EDITORIAL for Monday 16 October 2017

Welcome to the current edition of i2P (Information to Pharmacists) E-Magazine, dated Monday 16 October 2017.
It is interesting to note that PSA and PGA are beginning to work more closely on health issues, with the result that issues such as the sale of low dose codeine products, and the pharmacy proposition of the sale of such products employing a universal access and real-time recording system within strict guidelines, has attracted the attention and support of most state health ministers (the only exception being South Australia).
They have written to the federal health minister urging him to consider the pharmacy proposal.
A sensible solution that was developed and funded independently by pharmacists.

However, this response has incensed medical political organisations. 
One response by RACGP Queensland chair Dr Edwin Kruys claimed that the Guild was undermining the codeine upschedule process, “putting patients at risk”.

“It is concerning that those who have been given responsibility to look after the health of Australians take decisions influenced by commercial interests instead of sound evidence and common sense,” he said.

By any standard these comments are empty and inflammatory given that “doctor shopping” has been (and still remains), uncontrollable, and that prescription opioids have become  the major reason for increased drug addiction in the general population.
Further, doctors remain the only health group that have to report payments made to them by drug companies and display them through a public register.
This is simply a case of “people living in glass houses who should not throw stones”, for it is the medical profession that has been proven to be influenced by financial considerations and allowed themselves to be compromised.

So, pharmacy leadership organisations are congratulated for the rigorous and well put together campaign, upholding pharmacy interests and defending an economic and responsible access for Australian consumers.

Another campaign promoted as a success is the one of vaccination, which was also bitterly contested by the medical profession (again, for all the wrong reasons).
The PGA publication, Forefront stated recently:

“For the first time this year, pharmacists across Australia have been able to administer flu vaccinations in community pharmacies. A survey of patients earlier in the year showed more than seven million Australians aged 18 to 64 years planned to have a flu shot this year. This research also showed more than six million Australians were more likely to have a flu shot if it could be administered at a local pharmacy, including two million who previously had no intention to vaccinate against the flu.

The widespread success of pharmacist-delivered vaccinations has been underscored in academic reports on these services in Western Australia and NSW.

A report published in the September 2017 edition of AJP and authored by Peter Carroll and Jane Hanrahan examined the situation in NSW and concluded that the services delivered by pharmacists were “clearly” successful.

“The findings also suggest that many people who would not otherwise have been vaccinated did receive an influenza vaccine because of the convenience of having it in a community pharmacy setting. Administration of influenza vaccines in the community pharmacy setting is a major public health initiative which has the potential to significantly increase the influenza vaccination rate within the community,” the authors noted.

Significantly the report found the accessibility of pharmacist-administered vaccinations was a strong factor in the high uptake. And 21 per cent of those vaccinated by pharmacists were in high-risk groups who were eligible to receive the flu vaccination at no cost from their GP under the National Immunisation Program (NIP)”.

It is clearly a success in that the niche components of the market serviced by pharmacy have been serviced appropriately and pharmacists have illustrated they have the skills and competence to handle a wider clinical role economically.
Vaccinations are a good fit for pharmacists, but clearly pharmacists need to retain a level of independence in handling what is a flawed government policy surrounding vaccines.
i2P has been promoting the concept of “safe vaccines” for some time now, and the evidence we have published to date clearly indicates that Australian vaccination policy has delivered unsafe vaccines to a population group that has an immature immune system (infants and children), and that has caused a high level of patient damage.
And further, Australian vaccine policy is coercive and forces a situation of vaccine over-prescribing, removing choice from patients, carers and prescribers and the power of developing a national immunisation schedule to vaccine manufacturers, directly or indirectly, with resulting conflict of interest and a lack of accountability.
From i2P perspective it would be a greater success if we were able, as a united profession, assist in the straightening out of vaccine policy so that it could be universally supported and respected.
Pharmacists should have the knowledge to ensure they give a full and informed consent process.
However, the US-based National Vaccines Information Centre says:

“Those Who Give Vaccines Should Know The Ingredients in Vaccines
The chances are that if you ask most chefs about the ingredients they put into their favorite recipes, they will be able to list for you the name of every single ingredient and the corresponding amounts.
That is what you would expect.
By the same token, you would expect most doctors, nurses, pharmacists and other medical workers who administer vaccines would be able to list for you every ingredient in vaccines, along with the corresponding amounts.
That is what you should expect. However, that is not necessarily the case.

