Pharmacists and Trust
As a pharmacist, you’ve worked hard to get where you are. In Canada, it takes an average of five years to become a pharmacist. And that doesn’t include any years spent studying for specializations!
Your years of education and experience have earned you a place of trust in society.
Healthcare is a regulated industry; a factor that also encourages a firm sense of trust.
And with that trust has come increased responsibilities over the past several years.
From the ability to administer vaccines to telemedicine clinics in pharmacies and more. As of December 2020, Ontario pharmacists can administer the flu vaccine to children as young as two years old.
Among the changes in responsibilities for pharmacists is the renewal, extension, and adaptation of existing prescriptions. Today, when a patient’s primary physician is unavailable, pharmacists across all provinces and some territories can now renew and extend existing prescriptions.
As well, community pharmacists’ scope of practice has expanded to include the management of minor and common ailments to improve access to the primary healthcare system. With this new responsibility, pharmacists have been authorized to assess and prescribe medications for common ailments like allergic rhinitis and uncomplicated cystitis.
Over the years, pharmacists’ scope of practice has continued to expand, showing the level of trust society puts in the profession. Yet earning the trust of individual patients can present a more difficult task.
Why Pharmacists Must Earn Patient Trust
Why is trust so important on an individual level?
People are so vulnerable when it comes to their health. Patients suffering from an injury or illness experience everything from anxiety to depression.
In a study by the Canadian Medical Association Journal about the mental health outcomes after a major trauma among the Ontario population, “trauma was associated with a 40% increase in the post-injury rate of mental health diagnoses (Evans, et. al., 2018)”.
This means that individuals who suffered a major trauma are at a higher risk of developing a mental illness or even leading to suicide in the years following their injury. Furthermore, those with pre-existing mental conditions are at an even higher risk.
And this is where the true power of the pharmacist lies; in combining years of specialized knowledge with trust.
Because cultivating trust on an individual level empowers patients.
It can give them the confidence they need to take charge of their health, and even heal from illness or injury. Studies on the caregiver-patient relationship, for instance, are a great example.
Establishing an emotional connection with a caregiver can benefit a patient’s recovery.
Having a pharmacist they trust can also make all the difference in how patients adhere to treatment. In a 2021 study published by the Canadian Pharmacist Journal, it was found that pharmacist-specific behaviour could enhance the trustworthiness of the healthcare provider from the patient’s perspective, which leads to trust-building and better patient outcomes.
Societal vs. Individual Trust: What’s the Difference?
On a societal level, high levels of government regulation encourage trust. Stringent rules on compliance speak to a system of checks and balances.
Yet individual patient trust is very different. It’s a personal bond steeped in the rapport that enables patients to share vulnerabilities.
How Trust Inspires Better Patient Outcomes
Fran was terrified to get her COVID vaccine. As a natural health enthusiast, she was wracked with anxiety every time the subject came up.
Months into the COVID crisis, she still hadn’t had her vaccine. For a while, she hid behind lockdown. Her kids, who were high-school-aged, studied from home and she and her husband worked remotely.
There was little risk of exposure, she reasoned.
Her husband, Brad, assured her they’d get vaccinated together when she was ready. But he was starting to get frustrated with her putting it off. He’d been trying to get them booked into a clinic for weeks and hadn’t been able to.
Then one day Brad was out at their local pharmacy buying Band-Aids when the pharmacist called him over.
The pharmacy had extra doses they had to use up, and so he got the Moderna shot right then and there.
Next, it was the kids; there was a clinic at the local hospital for kids 17 and under, and off they went. But months later, Fran still hadn’t had the shot, and she felt so ashamed.
“Everyone was asking,” she confided one day over coffee. “And I kept having to explain that I wasn’t an anti-vaxxer, but some people got mean about my not being vaccinated. Then there were my kids, worrying about when I was going to get it.”
Finally one day she made an appointment at the pharmacy, but as she arrived her anxiety peaked.
“I wouldn’t have done it without my pharmacist,” she tells me, smiling. “He was so reassuring, so confident that it was the right thing to do. He even made a joke at the last minute so I was laughing when I got the needle. And of course, I’d known him a long time, so that helped. I trust him.”
