Communication is a key component to bettering the patient’s overall experience when in the pharmacy. The emergence of technological modes of communication, such as email, web-based forums, and communication softwares, has streamlined information to make for a more efficient and effective patient experience.
Pharmacists can look to these web-based forums, as well as scholarly journals and articles, to bolster and maintain their understanding of the healthcare realm as new policies and medications are being created everyday. Patient satisfaction and well-being is dependent on how effectively the pharmacist clearly communicates with the patient, staff, and other members of the healthcare team.Works CitedGusovsky, Dina. “Americans Still Lead the World in Something: Use of Highly Addictive Opioids.” CNBC, CNBC, 27 Apr. 2016, www.cnbc.com/2016/04/27/americans-consume-almost-all-of-the-global-opioid-supply.
html.Kim, Kevin J. “Joan Kim Interview.” 26 Jan. 2018.
“Quick Guide to Health Literacy.” Health Literacy – Fact Sheet: Health Literacy Basics, health.gov/communication/literacy/quickguide/factsbasic.htm.Tucker-Seeley, R. D.
, et al. “Retail Pharmacy Policy to End the Sale of Tobacco Products: What Is the Impact on Disparity in Neighborhood Density of Tobacco Outlets?” Cancer Epidemiology Biomarkers & Prevention, vol. 25, no. 9, 2016, pp. 1305–1310., doi:10.1158/1055-9965.epi-15-1234.