s Part three - a Better Umbrealla Organisation | 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.

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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

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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

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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.

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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

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‘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.

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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).

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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.

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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.

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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.

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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

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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.

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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.

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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?

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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

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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.

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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.

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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.

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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.

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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).

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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.

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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.

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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.

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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:

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Part three - a Better Umbrealla Organisation

Neil Johnston

articles by this author...

Neil Johnston is a pharmacist who trained as a management consultant. He was the first consultant to service the pharmacy profession and commenced practice as a full time consultant in 1972, specialising in community pharmacy management, pharmacy systems, preventive medicine and the marketing of professional services. He has owned, or part-owned a total of six pharmacies during his career, and for a decade spent time both as a clinical pharmacist and Chief Pharmacist in the public hospital system. He has been editor of i2P since 2000.

Because a workable umbrella model for management consultants already exists, it is suggested that this model be adapted for consultant pharmacist use.
The existing umbrella model established for consultant pharmacists would need to be altered dramatically and be opened up to other organisations e.g Consumer Health Forum, APESMA)
Or an entirely new organisation could be developed from scratch.
This is, in fact happening and is unrelated to any of my activities.
However, I am suggesting that the umbrella model of organisation provided by the Institute of Management Consultants (Australia) provides an excellent reference to adapt to a consultant pharmacist version.

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The following material has been copied from the site of the Institute of Management Consultants in Australia. To visit their site go to http://www.imc.org.au/html/s01_home/home.asp

“Management Consultants play a crucial role in the development of Australian organisations. 
By providing advice and assistance, consultants aid industry in determining and achieving their objectives.

The Institute of Management Consultants (IMC) is the professional body representing management consultants in Australia.  The Institute's mission is to represent and promote the management consulting profession, set and maintain internationally recognised standards and develop members.  Clients demand the utmost in professional competency and as a result seek out IMC management consultants.  For this reason, upon joining the Institute, members agree to abide by the Institute's Code of Professional Conduct.

To maintain a high standard of professional competency, the Institute provides regular professional development programs.

The Institute's vision is for the IMC to be recognised by all as the leading organisation representing and servicing the management consulting profession.  Members of the Institute participate in both National and Chapter activities.  IMC has Chapters in:

* the Australian Capital Territory,
* New South Wales,
* Queensland,
* South Australia,
* Tasmania,
* Victoria, and
* Western Australia.

The Institute is the awarding body of the Certified Management Consultant (CMC) designation.  CMC is the mark of competency for the management consulting profession and indicates that a management consultant meets certain requirements of character, education and experience.  The CMC designation is recognised internationally.  Institute members are part of an international network of professionals through the peak management consulting body - the International Council of Management Consulting Institutes (ICMCI).  There are more than thirty member Institutes of the ICMCI and membership of the Australian Institute allows reciprocity of benefits with each member country without the need for further assessment or examination.

My Comment:
(i) Note that the Institute is comprised of individual consultants,.
Corporate structures are allowed for groups of consultants.

(ii) Full membership is achieved after completing written and oral exams and post-nomials are set by the Institute.

(iii) Their view is global and reciprocal accreditation provides international opportunities for employment for all consultants. This alone could provide global work opportunities for Australian pharmacists in the 21st century and broaden the scope of educational opportunities and services development.

(iv) As management consultants play a crucial role in the development of Australian organisations, so should consultant pharmacists. The role of a consultant requires constant research, and as that happens pathways to a professional future are easier to visualise and plan.
Consultant pharmacists have the potential to create a practical lead for all of pharmacy in an advisory capacity.
Instead of deflecting proper development of consultant pharmacists, PGA should have a good look at their current leaders and have a purge of the non-performers.

Because the nature of consulting work is different to other types of employment, it is necessary to have a code of conduct and other statements about how consultancy services are to be provided.
Apart from holding a consultant legally liable for any breaches of code or statement, it instils a confidence factor for clients (patients) and alliance partners.

