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From the desk of the editor - Introducing current ideas, perspectives and issues, to the profession of pharmacy
Issue 82: May 2009
Welcome to the May edition of i2P (Information to Pharmacists).
This month some of our writers are reflecting on some of the confusing events that have developed during the credit crisis and the lack of momentum and frustration on the professional front.
Could I suggest that you start with Barry Urquhart’s article “The Pain Threshold is Coming” where a number of financial and marketing strategies are discussed.
Painful, but necessary reading as we switch up into survival mode over the next three or more months.
Read this in conjunction with the article by Harvey Mackay “Morale Busters vs Morale Boosters” for some good insights.
On the professional front we have an article “The Lessons from History” where it is postulated that pharmacy was very much a primary care force in at least two major pandemics of the past and wonders why there is such a nonsense about the debate as to whether pharmacy justifies being in primary care at all in the current pandemic activity.
Peter Waterman - The Latest from the Pharmaceutical Society of Australia
PSA News - the latest from the Pharmaceutical Society of Australia. Keep in touch with activities of the Pharmaceutical Society of Australia and their professional support for Australian pharmacists.
* PSA WELCOMES ELECTRONIC HEALTH RECORD RECOMMENDATIONS
* NDPSC CODEINE PROPOSALS PREMATURE
* PHARMACY SELF CARE TACKLES ARTHRITIS
* PSA-NAPSA SIGN MEMORANDUM OF UNDERSTANDING
* EXTRA HOSPITAL PHARMACISTS WELCOMED
Katie Butt - From a Good Prescribing Perspective
The National Prescribing Service (NPS)is a valued independent resource for good and unbiased prescribing information and education.
Given the marketing pressures applied by global drug companies, Australia is blessed to have such a resource.
Pharmacists are moving closer to a prescribing role within the health system and it is appropriate that i2P promote the message of the NPS.
* Prescribers urged to use accurate, independent information sources
* NPS urges judicious use of Proton Pump Inhibitors
* Discuss pramipexole for restless leg syndrome with patients
* Feedback sought on medicines issues in palliative care paper
Bob Bowden - Media Contact for the Australian Self Medication Industry
For over 30 years, the Australian Self-Medication Industry has represented companies involved in the manufacture and distribution of non-prescription consumer healthcare products and related firms.
ASMI is the peak industry body for the Australian self-care industry including consumer healthcare products ranging from over-the-counter medicines (OTC) to complementary medicines.
Also represented by ASMI are companies providing manufacturers with services, such as advertising, public relations, regulatory consultancy, legal advice and industry statistics.
Topics for this month:
* ASMI welcomes Pfizer Australia as new member
Caution urged over restrictions on medicines containing codeine
Global Health News from the Internet - Pharmacy Related Links
This section of i2P aims to keep readers informed of global news that may affect pharmacy.
Readers are encouraged to comment on any news item by contacting the editor through the "Contact Us" panel located on the home page.
News items and topics displayed range from drug-related news, Information Technology, medical communications, medical research breakthroughs, management and marketing issues.
Because this news area is dynamic and changes daily, readers should immediately bookmark any links that they find interesting.
Response to any item will be published through the "Letters (Your Say) " column.
By a Staff Writer - News Items, Background Information and Items of Interest
Organisations with pharmacy connections are invited to share their news, product releases or opinions in this column.
* HIP Newsletter
* A new medication management aid for the visually impaired now available
* GSK and Pfizer Form new Specialist HIV Company
By a Staff Writer - Publications to Note
This section of i2P is designed to be an experimental section to introduce other publications that have similarities to i2P, but are based in other countries.
The globalisation of Australian pharmacy started around the year 2000.
It has had minimal impact up to 2004, but that is now changing and i2P must reflect that change.
There are many aspects of globalisation not yet fully understood, but I think that to most of us, globalisation means that we must be quicker on our feet and have pharmacy practices with sufficient critical mass to withstand global pressures.
Depending on the model of pharmacy chosen, and its location, global pressures will vary.
As pharmacists we must begin to open up our minds to new ideas and innovative ways of delivering pharmacy practice.
By a Staff Writer - Conferences and Events
As part of our information service, i2P informs on Conferences, Workshops and Seminars or press releases that may be of interest to pharmacists. PSA event information will be found here, but PSA news will continue to be published separately in the section reserved for PSA press releases.
Pharmacy organisations may submit material for publication, preferably in digital format (Word document).
* Pharmacy Expo - The Premier Pharmacy Practice Event
* Pharmacy Management Conference 2009
* Second Annual HITH Society Conference
* NSW Rural Allied Health Conference 2009 - Beyond the Rhbetoric
Rollo Manning - A Regular Column Reporting the News Behind the News
Editor's Note: This month Rollo Manning is presenting at a conference titled "The 6th Annual Future of the Pharmaceutical Benefits Scheme". It took place on
Friday 1st May 2009.
Rollo's presentation notes follow, substituting for his normal Pharma-Goss column.
Neil Johnston - Management Consultant Perspective
It has always been said that there are “lessons to be learnt from history” or that “history repeats itself”.
