Pharmacy Care- a Search for Competition?

It’s some time since I caught up with Seth Godin (the international marketing guru with a seemingly inexhaustible supply of words of wisdom and inspiration).
One of his recent quotes caught my eye:
In search of competition-

The busiest Indian restaurants in New York City are all within a block or two of each other.

Books sell best in bookstores, surrounded by other books, their ostensible competitors.

And it’s far easier to sell a technology solution if you’re not the only one pioneering the category.

Competition is a signal. It means that you’re offering something that’s not crazy.
Competition gives people reassurance.
Competition makes it easier to get your point across.
Competition helps us understand that people like us do things like this.
If you have no competition, time to find some.”

In line with these self-evident thoughts it follows that health care sells best in its own independent environment.
The model of community pharmacy is a strong example of this concept in action – except for the fact that the market niche it embraced (Pharmaceutical Care) had become blurred with “fuzzy” boundaries and no clarity for future directions.

This problem had its origins in poor and divided leadership that resulted in a lack of cultural evolution.

A culture is strong when people work with each other, for each other.
A culture is weak when people work against each other, for themselves.”

Because pharmacy leadership was weakened through selfishness and conflict of interest issues, the “followers” only recourse was to emulate perceived competitors.
Often, the competitor was identified as a major supermarket because of that business model’s ability to retail products held in common, at a lower selling price.
And in that perception, a large segment of community pharmacists began to deviate from their “core” business, becoming retailers rather than providers of Pharmaceutical Care.

One other major factor that contributed to a community pharmacy imbalance was the fact that the Pharmaceutical Benefits Scheme (PBS) consumed a large component of community pharmacist time to the extent that PBS equated to the only offering of Pharmaceutical Care.
As the PBS product lifecycle came to an end, so did profitability and incentive, leaving only a commoditised system in need of revitalisation.
Uninspired leadership was directly to blame for the demise of Pharmaceutical Care, with the resultant business model unstable and deficient in cultural growth, and that prevented creativity and innovation from flourishing.

However, a handful of thought leaders kept Pharmaceutical Care alive by suggesting that core business should be re-balanced through the development of professional services – in particular, value-added services for dispensing activities and totally new clinical services that could inspire and refresh Pharmaceutical Care offerings.

Before we can build the world we want to live in, we have to imagine it.
Greatness starts with a clear vision of the future.”

It has taken a long time for this vision to become implanted within leadership ranks, but recent material posted in the Pharmacy Guild publication, Forefront, indicates that a process is under way that will utilise and develop new clinical skills and services to be delivered from a community pharmacy platform:

The Guild has commenced conversations with Minister Hunt about how community pharmacies can make a real difference in helping deliver on his third wave of health reforms and our willingness to consider funding models that reward community pharmacies for delivering health outcomes that keep patients out of hospital.
The Minister is genuinely interested in the role that pharmacies can play.”

While there are a lot of dots yet to be joined, basic decisions on funding and incentivising outcomes have been taken, and at least a framework has been established that will stimulate innovation and promote cultural change.

The hardest part is starting.
Once we get that out of the way, we’ll find the rest of the journey much easier.”

Another item from Forefront indicates that the two major leadership bodies, PSA and PGA are finally sorting out their roles and working collaboratively with each other as well as communicating with other pharmacy organisations such as franchised market groups:

In the middle of last week, the National Presidents of the Guild, George Tambassis, and the Pharmaceutical Society of Australia, Shane Jackson, met to discuss a number of issues of common interest, including codeine, where the Guild and PSA are working in tandem.  
There is a good rapport between the two Presidents along with a recognition by both that our two organisations are stronger and more likely to succeed by working together.”

These are the words that the entire profession of pharmacy has been waiting to hear.
Collaborative leadership extending that collaboration to other pharmacy groups and organisations has long been the missing link that was thwarting pharmacy ambitions and destroying motivation for all.
The journey suddenly does become much easier, and with a process of trust building, many of the past roadblocks will simply disappear.

“Great leaders give everyone something to believe in, not something to do.”

Creativity is a two-way process and true leadership gives direction through drawing innovation in from the “bottom up”.
A “top down” culture stifles imagination and slows cultural change through rigidity of process.
This will possibly be the change process hardest to adopt by the pharmacy leadership organisations, but unless genuine change occurs here, outcomes will be measurably minimal.
Learning to share openly with membership and others will require a thorough overhaul of existing communications systems and a revision of policies describing how information is to be shared.

“The passion to change the world for the better is a more powerful force than defence to keep it the same.”

Changing the pharmacy world for the better does not mean just changing everything.
For example, Location Rules do have justification when dealing with government, because there is a system in place for the even deployment of public/private partnership services.
However there does need to be a better investment system for the creation of community pharmacies such that new pharmacists can be phased into ownership structures, with less stress.
There is a need to develop larger-sized community pharmacy environments that can accommodate an expanded clinical service “core” rather than multiples of smaller pharmacies.
Larger environments will better accommodate the aspirations of a Pharmacy Care system while simultaneously developing jobs with a higher level of satisfaction.

“Work is expending effort on things we don’t want to do.
Passion is expending energy on things we love to do.
The goal is to do no work.”

Pharmacy Care business models will explode and compete with each other given an appropriate framework and trusted leadership.
And, as Seth Godin’s comments stated at the beginning of this article:

Competition is a signal.
It means that you’re offering something that’s not crazy.
Competition gives people reassurance.
Competition makes it easier to get your point across.
Competition helps us understand that people like us do things like this.
If you have no competition, time to find some.”


Leave a Reply

Your email address will not be published. Required fields are marked *