Publication Date 01/07/2014         Volume. 6 No. 6   
Information to Pharmacists


From the desk of the editor

Welcome to the July 2014 homepage edition of i2P (Information to Pharmacists) E-Magazine.
At the commencement of 2014 i2P focused on the need for the entire profession of pharmacy and its associated industry supports to undergo a renewal and regeneration.
We are now half-way through this year and it is quite apparent that pharmacy leaders do not yet have a cohesive and clear sense of direction.
Maybe the new initiative by Woolworths to deliver clinical service through young pharmacists and nurses may sharpen their focus.
If not, community pharmacy can look forward to losing a substantial and profitable market share of the clinical services market.
Who would you blame when that happens?
But I have to admit there is some effort, even though the results are but meagre.
In this edition of i2P we focus on the need for research about community pharmacy, the lack of activity from practicing pharmacists and when some research is delivered, a disconnect appears in its interpretation and implementation.

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Accelerated Decline- The Pharmacy Profession finds itself on Skid Row

Neil Johnston

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Neil Johnston is a pharmacist who trained as a management consultant. He was the first consultant to service the pharmacy profession and commenced practice as a full time consultant in 1972, specialising in community pharmacy management, pharmacy systems, preventive medicine and the marketing of professional services. He has owned, or part-owned a total of six pharmacies during his career, and for a decade spent time both as a clinical pharmacist and Chief Pharmacist in the public hospital system. He has been editor of i2P since 2000.

Decline in our profession has reached a point of no return. Events will now play out until we all find ourselves with no professional place to go.
At that point the only way out will be up, provided we have sufficient emotional and financial resources left to support an elevation.
For 10 years i2P has dogged the leadership of the profession of pharmacy to try and get some real change and growth, plus a sense of direction and purpose for the profession of pharmacy (not just the business elements of pharmacy).
We believe that we have failed because we are starting to see professional decay in the form of unemployed pharmacists, no new professional services (except for a few “top down” computer programs), a depressed outlook and the existing work of dispensing becoming “crunched” through the increasing use of automated dispensing machines and the development of the role of the dispensing technician.
It means pharmacy leaders have definitely not done their homework and have been divided in their efforts. They have failed miserably.

Pharmacy owners, a powerful minority within the world of pharmacy, have been totally uncreative in developing new roles for their displaced pharmacist colleagues, preferring to corporatise pharmacies and eliminate the once highly personal nature of pharmacists.

There has been no new investment in people.

It is also happening in New Zealand.
Johns Dunlop, one of New Zealand’s leaders in the development of professional services for pharmacists over there, has this to say in the feature article section of this month’s i2P:

“What has become of our profession? The profession itself has much to answer for, when those in a position of power i.e. the pharmacy owners, can denigrate the profession to such a degree by placing such a limited value on the services of a community pharmacist.

Is it that the role for which most of us worked so hard is now so inconsequential that it has no value in health care?

Or is it that lesser-qualified (technicians) individuals can now undertake the role we used to perform?

Or is it that the greed of the owners has become so entrenched that they are prepared to marginalise pharmacists by ensuring that they have no money, no say and no future?”

And the other health professions in Australia, primarily doctors and nurses, have seized the opportunity created by the Pharmacy Guild of Australia (PGA) to help obliterate pharmacists in name and image from the primary health care landscape. For quite some time now it has been obvious that the traditional triad of health professions (doctors, pharmacists and nurses) has been displaced by the different triad of doctors, nurses and allied health.
That’s right, pharmacy has been consigned to oblivion – you can’t even find a mention of the word pharmacist in any official health planning document or press release.
Take the recent Department of Health and Ageing (DoHA) press release relating to Medicare Locals, the primary health care organisations that are being developed as a multi-disciplined environment to handle patients needing primary care, linking them rapidly to appropriate services.
That’s the department headed up by Nicola Roxon – the same department that negotiates all the community pharmacy agreements.
An extract reads:

“Medicare Locals will have strong links to local communities, health professionals – including GPs, practice nurses and allied health professionals – and service providers enabling them to respond more effectively to the needs of local communities.”

Can anyone find a mention for pharmacy in the above release extract?
Does this mean that pharmacists have lost their very strong primary health care role and function?
What is the real agenda here?
Shame on the PGA executive – they have sold their members and the profession “down the drain” for their “30 pieces of silver” having been bought, “body and soul” by the DoHA.
Why else would the PGA executive deliberately negotiate the Fifth Community Pharmacy Agreement without the PSA at the table (and all the bull***t excuses), and deliver an inferior result for all pharmacists.

Is it not time that the rank and file of the PGA begin to ask some hard and searching questions of their executive?
We have suggested before that a good starting point might be a detailed itemisation of their tax free expense accounts published for the view of all PGA members.

Warwick Plunkett, the national president for the Pharmaceutical Society of Australia seems to be growing an extra set of “balls” in that he is becoming more outspoken as the enormity of the problem becomes more obvious.
But is it too little, too late?
The following press release from the PSA may be a call to action:

“The Pharmaceutical Society of Australia has announced a range of initiatives to help pharmacists meet the need for, and embrace, the change necessary to secure the future of the profession.

Speaking at the opening of the Pharmacy Australia Congress in Melbourne, PSA National President Warwick Plunkett said the Society was taking a more proactive approach to finding appropriate places for pharmacists in the Government’s health-reform agenda.

“PSA will be a significant funder of a major long-term, awareness campaign which intends to change policymakers’ outdated views of pharmacists,” Mr Plunkett said.

“Currently pharmacy is not part of the health reform process, it is not integrated into the primary health-care environment, there is a lack of payment-for-service model, and a lack of definition of the role of pharmacists.

“We are determined to find solutions and develop strategies that will deliver successful outcomes for all members in the long term and so build a better professional future for all pharmacists.”

Mr Plunkett said PSA and other pharmacy stakeholders had agreed on a strategy to redress the knowledge gap of relevant health policy stakeholders about the potential role of pharmacists.

Mr Plunkett also announced PSA would implement measures to help implement change management in pharmacies which was critical to the long-term viability of their operations.

 “Through a team of field officers, PSA will be assisting its members to put into place better systems, models and patient focused pathways, linking more closely with our medical colleagues that will maximise their remuneration base and their service delivery to the community,” he said.

“Being the highly skilled workforce that pharmacists are, once patients know and are aware of the clinical care we provide, there will be no turning back.

“So we at PSA are not simply developing strategies for change; we are walking the talk – working with our members through such change and working with you to identify issues and opportunities.”

Good for you Warwick – all the i2P writers hope that it is not too little, too late!

And we are also hoping that there is a section in the PSA being devoted to “Practice Pharmacists” who can be franchised with prescribing powers and a fee for service.
By nature, these pharmacists would have to be structured as independent service businesses and they do have the potential to become the power-houses for professional pharmacy creativity and innovation.

Give them a voice and perhaps you will see the pharmacy star shining brightly once more, and maybe, unemployed pharmacists will become a thing of the past.

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Submitted by Dr David Arelette on Tue, 02/11/2010 - 12:50.

It's about time someone mentioned the Emperor's lack of clothing - why does the weekly supermarket catalogue have 4 pages or 20% of the space on HBA when it's 5% of their sales - it's the end game stupid - FMCG will make pharmacy poorer and poorer and the Government will not come to the rescue - it's time to admit that the halcyon days are over for all time, licence values are inflated to market reality and those that embrace the linkage driven customer value in a FMCG co-location will survive.

Maybe not today, maybe not tomorrow, but one day you will have to meet the economic reality of being paid for the real (and limited) value really added to umpacking a box, sticking on a label and handing it over.

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