EDITORIAL for Monday 7 August 2017

Welcome to the current edition of i2P (Information to Pharmacists) E-Magazine, dated Monday 7 August 2017.
I recently came across the following “one-liner” – a little philosophical “pearl” that tends to crystallise your thinking when you are looking for perspective on a current problem or issue.
It was:
“Accountability is hard. Blame is easy. One builds trust, the other destroys it”.
In reflecting on how the profession of pharmacy stood up against that “pearl” I have to say that pharmacists do very well in their accountability, as well as in their transparency.
Internally, anything that is not deemed professional or ethical seems to be “weeded-out” by pharmacists themselves.
Certainly we criticise one another, while our detractors, such as the Skeptic groups (you know who you are) try to apportion “blame” labels, that are inflated by an orchestrated “echo-chamber effect” through certain corrupted mainstream media publications.
They are deliberate attacks to create a diminishing level of trust in pharmacists by consumers.

These people will not win out, but pharmacists need to be aware of what is happening and improve their defence preparedness by exposing these attempts publicly.
That is, if you can find a mainstream media format that is ethically interested in publishing stories with “balance”.
On that note is it time for pharmacy to publish its own newspaper to carry its own message accurately?

Twenty years ago, I attended a sponsored drug company evening that involved promotion of an anti-psychotic drug.
It was unusually, a mixed attendance of health professionals that included pharmacists, doctors and nurses.
A professor of psychiatry (a paid drug company speaker) delivered his address, and possibly because of the mix of people present, he was peppered with some hard questions.
At the end of the session I was somewhat stunned when this speaker admitted that the drug under discussion did have some “problems” and that TLC (Tender Loving Care) provided a far better response rate than any drug on the market.
Fast-forward to 2017, the year that the Alzheimer’s Association International Conference was held and many of the medical experts on hand were more focused on non-medical therapies.
While that was something that the drug companies played down, it became apparent through participant comment that medications simply are not doing anything to help this problem, and in many cases, they are actually making it worse.

At the conference, the first Lancet Commission on Dementia Prevention and Care was presented, bringing together dozens of international experts to discuss this growing problem. They shared some interesting discoveries that could make a huge dent in the number of future dementia patients, and their findings were also published in The Lancet.

The commission reached the conclusion that non-pharmacologic interventions play a vital role in dementia treatment, especially when it comes to issues such as agitation and aggression. For example, it was said that the antipsychotic drugs typically given to help with these problems are very concerning because of the heightened risk of death, cardiovascular problems and excessive sedation.

One study published in the Journal of Alzheimer’s Disease found that patients who took antipsychotic drugs had a 60 percent higher chance of early death than those who did not take such drugs.

According to the panel’s evidence, social, environmental and psychological interventions like social activities and social contact were far better approaches than antipsychotic medications.
They also touted the benefits of group cognitive stimulation therapy and physical activity.

A recent study carried out by sports physicians and gerontologists discovered that physical activity has a direct impact on the brain’s metabolism by keeping cerebral choline concentrations stable.
Study participants who did not exercise noted higher levels of choline, which is linked to the type of nerve cell loss seen in Alzheimer’s patients.

So it has taken just on 20 years for a message delivered in the Northern Rivers of NSW to be broadcasted to the world that TLC is better than drugs.
The “placebo effect” I hear some (Skeptics in the background saying), rushing to the defence of drugs?

Placebo has come to be a derogatory term generally applied to the supposed evidence that pharmacists use to sell alternate and complementary medicines, also nutritional supplements.
It has also become a launch pad for any new drug that performs marginally above the level of placebo.
Selective application by opportunists.
But there’s more!

An international symposium is to take place at the University of Sydney on November 17, 2017.
We are even giving it a plug.

But it does seem strange that a mechanism used to deride a whole range of treatments and modalities (including that of homeopathy) is now being upgraded and fully absorbed into the medical repertoire of “evidence-based” and delivered by a cast of five international speakers (having their first name as “professor”) plus four local speakers (also having their fist name as “professor”), plus another four speakers that have their first name as “doctor”.
Is this an acknowledgement that the natural therapists may have gotten it right all along, because they call it “care” – definitely not “placebo”.
And it gets results!
The support information for the symposium (taken from the website) is as follows:

“Placebo effects are a component of each and every health care interaction (even without administration of a placebo). The outcome of any given treatment is the effects from the index treatment itself and the psychosocial (therapeutic) context in which it is given (placebo mechanisms). Equally importantly, negative elements on the therapeutic context have the ability to turn on discrete “nocebo” mechanisms which worsen outcomes. Understanding the mechanisms of these effects and the ability to harness and modulate them in both clinical trials and clinical practice may lead to improved clinical outcomes and quality use of current and future medicines. 

Clinical implications are wide-reaching – particularly understanding how to make our current therapies more effective by enhancing the context and manner in which we give them. Understanding the ‘negative’ or nocebo component of treatments (that is, even very good treatments delivered in a suboptimal manner) will only better help us enhance our treatment outcomes. Taken together, this is an important way of better understanding the quality use of medicine, surgery and other health care interventions.”

Note the use of the word “nocebo” defined as “good treatments delivered in a suboptimal manner”.
Is this to be the defence for the continuing use of anti-psychotic drugs (and others) that don’t work?

