Editorial
Welcome to the first homepage edition of i2P for 2012.
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Volume 2012 Number 1
Health Politics
Neil Johnston: Friends of Science in Medicine
Peter Sayers: Confessions of a Frustrated Pharmacist
James Ellerson: $75.5 million in 5CPA lying idle. Why is it so?EPublications
Dispense with community pharmacy
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PDF version | John Dunlop |
John has been involved in community pharmacy for most of his professional life. | |
I recently received from my community pharmacy, a folder produced by their national franchise owner The folder contained 12 vouchers, - one for every month of this year- to receive discounts and bonus Fly Buys points for a wide range of products.
The products ranged from dietary supplements, vitamins and skin care items to false finger nails. There was nothing surprising in this as the products were all reasonably well known and they certainly formed part of the normal range of stock held by most pharmacies.
What struck me though was that the pharmacy had not taken this opportunity to promote any health information, or health service that the pharmacy might be providing. Pharmacy is coming under the spotlight in New Zealand with, as we recently saw on TV, the public becoming suspicious of a health professional making money from the likes of homeopathic and herbal ‘remedies’ for which there is no scientific proof whatsoever. The criticism made on the TV show was that if pharmacists are really health professionals, why do they stock this stuff?
Governments are making sums of money available to community pharmacy to expand their role and provide medicine management and other professional services. To date there has been a paucity of literature demonstrating the ability of community pharmacy to undertake these roles.
In New Zealand the uptake of any medicine management service from community pharmacy has been abysmal, but having said that, I imply no disrespect to the community pharmacist. What I am implying though is that the opportunity, energy and money provided to community pharmacy may be misplaced.
My belief is that the current supply and distribution, product-focused, community pharmacy model of practice is incompatible with the provision of patient focused health care services. There is simply just not enough time during the day to day operation of a community pharmacy to focus on an individual patient’s care. Gathering the data necessary to provide a platform on which to build a clinical argument, plus researching the literature to gain information that would help you to conclude a course of action to alleviate or resolve an individual patient’s identified existing or potential problems is so time consuming that it would require an hour at the minimum to resolve. Taking this length of time out away from the retail sales or dispensing, which currently constitute community pharmacy’s main income earners, is not considered a worthwhile diversion by many community pharmacists, and especially not by owners. While the current model of community pharmacy is still very profitable (for owners at least), there would appear to be no future professional role for community pharmacy. The sooner we all recognise this, the faster the profession will transform into a real healthcare profession.
We need some honest discussion of how the profession might move forward and take advantage of the willingness of governments to fund new services. Community pharmacy should bury the retailing factor and make some room on the high ground for the new breed of pharmacists who are willing to up skill and put their neck on the line by moving into the primary care environment to work collaboratively alongside the general practitioner and other healthcare providers. The pharmacists who strive to create a clinical model of primary care, with no current models to follow or support from the profession generally, are breaking new ground for the pharmacy profession and are deserving of our complete respect and encouragement.
It is these people the future of the profession depends upon.
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Information Technology
Dr David More: Australian Health Information Technology LinksIndigenous Health
Preventive Medicine
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Submitted by Rollo Manning on Tue, 09/03/2010 - 05:47.
Well said John and the same goes in Australia where "community pharmacy" - a complete misnomer implying the "community" has ownership in the pharmacy - not true - is showing no sign of change and just choking itself up with more IT systems and management tools to improve patient care but no time to actually do it!
Read a letter I sent to The Australian newspaper (unpublished):
The announcement of local health networks to plan services gives pharmacists the opportunity to move out of the private retail market sector and into the mainstream primary health care environment.
The supply of medicines in the management of chronic disease states or acute care should be driven by the health system and not a private business lobby group where the health of the community comes in second behind the wealth of the business owners.
In rural areas where there is “one pharmacy” towns the citizens should not be relying on the goodwill of a business into the future to ensure continuity of supply of medicines.
It is time medicine supply was seen as a part of the total health system and not a by product of a retail establishment located a distance away in a shopping centre that may have worked 50 years ago. In 2010 it is costing far more than the Nation can afford with its 5,000 licensed outlets and many in areas where there is an obvious over supply.
This could be a challenging debate at the local health network level.
Any comment?
Rollo
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