The recent influenza potential pandemic has highlighted an anomaly.
After other health professionals had been detailed on the Mexican “Swine” Influenza pandemic and supplied with patient information, masks etc, it was found that the process deliberately excluded pharmacists.
This triggered a damning pharmacy bulletin board response by pharmacist Peter Crothers, who said in an open letter to the Minister for Health and Ageing (Nicola Roxon):
”It would have been useful therefore to include pharmacists in the recent emergency 'swine flu' communications to GPs and other 'front-line' health workers
Perhaps all those epidemiologists who have never been into a pharmacy might disagree, but I reckon that it is obvious that pharmacists' role in a pandemic won't just be in dispensing; educating the public about infection risks and control ; advising on products; redirecting people from our doors to other care without trying to assess them (how do we, by the way, simultaneously 'advise' and 'educate' people while not allowing them through the door?) and the other no doubt important but basically 'second line' and/or 'after the event' roles mentioned on the Australian Government pandemic website for pharmacies.” 1
Have we already forgotten that modern pharmacy was borne in the pandemic of 1665 during the black plague?
That’s the one where the physicians of London left town with their wealthy patients while the apothecaries remained to care for the sick and the poor who were unable to escape.
John Dunlop - From a New Zealand Clinical Pharmacy Perspective
Pharmacy is probably the only health profession to move into the third millennium that has not developed a clearly defined role to clarify to funders, the public and the profession where it fits within the health care environment.
This is beginning to cause many problems for pharmacy.
Community pharmacy was once the repository of a unique skill set upon which the public depended in order to receive the extemporaneous preparations that the doctor prescribed.
These days there is very little prescribed by way of extemporaneous product and this has left a big gap in the minds of the public as to what it is that pharmacists actually do.
Pharmedia News Reports - Commentary on Media Reports Worldwide that Affect Pharmacy
Ken Stafford - A Consultant Pharmacist Perspective
There has been much weeping, wailing and gnashing of teeth in the pharmacy press over the past few weeks about ‘Pharmacy missed in health report” as the AJP headline eloquently ran. In the article it was reported that “Community pharmacy has been sidelined in the National Health and Hospitals Reform Commission’s interim report – A Healthier Future for All Australians”.
Picture me as not being particularly surprised as I have, on a number of occasions, written about pharmacy’s almost invisibility where bodies making health decisions for government are concerned. It is difficult to grasp that a group of health care providers having potentially the greatest impact on the health of Australians seems to be continually ignored by government health agencies. “Why”, as Professor Julius Sumner Miller was wont to ask, “is this so”?
Loretta Marron BSc - From a Skeptics Perspective
The Australian Skeptics recently circulated an open letter to the ‘The Pharmacists of Australia’ imploring them to stop actively promoting and selling unproven, sometimes dangerous, quack products (1). Asking the question “when we ask our Pharmacist, what kind of answers do we want?” and challenging the standards they set for themselves and for their staff.
This month I’ll talk about it and why I believe that pharmacy owners are putting profit over patients.
Neil Retallick - A Friendly Society Perspective
Where I work we’re doing what a lot of other people are doing at this time of year.
We’re trying to forecast the future and commit to budgets for the next fiscal year.
As it turns out, this year the future for community pharmacy seems to be less predictable than it ever has been.
The fog is swirling in our crystal ball.
Nothing is clear.
Garry Boyd - From an Intellectual Capital Perspective
It is quite understandable that the Americans have embraced automated solutions with more relish than us.
After all, we dispense in manufacturers packs…….they don’t.
It is probably easier for a pharmacist to justify the employment of an automated solution for loose medicines rather than packaged medicines.
Mark Neuenschwander, who makes the occasional cameo in i2P has made a fine business out of advising the US industry how best to select and utilize automated solutions specific to individual environments.
We will no doubt catch up.
Pat Gallagher - An IT Consultant Perspective
I can understand that some of us will see the recent "back-of-an-envelope", announcement for a NBN as exciting.
I see it ending badly unless someone does a whole lot more homework on the numbers.
Reference is frequently made to this plot being “bigger than the Snowy Scheme”.
Maybe so - however a large Snowy Mountains committee spent two years doing the sums before that go-ahead was made.
Here we had a few politicians and some "Yes Ministers" do the deed apparently, over a few days, during a couple of aircraft flights!
The next thing we could hear is that Mr. Kehmlani is on his way back to fix up the funding!
Well certainly there is an ‘f’ and an ‘up’ lurking in there somewhere.
Red faces all round is the likely mid-term outcome.
Dr David More - From a Medical IT Perspective
Editor's Note: Dr David More is recognised as one of the health informatics industry experts and we are pleased to carry his column in i2P.
For this month we have selected his comments in regard to a report prepared after the National Health and Hospitals Reform Commission (NHHRC) released a supplementary paper to its Interim Report, which outlines the Commission’s support for person-controlled electronic health records for every Australian.
As he says, " I am vitally interested in making a difference to the quality and safety of Health Care in Australia through the use of information technology.
There is no choice.. it has to be made to work!
