EDITORIAL for Monday 3 September 2018

Welcome to the current edition of i2P (Information to Pharmacists) E-Magazine, dated Monday 3 September 2018.
Political events since our last date of publication intensified in the extreme as the Liberal Party disposed of Malcolm Turnbull in an orgy of self-interest that was emotionally summarised by Green’s leader, Richard Di Natale in an address to the Senate.
We reproduce an extract here, because there is a lesson for leaders in all walks of life, including the health professions.
Regular Australians have simply had enough of poor leadership and its associated and reflected behaviors in all facets of community life.

“While the Liberal Party has been tearing themselves a part, we’ve got 100 per cent of New South Wales in drought right now.
We’ve got the Great Barrier Reef on the brink of collapse, we’ve got floods in India, we’ve got a 12-year-old girl who’s setting herself alight in Nauru.
We’ve got kids who are in a catatonic state because they’ve given up hope, locked away in those offshore hell holes.

“What’s the Liberal Party doing?
Focusing on vengeance, on payback, focusing on themselves.

“We’ve got people who can’t afford to pay their medical bills right now, we’ve got young people who are being priced out of an education.

“There are a 100,000 people in this country who are homeless.

“There are women who fear going home tonight because one woman a week is killed at the hands of a violent partner.

“And what have we got?
We’ve got this spectacle, this disgrace.
You should be ashamed of yourselves.

“We have people across the country who are suffering and look at what you’re doing.

“You are so focused on yourselves that you have forgotten what the country elected you to do and that is to govern for themselves, for them, not for you.
Not for you.
You don’t deserve to govern, you deserve to be turfed out.
That’s what you deserve.”

“You walked away from climate change.
You walked away from an energy policy, you ditched your economic plan and why?
Because those dinosaurs inside your party room held the Prime Minister to ransom.
And he didn’t have the guts to take them on.

“And what’s he done instead.
What has your party done?

“We have the prospect of Peter Dutton or Scott Morrison as the next Prime Minister of the country.
Now, things are pretty crook right now but they’re going to get a hell of a lot worse.
I fear for those people in this country who have come from overseas when we’re going to have an election that focuses on race, that fans the flames of racism and division.

“That’s what’s coming right now.
We’re going to have an election campaign where people are divided – where neighbour is pitted against neighbour because you haven’t got the guts to stand up and lead.”

Powerful stuff!
And it resonated around the world.

The behaviour exhibited by our national leaders is reflected throughout the entirety of Australian society.
Health association leadership suffers from the same viral infection.
Self interest above all!

Take the recent example of the vice-president of the Australian Medical Association having a rant against pharmacy in the Medical Observer.
He comes out fighting over GP dispensing in the wake of a Pharmacy Guild of Australia attack that likened the AMA to a “salivating dog” as part of a renewed push to expand the scope of pharmacists to include prescribing.  

“GPs’ livelihood and ability to practice are being attacked on many fronts.
Dubious role substitution creep from usurper health care practitioners must stop.

Does the fight need to come to their doorstep instead of doctors always being in defence?

The acting president of the Pharmacy Guild of Australia recently likened the AMA to a “salivating and barking dog,” following a perceived “onslaught of abuse and derision,” in a response to broader scope of practice for pharmacists. 

The hyperbole was rousing!

It was suggested that prescribing medications, being able to capably understand and diagnose a patient’s medical problems without appropriate training or ability to garner a full history and examine, and to provide health prevention advice is within the scope of pharmacy training? 

Clearly not true.

The aircraft engineer doesn’t pilot the plane, serve the drinks, or unload the luggage.”

Nowhere in the above rant is there mentioned patient welfare or patient benefit.
Nor the responsible steps that pharmacists are undertaking to ensure a fitness to deliver service extensions.
The above is one of many continuing and unwarranted attacks on the pharmacy profession and it is indicative of a powerful profession that has lost its way.

It is not surprising, and indeed welcomed, that the Pharmacy Guild of Australia has drawn a line and is defending the rights of pharmacists to develop their scope of practice to improve patient care.
Australia’s health system is slowly going down the sewer as the medical profession continues to offload its toxic sludge.

This is exemplified in the recent Coroner’s report into the death of a Melbourne man following complications of methotrexate toxicity. 
In handing down her findings, Coroner Rosemary Carlin said the patient’s unnecessary death resulted from key failings of the pharmacist and prescribing doctor to work collaboratively to effectively resolve a prescribing error.
In particular, the coroner noted “Doctors and pharmacists should trust and respect each other, whilst retaining their independence.
In dismissing her concerns, it appears that Dr Lim did not afford [the pharmacist] the respect she deserved.
In dispensing the methotrexate despite her concerns, it appears that [the pharmacist] afforded [the GP] too much respect, or at least lost sight of her role as an independent safeguard against inappropriate prescribing.

To their credit, the Pharmaceutical Society of Australia (PSA) has moved in response to the Coroner’s findings, to host an inter-professional collaboration to explore how doctors and pharmacists can work together to more effectively support patient care through the safe use of medicines.
It will bring together leaders from key pharmacy, medical and consumer organisations at Pharmacy House in Canberra, and will have had its first meeting by the time this edition of i2P is published.
And maybe this human tragedy may act as a fulcrum to resolve perceived and emotionally charged “turf war” accusations on a broader scale, in the format of an ongoing collaborative summit.
Grass-roots members of the health profession organisations are totally fed up with executive leader self interest and conflict of interest.
It’s time to start talking and keep talking until it makes common sense!

