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From the desk of the editor - Introducing current ideas, perspectives and issues, to the profession of pharmacy
Issue 54: October 2006
Welcome to the October edition of i2P (Information to Pharmacists) E-Magazine.
We are now well into the season of Spring, which is traditionally associated with optimism and a natural cycle of renewal.
This analogy can also be applied to the pharmacy profession, as the new NSW Pharmacy Practice Act delivers a new infrastructure for NSW pharmacy in the form of “body corporates”- a mechanism for the propagation of renewal.
The state of NSW with the greatest population of pharmacies, is now in a position to drive a new surge in optimism and confidence on behalf of the entire pharmacy profession.
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.
* Introducing Our Best and Brightest:
2006 PSA Pharmacy Student of the Year State Finalists
* Let an Expert Help You with Your Medicines
* Ask for a CMI with Your Next Prescription
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 share links to items of interest, by simply e-mailing the story link to the editor located at firstname.lastname@example.org
Topics can 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 is also encouraged through the "Letters (Your Say) " column.
By a Staff Writer - Conferences and Events
Editor's Note: On the 7th September 2006, the Friendly Societies held their annual conference at Pepper's Salt Resort located at Kingscliffe, on the northern New South Wales coast.
Conference participants voted it the "best ever" and i2P would have to concur with that view.
Speakers covered the full spectrum of pharmacy managment, with an eye on the clock for potential 2010 deregulation.
Jim Howard, chairman of the National Pharmacies Group, opened the conference with his annual address.
National Pharmacies are fast becoming a "best practice" example of a corporate pharmacy model, utilising to best effect, a mix of non-pharmacist and pharmacist management personnel, who will have no difficulty in mastering a deregulated environment post 2010.
Jim Howard's address is published in full, and some photographs of the event follow on after the address, as well as links as to how to order photographs and how to contact the event managers.
By a Staff Writer - Conferences and Events
The Pharmacy 2006 Conference was characterised by a range of quality speakers with good information.
Some speakers have generously allowed their presentations to appear in i2P and readers are thus able to benefit by gaining knowledge and insight into many specialist and relevant subjects.
The conference was extremely well organised through Acclaim Event Management, a Queensland-based organisation that has been utilised by the Friendly Societies before.
Next year the conference is planned for Tasmania and potential delegates should pencil September 2007 into their diaries now.
The attendance at this years conference was a record, and the annual conference appears to be moving into the mainstream of general pharmacy events.
The attendance at this years event was a record and overwhelmingly voted by the attendees as "the best ever".
With accolades like that, next year should be a winner indeed.
Rollo Manning - A Regular Column Reporting the News Behind the News
Pharma-goss - With Rollo Manning
The column that provides the background to the news behind the news.
* Is this illegal?
* Strong words
* Row brewing over who can sell what
* Quote of the month
Neil Johnston - Management Consultant Perspective
On the 5th September 2006, the NSW Pharmacy Practice Act came into being.
For the first time it allows “pharmacy body corporates” to become a reality in NSW, officially in March 2007.
These are companies where all the shareholders and the total number of directors, are all registered pharmacists.
No non-pharmacist pecuniary interest - no family interest, venture capital interest or non-pharmacist general investment pecuniary interest is allowed.
To drive a national corporate uptake, this structure was needed in NSW, the state with the highest concentration of pharmacies in Australia.
Lead-time is also needed to allow pharmacists to adjust to this new type of structure, discover its many uses and learn that the "bogeyman" reputation a corporate had within pharmacy was genuinely undeserved - it was just another management/financial structure offering different opportunities to those of a sole trader or partnership.
While the advent of corporate structure is welcomed, it is still not within the spirit of the original Wilkinson Report circa 2000, which promoted pharmacy control, rather than total pharmacy ownership as the pertinent issue i.e. open ownership of shares up to 49 percent of voting capital.
That it has taken Australian Pharmacy so long to catch up with the rest of the world, and to emerge in a competitive structure by 2007, is astounding by any measure.
Neil Retallick - A Friendly Society Perspective
In the section of Woolworth’s recent first Half financial results that details the Supermarket Group Business Performance, the summary lists Sales followed by Gross Margin followed by Cost of Doing Business followed by EBIT to sales.
Expressed as percentages to sales, the gross margin was 22.72%, the Cost of Doing Business was 18.36%, resulting in an EBIT of 4.36%.
Importantly, the gross margin was lower than it had been a year ago (-0.63%), but the Cost of Doing Business was lower again (-0.81%).
Although sales grew by 17.7%, EBIT in dollar terms grew by 22.3% to $703.4 million.
Chris Wright - Dispensary Systems Perspective
Mrs Wright senior resides in an aged care facility that had the misfortune to be required to publicly deal with an AME recently.
While Mrs Wright senior is very senior, she is also very sharp.
Of the some 15 medicines she wrestles with on a daily basis, none are to do with anything remotely connected to intellectual function.
Staff do not check her taking any medication, as she is “trusted”.
Sounds a bit like being in gaol, which she declares is the case anyway.
I point out that in her environment there is no legal obligation by the staff to check her intake of medicines.
However, it seems as though different rules apply, depending on the resident.
She advises that the AME occurred when a Doctor advised staff to cease giving a patient a particular medicine.
The patient concerned apparently takes only two medicines, but the wrong one was ceased.
I don’t believe the consequences were serious, but that’s not the point, is it?
Heather Pym - A Division of General Practice Perspective
We moved our Division of General Practice into larger premises this week as we have outgrown our old quarters.
This has been due to many more programs of support we offer to GPs and population health programs, which support and work in tandem with General Practitioners to effect better health outcomes in the community.
