Welcome to this weeks’ edition of i2P E-magazine (Information to Pharmacists) dated Monday 9 February 2015.
While we have the greatest respect for the skills of our doctors and nurses there is always a point of competition at the boundaries of our professions where we have to fight each other to define these boundaries.
Generally, this is due to advances in knowledge by all professions.
It has always been a rough and tumble affair as far as the medical profession is concerned – no holds barred on their part, and very aggressive for any “cut and thrust” of any pharmacy aspirations.
Nurses have been more sedate and courteous, preferring to wait out any potential conflict but patiently absorbing whatever pharmacy “bits” come their way.
We have seen nurses doing medication reviews in nursing homes, dispensing in isolated locations and some early adopters in forming up clinics (US style) within some pharmacy groups.
I like the style of nurses because they are willing to prove their point rather than try to annihilate an activity doctor-style.
In the year 2000 i2P published an article pointing out that pharmacy’s real competition was not supermarkets, but collectively doctors and nurses.
We again reinforce this point and point readers to an article published in this edition titled “The Patient-Centred Primary Care Collaborative” that describes an evidence-based attempt to establish a medically-led patient “home” in the US.
It also describes the expansion of a pharmacy-led limited version, which is the “clinic” fast becoming a fixture in all major US pharmacies.
Some pharmacy clinics have even reached the level of having a doctor-nurse combination encased in an overall pharmacy environment.
All versions seem to be developing successfully and within the existing expensive version of US health systems, are providing value-for-money primary health care.
My point here is that nowhere is pharmacy taking the opportunity to have a “pharmacist hands-on” situation with a patient because pharmacists have abdicated their primary health care role by allowing nurses to deal with the simple ailments that pharmacists had traditionally treated.
Pharmacy patients and goodwill were very readily transferred to pharmacy-owned clinics, because it was logical and profitable. Patients have a very high trust level for both nurses and pharmacists, so the transition was virtually seamless.
Because of corporate and non-pharmacist ownership of US pharmacies, pharmacist professional aspirations have been deflected, even though ownership of the clinics was vested in the pharmacies.
I am not arguing that all the above, including medical initiatives, should be opposed.
Only that clinical pharmacists should be given the oxygen to share in primary health care that advances their traditional role, and pharmacy core business.
It is deeply disappointing to see that pharmacy leadership bodies in Australia, PGA in particular, do not have this view and short-sightedly suppress any pharmacist activity that they see as “competitive” to pharmacies.
PSA on the other hand, while representing all pharmacists, never seems to represent the “clinical pharmacist”.
I think because PSA membership comprises many pharmacy owners and that so many pharmaceutical activities have become in-bred, with PGA never hesitant to enter any conflict of interest proposition, PSA has become politically impotent.
The most impotent supposed pharmacy leadership body is the Australian Association of Consultant pharmacists, which has suppressed any aspirational activity, by not having a full membership vote.
As we all know, shareholding is vested equally between PSA and PGA but the reality is that approximately 75% of its power and policy base is directed by PGA.
I am pointing these things out not to cause political in-fighting, but simply to say that unless all these situations are unravelled, pharmacist/pharmacy aspirations will be a lost cause.
What used to be a collegiate profession is now a very pale imitation.
And I repeat – the opportunity-rich profession that is pharmacy, will fail and be picked apart by competing health professions, unless we are allowed to pull together.
The key to that is the single pharmacy organisation of PGA, which will have to find creative ways of sharing power – or destroy itself and all others to the extent that the profession will never be able to rebuild itself back to a credible level.
Also in this edition I would point you to a TGA problem where withdrawn drugs take up to four years to leave the Australian market.
This is indeed a cause for pharmacist leadership bodies and others such as the Friends of Science in Medicine, to get behind and eradicate. This is perpetuation of Pharma fraud in the extreme and damaging to patients.
We also publish the OHMS summary of recent evidence for vitamin D3. This is excellent material for pharmacists to print out to be included with their own data references.
Barry Urquhart is back with his thoughts on marketing trends.
Two sides of the same coin – success or failure – are dealt with by Harvey Mackay and Chris Foster, which is excellent planning material. We also publish the latest NPS and ASMI media releases.
Some thought-provoking material for this week.
9 February 2015