EDITORIAL for Monday 3 April 2017

Welcome to the current edition of i2P (Information to Pharmacists) E-Magazine, dated Monday 3 April, 2017.
As some of you would know, I live in what many regard as “Australia’s best address” – the Northern Rivers Region of NSW.
That boast is looking a little tattered since the drought broke and we received more than a fair dose of rainfall over the past few weeks, leaving towns like Lismore totally devastated.
Of course, we also shared the problem with most of coastal Queensland and the devastation in the form of Cyclone Debbie has been profound.
Our sympathy is extended to all those people who lost their homes or who had their personal belongings destroyed.
We also think of our extended pharmacist family now having to rebuild their practices – some almost from scratch.
i2P hopes that recovery will be swift and insurance companies do not take advantage and become a liability, as sometimes happens.
Fortunately (and with thanks), my home is in an area called “The Plateau” which was elevated enough to avoid all of the devastation that was so starkly displayed on our TV screens.

April 1 (April Fool’s Day) saw the release of a story that proposed the King Review had been asked to extend its brief and investigate global open ownership of Australian pharmacies as well as nationalisation of Australian pharmacies.

At our publishing time deadline there was no formal rebuttal of these concepts, so i2P has created an analysis for the potential of these scenarios to occur.
As we already believe that government is committed to an open ownership policy there is also the possibility that nationalisation has been floated to deflect the criticism that would flow from an open ownership decision, possibly open ownership being the more palatable to the Australian Public at large.

As i2P has regularly reported, the PBS as a health product, has come to the end of its life cycle.
The King Review is simply a mechanism to find a replacement for the PBS – and our pharmacy leadership have not been innovative enough to have a holistic solution to suggest to government.
This allows the entire situation to develop into a point-scoring exercise with pharmacy and government looking to scapegoat each other.
Also, Stephen King is not looking as being the best choice to work out a PBS replacement because he comes from that inexact science of economics, which has failed more than once in trying to predict or create appropriate frameworks.
Economists rarely get it right!

In this current edition we have focused on those health consumers called patients and we have asked a few hard questions, because we believe that predominantly, Australian pharmacies are not in the patient business.
Why so?
Well pharmacists individually and collectively refer to all pharmacy consumers as customers, and this even includes professional journals that commonly use the word customer when the word patient is clearly more appropriate.
Most pharmacies also spend exceptionally large sums of money to belong to franchised marketing groups to generate – you guessed it – customers!

Even when a market group puts together a promotion for a professional service they still advertise it to customers – and a recent example is given in one of the articles in this current edition.

So i2P proposes a question that every pharmacist should ask themselves:
“If you are not in the patient business, why are you still in pharmacy?”

Our lead article this week highlights a proposition put forward in the US by a group of medical professionals (called A4M) specialising in the slowing or reversal of the ageing process.
Ageing populations in western economies now represent a major demographic of populations and are rapidly expanding, also medically intensive – particularly in the last seven years of their lifespan.
Our formal health systems are built on illness management and maintenance rather than wellness strategies and maintenance, yet the latter represents a platform to keep people in the workforce for longer periods of time and be a cheaper alternative to patented drugs that do not talk in terms of cure, or even of prevention.
And a lifespan increase reduces the medically intensive period prior to death which reduces cost to government. There is also the potential to even eliminate the medical intensity surrounding end of life providing a further benefit where lifestyle matches lifespan – a quality of life improvement.

The A4M proposal is remarkably similar to proposals suggested by i2P over time, so it is suggested that this program might be able to replace our PBS program, putting pharmacy at the centre of the program management and a primary collaborator in areas requiring a team effort of a range of health professions.
Is it possible that one or more pharmacy leaders may pick up on this idea?
Read: A4M Proposes a $1 trillion health cost save for US – why not Australia?

