EDITORIAL for Moday 6 April 2015

Welcome to i2P (Information to Pharmacists) E-Magazine for Monday April 6, 2015.
This week we are developing more insights into the new paradigm for pharmacy, in its physical, managerial and professional requisites.
And it is taking shape so that we can conceptually “see” what it looks like.
In this edition we expand on the types of pharmacy that will survive.
Sadly, we believe, the community pharmacy we know at this moment will not survive.
But there is opportunity to evolve to a better type of pharmacy, one that involves “collaboration”, “patient engagement” and also one that can add “environmental health” in its line up.
More a “Specialist Community Pharmacy”.

A better understanding of all these terms needs to occur within pharmacy and all other health professions before sensible conversations can begin.

Collaboration will only occur where existing or new activities “dovetail” rather than “compete”.

Pharmacy has drug or drug-related perspectives at its core with professional overlaps to support primary objectives.

Doctors have diagnostics as their core with professional overlaps into retailing of vitamins, dermal cosmetics, travel vaccines, skin care ranges, flu vaccines, and some even have compounding labs.

In my region we even have specialists purchasing non-pharmacy grade marijuana oil  (direct from grower) for supply to patients organised into private clinical trials (mainly for neurological pain).

When you lift up the veil you begin to see a lot of activity that might be contentious, and while it remains “under the radar” it does not seem to attract attention or criticism.
It’s only when it becomes more visible that the chorus of detractors begin to grow and make louder noises.

Collaboration will only occur when value becomes the primary reason to do something in a patient’s interest – and to do it better.
So maybe we are experiencing the beginning of change that is the beginning of the break-down of silo mentality.
Much like the destruction of the Berlin Wall from the Cold War era.

While the war between doctors and pharmacists has become more visible, it has always existed. Pharmacists simply chose not to go “full frontal” because in warfare, you choose only the wars you can win.
Some of these concepts are discussed in the article Your Future Pharmacy – there are choices.

But you can’t hold back progress. Pharmacists are a well-trained and highly educated diverse group of people, strategically located and highly visible through all areas of our country.
It is natural that as research delivers better health understanding that all health professions will grow according to their different abilities to absorb and utilise new information.
Professional expansion is a natural course and should be embraced by all rather than have “turf” wars. That process becomes tedious and expensive to all professionally, and eventually to government as well, particularly if they are unable to reduce the national health bill to take advantage of new developments.

Add to this mix is the fact that the word “collaboration” conjures up different things to different people.
To the political faction of GP’s it means pharmacists working as employees or inside a GP practice in another format.
To see what that means in practice read So you want to collaborate? – a US experience.
To others it may mean independent practices working in parallel to achieve health objectives for patients through a respectful alliance of skills.
There may be many variations of the word “collaboration” that already exist but are not identified as such.

Underlying much of the recent changes and directions within health professions are computer systems and technology.
This has proven disruptive to many major occupations e.g. Kodak and film processing, booksellers and publishers, mainstream news media etc.
So why would you expect health to be immune?

In this edition we introduce a new writer for i2P in the form of Craig Frawley, a Melbourne pharmacist who is grappling with all the above issues and is working his way to a solution, prepared to take risk and manage financial loss along the journey if and as it occurs.
Read his insights in Competitive Advantage Points Back to the Future.

Pharmacy has long been criticised for its location rules and its ownership rules.
Maybe it is now time to consider alternatives?
If not, adverse changes may be made by forces outside the control of pharmacists.

In this edition of i2P we advance a concept to eliminate location rules so that cheaper pharmacy models can emerge and allow engagement by young pharmacists.
Otherwise, we have an out-of-balance profession with minimal renewal, and lost energy as pharmacy owners stagnate through lack of intellectual competition (as distinct from commercial competition).
That is exactly the point we have arrived at now coincidental with the end point of the PBS life cycle and the problem as to how to evolve it to something else of value to government and pharmacists.

And I am not talking about supermarket competition here, but competition between different types of pharmacists to produce a better health system for their communities.

i2P can see an end to location rules, but I would never concede that a supermarket would ever be capable of providing a decent health system that would equal or better a dedicated pharmacist operating ethically under a proper code of conduct.

While pharmacists can be unified in respect of doing battle with external “enemies” it will never have full strength until collaboration exists between the different elements or groupings that comprise the entire profession.
Unless a better balance of power is seen to emerge and work respectfully, one to the other, pharmacy will never achieve its full potential.

We also have an article this month on basic “patient engagement” written by Peter Sayers.
This concept is a multi-faceted one, much like the concept of “collaboration”, and it even overlaps with collaboration – patient collaboration.
While we may all fully understand in some way what patient engagement is all about, there is a definite “hole” in current community pharmacy offerings. Pharmacists have not been budgeted or managed for “time” to even begin to be involved in patient engagement.

Read the article Basic Patient Engagement and begin your journey.

Barry Urquhart is back with his Marketing Focus articles and some insights that might prove useful for pharmacists trying to find their direction.
Read Marketing Focus- What Industry are you in? along with other items of interest.

International writer Harvey Mackay has some thoughts this week on Take charge of your attitude.
In other words, own what you do professionally.

We also have an article titled  What Happens if the Bees Die?.
One of the enormous hidden problems in health today is the damage being done through the use of chemicals at every level of the food chain.

Pharmacists must engage in this subject as a means of delivering real primary health care – targeting the political associations of “deep pocket” global manufacturers and their influence on legislation that affects profit generously, but affect population health adversely.
From this short article on bees ask yourself if this is one of the reasons neurological disorders have become epidemic in recent times – and how can we prevent future occurrences?
i2P is looking at environmental health for the long term, and has come to the conclusion that the modern supermarket is an “environmental health hazard”.
Apart from selling tobacco and cigarettes, supermarkets concentrate a range of processed foods and GM foods that contain pesticides, herbicides and preservatives often packaged in plastic containers that “out-gas”.
None of these products are are fully labelled as to contents and none contain any warnings as to the potential for an adverse outcome.
Supermarkets do not have any credentials whatsoever to claim ownership of any health system, particularly pharmacy.
So here is an argument that the PGA can expand on in respect of only pharmacists owning pharmacies and take the debate right back at them.

Also, please find current media releases for PSA and NPS.

Plenty of reading to keep you occupied over the week.

Neil Johnston
April 6 2015

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