Welcome to the December edition of i2P-Information to Pharmacists.
As we wind down in 2013 for the holiday period we will be filing some updates, but at a little more leisurely pace.
Where has the year gone?
Certainly the rate of change for 2013 has been more than hectic and there has been little time to organise thoughts and set appropriate directions.
This is the season for hard negotiations for the 6CPA but there is little left to squeeze.
Pharmacy has had the equivalent of bariatric surgery.
Government has taken it all, as usual.
As current price changes work their way through the pharmacy cash flow cycle, for some there will be insufficient- and heartburn.
Crunch time is that there will be more bankruptcies over 2014.
Media reports that some pharmacies have received free shop refits as a form of payment for purchasing a specific generic drug range is certainly not obvious, as the average pharmacy is in need of some renovation or repair and looking a bit jaded.
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 4 Number 1
Volume 4 Number 2
Volume 4 Number 3
Volume 4 Number 4
Volume 4 Number 5
Volume 4 Number 6
Volume 4 Number 7
Volume 4 Number 8
Volume 4 Number 9
Volume 4 Number 10
Volume 4 Number 11
Volume 5 Number 1
Volume 5 Number 2
Volume 5 Number 3
Volume 5 Number 4
Volume 5 Number 5
Volume 5 Number 6
Volume 5 Number 7
Volume 5 Number 8
Volume 5 Number 9
Volume 5 Number 10
Volume 5 Number 11
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.
Editor's Note: Sometimes we find ourselves in difficulty and the subject of an official complaint.
Often, the first knowledge of this complaint is when an inspector from some agency arrives on the doorstep and begins to interrogate you over the counter.
Sometimes (and I think deliberately) in earshot of staff, customers and patients.
Suddenly you find yourself fighting for your professional life.
We asked Mark Coleman what he would do if faced with a situation similar to what happened below:
Editor's Note: Sometimes we find ourselves in difficulty and the subject of an official complaint.
Questions on mandatory reporting after defamation decision
30th Apr 2012 by Byron Kaye
Medico-legal experts will be reassessing mandatory reporting laws after a court ruled a doctor was entitled to sue her colleague for defamation after he reported her to the authorities.
Sydney psychiatrist Dr Julian Parmagiani reported his colleague, Dr Yolande Lucire, to the NSW Medical Board in 2008 after he claimed he saw her lying under oath about whether she had registration conditions whilst giving expert evidence in court.
Dr Lucire sued for defamation claiming the complaint did not fall under mandatory reporting requirements, which are for cases of suspected sexual or substance abuse or “impairment”.
Dr Parmegiani initially won in a bid to have the matter struck out, claiming he had “absolute privilege” when reporting a colleague to authorities.
But in a landmark ruling last week the NSW Court of Appeal ruled that Dr Parmegiani’s complaint was not covered by absolute privilege since the Medical Board “has no powers of investigation [and] exercises no quasi-judicial function; its process is purely administrative”.
As well as overturning the decision to strike out the defamation claim, the court ruled Dr Parmegiani must pay the cost of Dr Lucire’s appeal.
“It’s a great relief because it was double or quits,” Dr Lucire told MO.
Dr Parmegiani’s complaint and Dr Lucire’s legal action both predated national mandatory reporting rules which began on July 2010. But the matter is being seen within the medico-legal profession as a test case for the new rules since it concerns medical professionals’ ability to report their colleagues with impunity – something they are now legally required to do under certain circumstances.
Slater & Gordon group leader for medical law Bill Madden said the ruling should broadly reassure doctors because it ensured that, if a complaint were made against them, they had the right to test whether it was made in good faith.
“It’s always been understood that under the new national law there is a protection in place for good faith reports,” he said.
“What we’re talking about here is [what happens if] there is a report made in bad faith.
“You would assume that most doctors would want that position to apply because that means that if somebody does make malicious reports they [the recipient of the complaint] still have the option of being able to turn around and demonstrate bad faith. It’s a balance.”
Dr Parmegiani declined comment when contacted by MO.
A directions hearing will be set down for a later date.
The following comments must not be construed as legal advice and reliance must not be placed on these comments if you find yourself in legal difficulties as a result of a formal complaint against you.
I once found myself the subject of a complaint made by the local GP to the Pharmacy Board.
The first glimmering that I was in trouble occurred when I received a telephone call from one of my staff during a period when I was having a short break, after some months of high-intensity workload - you know, one of those periods when one day merges with the next and although you go to bed reasonably early, you still wake up exhausted.
I prescribed for myself a beach-side holiday.
Although I had given my telephone number out to a senior staff person for any emergencies, I was not anticipating that one would occur.
The staff person calling me told me that there was a Pharmacy Board inspector rummaging around through my store of PBS duplicates and that he had demanded to speak with me.
I agreed, and was then subjected to a threatening discourse for about 10 minutes.
I was told in no uncertain terms to present myself back at the pharmacy that day (the holiday resort was only about 90 minutes away) otherwise a warrant would be taken out.
In those days I was in my early 30's and had not had anything of a crisis nature happen before.
I was "wet behind the ears", otherwise I would have rung my solicitor immediately and brought this inspector to heel.
Anyhow, I returned to the pharmacy.
I was not immediately told what my transgression had been, only that I was to find a PBS duplicate for a particular patient.
I found the duplicate (it was for an eye drop) and the inspector departed, stating that he would be in contact again.
At no stage was I given an outline of the complaint by the doctor or the Board inspector.
Naturally, I became quite worried, but still tried to relax on the remainder of my break (the definition of impossibility).
About two months later I received the formal paperwork outlining the complaint with the demand that it be responded to in writing, which I did.
It seemed that I had been accused of changing the prescription of a doctor - and mislabeling it to boot!
The eye drops had been prescribed by a specialist. At the point of dispensing, I did not have the stock on hand. I rang the specialist to get a change agreed to, for a brand that we did have in stock (but a slightly different formula).
A simple enough process that we are all familiar with.
During that process I forgot to alter the dispensary label to illustrate the label of the new product.
The local GP got in on the act when he was asked to write a new prescription and noted the differences at that time.
An official complaint was immediately lodged - no courtesy there. particularly as I was not copied in.
The Board complaint was responded to quickly by me, but they were not satisfied and a hearing was set down for a future date.
To me (then and now) the process seemed to be a complete over-reaction and I began to suspect other forces at work (such as a disgruntled opposition with good political contacts who was losing a major market share to me at that time).
The hearing went ahead and I received a reprimand for the mislabeling - not the original charge of changing the prescription of a doctor.
Somehow, during the hearing a press item appeared in the local paper that alleged that I was under a cloud facing possible deregistration.
I asked my legal people what options I had in pursuing the doctor and the board inspector, believing that I had been defamed.
The best I could do at that time was force the local paper to print the result of the Board hearing.
Now it seems that with the passage of time and the recent case fought out between the doctors identified in the above news item, I might now have a chance at winning.
In the days I am talking about we did not log Incident Reports as we do today and professional discourse was usually a bit more courteous.
All I can say is that if that incident had occurred today, I would certainly have been more aggressive in my pursuit of both the doctor and the Board inspector - but that only becomes possible through the experience gained over the years.
In fact the opportunity did come up many years later when I was accused of running a clinical practice while being employed in a public hospital.
I erupted immediately, threatening legal action against a GP who made the allegation, the Director of Medical Services who drafted a letter of reprimand and the hospital EO who also got in on the act.
Again, not one of these people thought to approach me for an explanation.
The matter resolved that same evening with all parties apologising-the GP actually called around to my home to present his apology.
What gets into these people?
Both these events are still indelibly etched on my mind to this day.
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