s Dark Forces Emerging - Including Colesworth | I2P: Information to Pharmacists - Archive
Publication Date 01/11/2013         Volume. 5 No. 10   
Information to Pharmacists

Editorial

From the desk of the editor

Welcome to the November 1 2013, Homepage Edition of i2P – Information to Pharmacists E-Magazine.
We are approaching the end of a calendar year, a year many of us would like to put behind us.
In this edition we report on the “dark forces” that are beginning to surround us while the profession and industry find themselves in a weakened position – far weaker than they were this time last year.
Quite a few opportunities exist and quite a few opportunities have been squandered by our leadership organisations and their executives.
What pharmacy seems to not have is a group of mentors capable of guiding the introduction of paid clinical services.
Because this activity requires a paradigm shift in attitude and culture, their introduction has to be driven by local leadership.

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News Flash

Newsflash Updates November 2013

Newsflash Updates


Regular updates from the global world of pharmacy.
Access and click on the title links that are illustrated.

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Feature Contribution

Is a Community Pharmacy an Incompatible Environment for Clinical Services?

Dr John Dunlop (PGDipPharm, MPharm, DPharm(Auck), FACPP, FNZCP, FPSNZ, MCAPA)

The recent article “observations on implementing a clinical service”,1 stimulated me to share my perceptions of this well meaning approach to providing a clinical service within a community pharmacy.
Firstly let me admit to being much older than the author of this article, and let me establish that I spent over 40 years in community pharmacy before embarking upon a clinical career.
The perception that a viable clinical pharmacy practice can be undertaken in a community pharmacy is contrary to the reality and numerous assessments described in the researched literature.
Having studied this problem for many years, I have come to the conclusion that a community pharmacy environment, which is predominantly a supply and distribution model, is incompatible with the provision of clinical roles.

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Stuff to Think About

Gerald Quigley

Editor's Note: Gerald recently attended a meeting hosted by Medicines Australia.
He picked up on the undercurrent related to the meeting's real agenda.
There are some sinister elements that sense that pharmacy may be in a weakened state with a large number of pharmacists being focused on survival-both employers and employees.
These elements are looking to exploit pharmacy and limit its independence as part of a wide-ranging agenda.
Your help is needed.

The words which literally grabbed me at this meeting included “caught”, “capture” and “tracking”.
No, we weren’t discussing wild animals or escapees from the penal colonies……we were discussing dedicated, hard-working, committed and patient-focused health professionals in Australia.
I attended the Medicines Australia Transparency Working Group meeting in Melbourne last month.
The discussions were centred on the medical profession, more especially on prescribed medicines from my understanding.
References though were continually made about pharmacists.

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Roadblocks in Clinical Services Provision

Neil Johnston

I have been reading with interest, Peter Sayers' journey into paid professional services and his cautious optimism.
Now, as a feature article in this current edition of i2P John Dunlop, a respected New Zealand pharmacist, expresses doubt that clinical pharmacists are going to make it in a community pharmacy setting.
Further, Professor Austin Zubin at a recent PAC2013 conference in Brisbane identified a problem amongst pharmacists he describes as ‘Paralysis in the face of ambiguity’ as he pondered why pharmacists were not taking up opportunities in primary health care.
“Despite abundant opportunity and patient demand, government recognition etc, across the world, a similar picture emerges of a profession that is its own worst enemy,” he said.
 “The standard response to new opportunities is, ‘I don’t have enough time, I’m not trained for this, I’m not getting paid enough, it’s too costly….”

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A Report on HPV Vaccine at the 3rd world congress on Cancer Science and Therapy in San Francisco October 2013

Judy Wilyman

The University of Wollongong recently provided funding for me to present my research on the HPV vaccine at the 3rd world congress on Cancer Science and Therapy in San Francisco.
On the 22nd October I presented my research that demonstrates that HPV vaccination has not been proven to be safe or effective against cervical cancer.
Japan and India have recently stopped recommending this vaccine due to deaths and disability after vaccination.

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Is the CHF (Consumer Health Forum) representative of consumers?

Mark Coleman

i2P has often commented on the orchestration of various lobby groups and their suspect behaviours when orchestrating their seemingly unrelated activities.
They seem to have gotten their chorus to be sung in tune.
Gerald Quigley referred to these "dark forces" in his article in this month's edition.
Their activities are disruptive, damaging and distracting to say the least and some border on the illegal.
They also have a common thread in that members of the Skeptics Society are common within their membership allowing the various groups to work in concert.
i2P readers need to be aware of these activities because they may have to mobilise their resources to counter behaviours that affect pharmacy-directly and indirectly.