According to neurosurgeon Russell Blaylock MD:

You’d be amazed at the number of physicians, you ask them what’s in a vaccine?
They’ll say, well, there’s the bacteria, the virus you want to vaccinate against, and then there’s a little immune stimulant in there to help stimulate the immunity so they react against those viral antigens.
They don’t know about these other chemicals in there like formaldehyde, special proteins, special lipids that are known to be brain toxic, that are known to induce autoimmunity in the brain.
They’re not aware of that.
They don’t know that MSG is in a lot of vaccines―monosodium glutamate, a brain excitotoxin.
They’re not aware of what’s in the vaccine they’re giving.

Nephrologist Suzanne Humphries, MD concurs with Dr. Blaylock.
She admits, “Doctors are not taught about vaccines in medical school.
We are not taught what’s in vaccines as far as the adjuvants.
We are not taught how vaccines are manufactured as far as what kind of animals go into them.”

So there might be a valid health literacy model that could be developed by pharmacists that can create a valid informed consent, given that the above comments may relate to Australian pharmacists as well.
Are we there yet, pharmacy leaders?
This could be a first step towards the rectification of the obvious flaws in the current policies which have arisen from conflict of interest issues that abound through the entire vaccine industry – its manufacturers, its researchers, its regulators and its health promoters and influencers.

But great work PSA and PGA getting vaccines into a pharmacist scope of practice, to the current level of acceptance.
However, it remains an incomplete success to this point, because of flawed policy.
Are you up to completing the job?

The lead-time for a disruption to enter the pharmacy market place has reduced from around five years’ lead-time to as little as 24 hours.
For example, we know that Amazon is already in Australia and it will disrupt the entire retail market, including that of community pharmacy.
Because Amazon relies on developing its own disruptive technologies, keeping their strategies in-house until the last minute, Amazon generally succeeds in taking market share from a zero position to a dominant position in a very short timescale.

This type of strategy was successfully employed by Kodak, the photographics manufacturer, that had a policy of expanding through the deployment of its own in-house technology research.
That policy kept them as market leaders for well over 100 years until digital photography emerged.
Then they faltered, even though they had pioneered some of the original digital technologies.
Digital technologies were licenced to other photographic manufacturers because Kodak management could not envisage that the digital market could provide a quality product.
How wrong they were – they actually provided resources to their competitors who then took their market share from them.

The lack of lead-time available to understand Amazon’s new technologies and develop counter-technologies is the primary factor in their success.
Like Kodak, it will eventually be subdued by a smarter competitor who will beat them at their own game.

However, change can be accelerated in a pharmacy context if investment is made in a system of continuous culture development (and becomes a permanent cost), which can develop processes for the management of rapid change.
And it has to be a shared system with others, because shared inputs make for more rounded decisions, but more importantly, the opportunity for sharing the costs of new tailored technologies.
A system involving entrepreneurs and intrapreneurs needs to evolve.
Our lead article discusses that specific system.

