s Pharmacist Succession - employer and employee | I2P: Information to Pharmacists - Archive
Publication Date 01/07/2014         Volume. 6 No. 6   
Information to Pharmacists


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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Newsflash Updates for July 2014

Newsflash Updates

Regular weekly updates that supplement the regular monthly homepage edition of i2P. 
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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

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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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Pharmacist Succession - employer and employee

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.

Pharmacist ageing is a process that has had little thought or input particularly when retirement age is reached and how a succession is to be achieved.
And there are two levels of succession.
One involves the business succession to create a survival and renewal process for the business.
The other involves a more personal professional succession for those pharmacists that seek a rewarding extension of their professional skills.

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Business succession is not always a planned process, but it should be and needs to be for the survival of the business of pharmacy.
The vehicle to promote succession, although imperfect, is already in place in the form of a company structure.
You do not hear of any media releases announcing pharmacists being appointed to the board of a company pharmacy (as you do for others in the general business press), but moving from an executive position in any pharmacy business to the board of a pharmacy company ought to be a natural succession process.

This allows an economical leveraging of the director pharmacist skills spread through one or more pharmacies under common ownership, with or without ownership of shares in that company.

More importantly, it creates employment for senior pharmacists that is dignified and creates a “win-win” situation where senior pharmacists can be valued and where value continues to be created within the business.
Also, it is economical because director fees are not wages and can be negotiated at a reimbursement in line with business returns (and even indexed with profit generation of the business).
Depending on the size of the pharmacy business, director meetings are usually called monthly or weekly, depending on activity.

Obviously the owners of the business (shareholders) gain role models and mentors at an economical rate, when they become executive directors.

To what extent pharmacy businesses have matured to this type of succession is not really known. It is obviously occurring in some levels of group pharmacy activity, but it has not gravitated to a level where qualified directors can offer their services in a marketplace that is open and encouraged.

The other form of succession that is not in any mature form of development is professional succession.
The major professional role of a community pharmacist is found in dispensing prescriptions with some embryonic offshoots being leveraged from the prescription base e.g. Home Medicines Reviews, Patient Interventions.

For senior pharmacists the aging process slows down physical responses and damages joint health. As pain levels develop it can slow down mental responses.
This means that there is a definite limit to the amount of time a senior pharmacist can be embedded in a production line dispensing process (pharmacy owner or employed pharmacist).
This activity can further damage an employed pharmacist where diminished respect is afforded to that pharmacist by junior staff, (dispensary technicians or younger pharmacists), who demonstrate through body language or other language that the senior pharmacist is an impediment to their daily activity.
This can be depressing and distressing to that senior pharmacist, who would otherwise be extremely productive if the requirement for physical stamina was replaced with a chair in which to sit and an intellectual output that would benefit a patient.

The fact that pharmacy leaders have not progressed paid clinical consultations in primary health care to provide a professional succession is criminal, given that they were piloted over 35 years ago and found acceptance with pharmacy patients.
Patient consultation, although unpaid, has always ranked equally with dispensing as “core business” in pharmacy.
In allowing the consultation sector to languish, we have seen:

(i) No professional succession for pharmacists after retirement age is reached.
You fade into the sunset, go into another form of activity or simply languish without the stimulation of a formal working structure, to become a drain on the health budget as a dementia patient.

(ii) No separate pathway for younger pharmacists to enter and create specialties and growth in professional service activity. This is further compounded as young pharmacists become unemployable as the PBS budget blows out and the resultant government “claw back” leaves no money to support pharmacists – only technicians.
The consequence of this can only mean that we are getting closer to transferring dispensing into supermarkets.
We are already seeing commoditisation of dispensing with more of the process being accomplished by automation.
It is only a matter of time as the trending business structure fulfils the dream of major retailers.

A recent report from the Australian Institute of Actuaries suggested it was plausible that the life expectancy of young people living today could exceed 120 years.

And not only are we living longer, we are living in better health. At age 65, females can now expect to live another 21.8 years, including 16.1 years without a severe or profound core activity limitation. For men, the figures are 18.7 years and 15.2 years.

How do we gainfully live out those extra years now available to us?
For pharmacists it should represent an opportunity, because simultaneously with this explosion in lifespan we are seeing an epidemic of non-communicable diseases (also known as lifestyle diseases), many of which would be found within the senior pharmacist population.
By researching their own conditions and mentoring patients with similar problems, senior pharmacists are able to communicate effectively because they can directly relate to their patient’s condition. Patients would respond positively to consulting with someone who can truly understand their medical problems.

According to Age Discrimination Commissioner, Susan Ryan who recently released a paper on the subject:

''Today's physically active 70-year-olds who don't smoke have scans showing brains that look 10 to 15 years younger than those of their parents' generation at the same age - more of whom were smokers."

In 1909, when the age pension was introduced in Australia, 96 percent of people died before they reached pension age. Now 75 percent of men and close to 85 percent of women reach the age of 65, and the average life expectancy today is 84 for women and nearly 80 for men, and it is increasing every year.

Instead of the 4 percent of the population being age pensioners in 1909, 11 percent of the entire population draw full or part pensions and will continue to do so for a long time - 20 or 30 years. Over time this figure will get closer to 25% of the population.

“On average, we denizens of the 21st century, compared with our grandparents, have another 30 years, what I am calling an extra life to lead.

These demographic changes are well-documented, much reported and should be widely recognised in public policy, employment practices and community values. Strangely, they are not. Right now in Australia we waste the human capital represented by older workers.”

Susan Ryan recently commissioned Deloitte Access Economics to measure what we would gain, what the impact would be on the national economy, if we could increase the workforce participation rate of the over-55’s.
“The figures are astounding. With just a 3 percent increase in participation by this group, we should see a $33 billion annual boost to the national economy. With a 5 percent increase in participation, we would see a $48 billion boost. To place numbers on these dollar figures, a 5 percent increase would mean about an extra 750,000 over-55s in paid work instead of living on benefits.

So many rules and attitudes in public policy and commercial practice seem to contain the notion that 65 is the cut-off point for most things. The fact is, those 90s are rushing towards us.

But our whole physical environment seems to have been constructed in denial of this inconvenient truth. Streets, signage, access to buildings, shopping centre design, lighting, public transport are all constructed on the assumption that users are, without exception, between 20 and 40 years old, in peak physical condition, have perfect night vision and 100 percent hearing.”

Surely a similar effect would translate through pharmacy by updating our attitudes and values towards aging – to value senior employees and nurture them into productive activities to actually service patients in the same demographic.

Since the late 1970’s pharmacy leadership has been characterised by non-collegiate relationships, bitter divisions and deals done by the PGA and government that do not reflect the majority pharmacist attitudes and values.

Lack of cohesiveness has allowed predatory and competitive activities to chisel off major elements of “pharmacy turf”.
Much has been lost, but much can be preserved and redeveloped with some decent planning by pharmacy leaders.

Let’s all get on with the job.

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Submitted by Martine Light on Mon, 17/09/2012 - 08:07.

I applaud Peter on such a well written and intuitive article. I agree that more thought needs to be given to succession in pharmacy and perhaps both the "young" and "old" pharmacists will benefit, thereby improving the business.

Submitted by Kay Dunkley on Sun, 16/09/2012 - 19:08.

The many years of exerperience of older pharmacists and their well developed comunication skills lend themselves to a mentoring role for younger staff. Pharmacy also needs to utilise these skills to develop customer loyalty and improved PR for the profession.

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