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Are On-Line Shoppers Only Concerned With Price?

Chris Foster

It’s easy to assume that the on line shopper is attracted to that medium solely by the cheaper prices that may be available.
And, if price was the only criteria, the majority of bricks and mortar stores (B&M) would well and truly be out of business by now.
Yes, as always, there are a number of consumers where price is the sole determinant in the decision to purchase. Traditionally, this has been around 10% to 15% of consumers.
However, what are the real facts?

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I’ve been texting, I mean thinking about texting, as well as dialing, handwriting, and face-to-face talking in our hurry-up worl

Mark Neuenschwander

These days we call the US Post Service [sic] snail mail. But in 1775, Ben Franklin’s innovation sped up letter travel between Philadelphia and San Francisco from forever to a few months.
In 1844, Samuel Morse accelerated message delivery exponentially. Transmitting words at the speed of light, the inventor’s telegraph made Abraham Lincoln our first online president, enabling the commander in chief to chat instantaneously with his generals on the front lines.
In 1862 the transcontinental railroad relegated the year-old Pony Express to mothballs by whisking letters from coast to coast at 30-some miles per hour in under ten days.

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Caring for you Caring for others – a report on the Health Professionals’ Health Conference 2013 3 October to 5 October 2013

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

Evolving from the Doctors’ Health Conference the program of the Health Professionals’ Health Conference included much of relevance to all health professionals including pharmacists. Delegates came from all over Australia and New Zealand as well as several travelling from countries further away including England, Ireland, Hong Kong, Singapore, Canada and USA. Delegates included a range of health professionals and medical students. Notably only two pharmacists attended this conference which had approximately 160 delegates.

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Culture Bonds, Right?

Barry Urquhart

PAY ATTENTION: Applying “automatic cruise” is not a viable or appropriate option for management by business leaders today.
The pathway to success and to the future is littered with numerous, often unforeseen barriers, impediments and filters.
There is a clarion-clear message in this for all. It parallels the findings of a recent detailed study among motor vehicle drivers and into the causes of road accidents.
The consistent and most disturbing primary cause of motor vehicle accidents was not speed, alcohol, climatic conditions or unfamiliarity with the local road network (through these were significant, often independent contributors to the accident statistics).
The highest ranking causal factor was INATTENTION.
Being distracted from the primary focus can, and often does have dire consequences.
On the road these can include receiving and sending text messages, mobile telephone calls, loud and aggressive passengers, external eye-catching activities and simple tiredness, boredom and outright inattention.
The consequences can and do impact on many.

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Treating ADHD with Vitamin B-3 (Niacinamide)

Staff Writer

From Orthomolecular Medicine News Service- Editor: Andrew W Saul

ADHD is not caused by a drug deficiency.
But it may indeed be caused by profound nutrient deficiency, more accurately termed nutrient dependency. Although all nutrients are important, the one that an ADHD child is most likely in greatest need of is vitamin B-3, niacinamide.

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Celebrating youth service at We Day

Harvey Mackay

The atmosphere was beyond electric: 18,000 cheering teenagers, and it wasn’t for a rock star, a pro athlete or even canceling school.
This remarkable group of students gathered in St. Paul, Minn., for We Day in early October to be recognized for their stellar record of volunteering.
And this was only one of more than a dozen such gatherings across North America.
We Day is described as a celebration of the power of young Americans to create positive and lasting change, not only in their communities and around the world, but within themselves.

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Pointless and perilous pathologies

Loretta Marron OAM BSc

Off sex, always tired or feeling low? Why not see a natural therapist to find out what's wrong. They offer a variety of tests to nail your problems - but do they work? Hang on, the experts say "No"!
"Commercially driven, unvalidated, pseudo-medical tests are endangering the well-being of Australians by giving wrong diagnoses and incorrect reassurances of their health",
so say the Friends of Science in Medicine (FSM) Pathology Advisory Group. Consisting of distinguished pathologists and allergists from both Australia and New Zealand, their warning comes with the support of The Royal College of Pathologists of Australasia (RCPA).

