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EDITORIAL for Monday 21 December 2015 – I2P

EDITORIAL for Monday 21 December 2015


Welcome to this weeks’ edition of i2P (Information to Pharmacists) E-Magazine dated Monday, December 21 2015.
We now take a break to join with our own families and celebrate the festive season and will rejoin you after this recess early in January 2016.
But what a year 2015 has been, with Pharmacy almost being turned on its head, with more to follow in 2016.

The $1.00 co-pay decision by Sussan Ley (but pushed by the economic rationalists) not only adds more pressure to an already pressured “bottom line” but creates division in community pharmacy ranks.
In every pharmacy business cycle of 20 years there is always a “price leader” either discounting prescriptions, or OTC items or both.
The current cycle which commenced in 2012 features a “price leader” for the “both” concept which is probably the first time that pharmacy has competed across the board with the “both” business model emerging and rapidly encroaching on individual market share.
Always, pharmacy as a whole has whittled away any “edge” the price leaders may have developed.
In marketing terms, any benefit that creates an increase in market share will gradually erode as alternative business models emerge – first as direct copies forcing the initiator model to elevate margins to offset the cost of competing, which is always expensive at the discount end of the market place.
This becomes the first levelling factor.

So while the “price leaders” have an initial edge because of their well thought out model, all they have is lead-time before everybody else develops their own competitive models.
2016 will see market forces, both PBS and Warehouse pharmacies (and Woolworths in the background) translating into community pharmacy forward-planning decisions, simply because not to change and adapt will represent business suicide.
And it is a management problem to adjust costs.
A business model restructure requires good management skills, and when the model is in place, a marketing program that drives the concepts that the new model has been structured for.
Don’t wait for solutions from the PGA or your franchised marketing group – research your own solutions.

We are seeing a complete medical paradigm change for health in Australia, along US lines.
Why governments think that the US health model is a great system is beyond me, but that is the thinking.
Certainly elements of the US system are starting to show creativity and innovation by focusing on outcomes and only paying practitioners for desired outcomes.
For Australian pharmacists, that means engaging with private patients to sustain the core business of dispensing and advisory services and developing “packages” that attract patients.
If governments want to eventually subsidise that style of program, then it must be done through the patient with bulk-billing options kept to a minimum, to avoid the domination that occurred with the PBS.
But remember that health benefit funds, all private, will now take on the role of adopting government agendas through government financial incentives– it will always be a fight for dominance of your own market, and unless you keep a minimum of 55 percent of your market as your own, you will eventually be owned by the “payers”- who are not individual patients.

One of the more disappointing aspects of health decisions by government in 2015 was the coercive legislation that was enacted to enforce vaccination of children by having parents (or individuals) lose unrelated financial benefits.
This is not producing a climate of safe vaccination but one of unbridled pro vaccination with a lack of safety.
This is an unprecedented decision that is a human rights violation, even though government argument is opposed to that thought.

It is an astounding outcome for Big Pharma marketing that needs to be completely reversed.
i2P has opted to support safe vaccination which means we are pro for the vaccines that have proven safety and efficacy, but definitely against the vaccines that do not fit that profile.
Informed consent will become an ethical problem for some pharmacist vaccinators.

Similar legislation was enacted in the US not so long ago (isn’t that a coincidence?), but was recently contested by five US mothers concerned for their children’s welfare.
The following was sent to i2P from one of our network sources:

“In a trailblazing victory for families with young children, and a triumph for liberty-minded citizens across the country, the New York State Supreme Court has just overturned a municipal ruling which would have mandated flu vaccines for young children attending day care programs and pre-schools in New York City.
This mandate had worrisome implications for families everywhere.

The most amazing part of this historic decision?
Five inspired mothers joined together, hired a lawyer, and sought the help of the state court.
Their steadfast efforts will bring health and hope to families in New York City, and throughout the nation, in the widespread war against vaccine mandates.
Informed parents know they deserve a choice about what chemicals, if any, should be injected into their child.”

