s What are we doing to ourselves? | I2P: Information to Pharmacists - Archive
Publication Date 01/12/2009         Volume. 1 No. 7   
Information to Pharmacists


From the desk of the editor

Welcome to the December 2009 edition of i2p - Information to Pharmacists E-Magazine.
When i2P first began in February 2000, it was decided that a fortnightly publication might prove to be the optimum publishing cycle.
This thought was soon dispelled as it was found that having sufficient content to maintain this cycle became a problem.
Oh for those quieter times!
The cycle then became monthly and has been maintained up to now.
The problem is now coping with the volume of news and opinion that is generated on a daily basis.
Very much the reverse of the year 2000 - a statement for our time and how the pace of pharmacy life has increased.

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Recent Comments

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For some pharmacists the truth will be ‘inconvenient’. WHY is it so??

James Ellerson

Sir Winston Churchill said “Truth is incontrovertible, malice may attack it and ignorance may deride it, but, in the end, there it is.”
Elvis Presley said “Truth is like the sun. You can shut it out for a time, but it ain't goin' away.”

At the PAC 2009 Conference John Menadue’s forthright messages made it abundantly clear that the sun was shining very brightly indeed.
Here are the ‘message sticks’ that resonated with me:

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About that "Un-Invitation"

Dr John Dunlop (PGDipPharm, MPharm, DPharm(Auck), FACPP, FNZCP, FPSNZ, MCAPA)

It was interesting reading John Menadue’s speech given at the Pharmacy Australia Congress in Sydney in October.
It was even more interesting to read of the UN-invitation by the Queensland branch of the College of Pharmacy Practice and Management, the stance taken by the Pharmacy Guild of Australia and the Pharmaceutical Society, to support only pharmacy activities provided from within a community pharmacy.
How draconian is that?
Research has demonstrated, as has the low uptake of new professional services from within a community pharmacy, that the existing community pharmacy model is not compatible with the implementation of these new professional opportunities.
The two major arguments put forward are ‘lack of time’ and ‘lack of funding’.

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A Green Pharmacy is Gold

Neil Retallick

Simon Divecha, Director of GreenMode, a consultancy that assist business and people to find their carbon and sustainable advantages spoke at the recent Pharmacy 2009 Conference.
Simon has assisted businesses including BP Solar, Origin Energy, Lend Lease, ANZ and IAG.
His challenge to community pharmacy is to identify and take advantage of the opportunities that exist for businesses that have such close relationships with their local communities.

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What are we doing to ourselves?

Heidi Mahon

Over the last months, I've noticed the position taken by both the Guild as well as individual pharmacists on our on-line forums.

In his recent address Mr John Menadue poses the question - are pharmacists the most change-resistant health profession?

And if so, what is our future likely to hold?
What can we do about it?

Personally, I have to agree with him - if we as a group - and not just the Guild, DON'T take innovation as a prerequisite for how we practice our profession, then in 20 years time, what will we have left?

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Picture - the wood for the trees

Pat Gallagher

Another year has gone by and what have we done with technology in the health sector?
A good question that deserves a long and detailed review as a written dissertation by somebody learned and influential in health informatics, government, consulting or from the many agencies, departments and committees engaged in delivering e-health service to the Australian public; notably as a value proposition for the tax payers in the greater voting public cohort.

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Advancing Self Care

Neil Johnston

Imagine a pharmacy that had a range of eye catching kiosks that utilised easy to use touch screen technology.
Not passive kiosks, but kiosks that are interactive with customers/patients to efficiently provide a perceived need.
It’s not a new idea, but the marketing of health care through kiosks certainly represents an organised method of transferring information to customers/patients and assisting them to make good health decisions.
One current form of kiosk that is beginning to take hold in Europe and the US is the vision kiosk.