Comments: 1

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Multi-Professional Prescribing- The AMA Lost Out

Neil Johnston

You have to scratch your head sometimes, particularly when you see news reports quoting Steve Hambledon (AMA President) stating that autonomous prescribing by “non medical health professionals” (which, of course, includes pharmacists), is “dangerous”.
This statement is just about as ridiculous as an earlier statement indicating vaccines provided through pharmacy were dangerous because pharmacy lacks suitable refrigerators.
This followed the decision by COAG to approve the draft Health Professionals Prescribing Pathway, now only requiring legislative approval and Board Guidelines to become a significant factor in the pharmacy profession moving forward.

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Niacin Beats Statins Supplements and Diet are Safer, More Effective

Staff Writer

OHMS Newsletter
by Andrew W. Saul, Editor

 Statins for everyone?
If media are to be believed, and if the drug industry has its way, the answer is "you bet."
The American Academy of Pediatrics has stated that kids as young as eight years of age might take statin drugs.
Specifically: "As a group, statins have been shown to reduce LDL cholesterol in children and adolescents with marked LDL cholesterol elevation . . . when used from 8 weeks to 2 years for children aged 8 to 18 years." http://pediatrics.aappublications.org/content/128/Supplement_5/S213.full
Strangely enough, American Academy of Pediatrics projects receive cash from Merck & Co., Pfizer and Sanofi-Aventis, as well as from Procter and Gamble, Nestlé and other large corporations. http://www.aap.org/en-us/about-the-aap/corporate-relationships/Pages/Friends-of-Children-Fund-President%27s-Circle.aspx

Comments: 1

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Chiropractors and GP’s told to team up after published research

Mark Coleman

Recently, the Chiropractors Association of Australia partially funded a study undertaken by researchers at the University of Melbourne, which has provided the best picture yet of the most common conditions treated by chiropractors.
It suggests most chiropractic treatments and consultations undertaken in Australia are evidence based.

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Fart With Confidence

Peter Jackson

Technology derived during the development of protective clothing for use in chemical warfare has now been adapted for everyday consumers to assist them in daily living. The discovery that carbon fibre can absorb and filter flatulence odours and incontinence odours has now been put to practical use in a commercial product called "Shreddies".

Comments: 1

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What Replaced Kodak?

Neil Johnston

At the turn of the 20th Century Kodak  reigned supreme.
Box Brownies were the camera for every occasion and the developing and printing of film was big business for pharmacy.
Kodak liked the alliance with pharmacy because pharmacists understood the science behind the various types of film, the processing chemicals and the nuances of the various printing papers.
Yes, Kodak liked the pharmacy retail environment so much that any pharmacists could order a repaint of their front of shop awning at any time – free of charge, provided the name Kodak dominated in the Kodak colours of red, yellow and black.

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A Catalyst for Change

Gerald Quigley

Editor's Note: Australia, it seems, has had the highest global rate of prescribing for statins.
That seems to suggest that Australian doctors may have been prescribing unnecessarily, and behind that fact, allowing drug companies to influence them to a greater extent than necessary.
Those $10 meals certainly provided a return on investment for drug companies to the extent that the party may now be over as approximately 40 percent of doctors are reviewing their prescribing practices surrounding statin usage in their patients. Gerald Quigley relates one patient experience.

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Pushing the envelope

Harvey Mackay

“Pushing the envelope” is a phrase that originated with American test pilots like Chuck Yaeger and John Glenn in the 1940s.
It described max stress situations for the metal skin (“envelope”) of a jet aircraft.  In other words, the plane was designed to fly safely up to a certain speed for a certain distance at a certain altitude. 
The job of test pilots was to “push the envelope” by making the plane go faster, farther and higher.  The term “pushing the envelope” came into popular parlance in the blockbuster book and movie (1983) “The Right Stuff.”
Naturally, this phrase is near and dear to me.  On my business card, my title is “Envelope Salesman.”  So literally, I am pushing the envelope every day! 

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Medical Debate Censorship Attempt by NSW Government

Staff Writer

Editor's Note: Until today, I had never heard of the organisation Avaaz.
Avaaz—meaning "voice" in several European, Middle Eastern and Asian languages—launched in 2007 with a simple democratic mission: organize citizens of all nations to close the gap between the world we have and the world most people everywhere want.
Avaaz empowers millions of people from all walks of life to take action on pressing global, regional and national issues, from corruption and poverty to conflict and climate change.
The Avaaz model of internet organising allows thousands of individual efforts, however small, to be rapidly combined into a powerful collective force. (Read about results on the Highlights page.)
The Avaaz community campaigns in 15 languages, served by a core team on 6 continents and thousands of volunteers.
Avaaz takes action -- signing petitions, funding media campaigns and direct actions, emailing, calling and lobbying governments, and organizing "offline" protests and events -- to ensure that the views and values of the world's people inform the decisions that affect us all.

