s Six Degrees of Separation | I2P: Information to Pharmacists - Archive
Publication Date 01/07/2010         Volume. 2 No. 6   
Information to Pharmacists

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Newslflash updates for July 2010

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Regular updates from the global world of pharmacy.
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Feature Contribution

The New Competitors- Wholesalers, Manufacturers, Pharmacists and Nurses

Peter Jackson

As manufacturers get pressure from funders of their products such as the Pharmaceutical Benefits Scheme (PBS) in Australia, they will look at reducing costs in the supply chain.
Quite commonly this will take the form of direct distribution to pharmacies (and other business formats) rather than through wholesalers.
Wholesalers in turn face a series of challenges that includes developing a range of efficiencies, the battle for pharmacy numbers, manufacturer strategy, generic strategy and vertical integration. However, this may not be enough and wholesalers may need to develop a strategy involving industry dynamics.
While there will be modest industry growth over the next decade, new products will not be the major generator and research indicates that growth of branded products will be driven by primary care.

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English Pharmacists See Opportunity - Australian Pharmacists Hesitate

Staff Writer

The health systems of England and Australia have many similarities.
However, one NHS rule that we have escaped here in Australia is the 48-hour waiting time guarantee for a GP appointment.
Introduced by the former Labor government, it is now being scrapped as an initiative of the new government to eliminate bureaucracy and targets that had no clinical justification.
Patients in England will no longer be guaranteed a GP appointment within 48 hours under a scaling back of all NHS targets.
Instead, doctors will be allowed to prioritise patients, affecting up to 189 million consultations a year.

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Remote Dispensing Expands Globally

Peter Sayers

Systems for dispensing prescriptions remotely have been available in Australia for some time, but have yet to gain traction.
These systems are characterised by having a TV link to a “live” pharmacist who is located remotely from the machine.
One of the first remote dispensing machines built using Australian technology and manufacture was ExpressRx.

Comments: 3

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How to measure competence?

Dr Linda Bryant (PGDipPharm, MPharm, DPharm(Auck), FACPP, FNZCP, FPSNZ, MCAPA)

The concept of ensuring that our workforce is competent is an excellent idea. At a time of rapidly changing clinical information, our undergraduate degree of 30 years ago (now doesn’t that make you feel old!!) is simply inadequate. For those of us that went to University we learned Knowledge, Understanding, Thinking and problem solving. The rest of us were taught on the job. Our work experience, built on this foundation, helped make us competent. The problem is – measuring that competence over time.

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Community pharmacy’s crystal ball is fogging up

Neil Retallick

At the Generics Conference held in Sydney a couple of years ago, when PBS Reforms I was the Government’s latest and greatest initiative to contain the cost of the PBS, a number of speakers addressed the impending impact of WADP or Weighted Average Disclosed Pricing.
Two of these speakers had developed mathematical models to chart the revenue and gross profit dollars that would be generated in the dispensaries of community pharmacies over the following years through to 2012 and 2013. In both instances, the speakers presented data that showed the dispensary revenue and gross profit lines decreasing quite dramatically as the effects of WADP took hold of PBS medicine prices.
These soothsayers saw gloom and doom in their crystal balls, or their spreadsheets if that’s what they preferred to use.

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Quackery, Skeptics and Acupuncture….

Chris Wright

The reaction to the little piece about Naturopathy and my doctor (published in a June i2P update) has caused some not entirely surprising flame bursting by those who believe a remedy must be science based.
Hmmm, a good point.

Comments: 2

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Show me the Money!

Peter Sayers

Well, we are past July 1 and there has been no official statement on how, when and where the 15 cent payment for electronic prescriptions materialises.
Government does not appear to have specified how it wants a pharmacy claim presented, and system vendors may not have included a module to create an acceptable audit trail as yet.

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In the midst of change – everything remains the same

Neil Johnston

Pharmacist survival strategies have essentially remained the same for well over a century.
In simple terms when pressure is applied to dispensary margins more OTC opportunities are developed.
A conscious decision is made to expand the range of inventory items in niche markets and then key items are discounted to expand market share within that new market.

Comments: 2

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Sublime treachery, delivered par excellence

Chris Wright

It’s probably all been said but that astonishing ascent of the Member for Lalor Julia Gillard has nailed yet another nail in the coffin of our long cherished democracy.
Again, the power-crazed toe-cutters of the Labor Party were unable to muster the restraint required to allow an elected comrade see out the full game.
The bitter hatred (which is often factional but not necessarily in this case) that lurks behind closed doors was just too much. In the end those who read from the Graham Richardson manual on dealing with personnel superfluous to current requirements acted with rare brutality and “Kevin 07” became “Kevin gone to political Heaven” in a blink.

