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

Editorial

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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Newsflash Updates for July 2014

Newsflash Updates

Regular weekly updates that supplement the regular monthly homepage edition of i2P. 
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Feature Contribution

Woolworths Pharmacy - Getting One Stage Closer

Neil Johnston

It started with “tablet” computers deployed on shelves inside the retailer Coles, specifically to provide information to consumers relating to pain management and the sale of strong analgesics.
This development was reported in i2P under the title Coles Pharmacy Expansion and the Arid PGA Landscape”
In that article we reported that qualified information was a missing link that had come out of Coles market research as the reason to why it had not succeeded in dominating the pain market.
Of course, Woolworths was working on the same problem at the same time and had come up with a better solution - real people with good information.

Comments: 5

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Intensive Exposition without crossing over with a supermarket

Fiona Sartoretto Verna AIAPP

Editor's Note: The understanding of a pharmacy's presentation through the research that goes into the design of fixtures and fittings that highlight displays, is a never-ending component of pharmacy marketing.
Over the past decade, Australian pharmacy shop presentations have fallen behind in standards of excellence.
It does not take rocket science - you just have to open your eyes.
Recently, our two major supermarkets, Woolworths and Coles, have entered into the field of drug and condition information provision - right into the heartland of Australian Pharmacy.

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The sure way to drive business away

Gerald Quigley

I attended the Pregnancy, Baby and Children’s Expo in Brisbane recently.
What an eye and ear opening event that was!
Young Mums, mature Mums, partners of all ages, grandparents and friends……...many asking about health issues and seeking reassurances that they were doing the right thing.

Comments: 1

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‘Marketing Based Medicine’ – how bad is it?

Baz Bardoe

It should be the scandal of the century.
It potentially affects the health of almost everyone.
Healthcare providers and consumers alike should be up in arms. But apart from coverage in a few credible news sources the problem of ‘Marketing Based Medicine,’ as psychiatrist Dr Peter Parry terms it, hasn’t as yet generated the kind of universal outrage one might expect.

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Community Pharmacy Research - Are You Involved?

Mark Coleman

Government funding is always scarce and restricted.
If you are ever going to be a recipient of government funds you will need to fortify any application with evidence.
From a government perspective, this minimises risk.
I must admit that while I see evidence of research projects being managed by the PGA, I rarely see community pharmacists individually and actively engaged in the type of research that would further their own aims and objectives (and survival).

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Organisational Amnesia and the Lack of a Curator Inhibits Cultural Progress

Neil Johnston

Most of us leave a tremendous impact on pharmacies we work for (as proprietors, managers, contractors or employees)—in ways we’re not even aware of.
But organisational memories are often all too short, and without a central way to record that impact and capture the knowledge and individual contributions, they become lost to time.
It is ironic that technology has provided us with phenomenal tools for communication and connection, but much of it has also sped up our work lives and made knowledge and memory at work much more ephemeral.

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Academics on the payroll: the advertising you don't see

Staff Writer

This article was first published in The Conversation and was written by Wendy Lipworth, University of Sydney and Ian Kerridge, University of Sydney
In the endless drive to get people’s attention, advertising is going ‘native’, creeping in to places formerly reserved for editorial content. In this Native Advertising series we find out what it looks like, if readers can tell the difference, and more importantly, whether they care.
i2P has republished the article as it supports our own independent and ongoing investigations on how drug companies are involved in marketing-based medicine rather than evidence-based medicine.

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I’ve been thinking about admitting wrong.

Mark Neuenschwander

Editor's Note: This is an early article by Mark Neuenschwander we have republished after the soul-searching surrounding a recent Australian dispensing error involving methotrexate.
Hmm. There’s more than one way you could take that, huh? Like Someday when I get around to it (I’m not sure) I may admit that I was wrong about something. Actually, I’ve been thinking about the concept of admitting wrong. So don’t get your hopes up. No juicy confessions this month except that I wish it were easier for me to admit when I have been wrong or made a mistake.
Brian Goldman, an ER physician from Toronto, is host of the award-winning White Coat, Black Art on CBC Radio and slated to deliver the keynote at The unSUMMIT for Bedside Barcoding in Anaheim this May. His TED lecture, entitled, “Doctors make mistakes. Can we talk about it?” had already been viewed by 386,072 others before I watched it last week.

