Editorial
Welcome to the first homepage edition of i2P for 2012.
In many ways it has been a slow start to the New Year because of having to deal with the “leftovers” from 2011.
One of those items for i2P was that a third-party provider to the site did not advise of a code change to the security section in our subscribe panel, creating a range of frustrated subscribers not able to get on board.
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Columns
Rollo Manning: Pharma-Goss
Linda Bryant: Inside NZ
Loretta Marron BSc: Health Watch
Barry Urquhart: Marketing Focus
Mark Neuenschwander: I`ve been thinking about...Recent Comments
Past Editions
Volume 1 Number 1
Volume 1 Number 2
Volume 1 Number 3
Volume 1 Number 4
Volume 1 Number 5
Volume 1 Number 6
Volume 1 Number 7
Volume 2 Number 1
Volume 2 Number 2
Volume 2 Number 3
Volume 2 Number 4
Volume 2 Number 5
Volume 2 Number 6
Volume 2 Number 7
Volume 2 Number 8
Volume 2 Number 9
Volume 2 Number 10
Volume 2 Number 11
Volume 3 Number 1
Volume 3 Number 2
Volume 3 Number 3
Volume 3 Number 4
Volume 3 Number 5
Volume 3 Number 6
Volume 3 Number 7
Volume 3 Number 8
Volume 3 Number 9
Volume 3 Number 10
Volume 3 Number 11
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
Do you feel good about yourself?
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Introducing current ideas, perspectives and issues, to the profession of pharmacy | |
Editor: Just every now and then you read something in the Pharmaceutical Press that really drives home how distorted the profession of pharmacy has become. Since the very first edition of i2P I have been commenting on the problems associated with the location rules governing where pharmacies will set up, how far from each other they will be, and how a bureaucratically organised market place never quite keeps up with consumer expectation. While i2P has been commenting on the various distortions in pharmacy since the year 2000, we do not necessarily enjoy the process. It is highly frustrating to see the obvious and try to reverse the trend. It's always a slow and laborious process, and we would much prefer supporting positive initiatives. Over the same time we have seen the pharmacy labour market become disillusioned: 1. The opportunity for young pharmacists to go into business appears to be too daunting from a financial perspective. The location rules have artificially inflated the cost of a pharmacy through restricted PBS licencing. 2. Senior pharmacists have had no encouragement to stay on and become mentors because of the bad working conditions - long hours standing up, poor rest break conditions and sausage factory dispensing processes that prevent mentoring from taking place. Corporate memory of the profession resides with the seniors and that is often discounted. 3. Pharmacists with clinical aspirations have become disillusioned because the PGA supports only the supply side of pharmacy. While core business in pharmacy is dispensing, the value-added component in the form of patient advice and support has always been the component that patients valued most. Professional services have almost totally disappeared through the efforts of sausage factories and warehouse pharmacy models - both versions seeing professional services as not being profitable. A profession is supposed to nurture its talent to ensure that the next generation of pharmacists is able to provide a better profession, to be shared by all participants. The PGA has sold our profession short and for that, they cannot be forgiven.
In practice this means that the mistakes of the past continue to be repeated.
It is this "goodwill" that brings patients out in political support of pharmacy - but even that activity has become distorted.
Goodwill is evaporating as pharmacy is being "found out" on many fronts.
Greed and power have corrupted the collective soul of the PGA.
Shannon Mullen, one voice for the future of pharmacy, put it more eloquently in a recent post to Auspharmlist.
Shannon Mullen: With all the concern expressed on these forums I have been struggling to get my head around the entirety of the issues. The Guild is a target for being slow to bring about some things and for others completely dropping off the agenda e.g. pharmacist prescribing. At the same time the Guild has served Pharmacy well and from Kos's speech to the press club during the week they have got some well needed reforms in the pipeline. I do think Tim has identified a large problem for young pharmacists that the Guild can not readily defend. I spent time reading the transcript from the national press club and Kos performed well for pharmacy on a range of issues but his answer to the question about location rules was long winded and didn't provide me with a satisfactory reason for the impediment to new pharmacies and the next generation of pharmacists. I've attached the question and Kos' answer at the end of this post.