IMC Code of Ethics and Member’s Pledge 

Preamble

The Institute of Management Consultants Ltd (IMC) in Australia has adopted the following Code of Ethics, on 26th November 2008, as proof of the commitment of IMC Members to:

* Develop realistic and practical solutions to client problems
* Act in the clients best interests at all times,
* Render impartial, factually-based, independent advice,
* Accept only those client engagements they are qualified to perform,
* Behave with integrity and professionalism at all times,
* Agree with the client in advance on the basis for their professional fees,
* Safeguard confidential information

As the professional association and certifying body for management consultants in Australia, the Institute of Management Consultants (IMC) requires adherence to this Code of Ethics as a condition of membership and a prerequisite to certification.  All members have pledged in writing to abide by the Institute's Code of Ethics and their voluntary adherence to the Code signifies the self-discipline of the profession.

The Code sets out the principles of the ethical practice of management consulting. The purpose of this Code is to ensure IMC members maintain their professionalism and adhere to high ethical standards while providing services to clients; and also in their dealings with their colleagues and the public.

The individual judgement of member consultants is required to apply these principles and members may be liable to disciplinary action under the IMC rules if their conduct is found to:

* Be in violation of the Code, or
* Bring discredit to the profession or to the IMC.

The Disciplinary Committee of the Institute will investigate any such complaint and, amongst other options, may sanction or expel the member if a breach is confirmed.

IMC Australia Code of Ethics


1.It is the objective of each member, as a professional management consultant, to assist his or her clients to add value to the clients enterprise; whether that enterprise takes the form of a business, a not-for-profit organisation or any element of government.

2.A member will serve their clients with integrity, competence, objectivity, independence and professionalism.

3. A member will only accept assignments that the member is competent to perform; and, on a client project, will only assign staff or engage colleagues with knowledge and expertise relevant to the client project.

4.
Before accepting any engagement a member will establish with the client realistic expectations of the objectives, scope, expected benefits, work plan and fee structure of the assignment.

5. A member will agree in advance with the client on the basis for fees and expenses. A member will charge fees that are reasonable; commensurate with the services delivered, the value created and the risk or responsibility accepted.

6. A member recognises that the clients enterprise has many stakeholders whose interests are sometimes divergent, and will seek to balance and reconcile these different interests in their guidance to the client.

7. A members advice to the client will be delivered with independence and courage; always focussing on the long-term best interests of the enterprise as a whole, even when this guidance may lead to actions such as restructuring or retrenchments that may be painful in the short-term.

8. A member will continually invest in professional development to keep abreast of evolving knowledge within their profession and in areas of technical expertise.

9. A member will treat all confidential client information appropriately; will take reasonable steps to prevent access to confidential information by unauthorised people and will not take advantage of proprietary or privileged information, for use by the member or others, without the client's permission.

10. A member will avoid conflicts of interest, or the appearance of such, and will disclose to the client immediately any circumstances or interests that they believe may influence their judgment or objectivity.

11. A member will offer to withdraw from a consulting assignment when they believe their objectivity or integrity may be impaired. A member will represent the profession with integrity and professionalism in their relations with clients, colleagues and the general public.

12. A member will respect the rights of consulting colleagues and consulting firms and will not use their proprietary information or methodologies without permission.

13. A member will report to appropriate authorities within or external to the client organisation any occurrences of malfeasance, dangerous behaviour or illegal activities discovered during the course of an assignment.

14. A member will not accept commissions, remuneration, or other benefits from a third party in connection with any recommendations to a client without that client's prior knowledge and consent, and will disclose in advance any financial interests in goods or services that form part of such recommendations.

15. A member will refrain from inviting an employee of an active or inactive client to consider alternative employment without prior discussion with the client.

16. A member will not advertise their services in a deceptive manner nor misrepresent or denigrate individual consulting practitioners, consulting firms, or the consulting profession.

17. A member will promote adherence to the Code of Ethics by all other consultants working on their behalf.

18. A client, a member of the public or a member of the Institute may report any perceived violation of the Code of Ethics to the Institute of Management Consultants. In the event of such complaint a Disciplinary Committee will be convened to investigate and recommend appropriate actions, including but not limited to: mediation, arbitration or sanction against the member concerned.

Approved by IMC (Australia) Federal Council on 26th November 2008.

