s Building a clinical services model in a difficult marketplace | I2P: Information to Pharmacists - Archive
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.

read more
open full screen

Recent Comments

Click here to read...

News Flash

Newsflash Updates for July 2014

Newsflash Updates

Regular weekly updates that supplement the regular monthly homepage edition of i2P. 
Access and click on the title links that are illustrated

Comments: 1

read more
open full screen

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

read more
open full screen

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.

read more
open full screen

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

read more
open full screen

‘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.

read more
open full screen

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).

read more
open full screen

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.

read more
open full screen

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.

read more
open full screen

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.

read more
open full screen

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

read more
open full screen

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.

read more
open full screen

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.

read more
open full screen

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?

read more
open full screen

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

read more
open full screen

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.

read more
open full screen

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.

read more
open full screen

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.

read more
open full screen

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.

read more
open full screen

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).

read more
open full screen

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.

read more
open full screen

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.

read more
open full screen

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.

read more
open full screen

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:

read more
open full screen

Building a clinical services model in a difficult marketplace

Peter Sayers

articles by this author...

Peter Sayers is vitally concerned about pharmacy professional practice - its innovation, its research and development, and its delivery to create an ongoing revenue stream. Delivery of healthcare is increasingly involved with Information Technology systems. All perspectives in IT must be considered for the impact on pharmacy practice and its viability.

It seems to me that there is a confluence of events overtaking pharmacy.
On one hand there is a genuine disappointment by health consumers that they have not been able to access pharmacists for basic primary care services, and on the other, there are a host of pharmacy critics and academic advisers that have a range of solutions, none of which are compatible with a community pharmacy environment.
And in the middle are a host of dedicated pharmacists working and piloting a range of solutions while simultaneously being torn apart, as unreasonable chunks of cash flow and profitability disappear from its business heart.

This is not the first time that this has happened in the history of pharmacy and government, and was the primary reason negotiated community pharmacy agreements came into existence with the PGA as the lead negotiator for pharmacy.
Originally, these agreements provided certainty, but recent views indicate that pharmacy may be in for a period of uncertainty as the skirmishing preceding the 6CPA are under way.

The Pharmacy Guild of Australia is finally on the same page as the majority of pharmacists (owners and non-owners) by announcing proposals for a range of primary health care initiatives that will offer opportunities for clinical pharmacists.
Funding is to be negotiated under the 6CPA agreement that is about to commence preliminary discussion- with the initial rumour being that government will not be negotiating a new agreement.

Just as there was light at the end of the tunnel with a potential pathway to a clinical future, along comes the heavy hand of government, followed closely behind by the medical profession carrying on its usual disruptive campaign to suppress the aspirations for growth and development of other health professionals, who wish to be of benefit to the patient community of Australia.
Mutterings of “turf wars” directed at pharmacists, and removal of health benefits from others (like chiropractors) are reaching a crescendo.

The fact is that the medical fraternity are lashing out because their own patients are becoming savvy to the mediocre delivery of most medical services and the resistance to high service charges.
It costs in the order of $65-$70 to get a prescription renewed these days, so it is little wonder that they lash out at the approach by other health professionals to gain prescribing rights.
Other health professionals (including pharmacists) can see the mismanagement and price gouging and wonder why this should be.

Usually, when pharmacy becomes involved in political changes to its profession it invariably comes down to the prices paid for prescription (by government).
Even though the PGA does all it can to work out reasonable solutions, we still see government breaking its agreement simply to fulfil other budget promises it made without the money to fund them.
As pharmacy has generated savings above and beyond the cause, little blame can be attached to our profession and that leaves no reasonable excuse to under-fund our future service provision.
Last time we had to defend ourselves we had to go on strike.
The PGA recent petition was a shot across the bows to indicate community pharmacy had strong public support.
The stage is now set for a rocky future if government does not give ground and give back reasonable funding in a usable fashion. And this must include a mechanism for individual pharmacist contractors to be enabled to receive a fee for providing clinical services.

