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36 MEN’S HEALTH FROM PAGE 35 “Walking into a community pharmacy where it’s quite busy, to talk about some private issues isn’t all that comfortable for everyone,” he said. “It did make a difference going into a room where we can shut or even lock the door if we need to, but the external clinic is certainly a much better environment. “The consult rooms we now have are completely shut off and private, so the physical privacy part of it isn’t too difficult. I do feel that the blokes coming into our specialised clinics, compared with the blokes coming to the pharmacy, find it’s a better feel. “When we were in the pharmacy, the physical privacy wasn’t an issue once we were in the consulting room. We learned it’s more the external part of the patient experience that needs to be treated sensitively: the actual process of getting into the pharmacy in the first place.” Pharmacies considering offering a men’s health service should be careful to brief all staff on the importance of subtlety when speaking with patients. It may seem obvious, but telling the pharmacists within earshot of Mr Smith and others that he has arrived for his 3pm incontinence appointment is likely to guarantee you never see Mr Smith again. “When the service was first introduced, it quickly became popular and the impact on the rest of the business was felt by everyone,” Mr Stewart said. “In the early days, the pharmacy was becoming quite disrupted because having a pharmacist rostered on in the pharmacy who was then spending most of their day in the consulting room doing men’s health consults was quite difficult. “In terms of the pharmacists that are now rostered on at the pharmacy, we have separated the pharmacy rostering from the men’s health pharmacists, so either I or my colleague, \[Mr Butt\], will be rostered to Men’s Health Downunder.” With regard to qualifications, Mr Stewart says no official training is required, although to reach the point where he could consult confidently required plenty of reading. “What we do to upskill and keep current is a whole lot of reading,” he said. “We’ve also contacted urologists and specialists in the area, who have generously donated their time to talk with us about their specialty areas, teaching us more about what their patients are going through. “We go to the prostate cancer and urology conferences as much as possible, too. That would be the most formal type of training that we do. Anyone considering running men’s health as a professional service needs to be passionate about the topic, to be putting in all the time and kind of effort required to upskill.” Building a network Like any business, it’s important to have a steady flow of patients. Mr Stewart says the bulk of Men’s Health Downunder patients present through self-referral or referral from specialists, including GPs, urologists and sexual health clinics. “The majority of our patients are through referral. We do take self-referrals, and often patients do speak for themselves,” he said. “So, we might get a bloke from a local urologist, and we’ll help him along his journey of recovery from prostate surgery. Then he’ll go and have another follow-up with his urologist and tell them how our service has helped him, which typically will bring about more referrals in its own right. “That patient might also go and tell a couple of his mates who’ve been through a similar thing, and that might come back as another self-referral. “So really, in terms of promotion, we do a little bit on social media, but mostly it’s geared around getting information out there, as opposed to promoting our services. “Your patients are certainly your best advocate, so, if you’re providing an excellent service or if you get to the point where you can provide that good service, then they’ll do all the promotion for you. “I think it’s all about interprofessional collaboration as well: getting to know the specialists or the people already doing work in this space in your area. If you don’t have the support from them, you’re not going to get the referrals and you’re not going to make any progress. “It’s taken seven years, during which time we’ve gone through various ideas and made slight modifications to the service ... to get to our current position. I know that there’s still a long way to go in terms of how our service can end up, but in this specialised area of men’s urological health, we really can’t rush into anything. “We need to demonstrate that we’ve got the knowledge and we’ve got the specialised service and that we’re valuable to the team of healthcare professionals that might be looking after a patient. We’re conscious we need to prove ourselves to both the patients and the referrers, so we can grow further. It’s hard to rush into this.” A prostatectomy often leaves the patient with a range of health issues, such as erectile dysfunction, incontinence and others, including mental health problems. “When you think about erectile dysfunction, as a pharmacist it can seem pretty simple at first glance,” Mr Stewart said. “You have drugs like Viagra and that kind of treatment drug, but the more you read and study and the more you look into it, you realise it’s certainly not simple. “Mental health is almost always brought up in the conversation with patients. For some blokes, it’s more significant than others. The statistics in terms of linking erectile dysfunction, prostate cancer and post-prostatectomy patients show the rate of mental health issues or illness is ridiculously high, so we always try and touch on it. If we’re concerned, we’ll certainly have a good conversation with patients and also refer on to mental health specialists if we need to.” Appropriate pricing As men’s health is in high demand and can be significantly time consuming, it’s important to set up the service in a commercially viable way from the start. Mr Stewart says pharmacists often feel they should provide a service free of charge, so initially Men’s Health Downunder was barely covering its costs. “Since then, our service has evolved into quite a highly valued service,” he said. “We take into account our years of experience and the level of expertise we have in the area and the time taken for each appointment, because that’s taking a pharmacist’s wage out of the pharmacy. “The consulting space is part of the cost, too, as is the extra work done behind the scenes following each appointment, such as contacting the referring doctor.” RETAIL PHARMACY ASSISTANTS • JUN 2020