EDITORIAL for Monday 14 May 2018

Welcome to the current edition of i2P (Information to Pharmacists) E-Magazine, dated Monday 14 May 2018.
The King Review of Pharmacy Remuneration and Regulation was one of a long line of previous reviews and investigations.
Its onslaught was broad in nature and punitive in its lead up.
It has now died with barely a whisper and the Australian Government response is found at the following link:
Government Response to the Review of Pharmacy Remuneration and Regulation .

From a Reviewer’s perspective, success is measured by the number of recommendations delivered and the number taken up by those who commissioned the initial review.
A total of 44 recommendations were made but only four were taken up by government – a success rate of 9.1 percent (not a good result for the reviewer)
Quality rather than quantity is the determinant.
So we, the reviewed, must now wonder why we were originally targeted and why it was necessary to allocate and spend a large sum of public money?
Well, strangely, for community pharmacists, we got one very good outcome, even though it may not have been the intent of many of the persons driving the Review.
This particular outcome is the actual restoration of professional clinical discretion through allowing community pharmacies to be able to sell homeopathic products, and in that mindset acknowledging pharmacists as medication specialists for all varieties of medicines.
This is discussed in more detail in the lead article for this edition.
This is a stunning victory for the Pharmacy Guild of Australia on behalf of its members as well as for all other clinical pharmacists, because it opens the door for debate to be resolved in two other major issues.

The first issue concerns the availability of medical cannabis for needy patients.
Given the now published King Review acknowledgement of pharmacists as medicine specialists, it is a “no-brainer” that pharmacists could resolve the supply chain, educational and logistics problems surrounding access to medical cannabis, with a simple and sensible change to the Poisons Act.
Essentially create CBD in any strength as a recordable Schedule 3 product, and as well, THC in concentrations of 5 percent or less.
THC in concentrations above 5 percent should be simply Schedule 4.
Then remove the special doctor registrations at state and federal levels, treating THC like any other S4 drug, because all published evidence indicates that medical cannabis fits perfectly into those classifications.
Many pharmacists are currently equipped to provide Health Literacy consultations to patients and pharmacy schools are also developing knowledge bases around medical cannabis.
These regulatory changes would create a sensible framework and reduce much of the confusion surrounding current medical cannabis delivery.
That would be a suitable start-point.

The second issue that flows from recognition of pharmacist clinical discretion acknowledgement is the delivery of vaccinations to young patients.
Vaccinations need to be delivered with informed consent.
This is difficult when government mandates (through coercive policy) that financial benefits can be lost by patients unless they follow a published vaccination program.
There is something radically wrong here because patients are denied freedom of choice and pharmacists are thus not enabled to give proper advice for informed consent.
Medical fascists also target health professionals who endeavour to give appropriate health literacy, with ridicule, public scorn and complaints to government complaint regulators, causing high levels of personal stress.
As pharmacists, patient safety is always paramount and safety issues must be discussed when obtaining informed consent, otherwise you are essentially in breach of the Pharmacist Code of Conduct.
i2P believes that these confounding issues have been driven by Pharma-supported Medical Fascists.
Current government policy is unsustainable given the lack of safety for a large number of vaccine products and manufacturers need to be held accountable for the low-level of evidence to back therapeutic claims.
i2P believes that it is a natural fit for pharmacists to conduct and manage vaccination programs, but not without the ability to obtain proper informed consent and access to a base of high quality of evidence supporting efficacy for each vaccine.
Pharmacy leaders can help to unravel this mess and continue the development of a high quality and pharmacy managed vaccination program.
To not deliver that concept at a high professional standard is really defrauding the community at large – even though many of the restraints involve reform of existing and very dubious policy issues, and the need to rein in the delivery of false information to mass media by Medical Fascist elements.
The door has been opened by the King Review and the government response in recognising pharmacists as community drug specialists.
Pharmacy leaders need to push that door wide open and shine the light on corrupt practices and poor government policy.
That way, we might eventually develop an honest and ethical vaccination program that we can all be professionally proud of.
The current version falls well short of that aspiration.