Leaving all that behind for the moment, it is necessary to dwell on survival strategies.

Historically, when pharmacy has come under political pressure, it has turned to retail marketing to reduce its dependence on PBS activities.

The PBS has almost become an unworkable art form in that cash flows are continually disrupted (when claims are not fully paid due to government manipulation involving their own budgeting practices) and pharmacy can no longer sustain the over-regulation, the under-payment on expensive PBS products, and the manipulation of payments disrupting pharmacy cash flows.

However, because pharmacists have allowed their internal ratio of retailing to PBS to get out of balance (and this because of PBS compliance pressure) they are vulnerable.
Different models of pharmacy now exist with the warehouse model taking prominence.
While there is no argument that there should be variation in pharmacy business models, not everyone wishes to practice as high intensity retailers deriving little professional satisfaction.

Government planners have also allowed other businesses of the Colesworth variety to accumulate excessive market shares of products sold in common with pharmacy and then be involved in disruptive market activity to an unconscionable level.
Australia belongs to a handful of countries that has allowed this to happen.
And pharmacy has been one of the few small businesses that has survived this onslaught as far as ownership is concerned, but not as far as market share is controlled.

So trying to build a retail market with the combined pressure of the PBS compliance and retail giant disruption is concerned, makes life almost impossible, particularly when trying to assemble enough capital to research and develop paid clinical services.

In the midst of change, everything remains the same.
And that is true even in these days of disruption.

So my advice is to convert as many OTC branded products in your inventory to generic or own brand products, unless the branded product pays its way.
Be ruthless in rationalising your inventory range
It has been a long-standing practice for brands to buy display space in Colesworth and now, I believe , in warehouse pharmacies – let them do the same for you are have their products “disappeared”.
Look at new product categories that are health-related and develop those products with a pharmacy “value-add” component.

It is also now time to streamline your dispensary and prepare the transition for pharmacists to relocate in a clinical services area. Ask them to participate in the development of services and to generate innovative ideas. Twelve months is about all the time that is left to make a dispensary profitable and there is no other choice than to commoditise the dispensary and make the clinical service area pay by charging the general public for them.
Do not wait for the PGA to develop a system with government.
It will take too long and will never be reimbursed to an adequate level.
Also, for the independent services developed, do not let them fall under government control in the future or allow warehouse pharmacies to discount them to zero (if you are a provider).

Pharmacy business models will essentially remain the same, only the different segments of pharmacy will have a different emphasis, treatment or flavour.
The balance of segments will provide the “point of difference” between the various models, and an image can be earned through a small segment of activity.

For example, by delineating a reasonable area for clinical services that has a different “look and feel” to all other pharmacy segments and is separated from the dispensary (but still interactive with the dispensary).
This will be enough to alter the “image” of the pharmacy no matter what else is conducted within the same walls.
Ensuring that the marketing of this area is different, and the internal work-flows and patient services also show a point of distinction, and you are past the first post.
Then comes the hard part of building a solid clinical practice.
It can be done, but it will take a minimum of two years to achieve a critical mass.


Return to home

Post new comment

The content of this field is kept private and will not be shown publicly.
  • Web page addresses and e-mail addresses turn into links automatically.
  • Allowed HTML tags: <a> <em> <strong> <cite> <code> <ul> <ol> <li> <dl> <dt> <dd>
  • Lines and paragraphs break automatically.

More information about formatting options

CAPTCHA
This question is for testing whether you are a genuine visitor, to prevent automated spam submissions.
Incorrect please try again
Enter the words above: Enter the numbers you hear:

health news headlines provided courtesy of Medical News Today.

Click here to read more...

If any difficulty is found in subscribing, please use the "Contact Us" panel found in the navigation bar with the message "subscribe" and your email address.

Subscribe to our mailing list

Email Format
 

 

  • Copyright (C) 2000-2019 Computachem Services, All Rights Reserved.

Website by Ablecode