Welcome to this weeks’ edition of i2P (Information to Pharmacists) E-Magazine dated Monday 21 March 2016.
Well, this week saw the completion of another APP Conference and judging by the number of gloomy faces treading the corridors of power, not all went as intended.
They were all mouthing the name “Stephen King” and he seemed to have been judged guilty of asking the questions “Why” and “Why not?”.
Perhaps everyone was caught off balance because there were no thought -provoking answers in response.
Catching the mood through Seth Godin, Gerald Quigley sent me the following thoughts.
It’s as though Seth was in the room at the Gold Coast this weekend.

“There’s no choice!

It’s an easy mistake to make, and a tempting trap in which to fall.

It’s unlikely you have no choice.

It’s more likely that you have no easy choice.

No safe choice that also embraces your potential.

No choice you can make that doesn’t cause short-term misery in exchange for long-term benefit.

When we say we have no choice, we feel trapped and we are powerless.

There’s no way to do our work every day.

Do it, or don’t do it.

It’s up to you”.

(Compliments of Seth Godin – maybe he’s watching the developments in our profession)

Well everyone, change is in the air and unless there are some sensible forward thoughts put to the Department of Health investigating committee and chaired by Stephen King, please close the door and turn off the lights as you leave the building.

i2P would also advise that it is embracing a new project in a new pharmacy environment that will influence the time involvement for i2P preparation. To allow for sufficient time to build the new project, i2P must default to fortnightly publication rather than weekly.
That change is immediate from this date of publication but will return to a normal weekly cycle after a reasonable time investment in our new project.
More later.

It’s time to invest in your own future and privately develop what you see as your own future, because you will ultimately waste time and opportunity if you are waiting for the Pharmacy Guild of Australia to step up to the mark.
The “top down” leadership style destroys creativity and innovation – start building small projects that are uniquely yours, and then build on top of them again.
A “bottom up” process.
Just do it!

i2P has often quoted Gregory Haines, pharmacy historian and author, who once said:
“Change in pharmacy never originates from within pharmacy.
It always comes from government pushing pharmacy down the track supported by pressure from the Medical Profession”.

So all those decisions you have put on hold must now be revisited with a disunited leadership group and no real strategies to offer their members.
Did anyone else notice that the PSA were not offered participation of any sort this year in APP?
They were locked out of the whole process!
And that is very disappointing to the family of pharmacy and is a clear demonstration of a mean-spirited form of leadership.

There is a meeting of this government investigating committee in Sydney this coming Tuesday and I really suspect that minds will be made up unless someone on the invitation list has some “out of the box” input that might illustrate that pharmacy has some creative answers that can suitably align with government thinking.
This week we have published a mix of thoughts on some futuristic activities that are almost on our doorstep, as well as other thoughts that relate to change – safety issues that run with work-flow changes that may need to be thought through.

Digital Nomads – Providing Clinical Services That Appeal is a story that the next generation of HMR pharmacists might aspire to, with an armament that makes you a force to be reckoned with.
And the lifestyle can be as exotic as you are able to make it because other creatives in other professions have already mapped out the process and are willing to share it with you.
Whether you are single, married or have a family the lifestyle can be adapted to suit all family members.

Nissan Foresees Offices Powered by Electric Cars – We see Electric Cars Becoming Offices Occupied by Digital Nomads
This story fits in with the previous in that electric cars are about to be mass-produced, and are also designed to share power.
Creativity and innovation illustrates how this can extend to a truly mobile office with its own independent power source keeping you connected no matter where you may be.

Increase Safety Checks as Pharmacists Prepare to Leave Dispensaries
One of the first decisions that should follow after returning from APP is to consider the purchase of a robotic dispensing machine.
But before that happens, consider the impacts on work-flow and safety issues and plan any proposed changes in detail.
That includes how the time release and utilisation of at least 90 percent of a full time pharmacist plus one dispensing assistant which will become available for front of shop deployment after the changes.
It’s a massive change but a productive one if it is done properly.
The front of shop area needs to be designed to include a “home” for the pharmacist and some retraining for the dispensary assistant to become a clinical assistant and a brand new marketing plan to embrace a better world for pharmacy clinical services.
Government resistance to past programs in pharmacy not thought to have worked, has hardened an attitude against government support of pharmacist clinical services.
Now pharmacists themselves must design, create and deliver, what those clinical services will be at their own cost and that will quickly determine who dies and who survives.
Then government will provide patient subsidy as patients take up what satisfies genuine health need.
At that stage a new fight for control of that service will occur and pharmacy should be prepared to avoid that pitfall having fallen into the trap of the now moribund PBS.

