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Pharmacy Must Change to Meet Future Challenges.

Ken Stafford
A Consultant Pharmacist Perspective

Issue 77: November 2008
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I have found that attending professional conferences can certainly impact on your sense of ego.For a number of years I’ve been writing articles claiming the that pharmacy must change the way it works if it is to take its rightful place as a member of the health care team.
I often felt that I was a lone voice crying out in the wilderness, with no-one paying attention.
It almost gave me a feeling of smugness that I was “the visionary”, identifying problems no-one else could see and offering solutions.
Almost the lone voice – I was quite aware that many others were worried that we were standing still while other groups looked like displacing pharmacy from the forefront of healthcare.
I realise that I probably suffered from a martyrdom complex, with the whole world against me, but at least “I understood the problem”.
I even wrote a piece where I imagined a person in 2107 writing about how primitive the pharmacy profession was 100 years ago and describing his/her day (as I envisioned it) as a “modern” clinical pharmacist.

This was, I thought, quite the visionary until my last two conferences, SHPA’s WA State Branch Symposium in July and PAC 2008 in Perth this past week-end.
At both of these conferences Dr Lisa Nissen, joint Pharmacist of the Year, proved to be more hopeful than I and expects pharmacy to be operating quite differently in only 20 years.
Her day as a “Pharmacist Practitioner” bears an uncanny resemblance to elements of my picture of the 2107 pharmacist, so here we have two people, from totally different backgrounds, with eerily similar ideas.
What a blow!
Bang goes my role as pharmacy’s saviour, others are thinking along the same lines.

Then to squash my ego just a little more Professor Lloyd Sansom, at PAC 2008, spoke on “Challenge our preparedness for things to come”, worrying that unless pharmacy addresses its tunnel vision on how to provide services it will be left behind.
Professor Sansom, in his dealings with government, is seeing the same things I am, namely that pharmacy is no longer perceived, by those in power, as a major provider of, and player in, primary health care.
You and I know, and pharmacists can provide anecdotal evidence, that this perception is completely false but how do we disprove it?
Lloyd raised the point, as I did a few months ago, that community pharmacy is doing itself a disservice by refusing to systematically record the number of primary health care consultations and referrals carried out by every pharmacist out there.
Carrying out research, gathering data, analysing and publishing results is a an absolute priority if pharmacy is to be able to prove its claim of being possibly the primary healthcare provider in Australia.

Pharmacy can, of course, provide data (often to umpteen decimal points) about numbers and costs of prescriptions dispensed but this is self defeating.
Pharmacy’s future lies way, way, beyond the simple supply function of dispensing.
If machines can carry out this function faster, more accurately and cheaper than pharmacists how significant will this part of the service be in the future?
Hospital pharmacy departments have shown that using technicians to dispense and supply medicines will release the unique knowledge, and expertise, of pharmacists to provide improved health outcomes for patients.
Community pharmacy take note!!

Hospital pharmacists, doctors, nurses and most other allied health professionals have over the years carried out research to prove their claims of relevance, and it is up to community pharmacists to do likewise if they are to survive.
Remember, information is power so pharmacy must gather this power to itself and learn to use it appropriately.
The PGA has attempted to represent community pharmacy in general, and owners in particular, over the years but the model of service they espouse seems to be losing relevance with third party payers and thinking needs to be reviewed.

In my opinion it is up to pharmacy to change how it perceives its role in health care and question its model of service provision as then, and then, and only then, will community pharmacy be in a position to meet the future with any degree of confidence.
Listening to Lloyd yesterday I came to realise that although we have been hearing for the past 10 to 20 years that “pharmacy is at the crossroads” now when someone says it to you they really mean it!!

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