Comments: 7

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Cutting Carbon with Hydrogen Batteries

Staff Writer

TELSTRA'S mobile base stations and some exchanges could soon be backed up by energy efficient hydrogen fuel cells that promise to deliver a 20 per cent carbon emissions reduction compared with the diesel generators currently in use.

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The RACGP announces its new President

Staff Writer

The Royal Australian College of General Practitioners (RACGP) is pleased to announce the appointment of Professor Claire Jackson as President-elect.
Professor Jackson is a GP and GP Supervisor in Inala, Brisbane and is Professor in General Practice and Primary Health Care and Head of Discipline at the University of Queensland. She has been chair of the RACGP Council and the RACGP Queensland Faculty. She has had significant involvement in health reform in many areas, serving on the National Primary Care Strategy Expert Advisory Group and providing a commissioned paper for the National Health and Hospital Reform Commission.

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Outliving most of the world, but not healthy in every way, says nation’s health report card

Staff Writer

The national health report card released by the AIHW gives a pointer as to where primary health care funds are going to be directed to, and a guide as to what "specialties" will need to be invested in by pharmacists.
And following similar lines, the education that will need to be provided to back those specialties.
A systematic approach to developing and marketing pharmacy clinical services is long overdue, and leadership is stagnant.
What can be done?
In practical terms - probably nothing until after the next federal elections, but that gives a small window of opportunity for our lead pharmacy organisations to work out a plan of action and support each other in the process.
Political game playing, whether at the local, state or federal levels, is crippling initiative in all sectors of the economy - but in particular, health.
And pharmacy needs to attract some urgent funding to initiate some primary health care projects that can soak up some of the surplus graduates before it is too late, and we lose these valuable human resources.
It would also be interesting to know what impact existing pharmacy activities contribute to the report card statistics.

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Reviewing the Pharmacist Code of Ethics

Staff Writer

Renewing the code of ethics for pharmacists in the wake of the recent changes to healthcare legislation will be among the topics considered at a wide-ranging ethics conference at the University of Sydney (17-18 June 2010)
World-renowned ethics expert and Laureate Professor Peter Singer will deliver a keynote address on World Poverty: What are our obligations?
The Australian Association for Professional and Applied Ethics conference is being hosted by the Faculty of Pharmacy, under the theme Ethics in the Professional Life: Past, Present and Future.

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Study finds antidepressants not working in older men

Staff Writer

A recently published study in the journal PLoS-One has found that more than half of older men who use antidepressant medication or psychotherapy are not responding to treatment.
Lead author, Professor Osvaldo Almeida, Research Director of the Western Australian Centre for Health and Ageing at The University of Western Australia, said the finding was surprising and alarming.

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Tests help predict falls by Parkinson’s sufferers

Staff Writer

A group of tests may help predict which people with Parkinson's disease are more likely to fall, according to a study by Queensland University of Technology (QUT).
The study results were published recently in the American Academy of Neurology's online medical journal Neurology®.

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Cling Wrap Catches Carbon Dioxide

Staff Writer

High tech cling wraps that ‘sieve out’ carbon dioxide from waste gases can help save the world, says Melbourne University chemical engineer, Colin Scholes who developed the technology.

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Tea tree oil offers hope to skin cancer patients

Staff Writer

Tea tree oil may be used in future as a fast, cheap, safe and effective treatment for non-melanoma skin cancers and precancerous lesions, according to researchers at The University of Western Australia.
A three-year study by the University of Western Australia Tea Tree Oil Research Group has found solid tumours grown under the skin in mice and treated with a tea tree oil formulation causes inhibition of tumour growth and tumour regression within a day of treatment. Within three days, the tumours cannot be detected.

Comments: 1

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NPS Replaces TAIS Service

Staff Writer

NPS will discontinue funding the Therapeutic Advice and Information Service (TAIS) for health professionals as of 1 July 2010.

A guide to medicines information resources has been compiled on the NPS website which can be accessed via the health professional web page. Please note that some of the listed resources are freely available and others for a subscription fee.
Follow this link http://nps.org.au/medicines_information_guide.

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Consultant Pharmacists Freed Up

Staff Writer

The following press release issued by the AACP confirms changes to the HMR model that will at last see an opportunity to professionally collaborate with GP’s and to build a relationship with hospitals.That it has taken so long to deliver the obvious is sad.
But not to dwell on any negatives, it now frees up consultant pharmacists to develop independent business models to deliver services in a more economical, timely and streamlined fashion.
It may also open a secondary market for e-document exchanges capable of quickly sharing information for intended recipients.