Mark Coleman was given the brief of dealing with the April Fool rumours, but also  analysing the issues surrounding each proposal, in part, to devise any advance strategies that could be put on the table now, rather than later (too late).
As open ownership of community pharmacy is already thought to be in the pipeline (along with the privatisation of Medicare), there needed to be more of a focus on the concept of nationalisation of the pharmacy industry.
Because we are not likely to have a major national crisis in the form of a World War in the immediate future, there seems to be no grounds for suggesting such a process – even if it is only a tool to divert pharmacists from the real action of open ownership.
Read: The King and I – Shall we Dance?

Assuming that pharmacists really want to position themselves as being patient advisers/practitioners we asked Peter Sayers to explore the idea of developing a patient proposal.
Has anyone really had a good look at such a proposal or even written a draft version?
Read: The Patient Proposition

And following on from a patient proposition we postulated if we really collectively understood what a pharmacy patient was.
Do we have a full 360 degree input for what makes this group tick and how best can we convert this to pharmacy economic advantage.
So we pulled in ideas from our staff and all of our writing associates to see how we could develop a better understanding.
And it got down to an integrated patient information system with tentacles into different, but isolated, silos of information to obtain a holistic and a full 360 degree input and come up with what comprises a single view of a pharmacy patient.
This is a work in process because pharmacists have not yet invented the software to provide balanced information systems, and IT resources need to be diverted to this solution as a matter of urgency.
Read:  Developing a Single Patient View

Gerald Quigley is back and gives some insight to a major practice improvement – one valued by patients.
In this small illustration he illustrates one aspect of a quality health practice that respects its patients and seeks to provide reassurance at all points of delivery.
It is a positive goodwill stimulant.
Read:  Do you give out your mobile number?

Our regular column devoted to understanding the medical cannabis debate and its transition to a beneficial treatment of major chronic illness keeps uncovering how ignorant many government and leaders in health professions really are when it comes to readying this useful substance into an appropriate regulatory framework.
To this extent, one ethical organisation called United in Compassion is organising quality education directed to health professionals so that they may have a qualified evidence base around the human body’s endocannabinoid system – something not covered in the past in formal health education environments.
Prejudice must be eradicated through knowledge and documented evidence.
But it also requires health professionals to keep their minds open and be receptive to new information.
Read:  Understanding Medical Marijuana – UIC Symposium 2. Cannabis Legislation Support 3. Cannabis Curbs Opiate Epidemic

I sometimes despair of the deceit, dishonesty and corruption that so obviously surrounds the vaccine industry and its supporters, particularly mainstream media and key politicians.
That it is centred only on massive profits and not the health of the patient (usually a healthy child that can have their entire future lifestyle stripped from them with one vaccination) is a testament as to how low health profession ideals have plummeted given that those who should know choose not to know, with money being the motivator.
It is like a disease that itself needs a vaccine to boost ethics and principles.
We have established a permanent column built on Safe Vaccination.
Read:  The Safe Vaccination Debate – 1. Banning Unvaccinated Kids May Have Consequences 2. How Plumbing (not vaccines) Eradicated Disease 3. Aluminium in Vaccines Highly Toxic 4. Overvaccination 5. The Judy Wilyman Report

Harvey Mackay is back with us giving us some insights into winning and losing and the life skills needed to create a winning position.
We hope the principles embodied in this article can be employed in developing winning patient propositions.
You are allowed to fail along the journey, but as long as you build on the experience and share your knowledge for insights, you will arrive at the winner’s destination.
Read: Losing isn’t the opposite of winning, it can be a part of winning

And we finish our offering for this edition with media releases from major pharmacy leadership organisations. Only PSA seems to have been active since our last edition.

Read: PSA Media Releases – 1. Commonsense Outcome for MedsASSIST 2. Nominees for PSA elections increase 3. Pharmacy Services and Screenings Must be Evidence-Based 4. Compounding Standards – Feedback Requested

We hope you enjoy the content presented in our current edition.
We also remind readers that they are welcome to stimulate debate by entering comment in the panel provided at the foot of each article.

Neil Johnston
Editor i2P E-Magazine
Monday 3 April 2017

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