In times of increasingly tight budgets and in a time of greater accountability in healthcare, it is important that pharmacists show their value. Sometimes, however, it is important to step back and see value creation for services from a broader and more fundamental perspective than the individual, day-to-day tasks in the pharmacy.
Pharmacists create value for themselves and other stakeholders by improving patient compliance, triaging patients to see another supplier, or saving them money on their prescription or OTC drug purchases. Pharmacists often create value simply by showing they care, by helping solve problems or by brightening the days of others, be it a colleague, patient, colleague, prescriber or even a friend or family member. is. Pharmacists reading the literature will come across many studies demonstrating the effectiveness of a particular service.
Eriksson and Nordgren examined how the concept of value creation in service delivery has evolved over time.1 The authors explain that health care management used to take its cues out of production; that is, the so-called “value chain” was conceptualized with predefined and sequential steps. This resulted in the treatment of diseases in a linear manner through standardized processes. It relegated patients to the status of passive receivers of value at the end of the chain rather than recognizing patients’ active contributions and has often led to an overarching goal of treating everyone the same.1
A recent shift concerns the focus on value creation by putting the individual patient at the center of service implementation. The authors frame value creation in the context of social constructionism, which includes both the actor (ie the patient or user) and the structure (ie the provider or health care system) simultaneously rather than one or the other. This leads to a concept called ‘service logic’, which means that health care logic focuses on health, not on the actor receiving it or the structure providing it.1
However, Eriksson and Nordgren suggest that the pendulum has swung too far recently; that focus on only the patient may be unwise or unproductive. From the individualized perspective, group and public perspectives emerge. The group level focuses on creating value for patients’ families and for local communities, which makes sense as the health of the individual patient has an impact on their work, their families and their friends. This is taken into account when effectively starting and continuing a service.1 The public level goes a step further and characterizes concepts within the broader context of health equity and population contributions. This perspective understands, for example, that certain vulnerable populations may be more susceptible to disease due to problems with access, education and health literacy.1
With a more individual perspective, we focus on aspects of service such as empathy, caring, courtesy and kindness. These are not unimportant. However, the social constructivist view suggests that these are not sufficient to guarantee the success of a service, or that value has been created. It’s no different from a restaurant that has good food or friendly servers, yet closes its doors. The restaurant is likely to create more value by creating a brand in the community, addressing shortcomings in the local food culture, and creating a culture that invites large groups of people to participate in the service interaction.
The most successful pharmacy leaders and managers understand the interconnectedness of different individuals and stakeholders in the drug use process. They realize that value is created through interactions with individual patients and with various other groups. Effective leaders and managers implement services on an as-needed basis and will deploy entire populations and customers representing a large number of patients to create value that exceeds individual levels of satisfaction with components of a service such as staff friendliness and convenient opening hours.
Additional information about Create and manage value can be found in Pharmacy Management: Essentials for All Practice Settings, 5e.
About the author
Shane P. Desselle, RPh, PhD, FAPhA, is a professor of social and behavioral pharmacy at Touro University California College of Pharmacy.
Eriksson EM, Nordgren L. From one size to over-individualized? Value creation of service logic. J Health Organization Management. 2018;32(4):572-586.