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Vitamin C plays vital role in battle against cancer

Staff Writer

New research from the University of Otago, Christchurch, shows that vitamin C can help curb the growth of cancer cells.
The study, led by Associate Professor Margreet Vissers of the University’s Free Radical Research Group, is the first real evidence of a connection between vitamin C and tumour growth.
Associate Professor Vissers says “Our results offer a promising and simple intervention to help in our fight against cancer, at the level of both prevention and cure”.
The article is in the latest edition of the prestigious Cancer Research journal.

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Gut flora study gives insight into obesity

Staff Writer

A UQ academic's research into whether nature or nurture influences the development of gut flora has been published in Nature and may hold the key to understanding obesity.
Dr Florent Angly said the fundamental research was significant since some forms of obesity could be caused by the action of microbiota.

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At last - a peak national pharmacy group in formation

Staff Writer

A forum initiative developed by the Pharmaceutical Society of Australia (PSA) has seen discussion on the early stages of the first truly representative peak national pharmacy body.
It is presumed, when eventually formalised, that this body will be capable of generating national policies that will bind its membership and provide a cohesive single face for the "whole of pharmacy".
It is also presumed that this group will have provision to absorb emerging and new pharmacy organisations.
PSA is to be congratulated on taking the lead role in the establishment of the initial forum that is certain to win support by all pharmacists in whatever sector they work in.
In the current climate of severe political and commercial pressures on pharmacy, one wonders why it has not happened a lot earlier than this, because the disparate ambitions of various pharmacy organisations up to now has definitely worked against the best interests of the pharmacy profession as a whole.
i2P has often commented on this issue and the need for a peak body that is truly representative of pharmacy.

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Youth lead the adoption of e-health

Staff Writer

The ‘net’ generation, spanning 13 to 33 year olds, has embraced technology as the norm and is expected to adopt e-health as just par for the course in their highly connected lives according to several leading youth health experts.
Jonathan Nicholas, Chief Executive Officer of the Inspire Foundation, the organisation behind the web-based mental health support service for young people, ReachOut.com said, “As an organisation that uses the internet to connect with young people, we see a number of benefits for young people flowing from the proposed e-health record.

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US ‘Renaissance’ in pharmacy’s role as a vital health resource

Staff Writer

Pharmacists in Australia may be forgiven for feeling invisible as they search for roles and activities that gainfully utilise their experience and skills.
New projects and programs often mention "allied health" and nurses, but not pharmacists.
There are probably two major reasons for this problem:
* The Pharmacy Guild of Australia (PGA) has allocated resources exclusively to PBS-centric activities.
This has led to a reduction in jobs for new pharmacists and a surplus human resource. This is in stark contrast to all other health professions that seek to increase their practitioner numbers.
* GP lobby groups have promoted the use of practice nurses in key areas normally in the pharmacy domain. This has had the effect of increasing the number of "short" consultations, with the GP providing evaluation and the practice nurse to complete the work.
GP lobby groups have also been active in suppressing pharmacy initiatives particularly in the concept area of medication continuance.

In the US the opposite is occurring, mainly because of the fractured health service that exists in that country. However, while it can be said that Australia's health system may be better, it seems to be dysfunctional for the moment.
This may represent an opportunity for pharmacy if it can be properly articulated to politicians.
It appears that governments only turn to pharmacy when they need bailing out.
The end result always sees pharmacy disadvantaged as policies and promises are inevitably changed.
The following story recently appeared in Drug Store News

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Complementary and alternate medicines

Neil Johnston

There are many views held in pharmacy as to the efficacy and value of complementary and alternate medicines.
At i2P we endeavour to cater for all perspectives by publishing the views of skeptics such as Loretta Marron, who takes a “no holds barred” approach, and insist that the only perspective for medical professionals to prescribe/sell drugs be evidence-based.
On the other side, we recently published an article by Chris Wright (a regular i2P author), who is not a pharmacist but has a good working knowledge of pharmacy.
He opted to take acupuncture treatment from his GP instead of consuming anti-inflammatory drugs.
His GP gave him the choice.
Chris’s article drew strong comments from the “evidence-based perspective”.
(Follow this link to view comments at the end of the article)
Chris chose acupuncture because he felt it would work for him.

i2P asked Mark Coleman to make a comment which appears below the news item that originally appeared in Pharmacy News on June 24 2010.
Acupuncture is mentioned in the last line of that news item.

Comments: 1

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Six Degrees of Separation

Barry Urquhart

articles by this author...