This legal precedent can now be referred to for any group taking up a legal challenge to this coercive vaccine legislation.
Also, Judy Wilyman has sent out an urgent document concerning false and misleading information being circulated by the Chief Medical Officer of the Dept. of Health.
This should be printed out and displayed within your professional area because of its significance and areas relating to pharmacist vaccinators.

Patient-centred homes is a buzz word coined for a concept of a GP-led primary health care service that is focused on the patient and involves triage to services of other health specialists (like pharmacists) under the one roof.
The concept is currently being developed and promoted here in Australia and appeals to a range of clinical pharmacists.
However, the US model has not been a success, the main reason being that pharmacists in the US are not classified as “providers” and have to be paid indirectly through the GP who is a provider.
In many instances the pharmacist has been paid insufficiently or not at all.
Disrespect occurred as the culture of each collaborator health professional was not understood and was even competed against through preferential training and patient access to physician assistants.

So the patient-centred home has become a failure in the US and suddenly the visionaries have discovered that it takes more than one component of primary health care to deliver for a patient – it takes an entire neighbourhood.
So now we have the “Patient-Centred Neighbourhood” which in its latest stage of evolution has found that pharmacies have a central role in coordinating clinical services through their walk-in clinics and can efficiently triage to a wider range of health and non-health services all involved in primary health care.
i2P has been writing about triage in a wider world of public and emergency health systems and it looks like the US system will reach that model well in advance of Australia.
Peter Sayers is our lead writer for this week and discusses this concept which is probably a good model for Australian pharmacy to negotiate and follow.
The interesting thing is that it will require Location Rules to stay in place as part of a national health asset.
Read: A Home Doesn’t Need to Have a Single Roof – Because it Might Need to be a Neighbourhood

The solution to the co-pay discount lies in a management audit of your business model and a new marketing vision to drive the new business model.
It involves much overdue change in the community pharmacy model, so read about the process here: Taking the Initiative with Co-Pay

Management terminology and marketing thoughts have to be adjusted as the market place changes through disruption or by natural evolution.
The market is continually changing through the creation of new market segments, the destruction of some and the expansion of others.
Mark Coleman has investigated just one term and his article bears the same name as its title.
Read: Shopping
Harvey Mackay is back with an article on self confidence.
In these days of rapid change and stressful work-places, self confidence is always in need of a boost.
Read some strategies for self improvement here: Give your self-confidence the boost you need

Our friends over at the Australian Doctor publication seem to be perpetually worried about what pharmacists are up to and with some of their writers being involved in the Friends of Medicine at executive level (nearly all being medical Skeptics) we see doctors floating ideas that are more “turf oriented” rather than “patient-oriented”.
Gerald Quigley thinks they are being offensive and I would tend to agree with him.
Read Gerald’s thoughts at: Interesting weight loss perception

One of the most exciting research projects for 2015 has been the discovery that one gram of fat loss from the pancreas will completely reverse diabetes but it can be balanced with the help of fat injections in Boston.
This discovery will now create additional research into drugs that can create this pancreatic fat loss leading into the real causes of diabetes.
Diabetic patients will tell you the current drug solutions for diabetes are uncomfortable, sometimes dangerous and always frustrating in trying to find the right blood glucose level:
Read about this research here: Type 2 diabetes reversed by losing fat from pancreas

Judy Wilyman, a PhD student continually researching vaccine policy, is back with us to wind up a disappointing year for appropriate vaccine legislation by government.
She will continue the challenge, but read her final thoughts for 2015 here:
The plausible link between vaccines, autism and other chronic illness

And we finish up this week’s offering with information and media releases from leadership bodies for Australian pharmacy.

Australian Pharmacy Board – Pharmacy Board of Australia – December Newsletter

NPS – NPS Media Releases – 1. Rules for Unnecessary Imaging 2. Seek Advice on Common OTC Medicines Ahead of Holidays

We wish all our readers a happy and safe holiday break and we will be back again in 2016.
And we also advise that the Pharmacist Support Service is available throughout the holiday season.
If you, or someone you know is in need of support, call 1300 244 910 to talk it over with a colleague.

Neil Johnston
Editor i2P E-Magazine
Monday 21 December 2015


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