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From the desk of the editor - Introducing current ideas, perspectives and issues, to the profession of pharmacy
Issue 59: April 2007
Welcome to the April edition of i2P and what a great list of topics we have this month in our presentation.
One of the wonders of editing this publication is that in the countdown to the deadline, the in-box is quite often empty and you begin to wonder how you are going to deal with a lightweight edition.
Then all of a sudden material starts to flow and for 48 hours (four working days - the time it takes to put this publication together) you become glued to the office chair, and arise bleary-eyed at the end of each working day.
But it is worth it to edit and produce the only independent publication for Australian pharmacists, and when you consider the pathway we are being pushed down through PGA dictates, it is perhaps fortunate we will be around for some time to come.
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.
*Pharmacists’ professional body doesn’t support pseudoephedrine ban
Significant changes to CMI guidelines
Out-of-date Product Information may be more widespread
By a Staff Writer - Conferences and Events
As part of our information service, i2P informs on Conferences, Workshops and Seminars or press releases that may be of interest to pharmacists. PSA information will continue to be published separately in the section reserved for PSA press releases. Pharmacy organisations may submit material for publication, preferably in digital format (Word document).
* FIP Pharmaceutuical Sciences World Congress and the 67th Annual Congress (Beijing, China)
The Pharmacy 2007 Conference - organised by the Friendly Societies, this conference has gone from strength to strength each year to become the premier pharmacy conference.
Don't be disappointed - book now to ensure your reservation in Hobart this year.
New release - Therapeutic Guidelines Gastrointestinal 4 2006.
Order your copy to keep pace with current developments and guidelines.
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 through the "Contact Us" panel located on the home page.
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.
Rollo Manning - A Regular Column Reporting the News Behind the News
* The path ahead will be rocky – but you can get there.
What does really matter?
* The dilemma of pharmacy in the “bush”
* Competition gone missing from PBS pricing
* Know any Approved Registered Training Organisations?
Neil Johnston - Management Consultant Perspective
It is often said that people never seem to learn the lessons of history, so when I am in need of an idea or two, I often research successful businesses to see if there is a lesson or an inspirational example to adapt and emulate.
I came across a story about Charles Walgreen, the founder of Walgreen’s – one of the most successful pharmacy chains in the US.
The story related to his humble beginnings at a location on the south side of Chicago, in 1901.
As standard practice, when a patient rang in to order a prescription for a delivery, Charles Walgreen would speak to each caller personally and take down the relevant details.
He would talk to the patient for as long as possible until the patient said, “Excuse me, there is someone at the door”.
At that point an astonished patient would open the door and find the pharmacy delivery boy standing there with the prescription dispensed.
Con Berbatis - A Pharmacy Researcher Perspective
Editor's Note: Australia’s health care costs and performance indicators in primary care lie between those of the USA and United Kingdom.
According to State governors and presidential candidates campaigning for the 2008 elections in the USA, the US national health system may be transformed possibly into one more like the UK with universal health insurance underwritten by the national government .
Even against powerful lobbying , a national monopsony for a formulary of prescription drugs in primary care like Australia’s PBS and even the introduction of a third class of pharmacy- only drugs as exists in most other developed societies may eventuate in the USA perhaps within a decade.
Con Berbatis reports on costs of the US health system in relation to the UK and Australia which are driving the above changes.
Neil Retallick - A Friendly Society Perspective
The recent ‘compilation’ of the Fourth Community Pharmacy Agreement reflects the strong position that the Pharmacy Guild of Australia has when it sits at the negotiating table with the Federal and State Governments.
The profitability of Pharmacy is guaranteed into the next decade with this Agreement. At the same time, the Guild has been successful in lobbying a number of State Governments to introduce legislation that will see Australia’s Grocers kept out of the industry for some time to come.
Chris Arblaster, PhD - A Consumer Self-Care Perspective
The PBS is a complex system. It is about to have another layer of complexity added to it.
The PBS reforms will largely affect the prescription sector of the market, both generics and patented medicines.
However, some of the details of the proposed changes have only just come to light including a restructuring of pharmacy make-ups and an additional dispensing fee of $1.50 for every benchmark priced prescription.
The Government stated reasons for changing the PBS is to give Australians access to new and expensive medicines while ensuring the PBS remains affordable in the future.
The main changes will be the way that government prices medicines that are operating in a competitive market.
Chris Wright - Dispensary Systems Perspective
The world of pharmacy is slowly coming to the recognition that there will be less models evident post some form of deregulation.
Presumably, the smart money appears to be on only two.
Firstly, the discount model, which is actually a bit of a misnomer, because in my view it’s all a bit of a con.
My learned friend in Darwin has a different view, as you all well know, but that’s what i2P is about, being independent.
Stuart Adams B.App.Sc (Nutrition and Food) - From a Nutritional Activist Perspective
Whilst pharmacies, health foods stores and even Multilevel Marketing (the newer version of pyramid schemes) ventures sell meal replacement shakes which work short term (but fail long-term) the other way in which they can makemoney selling weight loss is though weight loss pills, which are supposed to “boost your metabolism”, “burn extra fat” or even “block carbohydrate absorption” and "supress cravings"
You'd think no one would be silly enough to buy them, though if sales in the pharmacies I have worked in are any litmus, they would be very popular indeed.
