Welcome to this weeks’ edition of i2P (Information to Pharmacists) E-Magazine dated Monday 30 November, 2015.
As we move into the festive season for a number of cultures, it does become a moment for introspection, family, a review of values and a collective moment to check on how we are all travelling.
While I am often a “majority of one” I do enjoy the debate along the way, but that is not without some disappointments.

This month we lose Loretta Marron as an i2P writer – we will miss her.
Our association with Loretta has been a long one and we originally met when Loretta became an activist for the exposure of fraudulent medical cancer practices and required some expert opinions on some alternative medicine treatments.
A small number of successes resulted.
It was some time later when Loretta contacted me and advised that she had been appointed as CEO of the Friends of Science in Medicine (FSM) and I congatulated her on her appointment to what appeared to be a potentially strong association, and offered i2P as a platform for her advocacy.

She did initially attract some extreme comments on her material, and that had to be moderated.
Loretta also invited me to join the FSM organisation but I declined at that time, stating that I would join when FSM tackled the real problems with evidence-based medicines – the fraudulent evidence developed through Big Pharma influence.

I2P was originally set up as a platform for strong debate, so it is no accident that we publish articles that are completely opposite in perspective, by different authors.
That ensures a rounded debate.
We have also tackled policies and issues regarding pharmacy leadership organisations – that is fair game, for unlike our general political theatre, pharmacy organisations have no organised opposition to debate any issue.
There is no majority vote on any issue, only member complaint and only if they become aware and motivated to act.
While i2P regards leader organisations as “fair game” we do not pursue individuals.

Pharmacy also does not have any independent “think tanks” to help pharmacy leadership to move in an informed and positive direction.
I2P does attempt to fill that gap and we know that we do have some influence on leadership thinking, although that occurs by osmosis and not through any formal process.

So as 2015 is rapidly reaching closure, I reflect that pharmacy is still not in a happy position and that its collective leadership must take responsibility for this, and must also take an open and collaborative approach with each other, or have everyone continue in a never-ending unhappy state.
Pharmacy has generated a number of substantial “enemies” over the past business cycle and has had a hard landing at the end of that cycle, which also coincided with the end of the PBS product life cycle.
A substantial number of conflict of interest issues still persist, and they work against the interests of all pharmacists.

A review of values and an update in culture has to be undertaken but leadership seems to be incapable of generating a vision that we can all share – only fragmented unsatisfactory versions.

When leadership creates a hiatus, it opens up the opportunity for “grass roots” leaders to emerge because they have to live with the poor policies, and they begin to energise themselves to take a positive direction.
This has occurred on a number of occasions over a number of past business cycle and this one, which started around 2012, will be no exception.
I am anticipating some “grass roots” developments early in 2016 and i2P encourages all pharmacists to consider support for these new leaders until sufficient influence is established to cause leadership thinking to change in an ethical and positive fashion through the major organisations.

And we should also begin to look out for each other and the broader community we serve.
Pharmacy has the capability to become a strategic component within public health.
If our established leaders are incapable of negotiating this pathway on our behalf, then seek out suitable alliance partners and do it yourself.
Times have now changed in that the front line of a war is no longer in an isolated part of the globe – it is in your own country and right outside your own doorstep.
As a population we need to increase our emergency readiness and pharmacy can play a strategic part.
For some ideas read: The Paris Attacks – an Impetus for Community Pharmacy to be an Emergency Triage Point

Gerald Quigley is back and he describes what can only be described as a political deal.
In A Healthy Relationship? Gerald describes a recent conference open to a range of health disciplines with pharmacy leadership presiding over the opening presentations for each day, and openly denigrating the modality of homeopathy.
This follows an Australian Pharmacy Liaison Forum policy decision to formulate the same message as official pharmacy policy, following what can only be described as a “stitch up” by the NHMRC, who have allegedly investigated homeopathy and found no evidence to support its reason to exist.