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Dispensing errors – a ripple effect of damage

Kay Dunkley - BPharm, Grad Dip Hosp Pharm, Grad Dip Health Admin, MPS, MSHPA

Most readers will be aware of recent publicity relating to dispensing errors and in particular to deaths caused by methotrexate being incorrectly packed in dose administration aids.
The Pharmacy Board of Australia (PBA), in its Communique of 13 June 2014, described a methotrexate packing error leading to the death of a patient and noted “extra vigilance is required to be exercised by pharmacists with these drugs”.
This same case was reported by A Current Affair (ACA) in its program on Friday 20 June
http://aca.ninemsn.com.au/article/8863098/prescription-drug-warning

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Take a vacation from your vocation

Harvey Mackay

Have you ever had one of those days when all you could think was, “Gosh, do I need a vacation.”
Of course you have – because all work and no play aren’t good for anyone.
A vacation doesn’t have to be two weeks on a tropical island, or even a long weekend at the beach. 
A vacation just means taking a break from your everyday activities. 
A change of pace. 
It doesn’t matter where.
Everyone needs a vacation to rejuvenate mentally and physically. 
But did you also know that you can help boost our economy by taking some days off? 
Call it your personal stimulus package.

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Explainer: what is peer review?

Staff Writer

This article was first published in the Conversation. It caught our eye because "peer review" it is one of the standards for evidence-based medicines that has also been corrupted by global pharma.
The article is republished by i2P as part of its ongoing investigation into scientific fraud and was writtenby Andre Spicer, City University London and Thomas Roulet, University of Oxford
We’ve all heard the phrase “peer review” as giving credence to research and scholarly papers, but what does it actually mean?
How does it work?
Peer review is one of the gold standards of science. It’s a process where scientists (“peers”) evaluate the quality of other scientists' work. By doing this, they aim to ensure the work is rigorous, coherent, uses past research and adds to what we already knew.
Most scientific journals, conferences and grant applications have some sort of peer review system. In most cases it is “double blind” peer review. This means evaluators do not know the author(s), and the author(s) do not know the identity of the evaluators.
The intention behind this system is to ensure evaluation is not biased.
The more prestigious the journal, conference, or grant, the more demanding will be the review process, and the more likely the rejection. This prestige is why these papers tend to be more read and more cited.

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Dentists from the dark side?

Loretta Marron OAM BSc

While dining out with an elderly friend, I noticed that he kept his false tooth plate in his shirt pocket. He had recently had seven amalgam-filled teeth removed, because he believed that their toxins were making him sick; but his new plate was uncomfortable. He had been treated by an 'holistic dentist'. Claiming to offer a "safe and healthier alternative" to conventional dentistry, are they committed to our overall health and wellbeing or are they promoting unjustified fear, unnecessarily extracting teeth and wasting our money?

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Planning for Profit in 2015 – Your key to Business Success

Chris Foster

We are now entering a new financial year and it’s a great time to reflect on last year and highlight those things that went well and those that may have impacted negatively in the pursuit of your goals.
It's also a great to spend some time re-evaluating your personal and business short, medium and long term goals in the light of events over the last year.
The achievement of your goals will in many cases be dependent on setting and aspiring to specific financial targets. It's important that recognise that many of your personal goals will require you to generate sufficient business profits to fund those aspirations

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ReWalk™ Personal Exoskeleton System Cleared by FDA for Home Use

Staff Writer

Exoskeleton leader ReWalk Robotics announced today that the U.S. Food and Drug Administration has cleared the company’s ReWalk Personal System for use at home and in the community.
ReWalk is a wearable robotic exoskeleton that provides powered hip and knee motion to enable individuals with Spinal Cord Injury (SCI) to stand upright and walk.
ReWalk, the only exoskeleton with FDA clearance via clinical studies and extensive performance testing for personal use, is now available throughout the United States.

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Attracting and Retaining Great People

Barry Urquhart

Welcome to the new financial year in Australia.
For many in business the past year has been described as a challenging period.
Adjectives are a key feature of the English language.  In the business lexicon their use can be, and often is evocative and stimulate creative images.  But they can also contribute to inexact, emotional perceptions.
Throughout the financial pages of newspapers and business magazines adjectives abound.
References to “hot” money draw attention and comment.  The recent wave of funds from Chinese investors, keen to remove their wealth from the jurisdiction and control of government regulations is creating a potential property bubble in Australia.

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Updating Your Values - Extending Your Culture

Neil Johnston

Pharmacy culture is dormant.
Being comprised of values, unless each value is continually addressed, updated or deleted, entire organisations can stagnate (or entire professions such as the pharmacy profession).
Good values offer a strong sense of security, knowing that if you operate within the boundaries of your values, you will succeed in your endeavours.

