EDITORIAL for Monday 8 August 2016

Welcome to the current edition of i2P (Information to Pharmacists) E-Magazine dated Monday, 8 August 2016.
Since our last edition the Olympic Games have burst across our television screens transmitting a very colourful opening ceremony and a wave of optimism – so different to the tone of pessimistic global news up to that point.
Australia seems set to be successful and you cannot help but experience pride for the calibre of some of our very articulate athletes representing Australia.

The Pharmacy Review, chaired by economist Stephen King, has released a range of questions for pharmacists to respond to and it is assumed that all interested parties will be documenting their responses for lodgement right now.
Given that the review is focusing on some very controversial topics one wonders how someone outside the culture of community pharmacy will make sense of our divided profession.
However, it will embrace a range of opinions and conversations that need to be addressed but it is hard to see at this stage that appropriate recommendations can be confidently put forward as a base for government policy.
But I guess the real discussions will begin with pharmacy leaders after the Review is completed.

The biggest problem in the pharmacy profession today is the lack of unity between leadership bodies and the lack of commitment to drive clinical services from the “bottom up”.
While PSA has made some moves in that direction with its Health Destination Project, PGA is reluctant to move because it sees that it may initially dilute its power and simultaneously divert some income to a new and independent clinical format of pharmacy practice.

The reality is that pharmacy proprietors can no longer rely on an income from a PBS product that has reached the end of its life-cycle, nor can they generate the unstructured time needed to create and deliver clinical services.
A sensible outcome would be to negotiate a shared income agreement with a clinical service practice company, and then design a community pharmacy infrastructure that can host as many new clinical specialties that can be represented under one community pharmacy roof.

Stubbornness to the point of stupidity through not adjusting pharmacy culture and redesigning a shared community pharmacy infrastructure, is the total reason for all the issues that have piled up behind the blockage.
If Stephen King can actually recognise this cultural constipation he may just be able to prescribe an appropriate laxative.
Until that point the PGA will continue to follow a flawed moral compass and remain forever compromised.
PGA membership activity is the only method left for creating a cultural movement, but that is a soft option because they claim they are all “too busy” enjoying their “profitless prosperity”.

The solution is simple but the unravelling of the blockage will be complex.
If pharmacy leaders are not seen to be moving in the right direction, government will simply step in and impose their own solution.
And that will not be a pretty sight.

And for the record, i2P believes location rules should remain because they are working and that the pharmacy network can be utilised in reducing costs in the public health arena through a range of public/private partnerships.
It is in the area of ownership rules that an adjustment is required.
Not to let in non-pharmacists, but to adjust ownership to allow progressive ownership by new pharmacists.
Or even a part enhancement by creating advisory boards that new pharmacists and senior pharmacists can participate in a non-executive capacity.

If pharmacy culture changes to embrace clinical pharmacist’s practices, they will need to be structured so as to avoid having a pecuniary interest in a community pharmacy.
This leaves a pathway for a range of skilled clinical pharmacists to be approved to prescribe because the lack of conflict of interest would allow that to happen.
And they could take up responsibilities for other clinical activities that would not fit a community pharmacy owner.
This type of practice would be of interest to new pharmacists and senior pharmacists seeking a method of succession and retirement.

The opportunities to advance the profession of pharmacy are able to be dramatically advanced under a new and sensible culture with new pharmacists having a choice of going down two major channels of activity – but it must be one choice at a time to avoid conflict of interest.

You can read more on this topic under the lead article for this edition.
Read: Good Pharmacy Practice – It solves the Problems of Moving Forward

Mouhamad Zoghbi is back and he also recognises that community pharmacies are running out of time to make survival and new directions decisions. He puts forward his arguments.
Read: It’s time for a new prescription

Gerald Quigley is also a contributor for this edition and he points out some of the gaps in pharmacist education relating to Integrative Medicine.
Lobbyists attack the pharmacy profession for being involved in this valid medical science.
But it can work to reduce the need for some mainstream medicines or reducing their dose requirements – supporting the need for de-prescribing and assisting the wellness of pharmacy patients.
These lobbyists are simply representing the interests of global drug companies, so they can simply be shrugged off, and pharmacists should ignore their spurious arguments.
Read: Education – Bring it on!

Barry Urquhart is back with his Marketing Focus column and it is full of management and marketing issues that have a direct application to pharmacy practice.
Read: Marketing Focus – Essays on Management and Marketing Issues

Where is all the pharmacy leadership interest in the medical marijuana market.
This industry segment is set to become a $multi-billion market and it is a market that is one that is a great pharmacy fit.
First, in regulation, the bulk of the CBD market should be regulated as a food and CBD concentrates should be designate Schedule 3.
Of course it will not work out that way – but why not?
Low THC products should also be Schedule 3, leaving only the high concentrates on a doctor’s prescription.
Medical marijuana will impact our PBS positively, reducing pain relief prescriptions considerably.
Clinical pharmacist specialties can be built around its use for many conditions.
It will be a major segment of primary health care.
All the natural forms delivered as Cannabis Oil will prove to be the cheapest forms and provide compounding opportunities in dispensing admixtures of THC/CBD in specific concentrations to suit particular medical conditions.
So why aren’t pharmacists front and centre in this market?
I2P staff have put together a composite report on its history and development
Read: Accessing Medical Marijuana

It’s been a long-running battle, but Judy Wilyman is finally peeling back the activities of pharma lobbyists who have been trying to discredit the science behind her thesis and even the quality and rigour of the academic process of awarding PhD status from the University of Wollongong.
At issue is the validity of the Australian government vaccination policies that have been put together to benefit drug companies rather than to assist Australian citizens.
The academics that have also joined the pharma-bandwaggon in some very disgraceful behaviour – well we can only guess at their motivation, but it probably tracks back to pharma-payments of some sort.
Read: The University stands by Anti-Vaccination PhD Thesis

Have you ever noticed that whistle-blowers are prominent in leaking information about government agencies and some of the controversial industries damaging the environment, but never do we hear of the whistle being blown by “insiders” from within the medical profession.
Medicos deliver swift retribution to their perceived traitors leading many observers to reflect on the efficiency of the “medical cartel”.
Jon Rappoport, a US based investigative journalist has some comment on that subject.
Read: Why are there no Medical Whistleblowers?

And we finish up our offering for this edition in the form of pharmacy leadership organisation media releases.

PSA – PSA Media Releases – 1. Pharmacy Review 2. Dorothy Lucardie OAM

NPS – NPS Media Releases 1. Australian Prescriber First Digital Edition 2. Venturewise Division

Enjoy the content contained in this edition and don’t hesitate to make a comment in the panel at the foot of each article.

Neil Johnston
Editor, i2P E-Magazine,
Monday 8 August, 2016

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