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Wind Farm will Power Sydney's Desalination Plant

Staff Writer

Source: AAP NewsWire

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Communications Technology - a nudge from the big end of town

Staff Writer

National Health IT assumed prominence recently when the National Business Council of Australia wrote directly to prime minister, Kevin Rudd, urging him to create a focus on communications technology and to invest appropriate funds.
I wonder if they were aware of the organisational performance 0f NEHTA and their inability to date, to actually deliver suitable infrastructure and systems.
And with $'s millions already wasted by NEHTA I am sure there is hesitancy by government to spend even more, given the dismal track record to date.
Health communications is stuck in a deep groove.
But it is interesting to note that the Business Council of Australia see productivity and investment opportunities in health if only the primary health players could integrate better and talk to one another.
Shared health communications underpins this potential benefit as the many writers for i2P have continually pointed out.
With the big end of town taking more interest, maybe government and health professionals can align themselves more fluidly.
A read of David More's blog article from a NEHTA insider in this edition of i2P, leaves you still wondering how an alignment can take place without removing the NEHTA structure completely.

Health info needs urgent technological injection

Source: Industry Search -24/11/2009


Read the BCA letter in full here

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Powering up by osmosis

Staff Writer

An unusual form of renewable energy has emerged recently in a novel format involving the use of fresh water and salt water interaction across a membrane that creates osmotic pressure.
This pressure has been demonstrated to be able to drive a turbine that can produce an electric current.
Osmotic pressure is well known in medicine with adjustments having to be made to eye drop and injection formulas to minimise the pain associated with the administration of these medicine forms.

The process is a more controllable form of natural energy when compared with weather-dependent versions of energy generation (solar, wind, tidal etc) and has a reasonably small and discrete footprint in the environment.
With a bit of imagination it is not too far of a stretch to have the salt water filtered through another form of membrane to create fresh water to be recycled within a closed system.

Norway tries osmotic power to harnessing power of salt

Source: Industry Search


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Insuring the Disabled

Staff Writer

Prime Minister Kevin Rudd is to be commended for the initiative in having a look at the feasibility of creating a no fault disability insurance scheme.
Disability can cause disaster to any family structure and can be a constant drain on financial resources that can add to further stresses up to, and involving bankruptcies.
By putting in place a proper financial underpin, each family member is enabled to be productive and self-sustaining. This can create a net gain to the taxation base when viewed globally, to include service providers and industries that can feed off that activity stream.

PM calls for national disability reforms

Source:DPS Guide to Aged Care


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Should patents apply to the natural world?

Staff Writer

I can't but help wonder if the move to be able to patent all things natural is a smart move.
Take for example the Neam tree that grows wild in the northern part of Australia.
The leaves of this tree make a great insect repellent with no known side effects.
An entrepreneurial Australian a few years back, decided to grow these trees and was surprised to have legal documents served on him claiming royalties and damages from some obscure US company that had registered a patent for all things Neam.
Unfortunately, there was no legal defence for the Australian grower.
Now there is an outcry by vested interests because the Australian government has resisted pressures to allow the patenting of human genes.
All sorts of calamities are therefore predicted for the local biotech industries.
But I wonder if these claims will prove to be valid?

Follow the debate in this article:

Ban drives 'biotech industry to its knees'


Source: AAP

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Public Hospitals - Time they were fixed

Staff Writer

Queensland Health struggles through another drama after using instruments that had been used on patients and left unsterilised.
But it's not just Bundaberg Hospital that is sick - the entire Australian hospital system needs a radical overhaul.
The Rudd government had promised to "fix" the problem after taking office, but so far has not made any noticeable progress.
Read about the latest problem.

Qld Health cleaning up after dental sterilisation scare

Source: ABC Online


By Chris O'Brien

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Patient uses initiative to attract nurses

Staff Writer

If anyone has ever been a patient in a hospital and tried the buzzer to get assistance from a nurse, then here is a new innovation to get attention.
Not that the nursing fraternity should shoulder the blame.
It's the politicians and the lack of political will to solve this issue and many others.
Congratulations to the patient and his initiative in dialling triple O.
Read the full story here:

Man rings triple-0 from hospital bed

Source: ABC Online

by Cate Grant


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What's good for climate is good for health

Staff Writer

Health professionals from around the world are slowly waking up to the fact that climate change can induce adverse effects on health.
At i2P we have been carrying messages for just on two years, regarding climate change effects, including research reports from our own writer Con Berbatis, in the hope that official pharmacy would see the need and develop policies and strategies for pharmacists to adopt.
Now, with the formation of the International Climate and Health Council a recognised forum is available to be addressed.
Will pharmacists be given a seat at the table?
Perhaps the Pharmaceutical Society of Australia should find out.

