Editorial
Welcome to the November edition of i2P – Information to Pharmacists.
The month just finished has been an exceptionally busy one for pharmacy with an interesting PAC being concluded.
The “Great Debate” from PAC stirred considerable interest, also the talk given by John Menadue.
The latter has been reported and commented on in the article “Pharmacy’s Professional Future” and it is recommended that this article be bookmarked.
Better still, add your comment at the foot of the article.
All our columnists are back on deck and we are delighted to report that our New Zealand columnist, John Dunlop, has been accorded high honours by the New Zealand Pharmaceutical Society.
See the article in the Recent News section or look for the editor’s logo in the column section.
Our congratulations go out to John for this honour that resulted from his work in the pharmacy professional services area..
Columns
Rollo Manning: Pharma-Goss
Loretta Marron OAM BSc: Health Watch
Barry Urquhart: Marketing Focus
Harvey Mackay: Strategic Thinking
Mark Neuenschwander: I`ve been thinking about...Recent Comments
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
Pharma News
Hospital News
Health Politics
Climate Change
EPublications
Pharmacy’s Future Professional Services
The recent “Great Debate” at the 2009 Pharmacy Australia Congress had an excellent topic choice (“The answer to our future is increasing front of shop sales, not professional services”).
The answer is, of course, that pharmacies need both activities as “core business” to survive – it just depends on what balance is required for each unique pharmacy practice sufficient to allow for differentiation and emphasis on specialties (whether professional services or retail activities).
However, it could be argued that policies in recent years have tipped the balance in favour of supply services that favour retail activity.
Little research or effort has gone into the development of professional services (there is actually major amounts of unspent grant money from the Fourth Agreement), so many pharmacies see little relevance in promoting services they may not have the training for, or the infrastructure to deliver the necessary training (which comes at a cost).
Servants to the world.
Recently I received a number of calls from a concerned relative of one of our veteran clients currently in an aged care facility.
The problems I am hearing about relate to the difficulty in getting the patient’s doctor to write prescriptions for necessary medications, echoing many of the stories I heard during my pharmacy visits about the problem of “owing scripts” and just how hard it is for pharmacists to get them written. If we break down the problem we get this sequence of events:
2
Communicate anywhere and everywhere – is getting nowhere
Is talking about talk the best way to start solving the sharing of data in a health informatics scenario?
I have often written on the subject off interoperability; referring to broken and failed systems and in the attempts to get everyone in healthcare, primarily inside a hospital, to exchange information without re-working it all the time.
This can be a complex subject matter because it has little to do with technology and all to do with people. If various departments and fiefdoms want to share their data it can happen; if they behave in a recalcitrant manner, it won’t happen.
Which takes us down a path, for perhaps another time, regarding the subject of IT systems and collaboration? We Australians are not good at this – there is something in our makeup that resists sharing certain things, notably information management systems. Not sure whether it is a streak of independence or immaturity, or both. Anyway, moving on to the matters at hand, let’s continue.
Power in Numbers rises up the charts in Pharmacy.
There is power in numbers.
It is said that Chemist Warehouse is growing at 25/30% per annum, the traditional franchises are growing at about half that rate and the poor old unbranded Pharmacy is trailing behind at about 10%. This really means that Chemist Warehouse is flying along with a wet sail doing nicely and all others are wondering where to find growth or are spending far too much time with their accountants’ trying to work out how to survive the future.
This is no surprise of course; the Chemist Warehouse business model is brilliant, they are compelling marketeers and proof that the power in numbers prevails.
It's all in the Genes
When you think about it, genetics are likely to determine your skin type.
It is little wonder that if one or more of your relatives, including your ancestors, had a predisposition to skin cancer, then you may have inherited that trait.
Researchers believe that there is up to a 50 percent risk involved that you will develop skin cancer through genetic inheritance.
Skin cancer can be inherited: studies
Source: Reuters
http://www.reuters.com/article/healthNews/idUSTRE5984VM20091010?feedType=RSS&feedName=healthNews
Why New Zealand must rapidly halve its greenhouse gas emissions
Editor: It is good to see the New Zealand medical professionals getting behind climate change strategies in their country.
Pharmacy, particularly here in Australia is conspicuous by its absence in this activity.
Yet there are many things we can influence - particularly in the areas of the supply chain, shop design and the type of fixtures and fittings we select.
Unless we all begin to be proactive in this area, events will pass us by to our detriment.
Add your comments at the foot of this article to start off a discussion.
