Welcome to the March 2012 edition of i2P E-Magazine.
We have continued to have programming difficulties into this month (hence we are a few days late in our publishing schedule), but it has caused the major decision to rebuild the site from scratch.
An expensive decision, but one that needed to be made to lessen editor stress and allow for a new educational module to be integrated, which will massively increase the 4 gigabytes of data we currently manage in our files.
We will spread the work over the next six months.
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
Volume 6 Number 1
Volume 6 Number 2
Volume 6 Number 3
Volume 6 Number 4
Volume 6 Number 5
Volume 6 Number 6
Regular weekly updates that supplement the regular monthly homepage edition of i2P.
Access and click on the title links that are illustrated.
A range of global and local news snippets and links that may be of interest to readers.
Pipeline Extras simply broadens the range of topics that can be concentrated in one delivery of i2P to your desktop.
Editor's Note: New Zealand is gearing up for pharmacist prescribing.
Australian pharmacy has just had legislation enacted creating a form of prescribing simply termed "medication continuance".
Doctor governing bodies in Australia have immediately reacted to the Australian development by starting a lobby group to have all "non-medical" (nurse, optometrist. pharmacist etc) prescribing over-sighted by a special review panel.
This is a peculiar reaction given that the only prescribing that has caused any patient problems or damage to date is that of medical practitioners.
It would seem that pharmacist prescribing may be about to enter a period of intense turmoil.
Pharmacists should not back away from this challenge.
Pharmacy has been debating the concept of professional services for a fee since 1978.
With the looming prospect of massive gross profit losses occurring after April 1 2012 (and beyond) there are few profit options available to replace the gap.
I can remember having a conversation with a well-known pharmacy historian circa 1978 and he told me that historically, pharmacy has never made a major change to its service structure unless it was forced to by the medical profession or by government.
There has been a bit of commentary in the media where the cost of the provision of government-subsidised medicine by community pharmacies has been assessed as excessive.
These same commentators have called for a more ‘commercial’ approach to the way in which pharmacists are remunerated for PBS supply.
These comments reflect a lack of understanding of the current model and its objectives.
They also betray a lack of understanding about the commercial aspects of a retail business.
As I write this, the nation waits for baited breath to see if our two political egos from the same side of politics can settle their differences.
A similar thing is happening with the academics and their opinions as to the value or otherwise of modalities of which they disapprove, because their particular scientific bent doesn’t understand the positives outcomes observed over centuries.
The 3rd instalment of a 1970’s “cold case” was played out in late December 2011, in the prestigious Royal Australasian College of Physicians' Internal Medicine Journal .
What seemed to be a dispute between the two wives of high profile “cancer guru” Ian Gawler, has taken a new twist, with the publication from two eminent cancer specialists.
For the past 30 years, Gawler’s story has brought hope to thousands of dying patients. In his best-selling book “You Can Conquer Cancer” he shares his own cancer journey; from radical surgery through the medical treatments that failed him; to the success of alternative therapies.
Gawler claims that his cure came about through a Vegan diet, enemas, complementary medicines and meditation.
Value is an intriguing, complex, subjective, and often misunderstood concept which is the product or consequence of a convergence of quality, design, price, predictability, and, often, originality and individualism.
Sadly, to many, value has been reduced to a single dimensional scale.
That is, price, and with it the whole precept has been debased.
Above all else, value is determined, accepted and appreciated by individuals, consumers at large and the marketplace.
It is they, individually and collectively, who assign the relative ratings and weightings of a disparate set of attributes and characteristics to determine the “true measure of value”.
The following exchange has taken place on the world wide pharmacy forum site E-Drug www.essentialdrugs.org/edrug/archives.php
A post from Ghana
In Australia the Pharmacists’ Support Service (PSS) provides a listening ear and support over the telephone to pharmacists in Victoria, Tasmania, South Australia and the Northern Territory and has plans for expansion to all states of Australia. The medical profession in Australia has a range of state based Doctors’ Health Advisory Services including the AMA Victoria Peer Support Service which provides peer support over the telephone. Victorian is the only state to have a state based health program for doctors; the Victorian Doctors Health Program (VDHP). At present the Medical Board of Australia is undertaking a consultation with the medical profession considering if doctors are willing to pay a levy on their registration to fund health programs for doctors throughout Australia. If this proposal proceeds it may set a precedent which the pharmacy profession can follow.
