Barriers to communication

 Objectives
1. Identify environmental barriers in communication
2. Identify and acknowledge personal barriers in communication
3. Identify and correct administrative barriers in communication
4. Know how to overcome time barriers
 Barriers- within communication process, disrupt
interpersonal communications.

 Potential barriers in pharmacy setting – large;

obvious; not obvious

 Key is to identify then acknowledge, minimize,

overcome

 Frustrating to realize an ineffective communication.

 Ex. complaints about meds, no eye contact, busy over
the phone
 5 essential elements in communication:
Sender-message-receiver-feedback-barrier
❖ deficiencies in these elements will cause breakdown in communication

5th element often neglected, overlooked.

How to minimize communication barriers: 2 stage-process

1. Awareness of the barrier (identify)
2. Take appropriate action to overcome barrier

 To become an effective communicator, you must realize when you are not
communicating effectively.
 Then analyze why you are not communicating effectively.
Environmental Barriers
 subtle barriers and obvious barriers
Ex.
1. in community pharmacy are glass partitions-
intimidating, hinders availability of pharmacist or
inhibit other staff to talk to the patient,
unapproachable

2. crowded, noisy prescription areas would inhibit

communication, interferes with ability to
communicate, no privacy/other people may hear
your conversation,
How do we overcome these barriers?

1. Increase amount of privacy – room dividers

2. Private counseling areas or step on the other
end of the room
 Sensitive issues should be kept private and
confidential
 High levels of professional ethics must be
observed even within peers
 During internship…

 Is the Pharmacist visible?

 Is it easy to get the pharmacist’s attention?
 Does it appear that the pharmacist wants to talk to patients?
 Is the prescription area conducive to private conversation?
 Do you have to speak to the pharmacist through a third party?
 Is there a lot of background noise or other distraction?
Personal Barriers

Potential Pharmacist-Related personal barriers:

▪ Low self-confidence
▪ Shyness
▪ Dysfunctional internal monologue
▪ Lack of objectivity
▪ Cultural differences
▪ Discomfort in sensitive issues
▪ Negative perceptions about the value of patient
interaction
 If you believe that you do not have the ability to communicate well, then your
tendency is to avoid talking.

 People do not realize that communication skills can be learned and barriers
overcome. But it requires practice and positive reinforcement..

 Situation: what might happen if you get into a heated argument with a
patient who appears to be unreasonable and rude? Or somebody who would
take advantage of you.

 You would probably avoid talking to the person, so there is negative

experience
 But if faced with positive experiences, then results to
positive outlooks and therefore, more confidence in future
encounters.

 No one communicates perfectly, there are always

realization that we were not able to communicate
effectively.

 But it can be corrected and improved, constant practice

and reflection of your strength and weakness is the key
to improve.
a. Pharmacist-related personal barriers

1. shyness – you tend to avoid interpersonal

communications (px, physicians, other healthcare
providers)
factors: anxiety, dialects, culture
Overcome: automatic desensitization, cognitive modification
(read books,lits on counseling psychology, socialize,etc)

2. Internal conversation- not focused, prejudging,

escaping,preoccupied, thus inhibit ability to listen,
disinterested, rude.
3. Emotional objectivity – “carried-away” by patient’s emotional
stress.
Help through physical needs and issues but not emotional.
Separate roles for each but remain empathetic.

4. Cultural issues –must be recognized in the patients

 Eye contact
 Definitions of illness
 Perceptions of what to do
 Health-related habits or customs (eating habits)
 Health-seeking behavior (folkoric)
 Perception of health care providers-negative experiences
5. Not sure how to respond in a situation- don’t know how to start a
conversation well, sarcastic reactions, awkwardness ,choice of
words,etc.

6. Perception of value of patient communication- not a priority, thus

reluctant to approach, not eager to participate in counseling.

Overcome: personal introspection and analysis of motivation and

desire to communicate
b. Patient-Related Personal Barriers

 Patients’ perception of pharmacist and staff –

knowledgeable and trustworthy. Any negative
perceptions & experiences must be altered thru sincere
and effective counseling.

 Patients’ belief that healthcare system is impersonal -

only concerned with disease states or cases and not as
individuals. Pharmacist should assess the manner of
treatment or pharmacy setting atmosphere.

 Patients’ perception of their medical conditions- anxiety,

vulnerability. Added information about medication should
be given .
Administrative Barriers

 Salary issues
 Counseling fees issues –third party provider
 Staff issues
 Pharmacist’s function – dispensing and counseling
conflict
 Inaccessibility of pharmacist- message relay system
Time Barriers

 Choosing inappropriate time to initiate conversation – lead to

communication failure , both parties must be ready at any
given time.

Situation:
1. anxious mother waited for 3 hours in the clinic, may not be
interested to talk anymore
2. In pharmacy during lunch breaks, etc.
Overcome:
A written instruction,info, to reinforce short message during
counseling.
Always have sense of urgency, so find the best way to tactfully
approach the patient.
 Interpersonal communication is a fragile process.
 Failure to communicate may result to negative patient
outcomes.

 Barriers must be overcome and always aim for the best

patient outcomes.
 Case study.

 A pediatrician phone two different antibiotic prescription into a

pharmacy-one for Brian Bentley and one for Brandon Bentley.
Unfortunately, the pharmacy assistant did not recognize that two
different names were given and did not realize that they were twins. She
subsequently typed both prescriptions for Brian ( Brandon sounded like
Brian to her.) The father picked up both prescriptions and gave them
both to Brian. Unfortunately, the parents did not discover the error
until the next day. They immediately called the pharmacy to address the
issue. Both the assistant and pharmacist on duty apologized to the
Bentleys; fortunately, Brian was not injured by taking a few doses of
both antibiotics.