Mechanisms of Trust in the Human Brain
If patients trust you they are more likely to:
- adhere to the prescribed therapy.
- feel less anxiety and fear about their condition.
- seek you out for questions and advice when needed.
So how exactly does trust work? On a neuroscientific level, trust comes down to two specific structures in the brain. In 2015, researchers at the University of Athens, Georgia did MRIs on 82 participants to study trust in the brain.
Since people all have differing levels of trust, differences in brain structure may play a role. Researchers posited that trust may involve two specific areas of the brain, including:
Ventromedial prefrontal cortex (vmPFC)
This is where we process our emotions, store memories, and make decisions. It’s also the area responsible for our self-image and general social cognition.
The amygdala is the part of the brain responsible for attaching memories to specific emotions. The amygdala is also at the core of our neural system which processes fear and things that make us feel threatened.
The study found that individuals who found it easier to trust showed a higher volume of gray matter in the bilateral vmPFC and bilateral anterior insula. It was also found that greater volume in the amygdala was associated with how a person rates the trustworthiness of faces.
Given that these areas are linked to emotions, memory and social cognition, it’s clear that trust is both triggered and built by a variety of social cues in our environment.
What Makes Patients Trust a Pharmacist
Researchers studied 28 patients in Ontario to understand more about patients and trust in their pharmacists.
Inclusion criteria for the study included:
- At least six previous health or med-related conversations with their pharmacist in the past 12 months.
- The team then conducted interviews with these patients to get their impressions on trust. Questions related to both individual pharmacists and pharmacy as a whole.
During these interviews, five factors were identified that relate to trust. These included:
- Interpersonal chemistry.
This study also found an interesting lack of comment by patients on technical skills on the part of the pharmacist.
The conclusion: patient trust is a complicated subject, but in many ways, it comes down to interpersonal skills. Skills such as active listening, empathy, and the ability to build rapport.
Three Steps to Building Patient Trust
When it comes to patients, there are several ways to engage with patients in a way that will enhance their ability to trust you.
Have you ever interacted with someone who gave 100% attention to the conversation? It’s a wonderful feeling that leaves no doubt that they care about what it is you’re saying.
It’s an experience that makes you feel heard; it also makes you feel safe putting your trust in that person.
If you’ve run into this, you’ve likely encountered someone skilled at active listening.
Active listening involves connecting with the speaker by staying fully present in the conversation. It’s an active skill that allows for a deep understanding of the concepts put forth by the speaker.
Active listening is a great tool for building trust.
Active listening helps you understand where the speaker is coming from. It helps you to put yourself in the speaker’s shoes and see the world from their perspective.
It’s an important precursor to empathy, or the ability to share the feelings of your patient. But understanding is only the first step; it’s also important to convey empathy.
Conveying empathy builds trust by helping others feel safe revealing their fears. In the case of a health-related issue, it all comes back to that feeling of vulnerability when we’re not well.
By taking the time to convey empathy, you communicate understanding. And understanding, especially in a person’s time of need, leads to trust.
Communicate with Respect
The ability to communicate with respect is vital to building trust. In failing to do, you sacrifice your patient relationship on many levels.
But it’s not always easy.
We can all think of a time or situation where communicating with respect was difficult. It happens everywhere, not just in the pharmacy.
Perhaps it’s a stressful, busy day and you encounter a patient who is rude or who doesn’t respect you. For many of us, even with active listening and empathy, it can be tough to respond with respect when provoked or under pressure.
But communicating with respect over time can help build rapport and trust with even the most difficult patients.
The ability to build trust is one of the most important skills a pharmacist can develop. Of course, there are others: a sound knowledge of the chemical components of drugs. A keen eye for detail, and the ability to work under pressure.
Whether it’s a simple matter such as a vaccine, or a serious health issue, most patients are vulnerable. As a pharmacist, you have more power than you may know.
To dispense medication is to dispense hope; healing.
Yet to reach a level where you can inspire this hope, you must gain trust.
Interested in learning more about Active Listening? Download a copy of our Active Listening Resource today!