Ten years ago Con Berbatis was involved in an accident while on a holiday in Greece. The injuries he sustained eventually affected his health to the extent that he had to curtail his workload, including the writing of research reports for publication in i2P.
A list of some of his more important reports appears below.
When you check the date of publication against the content you will note that Con was well in advance of his time.
In his letter of resignation to Curtin University, Con outlined some of his difficulties since his accident:
I’ve stayed at hundreds of hotels across the nation and in 31 countries.
My kids say I’m a hotel snob.
When a Kimpton Hotel is in town, it's a no brainer, unless there’s more than one.
The interior design appeals to my side of the brain.
The fresh, clean rooms are inviting.
The beds are “just right,” the linens and pillows are comfy, and when there’s body wash or shampoo left, it’s worth taking home.
All this at sane rates.
We are republishing the article below, written by Dr Joseph Mercola.
It reveals the extent to which medical fraud has become systemic and commonplace.
The people that do original research and have it published are in the main, medical academics - similar to the medical academics that have joined together under the Friends of Science in Medicine (FSM) banner which is lobbying to have complementary-based science courses banned at universities.
While we are not suggesting that any of the members of this group have been involved in medical fraud, we do find it strange that their agenda does not include putting their own house in order first, to illustrate a lack of bias and a willingness to lead by example.
This would create a level of support for the cause from all health practitioners because we all want to do "what is right".
Certainly they would present as a more credible organisation if this was the case, rather than a group that is trying to get "points on the board" by pursuing the stated soft targets (chirporacters, naturopaths etc), because they are not the real problem.
Professionally we all allow ourselves to be bound by "evidenced-based medicine".
But what happens when significant components of that evidence (up to 50% according to Dr John Ioannidis mentioned in the Mercola article) is corrupt and unable to be relied upon.
What happens then?
It was a grey and wet Sunday afternoon when I recently watched a program produced by the ABC about Faram Brothers, one of the last independent hardware stores.They closed their doors in a Melbourne suburb (Port Melbourne) circa 2007.
It had been an institution in Port Melbourne since the very early 1900’s and attracted my attention because of the historical perspective it covered.
But it also paralleled the story of pharmacy over the same period, because it had started life as a family business that by choice set out to be as helpful as possible to the community, and valued the retention of customers through goodwill and providing service well above customer expectation.
And in some cases, well above the ability of those customers to afford the service they received (but they still received it nonetheless).
Drug shortages are a growing global engineered disruptive problem.
Apart from obvious and unexpected factors such as plant fires, earthquakes, volcanoes, floods and other natural disasters capable of major supply disruption there are a myriad of other excuses offered that are well and truly under the control of manufacturers.
These include equipment breakdowns, industry consolidations, limited raw material supplies, changes in inventory and distribution practices (just in time inventory practices are causes for potential disruption), production delays through industrial unrest, increases in demand, site closures for business reasons – all these reasons create difficulty in the formation of “buffers” to cushion any stock shortages.
Within Australia, there have been some very torrid exchanges between interest groups associated with the use of vaccines and their effectiveness and safety, both for and against.
This exchange is not limited to Australia, but a local organisation titled the Australian Vaccination Network has been prominent in disseminating the "anti-" side of the argument, while the Skeptics (mainly the Victorian branch) have been very prominent for the "pro" side of the argument.
Argument has often centred on the heavy metals (particularly mercury) used to stabilise vaccines.
Gary Mortimer was formerly Retail Operations Manager, Coles Group - Shell Alliance (Fuel & Convenience) from 2008 to 2010.
Given that he has had insider experience within a division of one of the major retailers, he gives a clear perspective on the contemporary thinking of major retailers.
It appears that the current strategy to "capture" pharmacy is to increase product range and surround it with health services such as optical.
This, in preparation for the final storming of the barricades set for the year 2015.
Globally, supermarkets captured pharmacy at a very early stage.
In Australia, the Pharmacy Guild of Australia has put up a strong resistance to this process.
It would be nice to think that Australia might retain its individuality by standing out from the crowd, leaving pharmacy to set its own destiny.
As Gary Mortimer points out, healthcare is not a commodity.
Currently, Medicare funds a range of pharmacist interventions at a rate that is determined mysteriously (nobody knows the formula). Pharmacists might be well advised to develop this channel of professional reimbursement as a further means of distancing itself from supermarket operations.
