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Our own Worst Enemy Ė Again!

Ken Stafford
A Consultant Pharmacist Perspective

Issue 74: August 2008
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What is it with the pharmacy profession in Australia?
Some time ago I wrote a column entitled “Our own worst enemy” where I looked at how pharmacy seems to take great delight in shooting itself in the foot.
It seems that all I have to do is save my article and recycle it at regular intervals because nothing has changed.
The Guild and the Society cannot seem to agree on very much, everyone steadfastly defends his/her own little patch and we continue to whinge about how nurses want to take over everything

Let’s be honest, at least the nursing profession is willing to present a united face to government and other health professions, it is happy to stick its neck out and say “Nurses can do it just as well, if not better” and has become a leader in presenting data to back up its claims.
As for pharmacy, a great majority of our colleagues appear quite happy to sit back, acting as the “quiet achievers” of health and complain bitterly about being left out of government initiatives.

OK, I am possibly being a little unfair but why are we not jumping up and down, yelling at the tops of our voices “What about us”.
Pharmacists are the first line contact for many people when they begin to feel ill, as a group we save Medicare umpteen millions of dollars annually in unpaid consultations and, at present, have the trust of the general populace.
You know that, I know that but has anyone ever quantified just how much pharmacy saves the taxpayer?
To the best of my knowledge community pharmacy, unlike our hospital colleagues, has never carried out such a study and so does not have the solid basis that nurses have developed to argue its case for greater recognition by government.

It has even reached the stage that when a quantitative study is proposed pharmacists are unwilling to become involved.
Reading my latest copy of the AACP’s newsletter “The Accredited Pharmacist” I see that the VALMER research project is widely promoted attempting to encourage consultant pharmacists to submit home medication review data.
(Before going any further I must declare that I have a vicarious  interest in this as the project pharmacist is my son.)
VALMER (the Economic Value of Medication Reviews) aims to determine the value of a sample of HMRs and, using sophisticated modelling techniques, thereby improve the HMR process leading to better health outcomes.
I would have thought that consultant pharmacists would be falling over themselves to offer the five reviews for analysis but I understand this is not the case.
I haven’t discussed this with Andrew but my feeling is that it is “just too much effort” for pharmacists to participate, why I don’t know.
Not only is it an easy way to earn an extra $60 per review but, if our claims that pharmacist directed medication reviews add value to patient care are accurate, we would have a very strong basis to argue for better remuneration and greater input into policy.

Guess what, this is exactly how the nursing profession has argued its case for nurses to take a greater part in patient care.
Nurses now have prescribing rights, pharmacists do not, nurses are permitted to vaccinate patients, pharmacists –no way and nurses are the lead agents in many of the chronic disease management programs around the country.
Nurses are confident in their profession’s ability to argue their claims to expertise, state this in no uncertain terms and, as a consequence, not only out-rate pharmacists in the trust scale but are pushing us to one side.

Why must pharmacy continue to be its own worst enemy?
If you don’t agree with what I say, tell me so but please, please try to shake the profession out of its apathy.

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