Strengthening the “Core” of Pharmacy

UK pharmacists have a similar media nemesis to Australian pharmacists in the form of the Daily Telegraph.
That newspaper is not, however, owned or controlled by the Murdoch group.
The UK Pharmaceutical Journal reports that:
“The front page of The Daily Telegraph on 10 August 2015 read ‘Boots, Tesco and Superdrug to get access to NHS medical records’.
Similar stories ran in the Daily Mail and The Independent, with morning television in the UK also covering the story.
The reports say health officials plan to send sensitive data from GP surgeries to pharmacies starting this autumn, without considering the views of patients because research from pilots garnered only 15 responses, and their views were discarded since the sample was so small”.

Most of the public comment and social media responses indicated that while some concern existed by patients relating to technician and other pharmacist access to their records, most were strongly opposed to the idea of large corporate pharmacies accessing and selling their personal data.

Australian pharmacies are not really faced with this problem because most pharmacies are small independents.
But while privacy and confidentiality has not been a major issue within Australian pharmacy, it is an issue that has not been highlighted by pharmacies in their communication systems or in their general advertising.
It is, in fact, a positive issue for Australian pharmacy.

Apart from some pharmacy counselling areas not being considered private (and already highlighted by Australian media), system protection for data is considered strong, with good policies and procedures in place.

When the above article came to my attention, I was working on a client’s business plan and was actually working on the “Core Principles” component.
Core principles are actually those that rule every management decision made for a pharmacy practice.
They are also a work in progress and need to be regularly updated to ensure they genuinely do reflect the values of the pharmacy practice.

And from a marketing perspective, those principles will influence patient choice if they align with them, helping to build trust and loyalty.
So why not share them with the general public as a Core Principles Statement and let everyone know what you stand for?

The core principle I had just written appeared as #2 in a list of four.
It will be reviewed on at least three separate review meetings in line with all other components that will appear in the final business plan.

2. Privacy, Confidentiality, Openness & Transparency

We will deal with all persons that comprise our pharmacy practice truthfully and fairly, and strive for mutual benefit for all in our dealings.
We will seek informed consent in all of our recommendations to patients, and we will maintain any information, records or files held by us, privately and confidentially, and will not be shared with third parties without consent.

Evidence relied upon for patient recommendation will be made available on request.
Staff access to patient files will be limited to the extent that they are engaged in a specific patient service and require access to complete or document that service.
Transparency applies to all levels of our business and we will maintain honest and ethical dealings with our suppliers, service providers and all business and professional partners with whom we rely on for a reciprocal relationship”.

It is eventually planned to promote “Core Principles” regularly through websites, brochures or information booklets directed to patients and alliance partners (current and future).

The time has come for pharmacists to openly declare what they stand for because of the many unprincipled attacks by mainstream media (and others) on pharmacy.
Core Principles, published well in advance of any media “beat up” immediately provides a defence to point to.
Continuously delivered through your patients, they provide a strong foundation to your own goodwill.
While we know the information mainstream media publishes may well be a “beat up” and substantially untrue, unfortunately the mainstream media will not necessarily print retractions or “balance” their stories to truthfully reflect both sides to an issue.
Bias is quite often political in origin, so we are seeing here an erosion of our democratic structures allowing a powerful minority to overrule the majority.

This is happening globally through mega-companies being able to dominate market shares and multi-levels of associated activities.
The example of Big Pharma’s falsifying evidence by firstly influencing researchers to skew their findings to be as positive as possible and losing any data that is negative.
Then “spinning” the final story through ghost writers, many of whom have no medical qualifications but excel at advertising copy writing.
Further “massage” is then applied to selected members of the various peer-review panels of major medical journals to ensure publication of this so-called “evidence”.

Finally, various “opinion leaders” are paid substantial fees to promote the final product at conferences.
The monies paid at all levels of this corruption are typically written off as marketing expenses.
All the above is recouped by charging prices well above a true market price and enforced through a dubious patent claim.
Pharmacists are supposed to recommend products and processes that are evidence-based, but with the high level of pollution of evidence through processes outlined above, many despair that this is now not truthfully able to be done.

And, of course, mainstream media rarely reports these events because they benefit financially as well.

So, pharmacists definitely need to reinforce their core principles, values and an alignment with an appropriate Code of Conduct.

With respect to an appropriate Code of Conduct it should be noted that the Pharmacy Board of Australia (PBA) is the Pharmacy-Board—Code-of-conduct, but it does recognise other Codes of Ethics.
The following is an extract from the code-of-ethics-2011-PSA:

“All pharmacists registered with the Pharmacy Board of Australia (PBA) need to comply with the PBA’s code of conduct which provides guidance on the ethical framework through which effective health services should be delivered.

The PBA code contains important standards for practitioner behaviour on: providing good care, including shared decision-making; working with patients/ clients, other practitioners and within the healthcare system; minimising risk; maintaining professional performance; professional behaviour and ethical conduct; ensuring practitioner health; teaching, supervising and assessing; and research.

The PBA has endorsed the PSA Code of Ethics and advises pharmacists to be guided by the code(s) of ethics relevant to their practice in addition to the PBA code.
The PBA, in its role of public protection, may use or refer to the PSA Code in cases involving the conduct or behaviour of pharmacists”.

And it is the last sentence that raises alarm bells for me because already there have been statements about having homeopathy bans being placed in the PSA Code with those bans flowing on from an NHRMC investigation into homeopathy that excluded valid evidence and an expert homeopath on the investigative panel.

Homeopathy and chiropractic are targets of Big Pharma and their medical skeptic front groups.

Pharmacy needs to keep well clear of this type of manipulation.
We are not in the business of denigrating other health modalities.
And what about the pollution of the formal evidence base?

Are we supposed to rely on evidence that we have come to know through professional experience is not correct?
Or do we rely substantially on our own professional experiences to give appropriate advice to our patients?

The Society of Hospital Pharmacists in Australia (SHPA) has also had its own Code of Ethics endorsed by the Pharmacy Board of Australia.

And here lies a very good reason for Clinical Pharmacists to form up into their own representative organisation so as not to be bound by practices that work to limit and restrict activities which may appear in other organisation codes.
Pharmacists involved in Code of Ethics development need to be aware of the ultimate impact of a professional restriction if personal or industry bias is allowed to intrude.

Pharmacy Practice is becoming more complex by the day.
We are not just competing on a product/service level, but we are fast developing to have to defend ourselves against political competition on a global scale.
Unless we add political skills to our personal inventory, we become more vulnerable collectively to those minority people holding the balance of power for the majority.

Pharmacy leadership organisations can become targets in the power concentration game.
Individual members of such organisations must learn to recognise the signs pointing to these processes and speak up, lest democracy at all levels simply becomes impotent and then collapses.

At the very least the privacy issues that have publicly appeared in the UK mainstream media can actually be used as a political argument to support existing Australian pharmacy ownership laws.
Consumers don’t want corporate pharmacies to be able to access sensitive data transmitted from GP locations.

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