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Professor Phelps opens Pharmacy 2009 Conference

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Neil Retallick articles by this author...

Neil Retallick is a former General Manager, Merchandising, for National Pharmacies, the successful community pharmacy model owned by the Friendly Societies. Neil holds a Graduate Diploma of Marketing from Monash University, is a CPM and a graduate of the AICD.He began his career with Myer Stores Ltd and worked for FMCG companies including TIA (Sheridan) and Pacific Dunlop. Prior to these roles Neil worked for Cadbury Schweppes Drinks Division - Grocery, and Trimex Pty Ltd in Victoria in State management roles. He is currently Chief Executive Officer at the  Combined Dispensaries in Sydney and is a Member of the Advisory Board at Ehrenberg-Bass Institute for Marketing Science

Pharmacists from across Australia and across the Tasman gathered in Sanctuary Cove in September for the Pharmacy 2009 Conference.
Around 250 community pharmacists and their suppliers were challenged from the outset as Professor Kerryn Phelps, the former Federal AMA President now at Sydney University’s Faculty of Medicine in the Schools of Public Health and General Practice expressed her concerns regarding the development of health clinics in community pharmacies.

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In her presentation, “Promoting health, preventing illness and managing disease: Current issues for pharmacy management”, Professor Phelps acknowledged that the healthcare landscape has changed enormously over time. And in this dynamic environment it is important to recognize the political agenda of the incumbent government.

For the current Government, the key issues include:

 PBS policy and the potential for significant increases in its cost. Increases in the level of co-payments might become a regulating methodology here.

 Medicare policy might be adjusted as the Government acknowledges that the drive for universal access to quality healthcare has not been completely successful.

 The Global Financial Crisis has impacted on the Government’s ability to fund future costs

 A focus on preventive health is one way of improving community health whilst constraining costs

 Primary care policy is under review

 Multidisciplinary teams and clinics are being developed, offering holistic healthcare options, and

 Integrative medicine is emerging as an option preferred by many Australians.

The key areas of focus for the Government’s preventative strategy initially are obesity, tobacco and excessive consumption of alcohol.

Professor Phelps made the point that community pharmacy is well-placed to support any Government initiatives here as pharmacists are more accessible than many healthcare professionals.

Integrative medical clinics are increasing in numbers.
These clinics are concerned with the whole person and provide a broad range of therapeutic approaches offered by a number of different healthcare professionals and disciplines.

The popularity of these clinics parallels the increased use of complementary medicines (CM) in Australia. More than half of all Australians use CM each year and it is estimated that up to 80% of all cancer patients use CM alongside their conventional treatment.

A concern expressed by Professor Phelps is that this increased use of CM has not been supported by a corresponding increase in public education. Pharmacists have a key role here. She contends that the increasing use of CM and the evidence supporting its efficacy compels the pharmacy profession to include herbal and nutritional supplement training into undergraduate teaching and to offer Continuing Professional Education programs for graduates. The funding for this curriculum development would need to be provided by the Government.

The notion of the development of herbal dispensaries alongside conventional dispensaries was invoked. Whilst the management of these would be more complex, due to the nature of the products involved, the capacity for community pharmacy to extend their healthcare offer would be welcomed by many Australians.

Professor Phelps’ most direct challenge to community pharmacy focussed on inequities in current government regulations and the potential conflict arising from the development of healthcare clinics in pharmacies. Professor Phelps pointed up the fact that a pharmacist could own a medical practice and could, in fact, open one right next door to an existing medical clinic. Pharmacy ownership, to the contrary, was protected – as was the location of new pharmacies. In this environment of protectionism, pharmacists need to consider three issues.

Firstly, there is a concern about unqualified people providing medical advice. Whilst the ‘minute clinics’ in pharmacies are intended to deal with minor healthcare issues, in many cases what presents as a minor health concern might actually be the beginnings of a far more serious health issue. The examination of a person often requires that person to disrobe – at least partially – and this must be accommodated in the pharmacy. Further, pharmacists need to ensure their health clinics refer people to general practitioners when necessary. The risk of medico-legal nightmares will be ever-present. The increased cost of indemnity insurance needs to be taken into account in any event.

At the philosophical level, or as a matter of principle, the fact that the pharmacy lobby, in an anti-competitive situation that limits a doctor’s ability to prescribe and dispense medicines, is promoting a pharmacist’s ability to do both is problematic. This coming from a position of comfortable protectionism.

Further, Professor Phelps is of the view that pushing this line can only strain the relationship between pharmacists and general practitioners.

Professor Phelps concluded by reflecting on the fact that the relationship between general practitioners and community pharmacists has been an invaluable one for both over many years.
Pharmacists need to reflect on the kind of relationship they want in the future.

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