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Evidence-based medicine is broken. Why we need data and technology to fix it

Staff Writer

The following article is reprinted from The Conversation and forms up part of our library collection on evidence-based medicines.
At i2P we also believe that the current model of evidence is so fractured it will never be able to be repaired.
All that can happen is that health professionals should independently test and verify through their own investigations what evidence exists to prescribe a medicine of any potency.
Health professionals that have patients (such as pharmacists) are ideally placed to observe and record the efficacy for medicines.
All else should confine their criticisms to their evidence of the actual evidence published.
If there are holes in it then share that evidence with the rest of the world.
Otherwise, do not be in such a hurry to criticise professions that have good experience and judgement to make a good choice on behalf of their patients, simply because good evidence has not caught up with reality.

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Laropiprant is the Bad One; Niacin is/was/will always be the Good One

Staff Writer

Orthomolecular Medicine News Service, July 25, 2014
Laropiprant is the Bad One; Niacin is/was/will always be the Good One
by W. Todd Penberthy, PhD

(OMNS July 25, 2014) Niacin has been used for over 60 years in tens of thousands of patients with tremendously favorable therapeutic benefit (Carlson 2005).
In the first-person NY Times best seller, "8 Weeks to a Cure for Cholesterol," the author describes his journey from being a walking heart attack time bomb to a becoming a healthy individual.
He hails high-dose niacin as the one treatment that did more to correct his poor lipid profile than any other (Kowalski 2001).

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Culture Drive & Pharmacy Renewal

Neil Johnston

Deep within all of us we have a core set of values and beliefs that create the standards of behaviour that we align with when we set a particular direction in life.
Directions may change many times over a lifetime, but with life experiences and maturity values may increase in number or gain greater depth.
All of this is embraced under one word – “culture”.
When a business is born it will only develop if it has a sound culture, and the values that comprise that culture are initially inherent in the business founder.
A sound business culture equates to a successful business and that success is often expressed in the term “goodwill” which can be eventually translated to a dollar value.

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ReWalk™ Personal Exoskeleton System Cleared by FDA for Home Use

Staff Writer

Exoskeleton leader ReWalk Robotics announced today that the U.S. Food and Drug Administration has cleared the company’s ReWalk Personal System for use at home and in the community.
ReWalk is a wearable robotic exoskeleton that provides powered hip and knee motion to enable individuals with Spinal Cord Injury (SCI) to stand upright and walk.
ReWalk, the only exoskeleton with FDA clearance via clinical studies and extensive performance testing for personal use, is now available throughout the United States.

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Pharmacy 2014 - Pharmacy Management Conference

Neil Johnston

The brave new world of health and wellness is not the enemy of Pharmacy, it is its champion.
Australian futurist, Morris Miselowski, one of the world's leading business visionaries, will present the Opening Keynote address on Pharmacy's Future in the new Health and Wellness Landscape at 2.00pm on Wednesday July 30.
Morris believes the key to better health care could already be in your pocket, with doctors soon set to prescribe iPhone apps, instead of pills.
Technology will revolutionise the health industry - a paradigm shift from healthcare to personal wellness.
Health and wellness applications on smartphones are already big news, and are dramatically changing the way we manage our personal health and everyday wellness.

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Generation and Application of Community Pharmacy Research

Neil Johnston

Editor’s Note: We have had a number of articles in this issue relating to pharmacy research.
The PGA has conducted a number of research initiatives over the years, including one recently reported in Pharmacy News that resulted from an analysis of the QCPP Patient Questionnaire.
Pharmacy Guild president, George Tambassis, appears to have authored the article following, and there also appears to be a disconnect between the survey report and its target audience illustrated by one of the respondent comments published.
I have asked Mark Coleman to follow through, elaborate and comment:

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Perceptive, Prescient Dr Peter

Barry Urquhart

articles by this author...

Barry Urquhart, Managing Director of Marketing Focus, Perth. Barry is an internationally recognised conference keynote speaker, facilitator of strategic planning workshops and marketing business coach.
Contact Barry: TEL:61 8 9257 1777 - EMAIL: urquhart@marketingfocus.net.au -
WEB: www.marketingfocus.net.au

“The Peter Principle” lives.
 In 1969 Dr Laurence Peter released a management book, with co-author Raymond Hill, which was an irreverent study of what became known as hierachiology.
 The underlying contention of “The Peter Principle” was that everyone in a bureaucracy is promoted to their level of incompetence.
 An extension of the principle, verified by ubiquitous anecdotal observations, is that everything that works will be used in progressively more challenging applications until it fails.

