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Interview with Peter, Qualified Pharmacist in Nairobi

Peter, 28 works in a pharmacy attached to a small community wellness clinic in Nairobi which is privately owned by a GP. He's got 5 years experience. He works closely with the doctors and clinicians on site, dispensing around 6 prescriptions per day from them, as well as serving 30 walk in customers. Some of them have real prescriptions, some of them want him to diagnose and prescribe him and some of which have texts/recommendations from a friend which they want to buy OTC.

Here's some key learnings

He will dispense or refer based on his own judgement

“I can do some diagnosis on a certain level for things like coughs, sneezes, wounds. I know whether a cough needs an antibiotic or if it's just due to a weather change. If it's something I don't know I’ll refer to a doctor."
"People often ask for amoxil. Around 5/20 customers will be asking for antibiotics, it happens so many times a day. People don't want to present to the doctor”

Patients are not invited to understand prescriptions, just directions

"The prescription is not for the patient, it is about the patient. It is only meant to be read by me, the pharmacist. I then create the label for them, with dosages (written on the bag of pills). See here, this is written in latin (Rx), it's not layman's language"

This is interesting - that in pharmacists and doctor's minds - the prescription itself is not meant to be read and understood by patients. It's no wonder really that people are self medicating and misusing antibiotics if they are kept in the dark about their diagnosis. This could be a really powerful element of Smart Prescription, giving patients guidance around their own health that's actually designed for them to read and act on.

Cooperation between doctors and pharmacies

"It's my job to review the prescription and notice any mistakes in dosage. The doctor may see 45 patients a day and be very tired. I will correct it. We work together, it's a synergy"

It's interesting that part of the pharmacists' professional pride is the ability (or even expectation) to catch and correct doctor's mistakes - in this way they're actually not purely dispensers. HMW design the smart prescription concept so that the pharmacy still gets to feel ownership of this moment - can we have them validate it before they dispense? giving patients even more sense that their care is accurate, and giving the doctor daily feedback on how many of their prescriptions needed editing?

About Smart Prescription

“It will make the client feel more high profile. The reminder is really good for compliance”
If everybody was part of this system it would give me very good links. It would mean I can recommend a dermatologist or a gynaecologist.

Interesting that Peter thought that the new service would be a way to network with other healthcare providers and potentially create new business too, by being a preferred dispenser.

About Doc in Booth

"This would be really good for when the doctors have gone home. Then i can still be dispensing prescriptions."
"It would not work at the counter because of privacy issues. It would need to be in the back. It would be great to have as an extra service"

Interesting that even though there was a prescribing doctor or clinician on site most of the time, he would still use the concept as a way to get competitive advantage and keep sales high.