The background to the story is like a conspiracy drama where the NHMRC investigating committee had an FSM member with an avowed anti-homeopathic stance.
This person resigned from FSM to avoid the appearance of conflict of interest, but still remained on the committee with all of his bias.
The committee then set about its investigation by disallowing an expert homeopath to be part of the committee and disallowed the body of evidence offered by the Australian Homeopathic Association to be entered into the record.
It also disallowed evidence from non-English speaking countries.

All the players from the “I’ll have coke and fries with that” debacle were present at Gerald’s conference, so what was the real deal done on that day, and why, as a pharmacist, should I have any interest in banning a modality I have never practiced and would only constitute a minority interest by pharmacists, generally attending to customer requests.

I2P interest has always been there to highlight unfairness and be part of the evidence debate.
We take issue with an FSM that exerts pressure on a modality that does have evidence to support it and has been tested by countries such as Switzerland and Germany, also Cuba, and thrives.
Homeopathy grows in these countries because of the cost of mainstream drugs and their lack of efficacy.
So you decide what the real agenda is.

Judy Wilyman is back with the story of the campaign against coercive vaccination and the fact that this appears to be another piece of legislation on its way that works only for major drug companies, not for everyday Australians.
I2P has always been in this debate taking a position of “safe vaccination” – we are neither anti or pro in the argument.
Judy reports in her article: Mandatory Over-Vaccination Bill likely to pass in Australia that the bill is likely to pass without considering the full range of responses sent to government and about a handful of 400 posts had only been recorded on the government website 24 hours before a decision was made.
This is not democracy and young Australians will have their lives damaged through irresponsible over-use of vaccines.
There is not even a system for compensation if something goes wrong.

I am just wondering whether professional indemnity insurances will now take an unnecessary hike in price as the pharmacy vaccination clinics become a reality.
Again i2P supports pharmacist vaccination clinics– but only with safe vaccinations.
And also with informed consent for patients by responsible pharmacists.
Can pharmacists genuinely prepare themselves openly and honestly to deliver a fully informed consent?
I guess that will be left for the courts to decide.

Loretta Marron’s final article for i2P is titled The National Centre for Research on Complementary and Integrative Health (NCCIM) – What is it? and she provides her normal meticulously researched material to debate the legitimacy of integrated medicine practice plus the legitimacy of a US organisation dedicated to research into some facets of that modality, which may involve complementary medicines.
For some years I have practiced an integrated medicine modality, using clinical nutrition to make life easier for patients who are on a string of mainstream medicines.
My experience has been that over three months of integrated treatments, most patients feel better and have been trained to take responsibility for their own condition(s).
As a consequence, I lose a happy patient except for an annual visit to see if any modification is required.
As my qualification was gained at a Guild Pharmacy College of Advanced Clinical Nutrition and clinical nutrition is a recognised medical science, I have felt quite comfortable practicing in this modality.
And it is very satisfying to have happy patients.
I have often noted that critics of this type of modality do not have patients, even those with “professor” as their first name.
But read and make your own decision on the subject.

Mark Coleman was interested to find that a leading US pharmacy publication was echoing some of the thoughts proposed in various i2P thought leadership articles published over time.
They concern the public health propositions and the use of triage at different levels of engaging with a patient. Read: Our Thinking and Thought Leadership is Reflected

A new “social enterprise” philanthropic wholesaler has emerged.
I2P discusses the ramifications for pharmacists to consider, as change continues to impact on the profession at an ever increasing rate.
Read: A New “Social Enterprise” Wholesaler

Harvey Mackay expands on a reflective theme in his article for this edition titled You really can buy happiness , where he discusses research that shows that happiness become apparent in how you spend your money.
No matter how much or how little you earn you will always be happier at the end of a day if you have spent on others rather than on yourself..

And we finish our edition for this week with media releases from various leadership organisations.

PSA – PSA Media Releases – 1. Vic Government backs pharmacists 2. Victorian Intern of the Year

NPS – NPS Media Release – Healthcare Variation Atlas

Enjoy this weeks offering and don’t forget to enter any debate through the comments panel at the foot of each article.

Neil Johnston,
Editor
i2P E-Magazine
Monday November 30, 2015