Source: New Zealand Medical Journal
Article written by: Scott Metcalfe, Alistair Woodward, Alexandra Macmillan, et al; for the New Zealand Climate and Health group
http://www.nzma.org.nz/journal/abstract.php?id=3827
The Pharmaceutical Society of New Zealand 2009 Honours
In Issue number six of Pharmacy e-Edge, the newsletter of the Pharmaceutical Society of New Zealand, four New Zealand pharmacists were awarded a range of honours.
The report was prepared by Richard Townley, the CEO of the Society.
Among them was John Dunlop, our i2P writer representing New Zealand, and we are pleased to share in John's achievement.
John was awarded a Fellow of the Pharmaceutical Society of New Zealand in recognition of his outstanding contribution to the advancement of the practice of pharmacy in New Zealand.
Congratulations John!
Brits love the NZ version - "Fush 'n Chups"
In a press release by Dr Allan Bell of Auckland University of Technology (sure to raise eyebrows with some Australian i2P readers), it is stated that:
"The New Zealand accent has been rated the most attractive and prestigious non-British form of English, according to a BBC survey.
New Zealand English came in first ahead of Australian, American and most regional British accents in the study published in the international Journal of Sociolinguistics, edited by Professor Allan Bell, Director of AUT’s Institute of Culture, Discourse and Communication."
Food as medicine - brown rice benefits diabetic patients
Choosing your rice variety may provide an inexpensive support for a program to treat diabetes.
Menus involving varieties of brown rice may reduce glycation and the rate at which sugar is absorbed by the body.
Cinnamon is another food known to sensitise insulin and reduce sugar levels.
With a some thought it appears that a variety of foods that combat diabetes could be combined to create dishes that are not only functional, but delicious to eat as well.
Brown rice could aid diabetes control
By Anuradha Alahakoon
Source: SciDev.net
The Starting Point
It was refreshing to read some positive recent announcements, comments and opinions in the media over the past three weeks.
First was the announcement by Nicola Roxon regarding the National Preventive Health Agency and the positioning by the Pharmaceutical Society of Australia firmly in support of this development of her initiative.
It is not quite 12 months ago that i2P ran a story on Nicola Roxon, her family and political background, at a time when she was relatively unknown in health circles.
Some observational and predictive points from that i2P article dated December 2008 -"Have you met Nicola Louise Roxon?" -are shown below.
Go to http://archive.i2p.com.au/?page=site/article&id=1168 for the full article.
"* Nicola appears to be a very normal and stable personality with strong family values, and is direct, straightforward and honest in her professional life.
* Nicola will endeavour to broaden the concept of health from illness treatment to illness prevention. She is well documented in many statements that “prevention is better than cure”.
* Pharmacy will be included within primary health care (something that other professions have tried to restrict), and the role pharmacy already plays in self-care will be recognised. I am sure that funds will be made available for the extension of self-care, work that has always been unpaid work performed by pharmacists.
* Nicola, however, needs to understand exactly what depth pharmacists have provided primary care, almost in a secretive fashion, because of constant harassment by doctors. While there is a surface cooperation between doctors and pharmacists, it is really only lip service.
The removal of this harassment would allow pharmacists to thrive as well as the general public.
* Nicola also needs to understand that while pharmacy owners provide infrastructure to provide medicine distribution, the pressure of this infrastructure works against the development of clinical services.
For this role she needs to recognise pharmacists individually as health practitioners and separate their income from the PBS model.
By providing incentives to individual pharmacist practitioners, development ideas and capital would flow in from these people and pharmacy owners would form beneficial relationships to harness benefit for the supply side of their businesses.
* From the recent address given at the Pharmacy Guild of Australia annual dinner, Nicola said, in part:
“The examples of existing Professional Programs and Services confirm the pharmacist’s role within the primary healthcare team.There may still be some debate about the borders of that role – but the direction is already well and truly established.
I want to be clear here – and I suspect my earlier comments have already given this away – any expanded role for pharmacists will take an incremental approach, and will be dictated by the need for safety and quality in health care.”
In other words, she will do what she has always done – carefully plan and test any program before it becomes policy.
It would seem that we were substantially correct and that the National Health Preventive Agency will offer a great opportunity for pharmacists to take advantage of their current training and skills set.
The second item was contained in a press release by the PSA dated 16/10/09 regarding a Memorandum of Understanding that was signed in Sydney by the President of the PSA, Warwick Plunkett, and the President of the RACGP, Dr Chris Mitchell, at a ceremony during the Pharmacy Australia Congress.
While details of the memorandum still have to be released, it may eventually mean that pharmacists will be able to practice independently and in alliance with GP's without the constant sniping that has been a feature of a relationship, which if worked cooperatively, has always been proven to provide maximum patient benefit. Good work PSA!
