Communication barriers with pharmacist

1. Barriers to
Communication

2. Overview
 Within the communication process, numerous
barriers exist that may disrupt or even eliminate
interpersonal interaction. Given the large
number of potential barriers that exist in
pharmacy practice settings, it is a wonder that
any communication takes place at all. Some
barriers are rather obvious, while others are
more subtle. The key is to identify when barriers
exist and then develop strategies that minimize
them.

3. Introduction
 As indicated before, the communication process
involves five essential elements: the sender, the
message, the receiver, feedback, and barriers.
Deficiencies in any of these essential elements
may cause a breakdown in communication. The
message must be clearly sent by the sender and
received accurately by the receiver. Feedback that
verifies understanding must be related in a clear,
unambiguous manner.

4.  The fifth element, barriers, is often
overlooked. Unfortunately, many things
seem to get in the way when you try to
communicate with someone else. Some
issues are rather obvious, while others are
not. Some are easily removed, while others
are more complex and require multiple
strategies to minimize their impact.

5. Minimizing communication barriers typically
requires a two-stage process:
 first, you must be aware that they exist.
 Second, you need to take appropriate action to
overcome them.
To become a more effective communicator, it
is essential that you realize when you are not
communicating effectively with another person
and then try to analyze why effective
communication is not taking place.

6. Environmental Barriers
 The environment in which communication takes
place is critical in pharmacy practice, and
distractions within the environment often interfere
with this process. One of the most barriers in
most community practice settings is the height of
the prescription counter separating patients from
pharmacy personnel.

7. These prescription counters exist for three
primary reasons:
 (1) they provide an opportunity for patients to
identify where the pharmacy is located;
 (2) they provide an opportunity for pharmacy
staff to look over the store area periodically; and
 (3) they provide a private area in which the staff
can work.

8.  Unfortunately, in some situations, patients cannot
see pharmacy personnel behind these strategically
placed partitions or counters. It is difficult for
patients to talk with individuals they cannot even
see. These counters may intimidate some patients
and inhibit communication because the
pharmacist is standing over them. This type of
environment may also give patients the
impression that the pharmacist does not want to
talk to them.

9.  Many pharmacies provide areas where the
counter is lower to facilitate pharmacist–patient
interaction. Ideally, you and the patient should
both be at eye level to enhance verbal and
nonverbal communication. This will also help
counteract patient perceptions that you are not
approachable.

11. Potential Environmental Barriers
The next time you enter a community pharmacy, check for
the following:
• Is the pharmacist visible?
• Is it easy to get the pharmacist’s attention?
• Does it appear that the pharmacist wants to talk to
patients?
• Is the prescription area conducive to private conversation?
• Do you have to speak to the pharmacist through a third
party?
• Is there a lot of background noise or are there other
distractions?

13. Personal Barriers
 Pharmacist-Related Personal Barriers
 Patient-Related Personal Barriers

14. Pharmacist-Related Personal Barriers
 • Low self-confidence
 • Shyness
 • Dysfunctional internal monologue
 • Lack of objectivity
 • Cultural differences
 • Discomfort in sensitive situations
 • Negative perceptions about the value of patient
interaction

15. Patient-Related Personal Barriers
 Patient perceptions of pharmacists are critical in
establishing communication rapport. If patients
perceive you as not being knowledgeable or
trustworthy, they will tend not to ask questions
or listen to the advice being offered.

16.  Another patient perception that hinders
communication is their belief that the health
care system is impersonal. Some patients sense
that health care providers are not concerned
about them as individuals but rather as cases or
disease states.

17.  Patient perceptions of their medical conditions
may also inhibit communication. Some may
believe that their condition is a relatively minor
one requiring no further discussion with you.
Thus, they may not seek out information from
you, or they may rebuff your attempts to
counsel them. In contrast, some patients may be
overly anxious about their condition and
therefore will avoid talking about it because they
feel so vulnerable.

18.  Some patients may feel that their physicians
would have told them everything about their
condition and their medication. Therefore, there
is no need to talk with you. In addition, many
patients think that all the important information
is stated on the prescription label.

19. Administrative Barriers
 Several factors dealing with the administrative aspects
of pharmacy practice serve as barriers to
communication. For example, most community
practitioners are not paid directly for educating or
communicating with patients. Counseling services are
not included as part of pharmacies’ business plans.
Therefore, many pharmacy managers perceive the task
of talking with patients as an expensive service and not
a high priority. Unfortunately, pharmacies often make
policies that discourage pharmacist– patient interaction.

20. Time Barriers
 The timing of the interaction is critical, since both
parties must be ready to communicate at a given time.
For example, a woman who just came from a
physician’s office after waiting for three hours with two
sick children may not be interested in talking with you
or anyone else. The most important thing on her mind
is to go home, get her kids to bed, and then relax. She is
probably not in the best frame of mind to sit down and
have a meaningful conversation about her children’s
medications.

21.  By the same token, you may not be in the best
frame of mind to interact with this mother. You
may be dealing with multiple issues: a physician
is waiting on the phone, a large number of
prescriptions need to be filled in the next hour,
and you need to go to the rest room. You may
feel that this is not a convenient time to talk to
the mother.

22.  In addition to the communication barriers discussed,
some communication habits can interfere with your ability
to listen well. Trying to do two things at once makes it
evident that patients do not have your full attention.
Planning ahead to what you will say next interferes with
actively trying to understand the meaning of patients’
communication. Jumping to conclusions before patients
have completed their messages can lead to only hearing
parts of messages—often pieces that fit into
preconceived ideas you have. Focusing only on content,
judging the person or the message as it is being conveyed,
faking interest, communicating in stereotyped ways—all
cause us to miss much of the meaning in the messages
people send us.