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Inquiry into the Promotion of False or Misleading Health-Related Information or Practices

Judy Wilyman

I'd like to draw your attention to an inquiry that is taking place in the NSW parliament. It is titled ˜Inquiry into the Promotion of False or Misleading Health-Related Information or Practices".
This inquiry is being held by the Committee on the Health Care Complaints Commission (HCCC).
This is the consumer watchdog that investigates consumer complaints or concerns.
The aim of the inquiry is to report on possible measures to address the promotion of unscientific health-related information or practices that may be detrimental to individual or public health.

Comments: 8

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New sensor passes litmus test

Staff Researcher

Edith Cowan University researchers have drawn on their expertise in nanotechnology to update the humble pH sensor, replacing traditional glass electrode devices that have been in use since the 1930s with a new sensor thinner than a human hair.
Electron Science Research Institute Director Professor Kamal Alameh said the sensor could have exciting new applications in the oil and gas and medical industries.

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Structure Sensor 3D Scanner Works with New iPad Air and iPad Mini

Staff Writer

Editor's Note: At i2P we're convinced that 3D printing is going to invade just about every aspect of pharmacy - from tablet and vaccine manufacture, drug testing on a patient's own tissue outside of the body. to design detail for any item of pharmacy furniture.
We are therefore stepping up reportage for this exciting and disruptive technology.


if you were one of the almost 3,000 backers of the Structure Sensor on Kickstarter and were hoping to attach the 3D scanning device to your new iPad Air and iPad Mini with Retina Display, you might be a little worried about compatibility. 
Well, fret not. Occipital, the startup behind the Structure Sensor, has adapted its product to Apple’s latest release.

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New nanoparticle delivers, tracks cancer drugs

Staff Researcher

Chemical engineers and clinicians from UNSW and Monash University have synthesised a new iron oxide nanoparticle that delivers cancer drugs to cells while simultaneously monitoring the drug release in real time.
The result, published online in the journal ACS Nano, represents an important development for the emerging field of theranostics – a term that refers to nanoparticles that can treat and diagnose disease.

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How fat could help solve part of the diabetes problem

Staff Researcher

The pancreas is a large organ that wraps around our gut, and produces the exact amount of insulin our bodies need when we eat – except when we start to develop diabetes, and insulin production slows down. Sydney scientists describe how a fat recycling system within pancreatic ‘beta cells’ determines the amount of insulin they secrete, and so may provide a target for future diabetes therapies.

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Receipt of licence application (DIR 126) from PaxVax Australia Pty Ltd for a clinical trial of a GM cholera vaccine

Judy Wilyman

I'd just like to make you aware of this government action to release a genetically modified live bacterial cholera vaccine into the population. Here is the link to this experiment on the government website http://www.ogtr.gov.au/internet/ogtr/publishing.nsf/Content/dir126
Cholera has not been a problem in Australia for many decades.
I have not seen this mentioned in the media so I hope people will take an interest to find out why this experiment is necessary in the Australian population.

Comments: 2

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Australia’s future healthcare system must be consumer-centric (ASMI 2013 Conference)

Marie Kelly-Davies

The importance of industry, policymakers and regulators putting the consumer front and centre of discussions on Australia’s future health system was a key theme of the 2013 Australian Self Medication Industry (ASMI) Conference in Sydney recently.

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ASMI welcomes community pharmacy support for S3 information-based advertising

Marie Kelly-Davies

The Australian Self Medication Industry (ASMI) is encouraged by strong signals of support from community pharmacy to expand the range of Pharmacist Only (S3) medicines as well as its widespread support of an information-based communications approach to consumers for S3 medicines, as demonstrated by the UTS Pharmacy Barometer released this week.1
Prescription to non-prescription reclassification (‘Rx to OTC switch’) and lifting the current advertising restrictions on S3 communication are key issues that remain high on ASMI’s agenda.