Our lead article for this edition, in part, discusses the role of how a clinical pharmacist should evolve, with independent prescribing being a central activity for a clinical services pharmacist role.
While pharmacists strive to improve patient benefit by improving their scope of practice, the delivery of new patient clinical services have found their way into the market place with a glacially-slow momentum.
The reasons relate to the fact that the profession has not had the political will to change its culture and evolve a balanced “core” business.
Some stakeholders involved in ensuring a retail direction for pharmacy have proven financially and politically stronger participants, thus suppressing and unbalancing the profession as a whole.
Others see pharmacy adaptation as a “turf war” and act as disruptors.
The ageing of our population and its increase in chronic illness demands that pharmacy adjusts itself to service these emerging health issues.
And because the scale of these issues is so large, collaboration with other health providers will prove to be a necessity.
Read: Ageing Population Chronic Illness Requires Integrated Care – That Requires Pharmacist Independent Prescribers

Gerald Quigley is back and has a comment on pharmacist clinical hesitancy.
A lack of cultural change by pharmacy leaders has obstructed a number of clinical pharmacists from increasing their clinical decision-making for patient benefit.
This hesitancy needs to be individually overcome, particularly when a decision clearly falls within the scope of practice of a pharmacist.
A scenario built on the concept of patient biometrics is developed and illustrated.
Could this be your next forward step?
Read: Getting Involved!

Investigative journalist Jon Rappoport is back with an article regarding the serious death rate that results from medical practices, many involving the use of prescription drugs.
He illustrates how clever marketing practices have masked the import and enormity of the problem and how other stakeholders financially benefit by the same process.
Read: Why Medically Caused Deaths Continue to be Ignored

We often hear the expression “The science is settled,” however, science is a process.
The idea that “science” cannot consider new information contradicts the definition of science.

People who promote vaccination as an extreme medical ideology are involved in “scientism” – the manipulation of the science surrounding vaccines.
And it is certainly “unsettling” to hear the dishonest scientism claims that blare out in all forms of media.
“First do no harm” is the concept that underwrites all medical practice.
Australian vaccination policy is so poor and damaging, that it beggars belief that legislators can be so close to manufacturer sales objectives as to guarantee them a market through coercive legislation that involves simultaneous removal of patient choice.
The evidence supporting vaccine policy failure and its lack of safety is becoming so voluminous that it will eventually destroy the unnatural power alliance that desperately tries to hold it all together.
Read: The Safe Vaccine Debate – 1. Dr Judy Wileyman Report: Newsletter 209 Part Two The Suppression of Scientific Debate on Vaccines in Australia 2. Robert Kennedy’s World Mercury Project: Study Claims Tdap Vaccine in Pregnancy Doesn’t Cause Autism—Is That True Given The Facts? 3. VaccineDamageNews:  A groundbreaking study CONFIRMS that a common vaccine additive is linked to autism-like behavior

WHO has made a statement saying that cannabis should be decriminalised world-wide because existing laws cause health discrimination.You can also visit their website to know more about cannabis usage and its legality.
In Australia, patients are being actively discriminated against as police are instructed to enforce existing laws and close down “illegal” supplies, leaving critically ill people with no workable solutions for their health problems.
Flawed health policy generates bad laws and lowered community respect for policy and laws.
Yet again, Pharmacy is in a position to provide solutions very simply and simultaneously create opportunity for the profession to treat chronically ill patients efficiently and economically.
Pharmacy leaders need to be proactive in the regulatory area because other health professionals are actively competing to lock pharmacy out of any opportunity whatsoever.
Potential for pharmacists is found in the compounding of THC and CBD in specific ratios to match the best result for patients with chronic illness.
Further pharmacist potential also lies in using cannabinoids in harm minimisation programs involving opioid dependencies and as an adjunct for the management of pain.
Pharmacists also need to be active and have a voice in the regulation of these substances ensuring that maximum patient access can be obtained through the application of Schedule 3 of the Poison’s Act.

Read: Understanding Medical Cannabis – 1. United in Compassion (UIC): 2019 UIC Symposium 2. Hemp Gazette:  Australian Cannabis As Medicine Survey (CAMS-16) Results Released 3. The Guardian: Brain scans show how cannabis extract may help people with psychosis

Harvey Mackay is back with an article about fairness in workplace rules.
For a workplace to function efficiently it requires good leadership and a good set of rules coupled with a good leader.
The primary element to ensure rule application acceptance is the test of fairness.
Interestingly rules do not always have to be applied evenly to be fair.
Read: Work Requires Fair Play Too

Barry Urquhart is back with an article illustrating that online business has less of a customer loyalty attached to it than say a bricks and mortar business.
This because the human contact factor is more remote in a full online business.
It has always been known that a careful blend that integrates a bricks and mortar pharmacy with an informational online support provides the best presentation for a pharmacy.
Read: Marketing Focus Newsbrief – Be aware. The Migration to Online Business Transactions is Having Unintended Consequences

And we conclude this edition with a range of media releases from two pharmacy leadership organisations.

PSA – PSA Media Releases – 1. Australians endorse pharmacist vaccinations 2. PSA summit to unite pharmacists and doctors for patient safety 3. Pharmacists offered incentive to move to the NT  4. PSA supports potential Real Time Monitoring in NSW

NPS – NPS Media Releases – 1. Taking medicines for gastro-oesophageal reflux disease (GORD)?  2. With millions taking multiple medicines, Australians are reminded to Be MedicineWise 3. Side effects: a major concern for parents and carers giving medicine to children

We hope you enjoy our current content and invite you to join in on any debate by adding your comment in the panel provided at the foot of each article.

Neil Johnston
Editor, i2P E-Magazine
Monday 3 September 2018

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