Other programs support improvements in the delivery of health services offered by General practitioners to their patients and recognise the expertise other professionals such as nurses can offer in general practice settings.
Chris Arblaster, PhD - A Consumer Self-Care Perspective
The Australian Self-Medication Industry (ASMI) Conference, Self-Care, The Consumer & Commercial Reality heard presentations from Commonwealth Government, the health industry, pharmaceutical companies as well as health economists on the future of self-care and its impact on individuals and health budgets.
Health economist, Paul Gross, director of Health Group Strategies said that inefficiencies in Australia’s health system meant that up to 15% of the total annual health expenditure of about $85 billion did not contribute to good health and quality of life.
He said the current system created incentives for people to use the health system for the simplest of ailments with up to 40% of GP visits unnecessary.
Ken Stafford - A Consultant Pharmacist Perspective
Over the years I’ve argued that pharmacists have to gain acceptance from doctors as fellow health professionals before they can truly take their place in the health care team.
My hopes were raised that this might be happening when, at a chronic disease management meeting a few weeks ago, I listened to the medical director of one of our larger divisions of general practice sing the praises of consultant pharmacists and medication reviews.
This, from a doctor who had been a severe critic of such reviews was a major fillip to the pharmacists present.
“The tide is turning, at least in this division” we thought.
The door had opened, just a little, I thought at the time and that maybe we might be getting somewhere at last.
Pat Gallagher - An IT Consultant Perspective
If you trawled the web for online health related publications, as some of us do every week, you might be stunned by the collective amount of activity in the relentless evolution of the click-on world.
On the other hand, if the day-job keeps the focus away from this view of things, all you may notice is bits and pieces that in isolation don’t seem to add up to much.
Which is wrong.
This can be described as only seeing a little periscope peeping up through the waves. Far off and not threatening.
Which is why it is wrong.
Particularly wrong if under the water lies a frightfully huge nuclear attack submarine that has the power to change landscapes at a flick of the wrist – so to speak.
Dr David More - From a Medical IT Perspective
Both in the USA and in the UK there are major efforts underway to increase the amount of prescribing done electronically. Additionally, as reported a little while ago in an article here, the Commonwealth is moving to ensure that by early next year there will be no regulatory or legislative barriers to introduction of E-prescribing (EP) in Australia.
The reason adoption is sought is that it is now very good evidence that EP has the capacity to substantially reduce the frequency of Adverse Drug Events (ADEs) and that if this is achieved considerable human suffering and cost can be avoided.
The objective of EP is to deliver to the dispensing pharmacist a prescription from the prescriber that is error free and which can then be dispensed in an error free fashion to the patient. Subsidiary objectives may include maximising the use of generic medication, where appropriate (to also reduce treatment costs), and assisting the pharmacist with accurate and timely claiming of the costs of medication from either the Pharmaceutical Benefits Scheme or the patient depending on the circumstances.
Analysis of the prescribing process identifies three distinct phases (plus financial settlement and inventory management which will not be discussed further as these are simple business processes which are already quite highly automated and well understood.)
Terry Irvine - Community Pharmacist Perspective
A topic that seems to get a frequent airing in pharmacy circles is the need for continuing education, and the requirement for minimum standards to be met.
From my point of view, this seems like a nice theory, but difficult to achieve.
Anthony Tassone - A Pharmacy Manager Perspective
Multi-national pharmaceutical company and movers and shakers Genepharm have announced an alliance with corporate medical centre group Primary Health Care (PHC).
In a statement from the Australian Stock Exchange, Genepharm has ‘entered into an alliance with (PHC) to promote Genepharm generics at its medical centres…
PHC will also promote the use of Genepharm products as a preferred supplier at the pharmacy outlets at PHC’s large-scale medical centres around Australia.'
Good business or questionable ethics?
Probably a little bit of both.
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.
A range of publications on pertinent strategies for harm-minimisation is available for dowloading at: http://www.redfernclinic.com/publications/
These e-publications may prove to be of practical interest to those pharmacists interested in dependence and addiction
This month we are pleased to publish a conference report prepared by Dr Richard Hallinan.
Dr Richard Hallinan has also had an interest in addiction medicine for about 20 years.
Since joining the practice in 2000 he has published several key papers on subjects including hepatitis C and optimising methadone dose levels.
He also has performed studies on hormones, mood disorders and related matters in dependency patients.
Dr Hallinan also worked for years as a professional violinist in both Australia and in Austria.
Barry Urquhart - International Conference Keynote Speaker
In the current marketplace, getting on a roll and getting off a roll are less important than staying on that roll.
The fruits of twelve consecutive years of boom times are being quickly lost, particularly for those who have complacently expected the good times to remain unabated for all.
Oversights and neglect on staff training, premises upgrades, product development and disciplined marketing are manifested in losses in sales, squeezed margins, the need to discount, lost customers and declining client loyalty.
There is evidence that a dichotomy is evolving among entities with some being winners and others, losers.
The good news is that it is not too late to arrest any decay and indeed to enhance the ratings of a diverse range of key performance indicators.
However, it will be imperative that the stimulants not be short time “fix-it alls”, but rather integrated, long term strategies with complementary initiatives which are supported by sound infrastructure and solid budgets.
For big and small entities, whether private, public listed or in the government sector, the best dividends will be those that commit to unqualified investments in the business, its resources, people, customer base and targeted marketplace.
Only then will it be possible to achieve and sustain the current fundamental rudiment of success … momentum.
I do hope that you enjoy the article on the topic, which is featured in this transmission.
By a Staff Writer - Conferences and Events
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.