Applying Patient Counseling to the Practice Setting (Scenarios)

Author(s):  
Harvey M. Rappaport ◽  
Kelly S. Straker ◽  
Tracy S. Hunter ◽  
Joseph F. Roy
1993 ◽  
Vol 27 (10) ◽  
pp. 1173-1179 ◽  
Author(s):  
Dennis W. Raisch

OBJECTIVE: To determine whether patient counseling activities in community pharmacies are related to payment method and practice setting. DESIGN: Randomly selected pharmacists voluntarily performed self-data collection (39 percent participation rate) of counseling activities for 40 hours. Observational data were also collected by trained observers. SETTING: Community pharmacies. RESULTS: Forty-seven pharmacists in national chain pharmacies and 26 in independent pharmacies collected data on 3766 counseling events. Patient counseling rates, defined as percentage of patients counseled per prescription per pharmacist, were significantly higher (p<0.05) for self-pay (median 12.9 percent) and Medicaid (median 13.0 percent) than for capitation patients (median 7.9 percent). Rates were somewhat higher (p=0.06) for chain (median 17.7 percent) than for independent pharmacists (10.7 percent). Although there was no difference in terms of pharmacist-initiated counseling, chain pharmacists had higher rates of patient-initiated counseling per prescription (median 4.3 percent) than independent pharmacists (median 2.7 percent) (p<0.01). Counseling information was related to payment method and practice setting. A significantly higher percentage (p<0.01) of counseling events for capitation patients pertained to chronic therapies (33.6 percent) compared with counseling events involving patients using other payment methods (21.8–24.8 percent). A strong correlation between observational data and self-reported data was found (Pearson r=0.696, p<0.001). CONCLUSIONS: The finding that pharmacists counsel capitation patients less frequently may be attributable to financial incentives or to pharmacists' perception that these patients do not need to be counseled. Independent pharmacists' higher number of capitation patients and increased workloads may have affected their counseling activities. These findings have implications for pharmacy service reimbursement programs, practice conditions, and continuing education programs.


Author(s):  
Harvey M. Rappaport ◽  
Kelly S. Straker ◽  
Tracy S. Hunter ◽  
Joseph F. Roy

2010 ◽  
Vol 6 (1) ◽  
pp. 24-32 ◽  
Author(s):  
Sridhar Krishnamurti

This article illustrates the potential of placing audiology services in a family physician’s practice setting to increase referrals of geriatric and pediatric patients to audiologists. The primary focus of family practice physicians is the diagnosis/intervention of critical systemic disorders (e.g., cardiovascular disease, diabetes, cancer). Hence concurrent hearing/balance disorders are likely to be overshadowed in such patients. If audiologists get referrals from these physicians and have direct access to diagnose and manage concurrent hearing/balance problems in these patients, successful audiology practice patterns will emerge, and there will be increased visibility and profitability of audiological services. As a direct consequence, audiological services will move into the mainstream of healthcare delivery, and the profession of audiology will move further towards its goals of early detection and intervention for hearing and balance problems in geriatric and pediatric populations.


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