It appears that the fight between pharmacy and the supermarkets is set to take another twist in the long running saga.
A little over a week ago I wrote an article on pharmacy renewal, based on the comparative experience of a Melbourne hardware store that had reached its “use by” date.
The “use by” date was, in reality, a self-inflicted one brought about by the owner’s refusal to depart from a service model that had not undergone any renewal processes since it opened its doors over 100 years ago.
The analogy with pharmacy was fairly obvious, but it did force me to review the current practice of pharmacy and its inability to find itself practicing out of a suitable business model.
In other words, pharmacy has also reached its “use by” date.
Unlike the family hardware store, pharmacy has adapted over the same period of time and has renewed some components of its business format.
The fact is that pharmacy is now relying on retailing, (and discount retailing at that), is not a suitable survival format- because it is not the core business of pharmacy.
Pharmacy’s core business is health care, or more succinctly, patient-centred care.
This is what needs renewing.
Mobile phone apps are becoming more prevalent, but few have made their appearance in pharmacy.
There is a range of pharmacy opportunities that can be linked with mobile phones, provided the pharmacy has a website that can handle the application.
The example following, developed by Foodswitch, involves some strong alliance partners. Even in its current format it could assist thos pharmacists involved in nutritional counselling.
It is obvious that health costs are spiraling and will shortly reach a stage where they become out of control.
Pharmacists are well placed to fill some of the gaps with economical services, but are prevented by various restrictions, mainly engineered by medical politicians.
Unless pharmacists are willing to take up the fight, they will be permanently sidelined and will become irrelevant.
There are many opportunities for pharmacists, but the leadership in pharmacy, and political will, is totally lacking.
Boots Pharmacies have been told to stop listing medical conditions in their in-store advertising of homeopathic products by the medicines regulator, following a complaint by Simon Perry.
The point-of-sale advertising in Boots stores recommended homeopathic products as suitable treatments for a wide range of medical conditions including allergies, infections, insect bites, headaches and earaches. But homeopathic products contain only sugar — they have no active ingredients.
By discovering how a blood clot-busting enzyme is switched on, researchers have unlocked a century-old atomic riddle that could lead to new treatments for clotting and bleeding disorders, and some cancers.
In findings published today in Cell Reports, Monash University researchers, led by Professor James Whisstock and Associate Professor Paul Coughlin, together with colleagues at the Australian Synchrotron, have shown how the protein plasminogen is converted into plasmin, an enzyme that removes disease-causing clots and clears up damaged tissue.
Stimulating the brain with a weak electrical current is a safe and effective treatment for depression and could have other surprise benefits for the body and mind, a major Australian study of transcranial Direct Current Stimulation (tDCS) has found.
Medical researchers from the University of New South Wales (UNSW) and the Black Dog Institute have carried out the largest and most definitive study of tDCS and found up to half of depressed participants experienced substantial improvements after receiving the treatment.
Administering tablets and capsules to patients who have difficulty swallowing or an enteral feeding tube is a challenge.
Healthcare professionals need to know “can I crush it?”, “can I dissolve it?”, “can I open the capsule?”, “is there a liquid formulation?”, “can I give the injection orally?”.
The medical profession have a history of dominating anything connected with health.
When a new extension of an existing discipline is developed to fill a niche e.g. clinical pharmacists, we see a parallel development coming out of medicine e.g. clinical pharmacology.
We see similar strategies occurring in offshoots such as pathology.
Laboratories that have sprung out of complementary medicine origins have their laboratory results refused by GP's and instead insist the patient have additional tests performed through their own associated laboratories.
This even occurs when the complementary laboratory has achieved the same national accreditation standard as any other laboratory.
Now there is a move to have all "non medical" prescribing monitored by a "watchdog" organisation.
The call for such an organisation comes after the 5CPA agreement was passed into law.
Included in the new agreement was a provision for "continued dispensing" that appeared to provide the trigger.
The Medical Observer reported the doctor's views (as indicated in the news item below) so we asked Mark Coleman to give some insights from a pharmacy perspective.
Kay Dunkley - BPharm, Grad Dip Hosp Pharm, Grad Dip Health Admin, MPS, MSHPA: Support services for pharmacists and doctors in the United Kingdom – Part 4 British Medical Association Doctors for Doctors | open full screen