Welcome to the October 2011 homepage dition of i2P-Information to Pharmacists.
Well, the month just finished did so with a bang as the Blackmore's/Pharmacy Guild proposed alliance hit the fan.
And what a mess!
To such an extent that many of the articles for this month touch on the qualities of leadership and the ethics of pharmacy promotions, how we are connected as pharmacists and how we all become tainted when one segment of pharmacy does something that goes wrong-and we all have to share the collective blame whether we like it or not.
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Volume 6 Number 1
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Regular weekly updates that supplement the regular monthly homepage edition of i2P.
Access and click on the title links that are illustrated.
A range of global and local news snippets and links that may be of interest to readers.
Pipeline Extra simply broadens the range of topics that can be concentrated in one delivery of i2P to your desktop.
I was reading up on the management experiences of two successful US companies that found they had to take some positive action to prevent a downwards slide.
Both stories are good analogies for current events in pharmacy - the first for the Blackmore's controversy and the second for mindless discount pharmacies.
The story for one company was that they agonised for over two months to decide to plan some layoffs of their employees, plus a further two weeks to implement them.
The downside was that it took two years for the company to recover from that decision.
When the CEO was asked why the company had done something that caused so much damage, the reply was “that it was expected by Wall Street and my CEO peers”.
The comparison to Blackmore's is that with vested interests jumping all over the PGA/Blackmore proposal, it damages a genuine opportunity (properly handled) for pharmacy and the issues surrounding responsibility for complementary medicines.
The controversy could delay, (even deter), pharmacists from becoming involved for at least two years.
The recent Royal New Zealand College of General Practitioners conference generated much debate and is relevant to the patient care provided by pharmacists.
Particularly provocative speakers were Professors Trish Greenhalgh (UK), James McCormack and Mike Allen (Canada) and Dee Mangin (NZ). To summarise, the concepts presented at the conference were:
Patient care Disease care Population care Data care
The Pharmacy 2011 Conference was clearly focussed on the challenges of operating community pharmacies and provided a broad range of practical solutions.
The theme for this year’s Pharmacy 2011 conference, the pharmacy management conference, was “take your business to new heights”.
Given the current industry landscape (and the fact the conference was held in the rugged Blue Mountains west of Sydney) it might well have been “avoid the cliffs and negotiate the ravines”.
Do Vice Chancellors simply wake up one morning and decide to introduce a course on psychic healing or ‘energy medicine’? Do students really want to invest a mountain of money and spend years studying, only to be labelled as ‘quacks’ when they graduate? So why, in the 21st century, are one third of our universities running pseudo-religious, anti-science courses and why are more of these in the pipeline?Comments: 1
Pharmacy patients and customers are a discerning group of people when it comes to deciding what they really want in service terms, from their local community pharmacy.
They want everything – and they want it immediately and at rock-bottom prices!
This is not recent news and in Australia, consumer expectations have been relentlessly increasing each year, and this experience is repeated in most western economies.
The latest survey confirming this consumer view has been provided by US market researchers J.D Power and Associates, that polled 12300 patients who had prescriptions filled in the previous three months, prior to June 30, 2011.
As children, we played "follow the leader" for hours on end.
The crazier the route and antics, the more we liked it.
Being the leader was the best part.
As working adults, "follow the leader" takes on a whole new meaning.
Leadership is an art and a skill. It's hard work that is extremely rewarding and occasionally completely thankless. What traits make a great leader?
These are my thoughts:
Traditions, established mores and long-held beliefs and practices should not be forgotten. However, in many instances, they should be discarded.
Technology, innovations and creativity represent the future.
Significantly, the future has arrived.
The past should be recalled, reviewed, refined and yes, in some instances, revered.
Then it should be put to bed, retired or archived.
The recent controversy over the Blackmore’s/PGA commercial deal has one positive - it opens up a debate on what would be the most appropriate processes for pharmacy to be involved in when engaging with patients and health consumers.
It also highlights how fractured each of the segments of the profession and industry are, in dealing one to the other, and to the community at large.
When the chorus of protest went up from a range of industry and professional critics in respect of the recent PGA/Blackmore’s alliance, the pressure generated was sufficient to cause its abandonment.
Not so much as a response to what had actually happened (because nothing much had been piloted or implemented), but in terms of what was perceived as to what could actually happen.
Perception (without evidence) was everything!
