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”?
I have pondered this question many times as I read health policies and initiatives formulated by my own government agency employer without coming to any definitive conclusion.
In its history DVA has initiated many programmes to improve and maintain the health of its veteran community client base but the number of these relating to pharmacy can be counted on the fingers of one hand.
Other than programs such as the Veterans MATES (Medicines Advice and Therapeutics Education Services), Australia’s first government subsidised home medicines reviews and subsidising dose administration aids for veterans, pharmacy has hardly rated a mention over the years.
This is despite the Department having had a very active (and pushy at times) group of pharmacists in its health division.
There are instances where pharmacists have been able to have some influence on government policy but I would dearly like to see more.
I am becoming very annoyed by pharmacists’, somewhat smugly, trumpeting that “we belong to one of the most trusted health professions in Australia”.
Sorry, how is this important in the big picture of government policy formulation? Pharmacists are popular, maybe even trusted, because they give things away free, things such as easy access, free advice and possibly free counselling.
Why would we not be popular and trusted?
I query how long that high level of trust (whatever the surveys mean by this) would last if pharmacists began to charge for their time.
On a number of occasions in the community setting I had to keep my annoyance hidden when, after spending time discussing a customer’s health problem and offering a product to help, the person complained that it “is much cheaper at the supermarket, your price is too high”.
See, happy to demand free consultation and advice but exhibiting a distinct lack of willingness to pay for it.
I wonder what would have happened if I had then asked them to pay for my time as would have a doctor, lawyer or even a washing machine repair man?
Community pharmacy has, for many years, suffered from an inability to decide if its practitioners are healthcare professionals or glorified shopkeepers. I don’t see other professions basing advertising of their role in terms of “We have the lowest prices in the area”.
Is it possible that the profession’s hierarchy has squandered many golden opportunities to parley that supposed trust factor into an effective power base, a base from which pharmacy can argue its case for a greater professional input to government health programs?
Clinical pharmacists play an important role in the formulation of health policies in hospitals and their expertise is readily acknowledged and utilised by management and other health professionals, why is this role not apparent in the community?
I found it interesting, when working one day a week in a community pharmacy, that I appeared to get more professional respect from local doctors who knew of my clinical role in DVA than from those who didn’t. I often wondered if it was possibly because they saw me as more than a “shopkeeper”, a fellow health professional maybe?
Just a thought.
I digress, however. The various pharmacy bodies, PGA, PSA and SHPA, continue to work hard to raise the profile of pharmacy with government agencies but I fear they have a hard road ahead of them.
With many in the upper echelons of various government agencies around the country pharmacists do not appear to be anywhere on the horizon and I’m afraid we are fooling ourselves if we think otherwise.
No matter how we might like to spin it, seven mentions of “pharmacist” in the 386 page NHHRC report merely strengthens my argument.
It will take a seismic change in perception of the profession by government before pharmacists become automatic members of committees, commissions etc planning the path of health in the community.
Dr Lisa Nissen, pharmacist of the year, envisages a future where pharmacists are able to fulfil a role in health care of patients way, way, beyond merely supplying medicines, let us hope she has greater prescience than I.
Lisa’s vision of pharmacy’s future is far preferable to the one I fear might happen.
This is one time I would really prefer to be wrong so let us all dream of a better life in years to come.