Community pharmacies have reached the stage that if they are to be viable, competitive, creative and innovative they have to design and cost in a system based on continuous culture evolution, tailored to their specific requirements, but having the ability to share their knowledge with other pharmacies.
And each to borrow and support the best concepts from their new emerging shared cultures.
These new systems also have to associate with technology entrepreneurs while simultaneously encouraging intrapreneurs to flourish within each community pharmacy unit.
This is the secret of Amazon’s success, and in a past life, the success of Kodak.
Staying viable and competitive means developing a competitive business model based on a unique pharmacy cultural equivalent.
Similar but different!
Read: Pharmacy Disruptors – Amazon, Artificial Intelligence & Holographic Health Practitioners

Harvey Mackay is back and discusses “Personal Touch” as being the magic ingredient that distinguishes a successful  business model.
It is the intangible that brings the concept of “care” alive, and in a pharmacy context underwrites the entire activity of patient engagement.
It also adds to the intangible value of goodwill in the Balance Sheet of a successful pharmacy practice, so the more it is practiced, the more valuable the sale value of the practice.
Every pharmacist brings a distinct point of difference to the concept of “Personal Touch” because they are all individual and different in nature and personality.
It actually underwrites the brand image for each pharmacy practice by being able to promote “Personal Touch” as being the point of difference for each brand.
Read: Your business depends  on your personal touch

Health is a subject that most people want to learn about.
They will engage with health practitioners who display a strong knowledge of health and they will adopt those practitioners who will mentor them in health literacy.
But in the initial engagement, the expectation of the mentee may be high and discontent enters the equation, if say a potential pharmacist mentor is unwilling or unable to engage in the process at a particular engagement level.
Gerald Quigley describes such a situation and says that these patients may appear “pushy”.
A successful technique for disengagement needs to be practiced but to be successful at patient engagement, the practice culture needs to be one of bending over backwards me3ntorwise, to successfully give patient satisfaction.
Then you will have a patient for life.
Read: “Pushy” customers or are they merely “informed”?

That Australia’s vaccine policy is a distorted and tortured policy dressed up to appear to be a valid contribution to patient health, turns out to be a public nightmare of adverse events.
Orthomolecular (nutritional) medicine holds the key to treating these negative adverse events, pre or post inoculation, and pharmacists are well placed to provide health literacy that could underwrite an informed consent for most patients trapped in this coercive and immoral policy.
Pharmacists may eventually become the impetus for change in vaccination policy, but in the interim should be assisting in the reductions of harms inflicted by this faulty policy.
Similar variations of Australia’s policy are found in the US – possibly the original model for Australia.
Read: Orthomolecular Medicine News Service – Vaccinations: To Be or Not to Be

 “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 Vaccine Debate – 1. Dr Judy Wileyman Report – Newsletters #176 & #177 2. AVN – VaxXed Tour of Queensland – Natural Health Petitions – Invitation to Govt Health Authorities & Medical Authorities -Banned in Australia 3. Overvaccination.net – Elizabeth Hart Responses

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. Cannabinoids Explained 2. Cannabis Effects Different for Men & Women 3. Could marijuana’s mellow cousin be the next environmental and economic boon?

Barry Urquhart is an internationally recognised conference keynote speaker, facilitator of strategic planning workshops and marketing business coach.
In his essays he analyses contemporary problems of managing and marketing arising from businesses of all shapes, types and sizes, and discusses strategies to enable you to offset and adjust your own business model (by analogy), so as to develop towards a competitive and consumer-friendly pharmacy business model.
Read: MARKETING FOCUS – TEN ESSAYS on Management & Marketing

And we conclude our latest edition with media releases from two of pharmacy’s leadership organisations.

PSA – http://i2p.com.au/psa-media-releases-1-pharmacists-support-reform-of-mandatory-reporting-2-psa-supports-marriage-equality-in-australia-rules/

NPS – http://i2p.com.au/nps-media-releases-1-tailoring-treatment-for-frail-older-people-2-managing-medicines-on-sick-days-3-october-edition-of-australian-prescriber-out-now-4-gps-on-the-front-line-can-help-lower-austr/

We hope you enjoy our current content and please do not hesitate to write your own comment in the space provided at the foot of each article.

Neil Johnston
Editor i2P E-Magazine
Monday 16 October 2017

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