s Why I joined APESMA/Professional Pharmacists Australia | 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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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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Why I joined APESMA/Professional Pharmacists Australia

Joseph Conway

articles by this author...

Joe Conway is an Irish born pharmacist who qualified in the UK in 1998.
After completing a residency in a hospital in London, he embarked on a 3 year locum stint that involved working all over the UK, Ireland, and Australia in over 350 pharmacies of all varieties (hospitals large and small, community, even a prison pharmacy).In 2002, Joe emigrated to Australia and worked in the Private Hospital sector gradually moving in to management positions with Slade Pharmacy where he developed a keen interest in Oncology services. In 2006, Joe took up a position setting up a Pharmacy service to a newly built Day Hospital in Frankston, Victoria. The Pharmacy now conducts over 40 clinical trials.
Joe is currently studying for a Master of Biostatistics to help him progress in the area of clinical trials, and think outside the square (or at least be left-field).

Before 2011, I didn’t really take much notice of what was going on in Pharmacy.
I used to read journals pretty much so I would get enough points for APHRA CPD registration requirements and PSA membership was enough to accomplish this.
I, like many others, saw the Pharmacy Guild as the ultimate representatives of pharmacy and was happy when the 5CPA was signed, even if it seemed a bit rushed?

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The lack of initial detail raised the first seeds of doubt in my head that the CPA process didn’t seem very transparent.
Later, when I saw the Blackmores® “Coke and Fries” comment that pharmacists could provide ''the Coke and fries'' with prescription drugs, I was flabbergasted.
Following this was the Lipitor® program, which seemed to be a marketing ploy by Pfizer® to increase its market share of Lipitor®, didn’t seem (to me) to be of benefit to Community pharmacy, patients and the Government as it its effect could have been to reduce generic substitution of Lipitor which would have led to higher list prices for Atorvastatin through the price disclosure process into the future.
Not to mention that Pfizer® through Pfizer Direct® had made it a bit more expensive for pharmacists to conduct business.
Why do this?
What were these programs?
Did the Guild actually represent me?
Who do they represent?
These were all questions that I started asking myself at this time.

The other big issue in pharmacy is the apparent oversupply of pharmacists (at least in major cities and towns) and the low wages for pharmacists.

Over the past 10 years there seems to have been an explosion of pharmacy schools and the result of this has been a stagnation of wages and a lowering of the ATAR score needed to do a pharmacy degree.
Is this good for the profession?
In 2010 and 2011, I felt that the main pharmacy organisations PGA and PSA) seemed quiet on this emerging potentially volatile point in pharmacy.
Their inaction I feel has contributed to Retail Pharmacists (ANZSCO code 251513) still listed on Skills Occupation List (SOL) and there are pharmacists overseas still trying to enter Australia on the potentially false premise that there is a shortage of pharmacists here.

After graduation, pre-registration pharmacists have one of the lowest graduate salaries in Australia. Afterwards, many pharmacists get “stuck” on a wage and find it hard to break $30-35 per hour no matter how much experience they have.
After 10-15 years in the profession, many other professions’ salaries have surpassed that of pharmacists:

http://www.professionalpharmacists.com.au/advocacy/pay/

Now, there is anecdotal evidence (at least in VIC) that many pharmacists are being paid close to award wages ($23-25 per hour) in some chemists.
This is the wage pharmacist were paid 20 years ago?
It’s embarrassing to the profession that such low salaries are reappearing and a lot of great talent will be lost for good from the profession if such salaries are allowed to become the norm.
The public would ultimately lose out from this as they are less likely to be able to talk to an experienced pharmacist.

What the PGA and PSA appeared to be telling concerned employee pharmacists was to “suck it up” and to “stop whinging”.
This is a market condition and when the number of graduates increases and overseas pharmacists are still arriving, it is only natural that the pay for pharmacist labour should be devalued we were told. However, for pharmacists outside the Guild (approximately 80% of pharmacists), I started to feel that the concerns of the 80% were not considered as much as the 20% allowed to be members of that organisation.
Is this good for the profession of pharmacy?
Is it right to expect the Guild to look after employees?
Although the Guild does a lot of great things for the profession, where is the accountability?
How can the 80% of employee pharmacists who also have “skin in the game” get a say on where the profession should go?

