s Has the horse bolted? | I2P: Information to Pharmacists - Archive
Publication Date 01/07/2009         Volume. 1 No. 2   
Information to Pharmacists

Editorial

From the desk of the editor

Welcome to the July edition of i2P, and of course, the first week of the new financial year.

Note that we are developing a new range of categories for you to follow e.g. health politics, hospital news, an expanded IT offer and we will be developing the category of anti-ageing medicine

Also, out of interest, could I refer you to the e-publications category located immediately below our columnists. If you click on the link contained there, you will find a range of e-publications that are recommended reading.

The first publication noted is the Pharmacist Activist written by Dr Daniel A. Hussar of the faculty of the Philadelphia College of Pharmacy at the University of the Sciences in Philadelphia. He is a pharmacy advocate.

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Recent Comments

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I’ve seen the future…….and I’m not happy, Jan!

Chris Wright

The ubiquitous Mrs Wright, in her quest to unearth a new erotic shopping experience, ushered this writer to a new Coles store located at the all very nice and leafy suburb of Ivanhoe in Melbourne recently.
This is contemporary retailing at its best, no doubt influenced by the gurus at Westfarmers and the rapidly changing retail climate in Australia, which of course involves the future of Pharmacy in some way….but more about Pharmacy later.

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Pharmacists losing their mojo

Neil Retallick

I read some market research recently that ought to concern community pharmacists across the country, as well as the Pharmacy Guild of Australia.
Groups of average Australians were brought together for a series of focus groups to discuss the community pharmacy landscape as they see it.
Some of the feedback was disconcerting.

Comments: 3

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Has the horse bolted?

Ken Stafford

Some twenty years ago uneasy tremors were running through hospital pharmacy here in Perth. Hospital management had suggested to one of my fellow Chief Pharmacists that the hospital needed a total parenteral and intravenous additive service (IVAS) .
When it was pointed out that this would be very labour intensive and the pharmacy did not have sufficient staff to provide it, the comment was that “nurses would be happy to run such a service”.

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Independent Pharmacist Practitioners

James Ellerson

In the region where I practice, GP’s are reluctant to comply with a patient request for a Home Medication Review.
The stock standard phrase is “I can do that for you” and so in frustration a patient will turn to me, in a professional, or quite commonly in a social setting, and asks if it is possible for me to perform a review without the doctor’s involvement.

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Disgraceful – discuss

Pat Gallagher

Disgraceful – discuss
The newspapers have been chock-a-block the past few days with dire tales but true about the black hole we are about to enter with the insane policy to re-regulate the ‘workplace’ to suit the union paymaster cliques.
While I never voted for Keating I did admire him a little bit this morning when I read a quote of his from the bad old days.
He said to some union goose: “you are carrying the jobs of (100,000) dead men around your shoulders”.
Giving a dead hand to this union unfettered power play will ensure that the nation will soon look like NSW; where the government is actually the plaything of a few loosely combined public ‘service’ union mugs.
Depending on how large your pharmacy is, in terms of overall staffing, you will soon be touched by the coming dead hand of the new/old order.

Comments: 3

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UK Dispensing Errors Under Review

Staff Writer

The recent furore in the UK over pharmacist Elizabeth Lee receiving a conviction for a criminal offence and subsequently a suspended jail sentence, has really lit a fire under the imbalances that exist when a pharmacy dispensing error is made.
The dispensing pharmacist or the supervising pharmacist under current UK legislation, has been made to bear the brunt of legal responsibility, with pharmacy owners escaping with little pain.
According to an article in PJ Online "In many cases, all that the employer needs to establish is that he had standard operating procedures in place and that the employee or locum had simply not complied with them. In these cases, the employer can walk away leaving the employee or locum to face the, often damaging, consequences".
There is now a rush in the UK to have current legislation amended to reflect a more proportionate responsibility for all parties involved.

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A New Ministery - Indigenous, Rural and Regional Health

Staff Writer

The appointment for the first time of a Minister for Indigenous, Rural and Regional Health and Regional Service Delivery is an important strategic recognition of the special needs and circumstances facing people in Australia's rural and remote communities.
People in the bush will expect this position to be part of a permanent increase in the Government's commitment to rural communities.
In welcoming Minister Warren Snowdon to the new position, Dr Jenny May, Chairperson of the National Rural Health Alliance (NRHA), said the appointment will be important both for substantive policy reasons and to boost the place of rural issues on the political agenda.

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NZ fish killed by water quality

Staff Writer

The following news item was recently published in Science Alert. It would seem that the pristine environment of New Zealand is under attack. The reasons are similar to those findings in Australia surrounding the protection of the Great Barrier Reef.

