Reutzel T J
Department of Pharmacy Practice, Chicago College of Pharmacy, Midwestern University, IL 60515.
J Clin Pharm Ther. 1994 Oct;19(5):301-12. doi: 10.1111/j.1365-2710.1994.tb00817.x.
The patient counselling and prospective drug utilization review mandates of the Omnibus Budget Reconciliation Act of 1990 raise the question of how compatible the retail pharmacy setting in the United States is with a patient-based model of pharmacy practice. In order to investigate this question, a self-administered questionnaire was distributed by pharmacy students to a convenience sample of pharmacists with at least one year's experience in the community setting. The questionnaire asks respondents to recall two incidents: one that caused them to gain or retain a patient or that was for some reason a source of professional satisfaction, and one that may have caused the loss of a patient or that they would handle differently if faced with the situation or problem again. The respondents practice in pharmacies in and around a large midwestern city. Data analysis showed that respondents tend to identify patient-based activities when recalling appropriate behaviours and traditional or customer-based activities when recalling inappropriate behaviours or mistakes. Patient-based activities can sometimes result in the loss of business, but they can also result in patronage gains, especially when performed in conjunction with good customer service. In summary, these pharmacists do implement a patient-based model in some situations. The patient-based and customer-based models can be complementary in that the patient can benefit from the services of an expert health professional while simultaneously being treated with the respect and 'customer knows best' attitudes indicative of the retail setting.
1990年《综合预算协调法案》中有关患者咨询及前瞻性药物利用审查的规定，引发了一个问题：美国的零售药房环境与以患者为基础的药学实践模式究竟有多兼容。为了探究这个问题，药学专业学生向在社区环境中至少有一年工作经验的药剂师发放了一份自填式问卷。问卷要求受访者回忆两件事：一件是使他们赢得或留住一位患者的事，或者是因某种原因让他们获得职业满足感的事；另一件是可能导致失去一位患者的事，或者是如果再次面对这种情况或问题他们会采取不同处理方式的事。受访者在中西部一个大城市及其周边的药房工作。数据分析表明，受访者在回忆恰当行为时倾向于提及以患者为基础的活动，而在回忆不当行为或失误时则倾向于提及传统的或基于顾客的活动。以患者为基础的活动有时可能导致业务流失，但也可能带来顾客光顾的增加特别是在与优质的顾客服务相结合时。总之，这些药剂师在某些情况下确实实施了以患者为基础的模式。以患者为基础的模式和以顾客为基础的模式可以相互补充，因为患者既能从专业健康专家的服务中受益，同时又能在零售环境中享受到体现尊重和 “顾客至上” 态度的待遇。