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Dark Forces Emerging - Including Colesworth

Neil Johnston

Editor’s Comment:
The media extract this month comes from a Pharmacy News report that Woolworths is on the move once more with pharmacy in its sights.
We would assume that Coles is also in the mix.
There are many “dark forces” aligned against pharmacy interests. In all my years as a member of the pharmacy profession I don’t think I have seen so many diverse groups waiting in line to “knee-cap” pharmacy activity.
Because many of these “dark forces” overlap and help each other along, I have asked Mark Coleman to clarify these “dark forces” from his perspective, because he has been researching some of these organisations and has written an article about some of them in this edition.
In no way can I see a Liberal Government, the representatives of big business, move to restrain Colesworth, except for minor marginal activities.

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Dark Forces Emerging - Including Colesworth

Neil Johnston

articles by this author...

Introducing current ideas, perspectives and issues, to the profession of pharmacy

Editor’s Comment:
The media extract this month comes from a Pharmacy News report that Woolworths is on the move once more with pharmacy in its sights.
We would assume that Coles is also in the mix.
There are many “dark forces” aligned against pharmacy interests. In all my years as a member of the pharmacy profession I don’t think I have seen so many diverse groups waiting in line to “knee-cap” pharmacy activity.
Because many of these “dark forces” overlap and help each other along, I have asked Mark Coleman to clarify these “dark forces” from his perspective, because he has been researching some of these organisations and has written an article about some of them in this edition.
In no way can I see a Liberal Government, the representatives of big business, move to restrain Colesworth, except for minor marginal activities.

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Politically, to keep the economy in balance and to ensure strong employment, they will need a strong small business sector empowered.
Pharmacy is central to small business structure, and if it collapses, so does the stable employment sector disappear (and presumably so would the Liberal Government at the next election through affected voters).
Below is the media segment and below that again you will find Mark Coleman’s comments.

Government plans to restrict supermarkets’ power

30 October, 2013 Nick O'Donoghue

As supermarket giant, Woolworths eyes a push into the community pharmacy sector, the Federal Government is planning to restrict the power the big retailers have in the grocery market.

Bruce Billson, the Small Business Minister, is expected to issue a warning to Woolworths and Coles, today, that the new Government plans to tackle concerns about their market power, The Australian reported.

A draft of the speech Mr Billson is due to give to food industry leaders in Canberra today, seen by The Australian, suggests the Government is unhappy with the duopoly’s hold over the market.

“While intensified competition between the two major chains has reduced grocery retail prices, there are concerns that those reductions come at the expense of suppliers and impact on the long-term durable benefit to consumers.” Mr Billson’s draft speech says.

“Some of the alleged behaviour by supermarkets may not necessarily be breaches of the competition laws.

“At the same time, this does not mean that the status quo is necessarily delivering the most efficient or optimal outcomes in the market.”

While the current Pharmacy Location Rules prohibit the operation of pharmacies within supermarkets, many fear a change to allow the retail duopoly to open pharmacies would result in the breakdown of the community pharmacy network.

Responding to reports that Woolworths had applied to trademark its “Pharmacy-in-Supermarket” brand, one Pharmacy News reader said, “if Coles and Woolworths get [PBS] approval numbers there would ultimately be fewer and larger pharmacies as we see now with butchers, bakers, petrol stations, clothes stores, stationery stores, bottle shops, corner stores or any other retail outlet you wish to think of”.

However, others have suggested the arrival of the big retailers into the pharmacy sector could be a boon for employee pharmacists, with several readers claiming they would pay above the Pharmacy Industry Award rates, a view refuted by Anthony Tassone, Pharmacy Guild of Australia Victorian branch president.

“Pharmacies in supermarkets won't improve wages and opportunities,” he said on Twitter last night.

“They're unlikely to pay above award plus, [they] only work for shareholder return.”

Meanwhile, a Pharmacy News webpoll of more than 230 readers has found the profession is divided 2:1 against allowing Woolworths and Coles to open pharmacies.


Mark Coleman

We’ve seen this all before. Government makes noises in the direction of restricting the monopolistic practices of Woolworths and Coles, and then it all fades away with the lobbyists getting to work to rationalise and “spin” the Colesworth moves.