Or is this a takeover of the evidence-base rationale (care component) of natural therapies being absorbed into the “scientism” of medical evidence so that it cannot be seen to be deficient, given that the Australian population (nearly 70 percent) have opted for natural therapies including natural self-care.

i2P has always respected other health modalities, and pharmacy has always existed with a duality in its culture by managing “illness” and promoting strategies for “wellness” and doing both simultaneously.
We still believe pharmacy’s future lies with an integrated mix, beast described as “Functional Medicine”.
We just need to keep upgrading accountability and transparency and shrug off Skeptic blame tactics, an advocacy supporting scientism and definitely following no evidence-based rationale.

Our lead article for this edition concerns why the medical profession is displaying a distinct lack of capability within its own ranks as the future shapes up in a very uncertain manner.
This pressure seems to have caused some very erratic leadership behaviours.
The leadership end of the medical profession has also recently stepped up its anti-pharmacy campaign, describing it as a “turf war” initiated by pharmacy.
That pharmacy has been very transparent in illustrating that it is expanding its “core business” well within its scope of competency is simply castigated and rudely commented on by the AMA and the RACGP.
In these days of inadequate patient care, high medical costs and future “disruptors” that will decimate professional jobs in all modalities, collaboration has been seen as a potential solution.
But how do you collaborate with rude and unprofessional leaders?
Read: Medical Culture (and others) in Decline – the real reason for attacks on pharmacy and other health modalities.

Mark Coleman has written a reference article for community pharmacists in the wake of the Interim Report of the King Review.
The Review is definitely not about a positive future for Australia’s independent pharmacies and more about a globalist agenda which is the exact opposite culture of Australian pharmacy and health generally.
It would literally take Australia’s health system ranking from close to the top (#2) all the way down to the bottom keeping company with the US health system.
The King Interim Report is a recipe for the complete destruction of contemporary Australian pharmacy culture and all pharmacists need to be prepared to wage war on all fronts if there is to be a survival that transports pharmacists to a place of their vision rather than to the vision of a global cartel.
It is also interesting that all other industry stakeholders have come out in support of pharmacy.

Having created value, they do not want to see pharmacy disappear from their future ambitions.
Read: A Glimpse of the Future – The King Review Interim Report Nightmare

Gerald Quigley is back with a pungent message.
Some supposedly intelligent members of the medical profession appear to act as though they are the one true leader of a medical dictatorship.
Using “Scientism” as their credo (instead of evidence-based medicine) ,what planet have these aliens come from?

Read: Hysteria personified – the perceived “anti-statin” cult!

In his current article Harvey Mackay talks about the skill of networking and how successful people integrate this skill into their personal and business life.
It is a major factor in the success of any activity -knowing that you can tap into a resource without having to research from scratch.
Business management and marketing as well as professional service delivery rely heavily on being able to network within a skilled community.
Read: Take a few minutes to learn the two-minute drill

Barry Urquhart is back with his Marketing Focus collection of contemporary issues concerning management and marketing in the broader business community.
His essays provide real insights into current management and marketing culture.
Pharmacists can readily adapt this material for incorporation into their own policies and forward planning exercises.
Read: Marketing Focus – Essays on Management & Marketing

WHO has made a statement saying that cannabis should be decriminalised world-wide because existing laws cause health discrimination.
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. The Pharmaceutical Journal -MS Chaity Recommends Cannabis be legal 2. Sydney Criminal Lawyers – Opposes Victorian Blanket Legislation 3. Australian Company to Provide Cannabis for Australian Prescription Market

There is something wrong with Australia’s public health policy, in particular the policies pertaining to vaccines.
Daily, these policies are exposed as being biased and unsafe.
Yet our politicians and medical health leaders pretend to remain blind to unsafe practices.
“First do no harm” as the foundation of all medical practice now has a hollow ring to it with the medical profession exhibiting cartel behaviour and public confidence is further eroded as the public find they have little choice in being able refuse a vaccine they have inadequate knowledge about.
Any queries on vaccine safety are aggressively disposed of and the complainant labelled “anti Vaxer”- no voice at all for “safe vax”.
The safe vaccination debate is continued here, despite the fact that it is not recognised by the extreme pro and anti-vax participants.
The pro-vax proponents sustain their immoral position with dishonest tactics and communications.
The anti-vax proponents also hold extremist views because vaccination principles are generally sound.
It is the manufacturers supported by a medical cartel, that are the real villains in this drama because they continue to make and promote unsafe vaccines and develop new vaccines without any formal evidence.
It is also obvious that vaccination does not equate to immunisation!
Read: Safe Vaccine Debate – 1. World Mercury Project – HPV Vaccination 2. Dr Judy Wilyman Report – Newsletters #166 & #167 3.EU Court Ruling May Hold Vaccine Manufacturers Accountable

And we conclude our offering for this edition with media releases from two of pharmacy’s leadership organisations.

PSA – http://i2p.com.au/psa-media-releases-nine-current-news-releases/

NPS – http://i2p.com.au/nps-media-australian-prescriber-volume-40-issue-4-august-2017/

We hope you enjoy our content for this edition.
Please comment in the panel at the foot of the article page and if you are researching any topic, look through our archive links – there is a wealth of material available.

Neil Johnston,
Editor, i2P E-Magazine
Monday 7 August 2017

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