In 2010, the Pharmacist Coalition for Health reform was formed.
This was an umbrella organisation that represented the 80% I thought.
I saw that a number of pharmacy organisations including the PSA, SHPA, APESMA and NAPSA came together and seemed united with goals of a better future for pharmacy.
Finally, another organisation was formed that could (in part) represent employee pharmacists’ concerns. The Guild was actually asked to join, but refused.

I found the disbanding of the Pharmacy Coalition for Health Reform (PCHR) disheartening and a telling experience.
NAPSA represents future pharmacy employers and employees.
They can’t and probably shouldn’t be seen as being biased to employers or employees.
The same sadly goes for the PSA.
The PSA does not represent employee pharmacists.
The PSA does not represent Pharmacy Owners either.
They can’t represent employees or employers given their structure?
However, they do write standards.
Standards are, of course, essential for professionals, but the PSA are not going to help you when your employer tells you that s/he has to decrease your wages as they paid too much for the pharmacy, are paying too much in rent, or need to cut costs to compete with the local “$2 dollar pharmacy stores”. They might give you sympathy, but little else in that situation.
When the PSA left the PCHR, it was proof that the PSA has to be impartial to the needs of employee pharmacists.
They represent all of pharmacy and as such are they can’t give independent criticism of the Guild even if the majority of their membership (i.e. employees) felt that it is warranted.
They are not independent of the Guild and many senior PSA members are former senior members of the Guild (e.g. John Bronger).
How then can the PSA be there to represent the needs of employee pharmacists?

I say that APESMA is there for all non-owner pharmacists.
Sure, it is a Union (so is the PGA) and many people in pharmacy may have a bad impression of the word “Union”.
There is a lot of negativity in the press regarding unions as they are seen as just increasing wages and thus making business more expensive to conduct.
I feel after seeing the Global Financial crisis (from Irish perspective) that unfettered capitalism without any “consciousness” can lead to devastating economic outcomes, which affects the poor in society disproportionately.
I think that APESMA has to capability to become the “conscience” of the Guild.
The Guild is doing a lot of great things for pharmacy.
However, with a lack of independent critique, they are prone to mistakes sometimes – particularly in how they sell the message of the work that is being done by non-member pharmacists and concerned people (e.g. Carol Bennett CEO of the Consumer Health Forum).
A more powerful APESMA could lead to a situation where there is greater harmony in the profession as there would be a clear line between employers and employees.
At the moment, the "80% line" is blurred by the PSA not knowing whether to side with employers or employees on particular issues, and satisfying no one.

If employee pharmacists want to lobby for more representation in pharmacy, then it’s not going to get given to you.
APESMA offers the structure with which to build an organisation that can represent all non-owner pharmacists.
It has the ability to lobby strongly for its members interests.
With a stronger APESMA-like organisation, the Guild could get about its business looking after the interests of its members without interference by the PSA.
I feel that such a system could offer more harmony in the profession as each organisation would have a clear agenda and stance for its members, and an agreement could be sought from these two vantage points.
With the PSA, there doesn’t seem to be a clear view of who or what they represent beyond standards and this creates confusion, and I feel is the root cause of much of the current disharmony in the profession.

That is why I joined APESMA and it was my first step to try to lobby for change within this profession I love.
For further information, please visit our website:

www.professionalpharmacists.com.au

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Submitted by Erin on Tue, 09/04/2013 - 16:47.

I actually think its great you've shared your reasons. Makes me think I should join too.

Submitted by Busy pharmacist on Tue, 02/04/2013 - 14:52.

Hmm - what is this attempting to argue? Another disjointed piece from Joe. There is plenty right with pharmacy & plenty wrong - much of it due to pharmacists themselves. A few extra dollars will not solve this.

Submitted by Joseph Conway on Tue, 02/04/2013 - 19:18.

Simple argument: Leave PSA and join Guild or APESMA:

I think that all pharmacists should seriously consider what they get from their PSA membership - besides quality and excellent CPD - what else?

That is why I joined APESMA and now that we offer CPD, pharmacists who would like an organisation with a goal for higher wages for pharmacists (both Owner and employee) have another option - Professional Pharmacists Australia (PPA).

Writing is certainly not my strong-point and I thank you for your feedback. More comfortable with numbers than words.

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