Barry Urquhart, Managing Director of Marketing Focus, Perth. Barry is an internationally recognised conference keynote speaker, facilitator of strategic planning workshops and marketing business coach.
Contact Barry: TEL:61 8 9257 1777 - EMAIL: urquhart@marketingfocus.net.au -
WEB: www.marketingfocus.net.au


Life remains interesting in a volatile marketplace.
Mervyn King, the Governor of the Central Bank of England stated in late May that the Global Financial Crisis is not yet behind us.

He contended in a public speech that all that Europe had achieved was the transfer of personal and corporate debt to sovereign debt.

A number of countries throughout the world still had to make some significant decisions to address (immediately) the liquidity issues, for better days to be ahead (intermediate term).

I concur, let me be emphatic. There can be no gain without pain.

In several interactive in company workshops and strategic marketing audit sessions, it was apparent that for a number of entities their philosophies, mission statements, marketing strategies and advertising campaigns were not in alignment.

Collectively, these were having a negative impact on the branding of companies, products and services.
In each instance, the necessary and appropriate changes were not quantum in nature. Considerable scope for growth, development and competitive advantage were identified and are now being pursued.

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It is a sobering realisation that we are each, potentially, just six contact points away from personal conversations or private audiences with the likes of Nelson Mandela, The Pope and President Barack Obama.
Former Australian Prime Minister Kevin Rudd may be another proposition, with questionable value for the effort expended!!!

The reason why most people and entities do not enjoy and achieve being in the presence of such luminaries is a lack of planning, sequencing, focus and intent. Most things are possible.
Success in marketing, particularly in the current volatile marketplace, requires similar discipline and the application of a like disciplined framework. The six degrees of separation, from ordinary to exceptional, in the current business arena are:


For sheer efficiency, effectiveness and economy, diligent and discrete targeting of primary, secondary and tertiary target audiences is imperative.

The term “mass media” is to a large extent now an oxymoron, a contradiction within itself. Media channels are fracturing. Broadcasting is to some considerable extent a thing of the past. Today, the reality is narrow-casting. Reliance on the use of a single medium is limiting.

Communicating to and interacting with those who are outside the profile of prospective, current and immediate past customers and consumers can, and typically does involve the expenditure and investment of considerable time, money, people and other resources, often for little return.

Particular care needs to be taken in the differentiation between customers (who buy) and consumers (who utilise). The needs, preferences, actions and roles in the buying process of both subsets differ appreciably.

Women remain the prime and key influential buying agents in up to 70% of instances for consumerable, durable and, to a lesser extent, capital goods and services.

There is a rich vein of gold to be mined among existing customers, who are largely unrecognised and not exploited. Develop and exploit the relationships.

The mantra, “share of wallet” in preference to pursuit of share of market has great potential for more immediate and significant returns.

Thus, seek out, communicate personally with, service and satisfy those whom you know best.


Hundreds of millions, possibly billions of dollars of under-performing products and services reside within the inventories of retail, wholesale, and manufacturing entities, big and small.
There is little or no scope for sentiment, nostalgia and inertia in business decision making in the prevailing marketplace. Opportunity costs, an impost borne, are not entries on traditional asset and liability statements.

Obsolesce is a further burden which impinges on and limits performance.

Stockturn ratios, sales conversion rates, internal rates of return and stock ordering lead times are not of themselves guarantees for better business performance levels and success. However, they are benchmarks to enable effective monitoring and measurement of absolute, relative and comparative progress to ultimate goals.

Recognition of the need for specific action is the first step to an improvement and success.

Individually and collectively they provide meaningful insights and sound bases for responses to the ubiquitous question:

“How are things going?”

Without objective and accurate measures things may not be going at all. They may be “sticking”……. to the shop and warehouse floors.
An integral part of the success of the complex and diverse product range of the 3M corporation, is that at all times a minimum of 60% of the product/range has been introduced into the marketplace within the past 5 years. That implies a strong dose of dynamism. In short, clean out, shape up and move forward.


The disturbing and disappointing attrition rate of the new and innovative products and services is a sad testament to poor and inadequate supply chains and distribution networks which operate globally and throughout Australia in particular.

Effective chains and networks deliver products, services and above all the key point of consumer appeal, convenience.

Inadequate distribution facilities are the primary source of failure in up to 70% of product launches.
Sophisticated, discerning and “now” oriented consumers and clients demand immediate access to those items they most need or want. There is a noticeable lack of tolerance in the marketplace. Offers of “rain checks” in which the products or services are guaranteed to be available at the same price at another nominated time are typically declined.

