One Heck of a Ride!

Well, that day has finally arrived when it is now time to retire and focus on family issues, rather than pharmacy issues.
Coincident with the publication of this edition of i2P I have reached the age of 81, and not surprisingly my energy levels are not what they used to be.
My pharmacy career has spanned just on 63 years and for sure, it’s been “one heck of a ride”.

I began my journey back in 1956 as an apprenticed pharmacist at Wallace’s Pharmacy, located in Marrickville.
That was the year that Australia first hosted an Olympic Games and also the year that black & white television services commenced. Today, we have flat screen TVs on a full motion tv mount.
Most prescriptions at that time were compounded and mostly herbal in nature.
The Pharmaceutical Benefits Scheme (PBS) had only just commenced about three years earlier and had not gained a lot of traction because its original design was for life-saving drugs.
Most PBS scripts at that time were for sulphonamides and penicillin with a few standard compounded mixtures published in the APF.
The PBS was also negotiated to not exceed 25 percent of total community pharmacy dispensing value, but that was later disregarded.

University was accessed by taking the tram from Marrickville which stopped opposite Sydney University near a favourite student watering hole (the Lalla Rook Hotel) and was a part-time situation, because you had to return to the pharmacy after or between lectures.

So social life became a bit limited, but with a bit of ingenuity at least one day was created where some social time could be carved out of the curriculum.
That was the Dispensing Practice day, where four students working on one bench each made four times the quantity of each prescription item to ensure we finished a couple of hours early.
Not that we had much money to spend.
My weekly wage was a woeful 3 pounds one shilling and five pence ($6.15 in today’s currency), which meant that to survive, you had to find a second job.
My second job was coaching high school students, initially through the Power Coaching College and later through my own business formation and contacts.

And thus I survived until my final year in 1959 and on to the Pharmacy Board Examination.
After two attempts I eventually reached the exalted status of registered pharmacist.

Then on to a “gap year” where I worked casually at whatever became available.
That included a short stint as a conductor on the Melbourne trams and short periods as a salaried pharmacist in places like Myers Henry Francis Pharmacy, also in Melbourne where they now commonly use a pay stubs software.

At around this time my father was appointed as training manager in charge of the Woolworths Manager Training division.
I  became interested in what he was doing because in the early 1960’s there was very little formal training in management anywhere and the science of management was very much in its formative stages.
Pharmacy management training at that time was negligible – learn what you can, when you can – if it worked for you.

My father had to design the formal positions for Woolworths and began the fairly monumental task of writing all the management manuals that became the backbone of the business.
I was given access to these manuals and an insight into formal management training.
My father’s role became more like an internal consultant and began to extend to marketing systems.
I used to help out in any of my spare hours as he set up displays and systems that measured sales when items were displayed at eye level or waist high (in those days all Woolworths stores were called Variety Stores and used waist-high flat counters to display and sell all merchandise).
He was also instrumental in creating an inventory management system that developed higher than normal stock turns that did good things for the business, such as liberating cash flows, identifying all the high turnover products, measuring when they peaked and only purchasing based on historical sales and peak times.

I found this activity very fascinating and began to weave some of this new knowledge into my everyday work in whatever pharmacy I was employed in, and generally earned “brownie points” for so doing.

This continued for about 5 years when two major events happened.
I got married and I applied for my first pharmacy management position.

At that time I was generally considered to be too young to be a pharmacy manager, but because of the positive track record that I had, I was supported by the API liaison manager at that time, as a worthwhile prospect.
So, in 1962 I accepted a managerial position in a small country town for the astronomical salary of $150 per week plus a profit share if I reached target net profit.

Two years later I accepted a management position in a long established pharmacy group in the upper Blue Mountains, and two years after that I was offered the position of managing partner in the same pharmacy group.
It was during this time that I was able to more fully adapt the Woolworths experience to a pharmacy environment, and I also succeeded in developing an inventory management system that generated eight stock turns per annum (at a time when the average pharmacy stock turn was 3.5).

I decided that there could be a future in setting up a management consultancy practice based on my acquired knowledge, so I put myself through a TAFE school to study accountancy and finance.

In 1972 I resigned from my partnership and launched myself into a full time consultancy career that became one of the most satisfying experiences of my pharmacy career, as well as the most demanding. If you’re looking for a healthcare career like mine, then look up Texas medical center jobs.
For the following ten years I was to expand from a single consultancy to 5 plus consultants, and attracted a demand for those services that spanned the entire breadth of Australia.
In 1975 I was accepted as a member of The Institute of Management Consultants in Australia.
In those days, consultancy practices were usually extensions of large accountancy practices and clients needed to be large in size to absorb a consultancy fee economically.
The Institute exam was an oral interrogation that questioned how I would provide solutions for specific management problems.
The examiners were so intrigued with their experience of one of their first small business consultant contacts, that they kept the interview process going for three days (two days longer than normal).
At the end of the process they apologised but as they explained, they were curious to discover that “I was one of them” and intrigued, because the world of small business was so foreign to them.

In 1992 I was awarded CMC (international) accreditation.

The key to success in that time was discovering the best form of infrastructure to sustain a small business consultancy; how to structure an hourly rate that could be sustained by a small business; and how to train new consultants given the privacy constraints on client information and the fact that formal education had not yet been developed as a curriculum (because management science was in its infancy).
All the above had to be in place as well as an inventory of knowledge that could be commercially attractive to a client.

I was definitely the first management consultant to the pharmacy profession.