Pharmacists who were lucky enough to get into business before the location rules inflated prices and restricted the market could make a great living while looking after their customers properly. Now the way to get rich is to run a script factory. A young pharmacist I know works 12 hour shifts and dispenses 450 scripts in a day. He has multiple dispensary assistants but says all he really has time to do is check they have put the right label on the right product. No this is not a discount warehouse. This is a medical centre pharmacy.
As a pre-reg I cannot express how disheartened I am to hear him describe his day. Is this the 'economy of scale' that the location rules aimed for?
450 prescriptions a day are dispensed for patients without time for any counselling, history checking or interventions. If the location rules were not so strict I could set up a pharmacy across the road and aim to capture some of this market. They might respond by discounting, to which I could respond by spending time performing proper counselling, intervening when therapy is poor, and basically doing everything pharmacists are trained to do. I might only get 100 scripts a day but eventually that may allow me to pay myself $150 000 pa and I will have pursued a successful and professionally rewarding career. Easily justifying my many years of study and HECS debt.
In this case with no competition the owner gets over 4.5 times those profits and only has to pay a couple of pharmacists at the most. I imagine they get paid well on that script volume but this guy/group must be making an absolute mint without having to provide any semblance of professional care. And if the employee were to make a mistake - well it it quite clearly their fault for accepting this work situation.
I am very jaded by the situation in Perth. The market for pharmacies is so tight that it seems the only way of getting into business is work extremely hard for an owner in the hope that they will be gracious enough to decide it is time for semi-retirement and offer you a 10% stake after many years of loyalty. And at the same time, you need to pray that when that day comes someone else won't come and offer them more than you can afford for that stake.
Many owners in Perth that got in before the location rules have multiple businesses but do so well out of them that they can own 2 pharmacies (or more? it's not like there is anyway/anyone to check) They can employ pharmacist managers, dictate the terms of the business to them (e.g. one pharmacist on duty at all times no matter the script turnover), and then pursue other activities. This may include lecturing, AFL coaching, politics, and dare I say it, sit on the council. Is it the location rules that have helped turn Pharmacy from the owner-operator to this situation?
I do hope that I am wrong about many things that are in this post but when employee pharmacists are talking to me this is what they are saying. I now turn it over to the rest of the forum to respond.
Mark 
Coleman: I have been asked to respond to this posting by the editor.
How did pharmacy owners allow this situation to evolve?
Well, in the harsh light of the day it is easy to see greed as the motivating factor, and a corrupted form of power working for all that is negative for the profession
Why is it that the current crop of pharmacy leaders (concentrated in the PGA) is so blind?
As recently as today (4th August 2009), pharmacy media are reporting on a petition taken up by residents in Colac, Victoria, to have the location rules altered. In Colac, there are two pharmacies owned by one person.
Local residents complain that they pay excessive prices and wait unreasonable times to have prescriptions dispensed and are being forced to go to another town to have their needs met.
Great headlines indeed that should be a wake up call for pharmacists in general !
A classic example of a lack of competition and a great opportunity for Shannon Mullen to tackle, if only the laws allowed.
I feel ashamed to be a pharmacist when faced with news items of that calibre.
Even the PSA does not seem to represent a valid alternative.
It can only represent professional pharmacy interests in a limited fashion because it has the continuing potential to be hobbled by a membership that can also have duality in being a member of the PGA simultaneously.
It certainly is time to push for a peak body for pharmacy that represents all interests.
And a peak body that will recognise a trade union of employers must equally recognise a trade union of employees plus all the other minority interests as well.
Balance within the profession is what has been lost and must be restored.
There is no doubt that the PGA has served its membership well, but in a very limited fashion.
It is up to the membership to instruct its executive to restore balance and retrieve the good name that pharmacy earned from the efforts of the earlier generations of pharmacists - they also have a voice and "they are not happy, Jan". In fact, many of the older (now retired) generation feel ashamed for what the profession has become.
I hope Shannon has the energy to challenge the pharmacy profession, in particular the pharmacy owners, to recognise their responsibilities.
She should be offered support from all pharmacists, as she appears to have the leadership potential to organise the required revolution
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Dr David More: Australian Health Information Technology LinksIndigenous Health
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