There were two primary perceptions:
(i) That the clinical evidence surrounding the publicised process was thought too weak to sustain credibility.
(ii) That the profit motive negated any professionalism. The perception was that all patients on particular drugs were going to be “up-sold” to a nutritional product that they may not derive any health benefit from.
Editor's Note: This article was originally written by Michael Vagg, who is a Clinical Senior Lecturer at Deakin University School of Medicine and a Pain Specialist at Barwon Health.
It was chosen for inclusion in i2P this week because we have begun a debate on evidence-based practice.
The Placebo Effect is the enigma confounding all attempts to scientifically rationalise "evidence" that so far has evaded all attempts to explain it away.
Quite often when drugs are discussed as not being evidence-based they are disparagingly referred to as being "little better than placebo".
If we are going to rely on "evidence" there needs to be a scientific explanation for all the effects generated by a drug or a therapy.
Until this happens, we can only validate certain components of evidence until placebo becomes measurable somehow under a validated scientific standard.
The fact that a placebo effect can universally produce a response in a patient means that it has to be included in evidence measurements and results as part of the total evidence.
As a pharmacy owner you must have the ability to monitor three broad areas of your business.
These areas are titled simply as Policy, Market Planning and Capital.
These are the pressure points in a pharmacy business where pharmacy managers must always be seen to apply positive pressure.
If pressure is not applied and becomes negative, business balance is lost.
Depending on the severity, it is appropriate to rebuild that positive pressure and keep the business in balance and under control.
If control begins become difficult, all efforts and strategies must be employed to break the existing cycle.
Speed of reaction is the essence.
Study points to the need to relook at current cancer therapies that target the body’s immune system
Scientists at A*STAR’s Singapore Immunology Network (SIgN) have shown for the first time that PMN-MDSC body’s immune system to combat cancer., a type of immune cell in the body that suppresses the immune response, can actually accelerate the growth and spread of cancerous tumours directly. This finding explains how inflammation, the body's natural defence mechanism when a tissue or an organ becomes affected, is linked to cancer progression. It also highlights the need for a careful reassessment of current cancer therapies that target the body’s immune system to combat cancer.
Meals made up of one-third protein, one-third fat and one-third carbohydrates allow the body to function best, researchers in Norway found.
Berit Johansen, a professor of biology at Norwegian University of Science and Technology, Ingerid Arbo and Hans-Richard Brattbakk fed slightly overweight people different diets and studied the effect of the diet on gene expression.
On 26 September the University of Sydney will launch a new website to help health professionals deal with the wide range of challenging ethical and legal issues they constantly encounter in their work.
The site, the Clinical Ethics Resource, was developed by the University and is funded by NSW Health.
The launch will feature a talk by Professor Julian Savulescu, Uehiro Chair in Practical Ethics at the University of Oxford, speaking on the controversial concept of medical futility.
Dr Greg Stewart, Acting Deputy Director-General Population Health and Chief Health Officer at NSW Health will officially launch the website.
For the first time, Australian scientists have detailed the proteins, or functional molecules, inside and around the ‘plasma membrane’ of a fat cell, the permeable barrier between the cell’s inner workings and the rest of the body.
Mapping a healthy fat cell at a basal level, or in a ‘pure’ state unaffected by its environment, allows us to understand exactly how it responds when exposed to hormones and other substances that blood carries around the body.
Why a fat cell? Because it plays a central role in metabolism, and its dysfunction is one of the factors that leads to the complex lifestyle-related illness we call Type 2 diabetes.
A new insight into global photosynthesis, the chemical process governing how ocean and land plants absorb and release carbon dioxide, has been revealed in research that will assist scientists to more accurately assess future climate change.
In a paper published today in Nature, a team of US, Dutch and Australian scientists have estimated that the global rate of photosynthesis, the chemical process governing the way ocean and land plants absorb and release CO2, occurs 25% faster than previously thought.
People with disability and their carers who rely heavily on the health system, as researched by the Australian Institute of Health and Welfare (AIHW), will soon experience a better primary health care system that has been designed to give people greater access to better coordinated services, Australian General Practice Network Chair, Dr Emil Djakic said today.
“AIHW’s report released today, The use of health services among Australians with disability, highlights the fundamental need to bring the health and social care sectors together, which will happen under the scheme of Medicare Locals,” Dr Djakic said.
