Do You Promote Free Advice?

Frequently there is a lament recycled by pharmacy commentators that the business model for community pharmacy has relied on providing services through the margins received for recommended products.
That model is still a valid part of community pharmacy culture, except that it has not been appropriately adjusted to counter market changes that have occurred over the last pharmacy business cycle.

One obvious change has been the rise and rise of the discount or warehouse model of retail pharmacy that has focussed on volume sales and low costs as its growth plan.

Obviously, lower margins on pharmacist-type recommended products in community pharmacies suffered in a comparison of retail prices thus creating pressure on the gross profit ability to subsidise free services.
Some offset and relief was gained by using generic versions of the original branded product, but even this was insufficient to conserve sufficient gross profit to pay for free services, so there has been little movement to promote existing or new services that could be “picked off” by the discounters.
Even services that build the professional base of pharmacy such as vaccination services and pathology type services (blood sugar, cholesterol etc) seem to be continuing in the mould of “free” or “at cost” – a commoditised variant of what was originally intended.

That community pharmacy culture needs a positive disruption is without question if it is to emerge as a valued component of our overall health service.

The demographic categories that matter most to community pharmacy are the 0-5 age group and the 50+ age group.
The 0-5 age group (actually pregnant women, mothers and carers) have recently begun joining peer-to-peer groups on Facebook for medical information and advice.
Because it is not being delivered through trained qualified health practitioners there is a high level of misinformation that could be potentially dangerous.

The most common types of information requested through Facebook concerns treatment for coughs and colds in infants, teething and nappy rash.
Medication discussions centred mostly on analgesics, cough and colds, and antibiotics.

i2P believes that, in part, this Facebook activity has arisen because community pharmacy has not organised any useful treatment for infants since cough and cold medications for children under age 6 have basically been removed from pharmacist intervention, due to changes to the Poison’s Schedules.
This gap in early clinical conversations involving the 0-5 age demographic also impairs approachability until much later in a consumer’s lifespan, so that communication streams needs to be repaired.

In other words, external disruptive changes have affected pharmacy and a positive response has been slow to emerge.
Nature abhors a vacuum, so a major market segment closely tied to pharmacy simply takes to Facebook to fill the gap.
But at the same time it creates a new opportunity to create an online service to these Facebook users if you are able to access these conversations in an authoritative and informative manner.

Again, online presence by pharmacists has been limited and mostly dedicated to product selling and there would be an obvious benefit to building up interactive online connections that could be integrated with social media.

As an observation it would seem that if pharmacists abandoned completely their flow of free information that consumers simply go to a new free source, not always at the same standard or quality.
It would therefore be logical for pharmacists to prepare a scale of information services ranging from totally free to that of a paid consultation fee that represents value for money.
In other words, constructing boundaries around each level of information service with investment in infrastructure, (online and physical), that can cater to each defined level.

A further investment in marketing each level of service would complete the cycle of patient engagement.
Linkages between each defined level should be promoted to convert and encourage free consumers to becoming paying patients.

Recently, I read an article by a person engaged in repairs of computers and associated equipment. It was titled “Leaving Money on the Table to Win the War”
and it described how a computer technician built a very large business by teaching his customers how to repair their own equipment, and who did not charge for the information provided.
He became very popular and very quickly, because he discovered that he got a high percentage of all future purchases by those enquiring customers.
In fact, if you adapted his system to pharmacy you might actually call it “Self Care”.
You know the same version as developed and promoted by the PSA for about 30 years.
It does however, need to be able to be delivered online to become an important part of patient information deliver with suitable boundaries around it to ensure that the right information gets to the right patient and unauthorised use by others is suitably restricted.
The online version can also be adapted for walk-in patients coming into a community pharmacy.
However it is important that the system employed can be made tangible and must stress safety and efficacy with information systems providing references to suitable studies or other evidence.

Steve Jobs of Apple fame also adapted the idea to his “Genius Bar” to become one of the world’s most valuable companies.

The repair assistance that the computer technician gave to his customers free of charge was an item that would normally be a “bread and butter” income item.
By educating consumers he gained trust and authority and through social media, became the “go to guru”.
Becoming a trusted resource takes time to establish.
Current practising pharmacists have inherited the legacy created by previous generations of pharmacists.
But they have not understood the value that has been passed on and have not invested intellectually in nurturing and continually reinforcing this valuable resource.

Providing a predefined content level free of charge is like “leaving money on the table” and you will win sufficient micro-wars for hearts and minds to turn that into becoming a victor involving some of the “heavy-hitters” in pharmacy – those that are currently flexing their muscles and those global entrants like Boots who are working on the fringe of Australian community pharmacy just waiting for the right opportunity to strike.

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