Clinical Pharmacy – a US Working Model

There is an excellent US publication available online and its title is “Drug Topics”.
I probably have some affinity because the range of topics discussed ranges from pharmacy management to clinical pharmacy, somewhat similar to material published in i2P.
One recent article caught my eye, and it was titled: The new pharmacy: Revenue streams, Part I .
The tag line was:
“To be successful in pharmacy, we have to get a divorce”.

The author was Mark Burger, an experienced and long practicing community pharmacist located in America.
He owns Health First! Pharmacy and Compounding Centre in Windsor, California.

His article was based, in turn, on a report published in The Atlantic, one that you might like to include in your own library as a reference article.
Mark urges you to:
“Read the article in The Atlantic to get a sense of the paradigm shift that is going on — especially if you think this is NOT happening”.

“The title that caught my eye was: “The Evolution of Alternative Medicine.”
I wasn’t hopeful.
As a pharmacist who practices compounding and functional medicine, I was ready for the usual slam: “It’s not science!”
“It’s snake oil.”
“There is no ‘proof.’”
“It’s just Big Supplements making $$$$ off unsuspecting people,” etc.

Except it wasn’t.
The subtitle read:
“When it comes to treating pain and chronic disease, many doctors are turning to treatments like acupuncture and meditation — but using them as part of a larger, integrative approach to health.”

Which is exactly the direction that i2P has encouraged since its formation in 2000.
There are further similarities as Mark describes his clinical practice:
“Well, I have a relatively rare type of practice that melds independent/compounding/functional pharmacy into one practice site.
We compound.
We teach.
 We sell professional-grade supplements, vitamins, herbs, nutrition, homeopathy (no OTCs).
We schedule and charge for consultations in 15-minute chunks.

We have weekly health seminars that draw 20-50 people, and we charge admission. We sponsor and promote prescribers when they want to give a seminar, and we often give them together: Pharmacist + Prescriber.
We act as a clearinghouse, of sorts, for the functional medicine practitioners in our area.

In other words, just a simple and straightforward service that has a high level of patient engagement that provides an alternative to the medical model for a patient “home”, particularly as other forms of health practitioners are invited into the model in a collaborative manner.

The proposal that pharmacists “get a divorce” to become “successful” alludes to the deceptions practiced by major drug companies that create a range of ethical issues designed to prevent health practitioners from looking at health solutions from any source, other than from a polluted Pharma evidence base.
You have to extricate yourself from the experience of being a victim of pharmaceutical “spin” posing as evidence.

In earlier articles, i2P likened the model to take pharmacists forward was much like the pre-1960 model that existed in Australian pharmacy – high levels of patient discussions, a diverse range of compounding, a small level of retailing to attract customers (for progressive conversion to patients).
We have been conceptually building a new paradigm pharmacy to take Australian pharmacy confidently into the coming decade – one that started with the integrative model noted above and designing it to be scalable.
One of our more recent articles has taken the concept to involve triage and become a back up to our national emergency services.
In other words, a new model based on the best of mainstream medicine and the best of complementary and alternative medicines, and ending the isolation with all other health practitioners through collaboration.
Becoming an outreach rather than a conservative “silo”.

Some advanced models of the new paradigm pharmacy will be multi-story buildings even to extending to living quarters for on call and after hours pharmacists.

And Mark even suggests individual practitioners starting their own practice and renting space from a community pharmacist as an alternative to setting up your own pharmacy!
This has been a concept that has never been fully accepted by the Pharmacy Guild of Australia because it means for growth, income has to be shared and the practitioner comes as a private contractor working across a range of pharmacies.

This working model was piloted (by me, through my management consultant practice) in Australia through five pharmacies in 1978.
It took 12 months to get five individual pharmacists trained up and working full time on a fee for service basis.

I suppose you could say that I am somewhat disappointed to see that it is now the year 2015 and clinical pharmacy is only just now taking its first tentative steps here in Australia.
Even now, the 1978 pilot was light years ahead of what we are currently seeing.

It is heartening to see that the US model is providing job satisfaction, patient interest and sustainable income at least in one part of the world.

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