Embracing the Empowered Patient
All areas of the pharmaceutical industry are undergoing changes with traditional cultures being dismantled and boundaries between supplier and provider overlapping or the jigsaw pieces being re-arranged.
Big Pharma has been globally active in developing channels of communication direct to patients yet not being actively “seen” in being involved in the process.
The television advertisement dressed up as news, or in the US, direct advertising to patients has now reached a stage where the American Medical Association is calling for an end of direct to consumer advertising because it is disrupting the normal prescribing process and adding to the chaos, orchestrated as being the worst health system in the world with ever escalating costs.
Pressure is mounting in Australia to advertise S3 products.
The process is identical with what has been developed for S4 products giving Big Pharma a direct line to consumers whilst remaining invisible.
This needs to be looked at in detail before committing.

Community Pharmacy or Commodity Pharmacy?
There is a scale that defines a range of pharmacies that present in various stages of being a community pharmacy, a commodity (discount or warehouse) pharmacy or a professional service pharmacy.
Each category of pharmacy is typified by its professional sales to total sales ratio with community pharmacy fitting in to the 45-55% range.
The commodity pharmacy is just what it is – every product or service stripped back to the lowest cost point with minimal clinical conversations occurring.
So live with that and decide which model you want to run with and with your own insight  and research start insulating yourself against the model that is most disruptive to yours.
Government is indifferent to an argument against a commoditised model because they can only see pharmacy as being a logistics component of the supply chain, and in that position all that matters is price.
Stephen King has already stated that with removal of location rules and ownership rules, an open market would soon determine what pharmacies would survive.
If that meant a large number of pharmacies closing, then so be it.
That is an economic rationalist speaking and in charge.
But remember, pharmacy has never presented publicly as a clinical service provider, being too involved in a PBS product at the end of its life cycle.
This is not a good position to be in.
PGA is still trying to be the power broker for all of pharmacy and will not collaborate with PSA.
PSA through its Health Destination Pharmacy project has genuinely found a “bottom up” project that will work in community pharmacy if given a chance.
The only chance for survival is to strike out on your own, forget about waiting for leadership bodies to provide solutions and start a creative and innovative collaboration between like-minded pharmacists.
Then the cream will rise to the top.

Australian Politicians presenting Myths about Vaccination
Judy Wilyman keeps exposing the dishonest processes underlying the vaccine manufacturers, politicians and medical skeptics (who attack health professionals on the basis of lack of evidence yet base their own policies completely devoid of any evidence whatsoever).
Through persistence, Judy is slowly winning.
i2P is totally behind Judy who has been awarded a PhD for a thesis based on government policy for vaccination programs.
I am hopeful that when pharmacists embark on their own vaccination services they will genuinely offer informed consent to their patients and oppose coercive government policy at every opportunity to do so.
It will be a conflicting process.

And we finish up this weeks’ offering with a range of media releases from leadership organisations.

PSA Media Releases – 1. Pharmacy Trial Program topics welcomed by pharmacists 2. WA Intern of the Year and Excellence Awards winners

ASMI Media Release – Consumer Healthcare Products fuelling strong ‘front of shop’ growth for pharmacy

NPS Media Releases 1. Safeguarding against unnecessary tests, treatments & procedures 2. Choosing Wisely – next wave

We hope you enjoy this weeks edition and that you can refocus for long-term success given that government will not be too involved or even concerned that their disruptive policies will destroy some elements of community pharmacy.
We’ll be back on our new schedule in two weeks and hopefully the project we are engaged with will provide some positives for the profession generally.

Neil Johnston,
Editor, i2P E-Magazine
Monday 21 March 2016