The third item of interest was an opinion article written by Geoff Marsh, president of APESMA.
Few comments have originated from APESMA, so it was good to see a comment from this organisation, as is really the voice of non-pharmacy owners, or to put it more succinctly, the logical representative of the pharmacists who provide professional services (whether or not they are paid up members).
The following appeared in Pharmacy e-News on 23/10/09 (located at
http://static.rbi.com.au/common/contentmanagement/pharmnews/PDFNOAD/20091023.pdf
Another Profession Targets Baby Boomers
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It is well known that lawyers are able to generate their own income, something you would find out if you were ever to engage one. Source: DPS Aged Care
After the first "free" introductory consultation, there follows an expression of confidence that the legal problem will dissolve.
Then follows the obligatory frenzy of letters, telephone calls and emails to the opposition lawyer (in 5-minute chargeable "bites" at an hourly rate that can only be called "stellar") until both lawyers agree that enough activity has been generated to create a base income.
At that point the difficulties are pointed out to the client and more instructions are called for, with the "nitty-gritty" of having to be faced with another round of high priced communications ((no strategic course is offered - you must "instruct" that yourself).
Maybe you eventually get a result, but never a good result, unless an extraordinary amount of money has been spent to guarantee a good result.
A new pot of gold has been found among the elderly and so strong is the cash flow, it has stimulated an entirely new body of law.
Called "Elder Law", it is based on the premise that "baby boomers" will steadily retire from 2010 onwards.
This group of people is fairly wealthy, independent and active, but will inevitably succumb to the ravages of ageing, including the onset of dementia and a period of time where an "elder" will not be legally capable of making decisions for themselves.
Over the next 30 years the elders are predicted to become 25-30% of Australia's total population, and right now there is a stream of lawyers upskilling in "elder law" in time to follow the money trail for most of their future professional lives.
Elder law booming for lawyers
http://www.agedcareguide.com.au/news.asp?newsid=4033
Dubbed "elder law", specialists in the field say come 2011, the niche area will be booming, with lawyers in demand to solve a range of complex family dilemmas including whether elderly parents have the capacity to make their own decisions.
An article in The Australian’s legal affairs section reports Brian Herd, elder law specialist and partner at Queensland-based Carne Reidy Herd Lawyers, saying that baby boomers would produce more work for lawyers than their parents because of the greater complexity of their lives.
"They're the ones that are going to have significant wealth, significantly complex lives, complex families. The current generation is a bit simpler in terms of their circumstances," he said
Mr Herd said a wealth of legal work stemmed from people growing old and this was not confined to the traditional areas of power of attorney and wills.
He said there was a growing need for "compacto agreements'' which established contractual arrangements between elderly people who were companions rather than partners in a defacto-style relationship.
"Older people tend, if they can, to join or become companions to older people and as a result we've coined the phrase compactos to describe people who live as companions, not in a sexual or relationship sense but simply as companions."
Mr Herd compared the relationship to students living together in a share house and said it was another example of "life coming full circle'' for older people.
Older clients were also increasingly demanding trusts be established for their pets because of concerns they would not be looked after when they died. Mr Herd said one client wanted to leave all her estate to her dog but because this was not legally possible, a pet fund was established, ensuring enough money was left for the dog's care.
There was also demand for "impoverished planning" because clients wanted to be eligible for even $1 of the aged pension due to other benefits that flowed.
Family agreements to establish how elderly parents would be cared for were also becoming more common. Mr Herd said he had one family who established an agreement that saw a daughter get paid to care for her mother because the family did not want to place her in aged care.
Issues surrounding the capacity of an older person was one of the biggest areas of elder law. He said disputes could arise in families over whether their parents had the capacity to make their own decisions and whether an enduring power of attorney should be appointed.
The economic downturn had also seen an increase in elder abuse and Mr Herd said some children saw their parents as being the solution to their money problems.
He said the area of elder law gave lawyers an insight into the "extraordinary amount of dysfunction'' in some families but it was this same dysfunction that created work and led to "legal bliss".
He said elder law transcended many areas and lawyers in other specialities needed to learn more about the practice.
Mr Herd also said lawyers held prejudices against older people, including that they were tight with money and sought legal advice over minor and trivial matters. But he said, in his experience, older people had many advantages as clients including paying promptly, always being on time and being prepared to pay for quality and reliability.
Research Reports
Practice Development
Dr John Dunlop (PGDipPharm, MPharm, DPharm(Auck), FACPP, FNZCP, FPSNZ, MCAPA): Time for a Right Model of Pharmacy - and Unity | open full screen
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