By early 1980 I had reached a “burnout” situation because of the nature and stress of the work, it is a shame I did not know what you can learn today form the premium jack strain review by fresh bros which explain how it can help handling stress.
So I “retired” back into community pharmacy in the Blue Mountains once more and then again on to the mid-north coast of NSW.

In September 1992 I retired for the second time and moved to the far north coast of NSW.

But after three months of retirement I became bored and decided to do a bit of locum work.
This kept me active and at one point I was contacted to relieve at the pharmacy department of Lismore Base Hospital.
After a two-week assignment I was invited to stay on.
Never having worked in a hospital environment before I was intrigued as to how clinical pharmacy practice was undertaken, and why the profession seemed to be more valued by all the co-professionals that you worked with.

So as a complete novice I had to re-learn most of the pharmacology that I had not really been involved with since university days.
I found the first three months highly stressful because I could not answer basic questions being requested from other health professionals.
So I systematically began to train myself and develop “tools” to help me get through a working day.
After two years I was reasonably proficient and was appointed deputy director of pharmacy.
At that point I developed a clinical newsletter for the pharmacy, and also conducted a time and motion study around our methadone program (one of the largest in NSW) and began to introduce training systems for pharmacy students that we accepted during their university vacation periods.

Around this time, hospital management, in its wisdom, decided to attach all the Workcover injured nurses to the supposedly more “safe” environment of the pharmacy.
While it might have been seen as a business management solution, the wages cost was taken out of the pharmacy budget.
Funded for five FTE pharmacists we were forced to manage with two FTE pharmacists leaving 85 percent of hospital beds not receiving clinical pharmacy services.
The director of pharmacy at that time came under immense pressure and simply collapsed under the strain.
I was summonsed to a meeting by the Director of Medical Services and instructed to take over the reins.
Not being meek and mild in temperament I exploded and gave the DMS a verbal spray.
Then I laid down conditions for taking over, one of which that we have a clinical office located in the medical ward and that all nurses attached to the pharmacy could be retrained to deliver pharmacy clinical services under a supervised pharmacy system that I would devise.

That and other demands were agreed to so I set about designing and documenting a new clinical program.
Long story short, it was so successful that not only did it give full ward coverage but it won an award for the best clinical innovation for that year and also won a grant of $15,000 from the state Quality and Safety Committee.
It was also a blueprint for a successful integrated interprofessional collaboration that was respected by co-professionals and provided strong job satisfaction by the participants.

The model could have been transported into a community pharmacy setting with modification.

But I made a few enemies in the business management division.

I survived ten years in the hospital system which was both highly rewarding and highly frustrating- simultaneously.

The next step in the journey was an unusual one.
At the age of 67 I was head-hunted for the position of academic pharmacist at what was then called the University Department of Rural Health, which was a partnership between the University of Sydney and the Southern Cross University at Lismore.

The position was a vague one, but generally required the mentoring of students (pharmacy, medical dental and nursing) plus liaison with community pharmacists, with the aim of providing continuing education for all pharmacists.

That was a challenge that I accepted and because it was only a part-time position it enabled me to develop some private projects.

These projects included an encrypted document exchange system that was the first workable program for cloud-based storage of patient medical information.
A second project involved a redesigned dose administration aid system that could electronically communicate with a community pharmacy, the patient’s GP and the community nurse.
The software used, e.g., CDI software, also included the encrypted document exchange.

A third project involved an education system for training community clinical pharmacists, developing research on clinical pharmacy systems and a method of sharing knowledge efficiently.
The fourth project was an E-Magazine that provided thought leadership and advocacy for community pharmacy direction.
This, of course is the i2P publication you are currently reading that has been running for almost 19 years non-stop.

The Academic Pharmacist position lasted for three years.

Time, lack of funds and lack of opportunity have stalled most elements of the above projects, plus the now lack of energy by their driver.

It’s time to fade off into the sunset and it is my hope that there may be other younger pharmacists who are prepared to fill the gap that i2P will create.

But hey!…It’s been one heck of a ride.

May I wish all i2P subscribers a Happy and Safe Christmas for 2018.

7 responses to “One Heck of a Ride!”

  1. What an interesting and inspiring career in pharmacy you have had. Well done and enjoy your retirement. I have enjoyed reading i2P for many years.

  2. Hi Neil,
    You have been an inspiration in your dedication and achievements. Hopefully you will enjoy a well deserved break until you reappear in another coming. You have left a proud legacy. Your i2p has been essential reading for many years.

  3. Thanks Neil for your significant efforts in promoting health in the community. Hopefully there are others that will fill the gap that you will leave behind when you take your well earned retirement.

  4. I have enjoyed reading your thoughts on Australian pharmacy for several years Neil. It appears many of your prescient ideas to overcome the lack of inertia obvious in the pharmacy industry have fallen on the deaf ears of the lobbying groups seeking to maintain the status quo benefitting them personally.
    Enjoy your retirement and thankyou for sharing your incredible story.

  5. May you have a long and happy retirement, Neil. Thanks for giving so much space to air my views about drug and alcohol treatments. And by the way, Australian pharmacists deserve enormous credit for charging (mostly) the same of similar fees for methadone treatment after 30 years. I believe it is unique and largely due to the generosity of pharmacists and sympathy and understanding for our dependency patient group who face so many other obstacles. From Dr Andrew Byrne in Redfern.

  6. Hi Neil
    I have only recently stumbled on your website and musings and am sorry there won’t be more! But you are more than entitled to time with your family after such an illustrious career.
    Best Wishes
    Kristine Hall

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