Recently, through a report published by the Grattan Institute and written by Stephen Duckett highlighted savings that could be made by government through the acceleration of the price transparency scheme negotiated by the PGA under c legal contract with government.
The savings would be generated by adopting a New Zealand style equivalent of the Australian PBS, where no mark-up would be applied to goods, and pharmacist income was to be derived totally from a negotiated dispensing fee.
Problem is, the purchase of PBS drugs incurs supply chain costs that have to be recovered as a mark-up and this cost represents approximately 25% of the value of stock held.
The New Zealand model is fronted by a Woolworths supermarket containing a pharmacy that is half-owned by Woolworths. This is their test market for an Australian version of that model

So pharmacy has been caught in a vice because the loss of gross profits caused by the price transparency process are unable to be replaced from other sources in time to prevent business disruption, bankruptcies, reduced employment and unemployment of new graduates.
And while there a number of multi-factorial forces tearing down pharmacy at the moment, this is just creating a soft pharmacy competitor for Colesworth that is more malleable and more easily manipulated.
So why would they not help all those dark forces at work out there

Each time Colesworth get a knock back in respect of pharmacy ownership they simply accelerate the number of traditional pharmacy lines they hold in their inventories.
The irony is that pharmacy ownership by Colesworth is only prized for its ability to be a destination point for their customers-not any profit contribution.
Profit is made from their liquor, tobacco and petrol enterprises.

Coles in particular has no intent on creating a career for a pharmacist unless they are able to integrate within their existing line management structure.
In other words, you have to join a hypocritical anti-health process, and go against your own culture. How would AHPRA handle that?
The last Coles suggestion that I heard floated was that a central automated dispensing process be established to service a number of Coles stores – one pharmacist to control an automated machine by Internet, from a central point.
That is to say the dispensing would become a mind-numbing process far worse than anything existing today, but with jobs for fewer pharmacists.

Stephen Duckett offset his money saving suggestion with the follow-up “Access all areas” paper, suggesting that pharmacists be diverted to remote areas and be licenced to practice a range of clinical services.
Mind you, only in those remote areas where there is no current infrastructure and even if fully developed, would create limited job opportunities.
In other words a very cynical suggestion, because Stephen Duckett is an economic rationalist and no friend of pharmacy.

Supermarket suppliers are the ones mostly affected by Colesworth because they are unable to extract a fair price for their primary produce.
It may well be that pharmacy aspirations could be partnered as an alliance with supermarket suppliers because a common problem is experienced, but by a different method.

Pharmacy should be looking beyond its current boundaries and constraints to embrace new technologies and enter into health-related goods and services.
New technologies such as 3D printing need to be explored, as well as research into functional foods, methodologies for removing contaminants (including fluoride) from the water supply.
Paid clinical services are seen as one option and it is a very good option, provided certain cultural difficulties are overcome.
Mentors that can engage those cultural aspects need to be employed to get the show on the road, and they may be found among the “old phart community” if they can be persuaded.

Other difficulties are being experienced in introducing paid clinical services because our leadership organisations have not been active enough in negotiating a price for pharmacy services.
The services that are currently funded are a pitiful offering in that they have no pathway to expand along, they are underfunded and little thought has gone into their design.
You can blame a decade of opposition by the PGA in blocking any potential for a small pharmacist-owned business that is not a pharmacy. Pharmacy has squandered more than a decade of lost opportunity and is suffering the consequences right now for following a pathway of protectionism instead of expansionism, for an unhealthy reliance on the supply chain, for greed and processes that enriched a few to the detriment of the whole, for aggravation of employed pharmacists and treating them as “enemy” rather than the traditional method of “collegiality”.
And so the list goes on, and thank heavens we now see the end to that style of leader.

All pharmacists have been asleep at the wheel with just about all sources of sales growth blocked off, except for the deep discount channel.
Go down that channel only if you have the nerves of a professional gambler

Even pharmacy marketing groups have ceased to work with wholesalers now actively working against the interests of pharmacy because they too see clinical services as something they should own e.g. vaccination clinics. So expect more friction and competitive damage here because they will only feed their supply chain rather than make pharmacies profitable.
Also drug manufacturers are going down slightly different pathways, but they want your patient database so as to continue their lobby for “direct to consumer” marketing control.

Individual pharmacists, both owners and non-owners should be forming up into different lines so as to create strong internal alliances.
Just as you may have a Local Area Marketing System you need a Local Area Leadership System.
The old Division of General Practice for GP’s was an excellent model and pharmacists may well see a way to break free from their current heavy and slow-moving structures to develop a new format that is competitive, relevant and less costly.
Beat the supermarkets by being secure in your own market structure.
That only comes with hard work and good, strong leadership.

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