In Canberra, home of the Australian Federal Government, resides the “Peter” Labor Government. The Prime Minister, “Peter” Gillard’s incompetencies focus on the telling of porkie pies about no carbon tax, gambling legislation and the tendering process for the Australian (Television) Network.
 
“Peter” Swan, arguably Australia’s first financially illiterate Treasurer incomprehensibly abuses and criticises our competently managed big four trading banks. In his initial three years of controlling the Treasury benches he converted a $12 billion surplus into a $60 billion deficit.
 
Only Senator “Peter” Conroy could commit to spending some $40 billion of taxpayers’ funds for a National Broadband Network without the rigours of a detailed cost: benefit analysis and critical review of available or emerging alternative  technologies. His rigid adherence to “The Peter Principle” of incompetence was highlighted in the conduct of the two tenders for the overseas telecaster Australian (Television) Network, in which non-preferred tenders (to the government) won both processes (by the unanimous votes of panel members). Senator Conroy withdrew the tender and granted the licensing rights to the ABC (Australian Broadcasting Corporation) in perpetuity. 
 
Our national safety and security is the ambit of Defence Minister “Peter” Smith, labelled-or crucified-by his own words as a “serious error of judgement”.
 
There is no need for parentheses or nuances when addressing the issue of Speaker of the Australian House of Representatives, Peter Slipper.
 
It’s a sobering consideration to realise that during 2013 the Australian electorate will have the right to vote on the retention or the removal of the incumbent “Peter” Labor Federal Government. One can only hope that they will do so competently.
 
MAKE IT EASY
 
Nathan Schipper is a principal of Tangibility, an outstandingly successful Perth-based promotional marketing company which since inception has enjoyed exponential annual growth in revenue, profits and clients.
 
Consistent, exceptional, personal and understated customer service is a pillar of the achievements of the business, complementing the outstanding creativity of Nathan, Jarad and the Tangibility team members.
 
Nathan believes in the virtue of making it easy for clients to do business with them.
 
Imagine the frustration he experienced over the Easter long weekend when he presented his four-wheel-drive vehicle to a total of three automatic car washes, only to be told the vehicle was “too big”. Given the high percentage of SUVS (sports utility vehicles) which are now sold in Australia and populate the roadways, this is one market sector that is denying itself considerable patronage and profits.
 
Responding to the unwelcome advice of one automatic car wash employee to “try” the manual car centre which was located about 1 kilometre down the road, Nathan finally undertook the labouring task of cleaning his own vehicle, in “good” clothing.
 
And the bottom line? When it came to pay, Nathan was advised the business didn’t accept payment by credit cards nor did it have available an automatic teller machine.
 
When will business operators learn that an essential characteristic of quality customer service is to make it easy for the customer or client to do business with the firm?
 
Remember always the words of Peter Kailis, founder of the Red Rooster fast food network:
“Business is simple, and should be made easy”
 
COST OF DOING BUSINESS
 
The current testing, at times challenging, marketplace conditions are placing enormous pressures on management teams and entities.
 
Endeavours are made to rein in costs, both variable and fixed. No stone is being left unturned. It is one way to insulate profit margins from on-going squeeze factors.
 
The enterprise and entrepreneurism of individuals, groups and sectors should be recognised and applauded. More importantly, they should be rewarded. To achieve just returns from efforts expended, capital and resources invested and risks taken, many existing businesses are being reviewed, refined and, indeed, remoulded.
 
Rents are one aspect of overheads which have come under close, often emotional scrutiny. Tests are being attributed to the “fairness and equity” of a cost burden, negotiated on a minimum sum, plus a percentage of gross or net turnover. That percentage figure morphs quickly into a fixed cost, which impinges on the profit reward of lessees and thus, on the market value of the business. The costs of doing business are being brought to book and nothing it seems is immune to negotiations. A first step in that process is the initiation of contact to set a time for a meeting and discussions on a fundamental platform for business.
 
MANAGEMENT GETS A SERVE
 
Memo to Management:
 
The findings of our latest annual survey on Australian customer service standards have identified management policies and corporate culture to be primary causal factors in the widespread decline of customer satisfaction during the last twelve months. Management decisions on expenditure in technology, staffing levels, inventory, product and brand ranges, staff training, warranty policies and communication deficiencies were nominated by 1,000 consumers throughout Australia during March.
 
