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- Issue 81: April 2009
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- Issue 76: October 2008
- Issue 75: September 2008
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#%@%$%#?#@ !

Chris Wright
Dispensary Systems Perspective

Issue 75: September 2008
Page: 1 of 1 Author's Profile | Send to a Friend | Printer Version
When setting out to write this little piece my usual calm demeanour momentarily deserted me. So rather than offend the sensibilities of those with sufficient time to be bored by this writer's rambling, the title remains.
Mrs “Very Senior” Wright resides in a Residential Care Facility (RCF) that to this writers opinion tends to maintain a reasonably high standard. At least it’s a good act if they don’t.

Like most RCF’s, they give the impression they are actually doing the providing pharmacy a favour by allowing them to supply their residents.
As this writer has commented before, to supply manually filled DAA’s to this environment is a labour of love, based on professional responsibility, rather than economic enrichment.

The pharmacist is removed from the action and has virtually no contact with the patient.
Herein is another problem, because the pharmacist cannot possibly forge a meaningful relationship with RCF staff if there is no contact with the patient.

The “blame game” was evident recently when staff at the RCF called me to say Mrs Wright requires a script for Neorecormon to be filled and the Pharmacy is not able to supply it, and could I pick it up myself at the hospital that often treats Mrs Wright.
My suggestion that somebody else either picks it up or supplies it was met with a wall of opposition.

Hmmm, how interesting.

The staff at the RCF is probably not to know that the pharmacist attending the requirements of patients at the RCF is known to me……..and I must say she is a particularly caring, engaging and professional young lady.

I decide to shoot from the hip, so I tell Mrs “Always” Wright jnr that I’m unable to do the lawns today as I’m on a mission.
After describing the problem to “Always”, she decides to be helpful by asking if she can pack a suitcase for me and then proceeds to dust off my Passport.

I arrive at the RCF in not exactly fine humour, but remain determined to maintain a balanced attitude……….

Staff at the RCF advise me that the pharmacist has told them she is not able to supply the Neorecromon because of the cost.
The pharmacist apparently apologised for this inconvenience but it is a policy of the management of the Pharmacy to not either stock or supply Neorecromon.

Methinks this is a highly unusual situation.
The Pharmacy is part of a large chain and I very much doubt that they would engage in this sort of behaviour, quite apart from the fact it is illegal to not supply a PBS script

I agree to visit the hospital and pick up the Neorecormon. After all, the health of Mrs “very senior” Wright is the important issue.
Upon my return to the RCF I seek out the staff member and ask that the Neorecormon be placed in the fridge……….after all, you never know, do you?

I’m told there are “issues” with the Pharmacy.
Rather than suggest that this RCF is damn lucky I’m not the providing pharmacist I rather stridently suggest that I’ve always found Henrietta (the pharmacist) to be very good.
The RCF staff member pales significantly at the knowledge I’m at the very least on speaking terms with Henrietta.

I’ve made a couple of mistakes.
Firstly, I perhaps should have discussed this matter with Henrietta before charging off to the Hospital to pick it up.
Secondly, I perhaps should have approached the management of the RCF to discuss with the view to report the Pharmacy to the Pharmacy Board.
This would have flushed out any inconsistencies in the story given to me by the RCF staff member.
And I have little doubt inconsistencies abound.

A few days pass and I decide to visit Henrietta to discuss and form a plan of attack to secure the next supply of Neorecormon.
Henrietta is quite rightly surprised and shocked at the notion that she has apparently “refused to supply”. This writer is grateful that her prodigious intellect does not allow her to do her block in a hurry……….
Henrietta advises that Neorecormon is not even on Mrs Wright’s medical chart.
This opens another can of worms to do with interaction both in a medical sense and communication, or lack of.

The lack of effective communication between Pharmacy and RCF/patient is endemic because of a dependency on hand written charts and fax machines.
Until the supply of DAA’s enter this century by way of efficient and accurate automation coupled with compliance and record management the blame game will continue, and patients will be at risk.

I’m more than unhappy that I’ve had to do an 84 kilometre trip that was seemingly unnecessary and even more peeved that Henrietta has been close to being slandered.
I live a considerable distance from the RCF and the Pharmacy, so I gather that I could be told all manner of porkpies without anybody batting an eyelid.

I decide to put the matter to rest by visiting the RCF to advise the staff member (who is clearly acting inappropriately) that I’ve reported the incident to the Pharmacy Board and have asked for clarification of the regulations dealing with the supply of PBS medicines.

I wonder Seamus Heaney, the gifted Irish Nobel prize winner, would be able to do justice to the fierce change of facial hue that was immediately apparent…….

This highlights the poor state of affairs that exist between RCF’s and Pharmacies.
No wonder so many Pharmacies are walking away from the DAA business.
As this writer has commented previously, pharmacists engage in the business of manually filling DAA’s through professional responsibility and more often than not disregard the financial consequences.

Chris Wright.

September 2008.



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