Our lead article for this edition discusses in more detail how the King Review stimulated a very important response from the Australian government in that it recognised the importance of the medication information services provided by the pharmacy profession for ALL types of medicine, including homeopathic versions.
Pharmacists need to understand the importance of that response and upgrade their information distribution service so that is more tangible for patients and other health professionals.
This is why i2P promotes the concept of Health Literacy consultations utilising innovative resources that value-add to each patient engagement.
Perceived value is something a patient will pay for.
It would also encourage other types of health practitioners to refer their patients to such a service.
Pharmacists should move fully into this self-evident role and continuously reinforce their claim as to being “medication experts”.
Read: Professional Discretion Restored – Much More than Homeopathic Product Sales

The amount of time required by a patient to assess the professionalism of a pharmacist is quite minimal – seven seconds according to Gerald Quigley who has provided supportive information to illustrate how important those first few seconds of engagement really are.
Therefore as part of a professional toolkit there should be a regular review of appearance, clarity of speech, use of simple rather than complex technical words when engaging a patient, how fluid the information flow is and how concise its delivery was.
The review can be a self-review, but probably a review by another person (lay or other health professional) would have more impact.
And, of course, periodic satisfaction surveys by actual patients on the receiving end.
This is probably the most significant process when developing improvements in pharmacist professional practice.
Read: We are Judged Within Seven Seconds of Meeting Somebody

OMNS has been providing resource information regarding the clinical use of Vitamin C.
In this edition they focus on the use of sodium ascorbate for the treatment of Infantile Colic and how this common condition can be emotionally disruptive for both the infant and the new parents, sometimes leading to the cause of irrational responses, as the infant may not be easily pacified.

This simple treatment could become part of a pharmacist toolkit, that in turn, may provide some peaceful respite for the parents of an infant with colic.
Read: OMNS – Infantile Colic

Dr David Byrne has attended an important lecture in New York, pertaining to the epidemic of prescription opioid overdose and addiction.
He has made useful commentary for sharing with those health professionals involved in harm minimisation practice, including pharmacists, who may provide substantial patient support to reduce the harms created by these substances.
Read: Medical Postcard from New York: Overdose Crisis Summary from NYU

WHO has made a statement saying that cannabis should be decriminalised world-wide because existing laws cause health discrimination.
In Australia, patients are being actively discriminated against as police are instructed to enforce existing laws and close down “illegal” supplies, leaving critically ill people with no workable solutions for their health problems.
Flawed health policy generates bad laws and lowered community respect for policy and laws.
Yet again, Pharmacy is in a position to provide solutions very simply and simultaneously create opportunity for the profession to treat chronically ill patients efficiently and economically.
Pharmacy leaders need to be proactive in the regulatory area because other health professionals are actively competing to lock pharmacy out of any opportunity whatsoever.
Potential for pharmacists is found in the compounding of THC and CBD in specific ratios to match the best result for patients with chronic illness.
Further pharmacist potential also lies in using cannabinoids in harm minimisation programs involving opioid dependencies and as an adjunct for the management of pain.
Pharmacists also need to be active and have a voice in the regulation of these substances ensuring that maximum patient access can be obtained through the application of Schedule 3 of the Poison’s Act.
Read: Understanding Medical Cannabis – 1. Ganjapreneur:  Study: New York MMJ Patients Reduced Opioid Intake, Saved Money on Meds  2. SHOTS: Canada To Measure Marijuana Use By Testing Sewage  3. Forbes: Binge Drinking Drops In States With Recreational Marijuana

“The science is settled”.
So say the people who promote vaccination as some form of extreme medical ideology.
“Scientism is settled” is a more accurate description of the manipulation of the science surrounding vaccines – and it is certainly “unsettling” to hear the dishonest claims that blare out in all forms of media.
“First do no harm” is the concept that underwrites all medical practice.
Australian vaccination policy is so poor and damaging, that it beggars belief that legislators can be so close to manufacturer sales objectives as to guarantee them a market through coercive legislation that involves simultaneous removal of patient choice.
The evidence supporting vaccine policy failure and its lack of safety is becoming so voluminous that it will eventually destroy the unnatural power alliance that desperately tries to hold it all together.
Read: The Safe Vaccination Debate – 1. Jon Rappoport: Europe under the vaccination gun: an expanding tragedy 2. Robert Kennedy’s World Mercury Project: CDC Still Paralyzed by Autism Epidemic: Report Shows One in 59 Children in the US Now Affected 3. Vactruth: Why Claims of Unvaccinated Flu Deaths Are Highly Deceptive

We conclude this edition of i2P with a range of media releases from three pharmacy leadership organisations:

PSA – PSA Media Releases – 1. PSA expands training services 2. Budget supports general practice pharmacists 3. PSA18 Shark Tank brings pharmacy innovations to life

ASMI – ASMI Media Releases – 1. ASMI concerned by Hawaiian sunscreen reports 2. ASMI to work with self care alliance

NPS – NPS Media Releases – 1. PHN immunisation online community launches with calls for further collaboration  2. CPD session on hypertension with Professor Markus Schlaich to be hosted in Perth   3.  NPS MedicineWise welcomes longer term certainty of funding: budget 2018

We hope you enjoy the content in this current edition and we invite you to become part of the debate by dding your comment in the panel provided at the foot of each article.

Neil Johnston
Editor, i2P E-Magazine
Monday 14 May 2018


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