Significantly, front-line customer service providers were not identified as major sources of annoyance, frustration and disappointment.
 
Also of importance is the clear segmentation of the buying/transaction cycle segments which are apparent from the unstructured responses of consumers. Clearly much of the negativity about service provision occurs before and after interactions with frontline staff members.
 
Detailed below are the key findings:
 
IN THE RATINGS OF SATISFACTION:

* Repurchase/pre-transaction

(In descending order of nominations and rankings)

* Automated telephone systems

* (Long) queues

* Absence of/access to service providers

* Purchase experience

+(Lack of) product/service knowledge of service providers

+(No or little) stock availability

+ Preferred brands, models, size (un) availability

* Post-purchase/post-transaction

+(Poor) warranty policies, responses

+ (Lack of) follow-up – communication

+ (Inadequate) accountability of buying/service entity

 
There is a clear message to management teams about the need to carefully review, and to possibly refine, enhance and develop current company philosophies, cultures, policies and practices.
 
An implied answer lies in the title of our latest customised keynote presentation:

“Service That Satisfies SELLS”

ARTICLE TEXT:
LOVE ME TENDER

There is a certain sameness about tenders. Compliance to the provisions of the tendering process promotes commodisation of tendered documents and the tendering entities. The sole point of difference is the quoted price.
 
Little wonder the concepts of value, originality, innovation, relationships and negotiated, mutually rewarding agreements are discounted and, often, dismissed.
 
Politicians may well promote, endorse and revel in “level playing fields”. Commercially, it is an ill-advised limiting strategic option in which there is only one winner... occasionally and rotationally. In the longer term no one wins and costs rise because of unallocated expenses which must be amortised on all projects and stock items.
 
In the prevailing straitened economic circumstances and with a price sensitive marketplace, an increasing number of business owners and managers are adopting the attitude that they and their entities cannot afford not to pursue every opportunity. Inadvertently, they do so at their own cost and detriment.
 
Saying “No” and turning one’s back on an invitation to submit a tender takes mental strength, a strong and singular focus, complemented by the resilience of a sound corporate philosophy. It is a refreshing, appealing alternative to being one of a long list of compliant, non-differentiated tenderers.
 
Being the same soon develops into a market image of being... “same ol’, same ol’”.
 
Similar templates and market consequences can be applied to those “bricks and mortar” businesses which choose to compete on price on-line with their global cyber space competitors and substitutes. Street-smart and tech-savvy consumers and clients are well connected, informed, discerning and price sensitive. They are also becoming increasingly numerate. Two-structure pricing policies (in-store and on-line) quickly disconnect the value of brands, services, businesses, physical presence and loyalty.
 
In the book “The Jindalee Factor”, which provided insights on Australian entrepreneurs, Professor Roger Smith and I were able to highlight the belief of several sustainably successful leaders of commerce that it is prudent not to pursue all available deals.
 
The profit incentive is not desirable. It is an imperative. Profits pay for premises, stock, staff and service, without which an entity “wilters on the vine” and the client is left unsatisfied and unfulfilled. “Unprofitable profitability” could only ever be considered and accounting term which measures cashflow. One cannot profitably invest cash flows in the long term.
 
A general slowdown in economic activity accords opportunity to review, refine and develop operations, strategies and to pursue those prospects which represent genuine, on-going value.
 
BRUTAL REALITY
 
There is no tenderness in the tendering process. It is a statistical and historical reality that only a percentage of tendered submissions and entities will be successful and profitable.
 
One need look no further than the appallingly poor recent track record of major engineering and construction corporations which won business with successful tenders and have recorded consistent, significant and increasing losses.
 
Losing such tenders has proven to those tenderers who were not granted the contracts to be winners.
 
NON COMPLIANCE
 
Whether the objective is to win custom on-line or in a tender, non-compliance is an appealing attribute because it provides scope for difference, enhancement and betterment
 
AT WORST
 
At the very least, entities that are requesting tenders should be made to pay for such. Decisions to participate in tendering processes should, and often can be complemented with a creative drive to find a better, faster and cheaper way than that stipulated in the tender document.
 
Remember, rules are for guidance, not obedience.
 
One should never apologise for being original, innovative, creative and profitable. Each is an attribute and building block for growth, sustainable competitive advantage and the delivery of value through quality products, 

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