The IMC Consultant's Pledge

As a management consultant my professional objective is to assist my clients to add value to their enterprise, whether that enterprise takes the form of a business, a not-for-profit organisation or any element of government.

I pledge to uphold and promote the IMC Code of Ethics in all my consulting activities.

I will serve my clients with integrity, competence, objectivity, independence and professionalism. I will only accept assignments that I am competent to perform and, on a client project, will only assign staff or engage colleagues who have knowledge and expertise appropriate to that clients needs.

I will establish with my clients realistic expectations of the benefits and results of my services. Together we will define the scope and process of the assignment and the basis of remuneration.

I pledge that considerations of personal benefit will never over-ride my focus on the interests of the client or their stakeholders.

I promise to uphold both the letter and the spirit of laws, regulations and contracts governing my own conduct, that of my client and of the societies in which we both operate.

My personal behaviour will exemplify the values I publicly espouse in making this pledge. I will be equally vigilant in ensuring the professional behaviour of other consultants within my practice or the wider IMC membership and will bring to attention any violation of this shared professional code.

I will not permit considerations of race, gender, nationality, religion, politics, sexual orientation or social status to influence my professional behaviour or advice. I will be respectful of those whose wellbeing may be contingent on my decisions or advice.

I will diligently apply objective judgement to all consulting assignments, based on the best information available to me. I will conduct independent research and analysis where possible, and will consult with colleagues and others who can help inform my judgement.

I will continually invest in professional development to keep abreast of evolving knowledge within my profession and in my areas of technical expertise.

I recognise that my status and privileges as a professional stem from the respect and trust that the profession as a whole enjoys; and I accept my responsibility to employ, protect and develop the above standards to enhance that respect and trust.

I do so solemnly pledge.

Decentralised Infrastructure

It is suggested that the structure of any consultant pharmacist umbrella organisation
be decentralised along the lines of the original Division of General Practice for GP’s.
This enables local decision structure and development overseen by a central administration at a state level morphing into a national body for political representation.
It also provides a structure to help manage any other pharmacy service where conservation of financial resources is necessary. also where distances may create administrative difficulties.
Cooperation and collegiality should be the aspiration.
The following is one of my business model notes prepared at an earlier date for this type of development.

A chapter will be the smallest unit of the organisation and the chapter’s physical boundary will be represented by one or more adjacent postcodes.
It should have a minimum of three members.
Each chapter should appoint/elect a suitable convenor.

A division is comprised of two or more chapters representing a minimum of 15 members located within a hospital-designated region, or a general practice divisional region.
The chapter convenors should elect one of their number to be a divisional convenor, with all others filling roles of deputy convenors.

A state group is a collection of a minimum of three divisions within a state boundary.
It will elect its own executive from the pool of chapter convenors/deputy convenors.

A national group is a collection of all state groups, each allowed to appoint  up to three delegates from the convenor/deputy convenor pool.

Utilising a decentralised structure enables each division to organise its own development and educational activity, leaving formal or mandatory education organised at a state level.
Also, organisations that wish to access the consultant group can do so by planning a state-wide itinerary that can be quickly and efficiently delivered.

A division can also enter in to independent projects and apply for grant funds separately for whatever research project deemed suitable.

For this reason, management control of grant funds by the PGA for this activity would not be acceptable, because of conflict of interest potential.

And I will leave the discussion at that point because the debate has only just opened for the future of consultant pharmacists.
This area of pharmacy has the potential to concentrate the best pharmacist professional brains and provide a driver for real professional development and expansion.
It is both an exciting and intellectually stimulating activity and has the further potential to lift the status and morale of the entire profession.
The disciples of supermarket pharmacies who can only see the supermarket vision and no other need to forget about competing with consultant pharmacists and look for a way to accommodate their independent practices within the supermarket.
That would create a stimulus for the sale of many professional items and prescriptions - a perfect alliance and a point of difference to any other discount pharmacy not housing such a service.

We don't have time for in-fighting and wasting resources.

Contribute to areas of need right now:

(i) Consultant pharmacist development
(ii) Creating work for new graduates
(iii) Creating roles for senior pharmacists

Do it willingly and throw off the sometimes devious, negative and non-collegiate behaviors of the PGA.

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