Mark Neuenschwander - From a Point-of-Care Perspective
None of us likes waiting.
Well, I guess that depends on who’s waiting for whom.
Someone observed that there are two kinds of people in our lives—people we keep waiting and people for whom we wait.
For example, at lunch today it bugged me when I had to wait for a table, then a waiter.
Of course, it didn’t bother me that the waiter had to wait for me to make up my mind (Don’t they get paid to wait?).
Rollo Manning - A Special Report on Indigenous Health from Northern Australia
Editor's Note: Currently there is a greater focus in respect of Indigenous health. And
about time, some would say.
Only very small pockets of the pharmacy profession have attempted to come to terms with this major problem, and they genuinely need your management assistance.
Rollo Manning could well be regarded as the pharmacy expert in indigenous health, and he vigorously defends the rights of indigenous people to enjoy good health - just like the rest of the Australian community.
Rollo's sympathetic insights reflect his long association with, and understanding of, the issues surrounding indigenous health.
Stephen Carbonara - From an Independent Professional Pharmacist Perspective
Given the current talk of codeine re-scheduling, I’ve decided to offer my opinion on the matter.
I believe that codeine is a significantly abused drug in the community (I witness it first-hand), and that something needs to be done to curb its use.
However I believe the NDPSC’s potential position is attempting to fix a problem using a scheduling system that is dated and ill-equipped for the job.
The S3 schedule is ill-adapted to contemporary pharmacy (it worked well in the past); but the resultant effect (which the codeine issue has now highlighted) will be an increasing presence of ‘busy pharmacists’.
S3 is assumed to restrict access, but contemporary pharmacists’ lack-of-time, sales-based remuneration model and resultant complacency will most probably result in a similar level of codeine abuse and a plethora of bothered pharmacists.
Who knows, maybe pharmacists may suffer from an increased frequency of headaches???.....you know where I’m going with this one!
Barry Urquhart - International Conference Keynote Speaker
Many businesses, those in Australia in particular, are about to break through the “pain threshold”, which will have long term, strategic and structural consequences for consumers, employees and the competitive market place.
Major changes can be expected.
As a consequence, the focus for management teams will change from variable costs to the fixed cost aspects of the businesses.
Up to this time, the primary emphasis for many entities, large and small, when addressing the global financial crisis has been on variable expenses.
These have centred on :
Staff numbers, Wages and overtime, Inventory levels, Advertising budgets, Travel expenses, and Retail prices.
Each of these can be and are readily changed in volume and nature.
Harvey Mackay - From an International Speaker, Author, Columnist and Consultant Perspective
Years ago a group of brilliant young men at the University of Wisconsin seemed to have amazing creative literary talent.
They were would-be poets, novelists and essayists.
Their skills were extraordinary.
These promising young men met regularly to read and critique each other's work. And critique it they did!
These men dissected the most minute literary expression into a hundred pieces.
They were heartless, tough, and even mean in their criticism.
The sessions became so merciless that the members of this exclusive club called themselves the "Stranglers."
Chris Wright - Dispensary Systems Perspective
Our Teflon coated Prime Minister has erred away from safe politics by opening the batting and going for a golden duck with Peking looking on with increasing anxiety.
In a chest puffing exercise which is no doubt designed to impress his new best friend, the US President, Kev 747 is ramping up naval and air force capability just in case China decides it really does want to rule the Planet.
Well, there is precedent for this sort of behavior, so it’s likely to happen again.
In the same breath, Kev has announced that 700 jobs will vaporize from the Immigration Department. Well done, mate, instead of the Immigration budget getting kicked around, send another 700 of ‘em to Centrelink, they seem to be flush with funds.
How strange that Kev 747 flicks Government staff, yet kicks the suitcase out of all and sundry for daring to do the same………
This is the stuff of considerable hilarity. Imagine the Chinese Premier, Wen Jiabao (WJ) calling Kev for a chat……..
Dr Andrew Byrne & Associates - A Harm-Minimisation Research Perspective
Editor's Note:Dr Byrne (and his associates) advocate for better policies which are proven to reduce risks for drug users and the general community under a framework in parallel with Australia's official policy of harm minimization. The findings of the New South Wales Drug Summit recommend better access to methadone, detoxification and other dependency treatments. It also advised investigating alternative services such as supervised injecting centres, leading to the opening of the Sydney Medically Supervised Injecting Centre in 2001. Dr Andrew Byrne has been involved in opioid treatments from a primary care background for 20 years at the same site in Redfern, an inner suburb of Sydney. He is recognised worldwide as a specialist in the addiction field and was involved in the seminal stages of the Chapter of Addiction Medicine, Royal Australasian College of Physicians. He received the Dole-Nyswander award from the American Association for the Treatment of Opioid Dependence in April 2006. In this edition of i2P, Dr Byrne comments on an article from the online version of the Annals of Internal Medicine titled:
First Do No Harm ... Reduction? Annals of Internal Medicine 2009 150;6 (Annals on line, pre-publication March 17) Gourevitch MN.
Previous Issue (Issue 81: April 2009)