Health Professionals Around The World Launch The International Climate And Health Council

Source: Medical News Today


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Ageing slowly and safely

Staff Writer

The ageing process is relentless with function loss noticeably diminishing over the age of 60.
Supplementation of nutrients holds one key to slowing down some of the processes, in particular the loss of muscle mass and the subsequent aches and pains that follow as the skeletal system is no longer held together in an optimum manner.
This process can be a contributor to falls and more serious damage.
Not being able to adequately stay on your feet as you age, robs you of your independence.
It would seem that a strategy of slowing down slowly might be prudent for the age demographic entering retirement - the "baby-boomers".

Antioxidants could help preserve muscle strength

Source: Reuters Health
By Marilynn Larkin

Found at this link

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Are we planning for future skill shortages?

Neil Johnston

National Seniors Agency have published a report indicating that Australia will have a shortfall of 1.4 million workers by 2025.
This shortage will also be reflected in the profession of pharmacy.
It is pointed out that a smart move would be to match an improved workplace to match specific requirements for mature-aged employees and thus retain them for longer periods..
APESMA has recently published an online survey in an endeavour to poll employed pharmacists on the issues that affect them specifically. Obviously, this is a move in the right direction, and much of what they are polling has a direct relationship to mature-aged employees.

So what is community pharmacy doing to retain their senior pharmacists?

Very little, it seems.

i2P asked Mark Coleman to comment and his commentary appears below the news item:

Comments: 1

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What are we doing to ourselves?

Heidi Mahon

articles by this author...

I am based in Brisbane up here 'sunny and warm' Queensland. I am vocal for the employed pharmacist as I have nothing to lose. I had a car accident just over 2 years ago, and I've tried my best to return to my profession either in hospital or community - and my injuries cause me too much pain for me to be able to continue. On the positive side, the Pharmacy Guild are unable to threaten my career any longer - and as I believe that our profession is in serious trouble, I consider it my duty to speak out now that I have the chance.

Over the last months, I've noticed the position taken by both the Guild as well as individual pharmacists on our on-line forums.

In his recent address Mr John Menadue poses the question - are pharmacists the most change-resistant health profession?

And if so, what is our future likely to hold?
What can we do about it?

Personally, I have to agree with him - if we as a group - and not just the Guild, DON'T take innovation as a prerequisite for how we practice our profession, then in 20 years time, what will we have left?

open this article full screen

PriceWaterhouse Coopers have released a very detailed yet an easy read on providing a sustainable healthcare system in the next 10-20 years -HealthCast 20:20 (I strongly recommend this document to anyone interested in where we are going - without PGA spin).

Mr Menadue's speech was a pharmacy-focused truncation of this document.

In a nutshell, the message is - our current health system is unsustainable, and unless we change the way we do things very significantly, we are not going to be able to pay for even today's level of care. The report goes on to detail seven areas of reform that MUST be undertaken in order to develop a sustainable system that remain equitable for all citizens.

The key point is however, change is inevitable, and those that don't embrace change will not survive.

This document also gives significant background to why the government is implementing the policies and procedures that we are currently resisting. A good example of this is the production of a very flexible workforce - or as someone in the Federal Summit 2008 said ' the right person, for the right job at the right price".

This principle is directly responsible for the advent of Nurse Practitioners as well as the horizontal movement of other health professionals into "traditional pharmacy" territory as well as gaining prescribing rights.

This has major repercussions for our profession. Let's face it, we are producing graduates that are highly skilled and better educated than ever. Today's newly registered pharmacists can confidently state that they are drug specialists, do HMR's in their sleep, and effectively counsel patients at the drop of a hat.

When they get out into the 'real world' they are expected to stick labels on boxes - and do this up to 400-500 times per day. In some 'franchises' pharmacists are actively discouraged to talk to anyone. As a result, we are reduced to 'label stickers'.