Short lead times, on-line real-time interface between the computer software of manufacturers, distributors and retailers, and paperless invoicing and ordering through automated imprest inventory systems are no longer ideals. They are increasing mandatory, for entities to minimise costs and to return to competitiveness.
It is noticeable that market leaders like Woolworths in Australia, Wal-Mart in the USA and Tesco in Britain have invested heavily in upgrading their supply chains over the past decade. Significantly, there is no slackening in the pace of such investments and innovations.

Which raises an interesting question. What industry are you in?
Today, there is only one answer.
Supply chain management, regardless of the related disciplines, products and services.


The recent public announcement by the Australian Federal Government of the introduction of legislation to remove differential labelling and branding in the packaging of cigarettes is an important lesson for all.
Too little attention is given to the art of effective branding. It is not an overstatement to contend that over 80% of entities, products and services available in the marketplace throughout the world suffer from being labelled rather than branded.

Commodization reduces, if not eliminates, the inherent value and thus satisfaction which is and can be attributed the uniqueness to a recognised and preferred brand.

A perusal of the real estate section of a weekend newspaper confirms the expenditure of considerable monies in a cavalcade of colourful signage and graphics. Real estate advertisements broadcast on radio stations present a similar cacophony of sound, with little effective branding.

Health specialists forecast that as a consequence of the removal of branding on cigarette packages in Australia (and as a result of 25% increase in taxes on the product range) 100,000 Australians will cease smoking within 12 months. Significantly, it is projected that in the same period of time more than 70,000 adolescent Australians will not take up smoking. Brand switching among existing smokers will be reduced.
More than ever before the cigarette companies will need to develop strategies and tactics which differentiate their market offerings centred on actual product presentation and below-the-line (non mass media) communication.

Little wonder there has been renewed and increased interest in our exclusive customised keynote presentation,

“It Is Better to Be Different Than It Is To Be Better”


For the past two years cash flows have been adversely affected, budgets have been reduced, financial institution lending policies have been tightened and outlays have been understandably constrained.

Business owners and managers have been confronted with the challenge to do more with less.

The scope of options which are viable, attractive and effective has narrowed.
Two lessons which recur across a broad spectrum of sectors and entities are:


No one aspect of the 20 elements of the marketing mix achieves greater traction than enhancing, remodelling and modernising one’s presentation in the marketplace. That reality reflects the importance being assigned by many retailers, precincts and communities to establishing an appealing, safe ambience. Obsolescence, or a sense of such, impedes endeavours.

Subtleness can be a virtue. Relevance is the objective.
Having a “good” place to visit and to work in, inspires confidence, imagination and demand.


It is one thing to upgrade premises. However, without informing, educating and encouraging prospective and past clients to visit, to enjoy and to become involved, the potential for increases in consumer/client traffic, revenue and profits remains latent.


Sadly, too many business leaders and practitioners separate sales and service into two distinct practices and disciplines.

A preferred philosophy integrates the two into a compelling, unified presence of conspicuous benefits and advantages.

During the boom years prior to the Global Financial Crisis (whose impact was universally evident from August, 2008) considerable difficulty was encountered by businesses in the recruitment and retention of qualified, experienced and engaging staff-members. High employee mobility was a common and exasperating experience. Loyalty was isolated, stability a thing of dreams.

Management attitudes hardened. Investments in training were understandably considered to offer little and only short term benefits. Many training budgets were curtailed and in some instances eliminated.

As a consequence, customer satisfaction plunged. Significantly, the primary causes seldom related to the actual products or services, quality, availability and maintenance. Rather it was the poor attitudes, inadequate product knowledge and poor presentation of staff members.

Cuts in training and the lowering of standards in recruitment proved to be false economies.

Leaders in the broader retail sector have been quick to embrace the prioritising of a “positive ambience” and a “great shopping experience” as the imperatives necessary to optimise revenue potential and profits.

Enthusiasm, pride, urgency and a sense of theatre are contagious emotions. Moreover, individually and collectively they are effective counter weights to a prevailing feeling of dullness, indifference and apathy which impede the realisation of attractive sales potential. Let me be emphatic. Good and great customer service costs. Poor and awful service costs more.
Greater emphasis needs to be assigned to upgrade the service experience for a sales advantage to be achieved and sustained. Price sensitivity will then be rightly assigned its ranking of the fourth, fifth or sixth most important purchase criteria by customers and clients.


Progression through the six degrees of separation is simple, but not easy. Hard decisions cannot be made to be easy decisions. However, addressing progressively each of the six degrees detailed above does make it easier to make the hard decisions. There are not short cuts. In the current marketplace one wins and retains business by degrees…. six, in fact.

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