Sense Makers

A week or so ago I wrote about how I was challenging myself not to be so critical as my default position. That if I go into something looking for problems I am going to find them, and as a result I might overlook some of the other offerings. I've since started reading/listening to two books that deal with this sort of stuff - Mistakes Were Made (But Not By Me), by Carol Tavris and Elliott Aronson, and Talking to Strangers, by Malcolm Gladwell. Now I know some more words and theories so I can sound clever when I talk about cognitive dissonance, cognitive bias and default positions.

I knew these terms before, and I thought I'd written about it before but it must have been one of those mental blurbs that I put aside to write in more detail later on. In any case, it is the sort of knowledge and awareness that is so useful in general life, but essential as a healthcare provider.

One of the aspects covered by the books relates to how bad most people are at detecting lies. That our default position is that people are telling the truth and not out to deceive us. The down side of this is that we might get scammed, your partner may have a secret family on the side, or an international spies may be able to hide in plain sight. But I want to talk about what I see as a potential upside, specifically in our role as Pharmacists.

I think medical care distorts this default position for many people. When people consult with doctors, it isn't a usual kind of social interaction. There might be a perceived power differential. A sense that the doctor is in charge and their time is valuable. A sense that the patient is too assertive and bullying in their behaviour. In terms of communication it's likely that there are all sorts of filters being applied by both parties and every situation is likely to be different. The patient might not offer up all the relevant information because they don't want to shift focus from what they think is important. The doctor might not ask certain questions because they don't think it applies. For whatever the reason may be, the doctor might not hear the patient's full story.

This is where I think we as Pharmacists have a great opportunity. This is where I believe we offer value routinely. Value that we sometimes don't recognise and definitely don't market.

We are much more likely to be able to engage people in more normal social interactions. That's the advantage of people assuming we're just there to talk about medicines, we can fly under the radar and they can be less guarded. By embracing the default position of assuming that the person is telling the truth rather than trying to find out the problem, we can encourage people share their stories with us and we can listen to them. Not the filtered, censored story. The long winded, divergent, sometimes a bit irrelevant kind. This is a position of privilege in healthcare. We shouldn't take it for granted, we should celebrate it. We can do that by making sense of the story.

By making sense of the story, for the patient and their care providers, we elevate our value above that of the volunteer that provides them with their tea and biscuits. They also hear lots of peoples stories, but they don't necessarily do anything with that information (although the good ones might). By combining the narrative that we're able to elicit with our domain knowledge of pharmacotherapeutics, and our clinical understanding of the situation we are able to translate that story into something of value for both patient and clinicians.

Our value proposition is not as the experts of medicines. It's not our active listening skills. They make up our skillset, but not our value to the overall healthcare team. Our value proposition is that we are the sense-makers.