“How Dare You Question What I Use to Treat This Patient?”: Student Pharmacists’ Reflections on the Challenges of Communicating Recommendations to Physicians in Interdisciplinary Health Care Settings

Abstract

A growing number of pharmacists practice within interdisciplinary health care teams, leading pharmacy educators to place increased emphasis on the development of interprofessional collaboration skills. In the pharmacist-physician relationship, pharmacists' medication therapy recommendations (MTRs) are a recurrent and significant interprofessional activity, one that can be challenging for both seasoned and student pharmacists. Drawing on in-depth ethnographic interviews with pharmacy preceptors and advanced student pharmacists, we identify and describe an important distinction between pharmacist-initiated MTRs and physician-initiated MTRs as contexts for interprofessional collaboration. We describe and illustrate a range of social, professional, and communication challenges that students experience in each context, as well as some strategies they use to navigate these challenges. Using the theoretical framework of dialectic tensions, we argue that the pharmacist-physician relationship is characterized by a tension between assertiveness and deference. We also offer recommendations to pharmacy preceptors, who can use this article to enhance the experiential education of pharmacists.

Challenges and opportunities of clinical pharmacy services in Ethiopia: a qualitative study from healthcare practitioners’ perspective

“…Possible reasons may be unacceptance of pharmacists’ professional standing by other health practitioners, lack of leadership qualities, patients’ perceptions, and existence of communication gaps between pharmacists and doctors. 5 , 6 , 7 , 8 In particular, these challenges are highly noted in developing countries like Ethiopia. 8 , 9 Physicians’ expectations and perceptions towards the pharmacists’ roles and responsibilities are the main factor influencing the advancement of clinical pharmacy service in hospitals.…”

Balancing Collaborative and Independent Practice Roles in Clinical Pharmacy

“…Integration of pharmacists into primary care is not new, but our study suggests that that there is great variation in how integration looks in practice. 20 Our study and that of Patterson et al indicate that a limited understanding of CP roles by other providers may complicate the efforts of CPs to negotiate their somewhat unique dual-role situation.…”

“…Integration of pharmacists into primary care is not new, but our study suggests that that there is great variation in how integration looks in practice. 20 Our what is most unique about the situation CPs find themselves in is the extent and frequency of the role conflict. Nurse practitioners (NPs) are another type of provider who may face this situation, at least on occasion.…”

The rise of non-medical prescribing and medical dominance

“…28 These strategies have the effect of reinforcing the superior role of the doctor at an interactional level in the workplace. 25,[29][30][31] Yet this is not the only possible way of working. With the growth in team working and collaboration across professional groups, it is possible for other professionals such as pharmacists with the appropriate skills to lead the team and achieve the team's patient management aims.…”