Medicines Australia has commenced a Review of its Code of Conduct and invites public submissions.The Medicines Australia Code of Conduct sets the standards of conduct for the activities of companies when engaged in the promotion of prescription products used under medical supervision as permitted by Australian legislation.
Medicines Australia chief executive Dr Brendan Shaw encouraged health stakeholders, healthcare professionals, consumers and members of the public to contribute to the review.
“The great strength of the Code over 50 years has been its careful ongoing evolution conducted in consultation with stakeholders and the wider community,” Dr Shaw said.
Radical overhaul of agriculture can create farms that enhance rather than degrade the world’s ecosystems, says a new report.
New practices could double agricultural production, protect natural systems and be “game changer” for global food security.
According to the authors of new research released recently at the World Water Week in Stockholm, a radical transformation in the way farming and natural systems interact could simultaneously boost food production and protect the environment—two goals that often have been at odds.
The authors warn, however, that the world must act quickly if the goal is to save the Earth’s main breadbasket areas—where resources are so depleted the situation threatens to decimate global supplies of fresh water and cripple agricultural systems worldwide.
The Minister for Health, Nicola Roxon, has confirmed today in a media release that there are ongoing problems with the implementation of the Government’s GP Super Clinics program, highlighted by the decision not to proceed with Super Clinics in Darwin (NT) and Sorell (Tas).
This comes on top of the much-publicised issues around the Redcliffe GP Super Clinic in Queensland.
Scientists have discovered a mechanism that causes an aggressive type of lung cancer to re-grow following chemotherapy, offering hope for new therapies.
The study, conducted by an international team of researchers from Monash, Stanford and John Hopkins universities, represents not just the potential for new drugs, but a novel way of approaching cancer treatment.
Professor Neil Watkins, of the Monash Institute of Medical Research (MIMR) led the Monash research team of Dr Luciano Martelotto, MIMR, and Associate Professor Tracey Brown of the Department of Biochemisty and Molecular Biology
During PAC11 the Pharmacists’ Support Service (PSS) will be launching a campaign to raise money for expansion and development of its service to provide support to all Australian pharmacists.
Currently the service only has adequate funds to service Victoria, Tasmania, South Australia and the Northern Territory.
However, with adequate funding, PSS would like to formally extend its services to all Australian pharmacists.
At present when calls are received from other states, the PSS volunteers do their best to help callers, but the level of assistance is limited due to a lack of local knowledge, networks and resources.
PSS is now inviting all Australian pharmacists to make tax deductible donations towards its future development and expansion.
A University of Sydney PhD student has discovered the different diets and lifestyles of South Asians compared to Europeans could lead to the two groups requiring very different doses of medicines commonly used to treat illnesses such as depression and psychosis.
Vidya Perera, a final year PhD student in the Faculty of Pharmacy, has found that people from South Asia could need lower doses of these medicines because they are likely to have lower levels of CYP1A2, an enzyme that metabolises drugs.
Dr Joel Yang from the Institute of Materials Research and Engineering (IMRE), a research institute of Singapore’s Agency for Science, Technology and Research (A*STAR), with collaborators from the National University of Singapore (NUS) and the Data Storage Institute (DSI) has developed a process that can increase the data recording density of hard disks to 3.3 Terabit/in2, six times the recording density of current models. The key ingredient in the much enhanced patterning method that he pioneered is sodium chloride, the chemical grade of regular table salt.
The Googleplex, Google’s corporate headquarters in Mountain View California, is legendary for its perks. Employees have access to unlimited free meals, haircuts, dry cleaning, massages, and even onsite medical care.
Yet earlier this year, when Google interviewed its employees about what they valued most at work, none of these extravagant benefits made the top of the list. Neither did salary.
Instead, employees cited access to “even-keeled bosses who made time for one-on-one meetings, who helped people puzzle through problems by asking questions, not dictating answers, and who took an interest in employees’ lives and careers.”
Editor's Note: The Pharmacy Guild of Australia (PGA) and Blackore's Laboratories recently structured an alliance for a program surrounding nutrient deficiencies that certain drugs were known to induce.
A simple strategy was developed whereby the professional input by pharmacists was to be utilised to educate patients on how to correct these deficiencies.
Problem was, the PGA did not include the professional body representing the pharmacy profession (PSA) and that managed to get them completely offside.