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New theory for global diabetes epidemic

Staff Writer

A new "fertility first" hypothesis published this week by a group of international experts in the American Journal of Human Biology, proposes that the global epidemic of Type 2 diabetes has its origins in the struggle, over millennia, to sustain human fertility in environments defined by famine.
A surprising and important implication for us in the modern world is that this hypothesis gives cause for optimism that the modern epidemics of diabetes and cardiovascular disease will diminish.
Source: Sydney University

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Immune system key discovered

Staff Writer

A team of Monash University researchers has discovered the importance of a protein, which could improve the way the drug interferon is used to strengthen the human immune system.
Published online in the prestigious journal Immunity, the findings show that the protein promyelocytic leukemia zinc finger (PLZF) is a key player in the body's immune response to disease, increasing our understanding of the function of the immune system.(Source: Science Alert )

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Political suspicions raised as China cracks down on bogus online health info

Staff Writer

China is notable for its authoritarian approach to the Internet and other forms of media communications.
Restrictions on Internet activity may have some long-term implications for Australia, particularly as these restrictions are intruding into the health arena.
Source: Tech.Blorge

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Senior Pharmacists - A Valuable Resource

Staff Writer

Little thought seems to have occurred in maintaining and supporting mature aged pharmacists in the workplace.
Given that this group of pharmacists is the one with the "corporate memory" of the profession, with many having started life as compounding pharmacists and counter-prescribers, there is a wealth of untapped intellectual resource that could be internally utilised in mentoring or even training pharmacists in how to sell a professional service.
This group of pharmacists is concerned with the development of retail clinics proposing to do almost exactly what they were successfully doing 30-40 years ago.
What went wrong?

Well, there is plenty of evidence to illustrate that the process of commoditising medicines is the primary reason for this loss, because if you strip everything out of a process to sell at the cheapest possible price, you get a barren professional offering
Source: Science Alert

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Terry White Makes a Move

Staff Writer

Introduction:

It is clear that the Terry White pharmacy group is on the move with the recent purchase of Pharmacy Direct and a restructure of its own management. Terry has had a distinguished pharmacy career and his stewardship will see possibly the strongest pharmacy group in Australia emerge He is opening up the opportunity for equity for senior members of his management team.
The following excerpt extracted from pharmacy media reports explains the process.

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Has the horse bolted?

Ken Stafford

articles by this author...

A Consultant Pharmacist Perspective

Some twenty years ago uneasy tremors were running through hospital pharmacy here in Perth. Hospital management had suggested to one of my fellow Chief Pharmacists that the hospital needed a total parenteral and intravenous additive service (IVAS) .
When it was pointed out that this would be very labour intensive and the pharmacy did not have sufficient staff to provide it, the comment was that “nurses would be happy to run such a service”.

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As you might imagine this went down rather like a lead balloon – who did these nurses think they were, trying to do a pharmacist’s job? If they want to act like pharmacists let them go to university and do the study! Sounds familiar doesn’t it? All this took place about the time nurse training moved from being hospital based to being a university degree course and nurses were looking to spread their wings. As it turned out the service was established, by pharmacists, within the pharmacy department with no input from the nursing division but battle lines were drawn. Nurses were moving out from being the doctors’ handmaidens to a brave new world where they would become recognised as health professionals in their own right.

“What does this have to do with pharmacy” you might ask but it came to mind when I read Warren Plunkett’s article in the June 2009 Australian Journal of Pharmacy. In this Warren claims the “profession needs a model of pharmacy that better utilises the skills of modern pharmacists”. This is exactly what the nursing profession had set out to do over 20 years ago. They had sufficient confidence in themselves to be willing to take on something totally outside the experience of the average nurse. An IVAS is not a service one would associate with nurses, it had long been the domain of pharmacists, but the group in my colleague’s hospital were confident enough to say “We’ll have a go”. The newly graduating pharmacists of today now indicate they do not want to carry out the usual supply function “beloved” by older generations – they demand the right to use their unique skills and be remunerated on this basis.

I really can’t blame the latest crop of pharmacists for wanting a new paradigm in pharmacy. Returns from the Pharmaceutical Benefits Scheme (PBS) are continually coming under pressure from government attempts to restrain burgeoning drug costs, community pharmacy ownership is not only moving far beyond the ability of young graduates buts appears under threat from the major supermarket chains and only hospital pharmacy offers any type of career pathway. Given all these constraints is it any wonder that there is a growing push to change how pharmacy operates?

My major concern is that this may be becoming a case of “closing the stable door after the horse has bolted”. Pharmacists seem to have been left behind in the area of prescribing, they are rarely considered by governments making health policy decisions and may even be under threat (see Matthew Eton’s editorial in the June AJP “Can pharmacy lump it?) and are frequently excluded from taking part in healthcare initiatives. Compare this to nursing, no minister or health department bureaucrat would dare to set up a policy developing committee without including nurses. Chronic disease management programs, an obvious area for pharmacists to take the lead, are almost invariably managed by nurses who may, or may not, have good working relations with clinical pharmacists. Many of these programs include a medication review component to patient care but I have not heard that there has been an overwhelming push to refer patients to accredited pharmacists. Another missed opportunity perhaps?

Twenty years ago the nursing profession made the decision that their newly acquired university degrees meant they could set their own goals, reach out to new horizons and become masters of their own destiny. They have succeeded in spectacular fashion. My hope is that pharmacy can to a great extent emulate this success. I must admit to a vested interest as both of my children are pharmacists trying in their own way to extend the scope of professional pharmacy, primarily by utilising the expertise of accredited consultant pharmacists and I am about to take part in a study whereby palliative care patients will be targeted for medication reviews to improve care in this group. Small steps such as these and similar activities by many consultant pharmacists will, I hope, possibly overcome the problem of a bolted horse and closed stable door.

 

 

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