The Nurses' federation as well as other professional groups are rightfully trying to reposition their members for the healthcare system of the future. They have stood up to the plate and said "we can do that" with regard to much of what we do as pharmacists. Nurses in remote and rural areas pseudo-dispense - they may call it supplying, however, they are doing the same job as the pharmacist. Queensland health is even teaching them how to run a dispensary - complete with a formulary that they can prescribe from.

In these areas, there is no need for a pharmacist. Even in most metro hospitals, the pharmacist dumps the medications for discharge at the nurse's station, and the nurse counselsthe patient. We can't blame the nurses for this - they realised much earlier than us for the need to innovate and increase their scope of practice so that they are positioned well for the future.

 So where are we with our profession?

According to John Menadue at PACC 2009 "A former president of the Pharmaceutical Society of Australia, Beresford Stock, said 27 years ago'... we have stagnated professionally'. (3rd Commonwealth Pharmaceutical Conference, Trinidad, February 1982).
He said that in 1982.

Eight years later, in 1990, in a paper prepared for the PSA, he said 'For too long the conscientious practitioners have been financially supporting those who have been avoiding their professional responsibilities to the community.' Professor Sansom said much the same to your congress in Perth last year."

As this shows, we are going somewhere - backwards. I read on our forums that we:

* Can't get our heads around dispensing the oral contraceptive pill - even where there is no other pharmacy.

* Refuse to consider vaccinations - we might get sued (realistically, doing 400-500 scripts per day is going to get me before the board, and LONG before a vaccination AR would).

* Refuse to consider prescribing repeat prescriptions - if people are serious about not prescribing, then stop stocking S3 medications immediately - they are pharmacist prescription items!

* Refuse to break the Guild's monopoly on HMR's - hence the programme hasn't shown the massive benefits that it should - the Guild should never been allowed to make accredited pharmacists work through a community pharmacy. It is even in our charter that we have the right to independent practice.

* Refuse to stand up to the Guild on their position regarding consultant pharmacists being employed independently in GP superclinics (it's a guild community pharmacy or nothing)

* Refuse to stand up to the Guild regarding OH&S - it is illegal to go without a break for 10-12 hours, and not being able to go to the toilet without breaking the law is ludicrous. Yet we put up with it.

* Making people pay for standardised tests such as blood pressure, etc (we used to even do pregnancy testing remember??) is now considered to be a sacrilege.

* Allow Kos Sclavos scare and threaten both pharmacist as well as pharmacy assistants with the sack - even though research has shown that the Global Financial Crisis hasn't affected pharmacy.

* Not complain that we haven't had a pay rise in at least 10 years - not even CPI indexed.

In real terms, this means that we've agreed to a 20% pay decrease.

With our profession, it is now to the point where the QLD Law Society are using us as their example of what happens when a profession refuses to innovate and change with societal requirements. My lawyer friend called me a few weeks ago and begged me to NEVER consider purchasing a pharmacy. To bring this into focus - when was the last time you saw a blacksmith, tinker or terrazzo floor layer? (my grandfather was one).

We have no 'god-given' right to survive as a profession - and as per the above examples, professions have and do disappear.

So what has our response been to date?

The Guild is the most visible and most politically powerful pharmacy lobby group, and rightfully, much of the blame is rightfully theirs.
We need to remember, they only represent the owners - the majority of pharmacists are disenfranchised.

Whilst this suits the Guild (no collective bargaining, no pay rises, no need to conform to OH&S law etc), we have not been proactive in doing something about our own situation.

We have a union - APESMA.
They are very very active for other professional groups that they represent.

For example, APESMA have recently organised a 'no overtime' strike for all engineers at the Brisbane Airport - this is forcing the airport management to negotiate otherwise planes wouldn't fly.

They don't do the same for us due to low membership - we aren't joining (we can't blame the Guild - whilst they may discourage us from joining, we are still in a democracy).

If the majority of us did, then we would have a bargaining position to force the government and peak industry bodies to listen to the every-day pharmacist. Perhaps then, we can set an agenda that would see us be able to negotiate where we (the majority of pharmacists) want our profession to be in 10-20 years time.

Whilst there are hurdles, in the end, our profession's future is in our hands.

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