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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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From this page you can share Six Degrees of Separation to a social bookmarking site or email a link to the page.
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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

STRATEGIC ALIGNMENT

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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SIX DEGREES OF SEPARATION

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:

1ST DEGREE - TARGET AUDIENCES

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.

2ND DEGREE - PRODUCT / SERVICE RANGE

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.

3RD DEGREE - SUPPLY CHAIN

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.

4TH DEGREE - DIFFERENTIATION

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”

5TH DEGREE - PRESENTATION

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:

· PREMISES AND COMMUNICATION PRESENTATION UPGRADES WORK

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.

 · MULTIMEDIA MESSAGES ARE IMPERATIVE

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.

6TH DEGREE – SALES AND SERVICE

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.

THE NEXT STEP

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.

health news headlines provided courtesy of Medical News Today.

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