s Pharmedia - The Vaccine Poll Hijacked by Pharmacists? | 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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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
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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Pharmedia - The Vaccine Poll Hijacked by Pharmacists?

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.

Editor's Note:
Professional services development was stymied when the AMA reneged on an agreement to support pharmacist vaccination clinics.
It has caused anger and unprofessional behavior has evolved on both sides.
It also appears that while the professional bodies of the AMA and the PGA attempt to disrupt each other, patients at large will become the eventual losers.
The PGA is central to other clinical service disruptions, even those within pharmacy involving contractor pharmacists.
This is damaging to an orderly development of clinical services in a pharmacy setting and demonstrates that current leaders of the PGA and the AMA are not fit to claim the title of "leader".
We asked Mark Coleman to provide commentary on an article recently published in Australian Doctor.

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Australian Doctor

30 January 2013

An investigation into the hijacking of an Australian Doctor poll on whether pharmacists should administer vaccinations has led to the door of the Pharmacy Guild of Australia.

Last week, Australian Doctor was forced to pull the online poll after a sudden and unprecedented upswing in votes.

During the first five days the poll ran, most votes were against pharmacist-administered vaccinations because of the perceived risks to patient safety.
However, on the sixth day more than 200 votes were cast within a few hours, backing the idea on the basis they would "ease GP workload pressures".

The poll was suspended and IT analysis revealed the extra votes came from just two IP addresses, both run through a server in Brisbane.
Before the plug was pulled, the results were picked up by the online newsletter Pharmacy News — published by Reed Business Information — claiming doctors were "backing" an expansion of pharmacists' roles.

Further investigation by Australian Doctor on the IP addresses then led to the URL mobile.qldguild.org.au, which is owned by the Pharmacy Guild of Australia Queensland branch.
There is no suggestion the poll was hacked — the Australian Doctor website can be accessed by registered health professionals.

But the guild denied it orchestrated a hijack to further the pharmacy cause.
A spokesman said: "I am informed that there are more than a hundred computers and mobile devices through the wireless network with access to the IP address you refer to. We don't intend to conduct a Royal Commission into which user or users may have been over-enthusiastic in their response to the poll.

"What I can confirm is that many guild people would have voted in the online poll because they feel so strongly about the importance of improving patient access to vaccinations — and removing the current impediments associated with delays and difficulties in getting doctor appointments."

Mark Coleman

I am asked to comment on the above news item, which is hardly "news" but simply an expression of the state of affairs between the two professions that is exacerbating and ongoing.
There are no winners in this type of squabble, only losers.
Opportunity and respect also suffer and that can interfere with some very good and long-established relationships, particularly those that have developed through the HMR program.
So patients become disadvantaged, and no doubt, disappointed by the behaviour of both professions.
What to say except that both professional group leaders ought to be ashamed of themselves.
At the moment, doctor leadership of all the health professions is a big question mark and the PGA is famous for its its bullying and devious attack tactics on groups inside and outside of pharmacy.

The AMA leadership is no better, particularly as government places pressure on medical funding.

The fact that the AMA reneged on its acceptance of pharmacist involvement in vaccines would have been the trigger and the fact that the Australian Doctor poll went "haywire" does seem to have the trademark of the PGA.

My comment:  Both organisations should get their professional backsides into gear and get on with the job.
It is in nobody's interest (doctors, pharmacists, patients and consumers) to have this background bickering, which has become such a feature of national politics in Australia.

About 5 years ago I researched the concept of pharmacists administering flu vaccinations.
The advice that I received then was to get accredited with an organisation that could teach the skill as well as assess competency and accredit.
I found a local registered nursing group that was willing to educate and accredit pharmacists.
My legal advice I received then was that any pharmacist appropriately accredited had no legal impediment if they wished to establish a vaccine clinic.
In an attempt to clarify the issue from an AMA perspective, Steve Hambleton was recently quoted as follows:

"AMA president Dr Steve Hambleton, in an attempt to clarify the organisation's position, said on Monday that the association was not giving a "green light" to pharmacists giving vaccinations, insisting that vaccinations should be administered through general practice.

It is currently illegal for pharmacists to administer vaccinations themselves but last year pharmacy chain Priceline started offering $30 flu shots that were administered by nurses
."

Thus the AMA inference that it is illegal for any pharmacist to administer vaccines is wrong and misleading.

And while I am on the topic of professional services, recent attempts by the PGA to have a moratorium on HMR funding, because of budgetary constraints, is an illustration of how this employer organisation tries to suppress (politically  or through the management of grants), funds travelling through to professional service providers.
Unless it is performed and controlled in a community pharmacy, the PGA will not support it, even though they were instrumental in formulating the original HMR process.
They assume wrongly that dispensing, with "bits and pieces" tacked on such as Medscheck and Clinical Interventions, are total pharmacy core business activities.
As funds have become limited to introduce the new services a hijacking of the successful HMR program must be undertaken by PGA for their new services to survive.
The fact that many consultant pharmacists have formed themselves up into successful professional service businesses means to the PGA that they now have competition.
The fact that the PGA is attempting to suppress this competition comes down to a conflict of interest, and perhaps an investigation by the ACCC should be instigated.

HMR is a good and an expanding business, and management of its funds and grants should not be in the hands of the PGA.
HMR contractors should look for an industrial-type organisation to represent themselves politically, even if they have to form up one from scratch themselves.
They could then appoint pharmacies who sign up to a franchise contract that gives form and substance to the development of clinical services.
I am not advocating a split into two armed camps, but it is becoming obvious that the PGA is not representing the interests of pharmacies that wish to pursue an independent approach to the provision of clinical services.
It is certainly not representing non-owner pharmacists who wish to pursue a clinical future, plus provide a future for newly graduated pharmacists.

The PGA has lost the leadership role so pharmacists should just abandon them to find a more cooperative and far-sghted leadership, truly interested in pharmacy as a whole.

Stop Press:

As i2P was about to go to press APESMA and the Consumer Health Forum have both written to Tania Pliberseck (Minister for Health) asking the minister not to cancel or halt the HMR program, pointing out the deficiencies of that program's financial management.
David Quilty, the executive director of the PGA has been in urgent discussions today (Feb 1 2013) still proposing a moratorium fon HMR's to government.
i2P thinks that the time would have been better spent deferring the introduction of new services to ensure that a proven and valued HMR service remained intact until new funding was put in place.
The whole debacle is simply bad management by the PGA and now that this is public knowledge, government should take the initiative and directly fund the PSA for this program and all future clinical services.
We can't afford to lose valuable programs simple so the PGA can play politics with the non-owner pharmacists who have delivered this program and are successfully expanding it.
Medicare should also enforce the rules to ensure that all HMR's are performed in the home, which will put a brake on those operators that have been chasing quantity (but not quality).

Return to home

Submitted by Gerald Quigley on Tue, 12/02/2013 - 19:31.

Consultant pharmacists need to explore membership of APESMA who will, in turn, represent them in any attempts to control their superb involvement in health, by the big boys in PSA and PGA. It's a simple solution.

Submitted by Joseph Conway on Sat, 02/02/2013 - 18:46.

Why pay PSA to administer this program? Surely, this could lead to even more waste of precious healthcare budget? Why can't accredited pharmacists be given provider numbers and claim HMR's independently from Medicare? Providers submitting too many claims could then be investigated. To stop a valuable program to the possible determent of patient outcomes really has to make people wonder about the PGA's true motives. By acting like thugs on the Australian Doctor poll, the PGA may have brought our profession into disrupt...

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