| Customers of health care have often been ignored when assessing the quality of the medical care that they receive. Historically, customers simply followed doctor's orders and did not participate in assessing the quality of the care that they received. As the focus of the health care system in general and pharmacy in particular evolves, both are making strides toward including the customers' perspective when assessing quality. However, current efforts to include the pharmacy customer in quality assessment seem to lack a theoretical underpinning. Therefore the purpose of this grounded theory research was to generate a substantive theory that explains customer expectations of community pharmacy services, as those expectations may be a foundation on which to measure service quality. A convenience sample of 27 community pharmacy customers was interviewed. In addition, observations of the pharmacist-customer interaction took place in four community pharmacies. Data were collected and analyzed using the grounded theory method. Findings show that pharmacy customers participate in a medication use system that they do not fully understand. This misunderstanding creates needs, the basic social problem, for those customers. Included are needs for information, needs for a problem solver, and needs for reassurance. This set of needs is addressed by the pharmacist acting on the customer's behalf in the medication use system. The pharmacist's acting, called interceding, is the basic social process that occurs in response to the customers' needs. However, two conditions, need identification and pharmacist expertise, must precede pharmacist interceding. Because interceding is a process, two phases occur: assessing and acting. Also, several conditions influence interceding. They include pharmacy environment, time, social structural variables, and personal characteristics. The consequence of pharmacist interceding is the formation of a relationship between pharmacist and customer. The proposed Model of Pharmacist Interceding illustrates the connection between customer needs, pharmacist interceding, and the pharmacist-customer relationship. Understanding the Model of Pharmacist Interceding provides pharmacists with new insight into the needs created by the medication use system for their customers. It shows pharmacists that customers expect their intercession in this system, and it demonstrates that a relationship is the consequence of pharmacist interceding. |