Occasionally, someone would ask me “do these things actually work?”
I explained to them that they probably did very little if any good, were ridiculously expensive and would be almost completely worthless by comparison with healthy dietary modifications and an increase in exercise.
When I then began trying to suggest how they could improve their diet and exercise habits, they would generally say “oh, okay”, before taking the weight loss pills to the counter and purchasing them regardless of what I just told them, which obviously wasn't what they wanted to hear.
Robert Forsythe - Globetrotting Community Pharmacist Perspective
I felt the hairs on the back of my neck stand up. I was putting away the S8 order and it was wrong and I knew why.
I had 20 too many Kapanol 10mg and no Kapanol 100mg.
I instantly started to sweat and felt like I was going to be sick.
A dose of 100mg could be lethal to someone who was supposed to get 10mg.
Fortunately, in this case I was able to contact the patient as the prescription had been collected by a friend (who was also a very good customer of the pharmacy).
I explained what had happened and the drugs were left in the sealed bag.
I went personally to the home of the patient after work and swapped them over.
Then I went home and had a beer!
Garry Boyd - From an Intellectual Capital Perspective
We Australians have a long history of significant inventions that clearly demonstrate that we play well above our weight when it comes to invention.
Victor Hugo once said:“When it comes to invention, chance favours only the prepared mind”.
This is no doubt true, although equally, many great inventions have hit like a brick in the middle of the night by pure accident.
Many inventions are arrived at by another motivating force.
For example, the motivation for David Warren to develop the black box is said to have come from the fact his father died in an airline accident.
Keryn Coghill - A Pharmacy Health Informatics Perspective
The eXact Story so far…………………
Keryn Coghill started work as a Pharmacist in 1974 when labels were typed, the drug records were hand written and paper prescription were posted to the government for payment.
Keryn Coghill still works as a Pharmacist in 2007 and medical records in hospitals and aged care facilities are still hand written, prescriptions are still paper and still posted to the government for payment
eXact Technology commenced 12 months ago to provide an IT model of medication management for any patient drug interface.
The principle product of eXact Technology is called RxRIGHT which has its origins in the prescription sign and the (ever increasing) Rights for medication administration.
Dr David More - From a Medical IT Perspective
Last week we had the following announcement from NEHTA.
“NEHTA sets direction for electronic messaging in health
NEHTA confirms Health Level 7 as the national standard for the electronic messaging of health information across Australia.
Across the Australian healthcare sector there are many different types of computer software and systems that are involved in the exchange of information.
Currently, these systems use various exchange formats to send and receive information.
To ensure that all systems across Australia have the ability to reliably and safely communicate with each other, a standard exchange format is required.
The National E-Health Transition Authority (NEHTA) has determined that this standard will be based on the HL7 family of standards.”
NEHTA's roadmap for deployment and adoption is outlined later in the press release:
Mark Bouw - From a Dispensary Systems Perspective
Throughout my career in the pharmacy industry, I have had the fortunate opportunity to spend time across pharmacies in Europe, North America, Asia and closer to home in Oceania. Current discussion has focused around the changing landscape of pharmacy in North America and the potential threats domestically from entrants such as Walmart, Walgreens, Albertsons, etc.
A more realistic view of what pharmacy practice landscape can be based on for the Australian environment must be that of The Netherlands community pharmacy.
A re-calibration of our bench marking process may be worth considering when reflecting on dispensary work flow efficiency.
Stephen Carbonara - From an Independent Professional Pharmacist Perspective
In this, my first article for i2P, I would like to stimulate discussion on the new frontier of pharmacist prescribing.
As an employed locum pharmacist in community pharmacy, I have watched with great interest over the development of this new area that might eventually see pharmacists being able to write prescriptions for scheduled medicines.
This may seem like a bit of a ‘pipe dream’ to some, but the reality is that this frontier is being explored, at least in the international sense.
Karalyn Huxhagen - A Queensland PSA Councilor Perspective
The second Rural pharmacist forum hosted by the Rural Pharmacy Workforce program was held in Albury on the 7th March and a diverse audience of pharmacists attended.
It was pleasing to see a mix of students, academics, practicing community and hospital pharmacists from regional and rural areas as well as representatives from the Pharmaceutical Society of Australia (me), the Pharmacy Guild of Australia and the Society of Hospital Pharmacists of Australia.
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.
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.
A range of his publications on pertinent strategies for harm-minimisation is available for dowloading at: http://www.redfernclinic.com/publications/. This month we are pleased publish Andrew Byrne’s impressions of China and the advances being made with methadone clinics and the acknowledgement by Chinese officials that AIDS does significantly exist in China.
Andrew Byrnes writes.....
Barry Urquhart - International Conference Keynote Speaker
Editor's Note: This month Barry Urquhart extols the value of independent retailers, in this case a liquor group in Western Australia.
There are obvious parallels for pharmacists to draw their own conclusions.
The importance of choosing your own pathway and developing a strategy to stay with your own considered decisions
despite all the odds arraigned against you, will give you the courage to take the fight up to all contenders - the Colesworths, the discount pharmacies, medical centres and any other predator group circumnavigating the pharmacy profession calculating their chances on picking up a "piece of the action".
Note the points made about staff training, product knowledge, "everyday lower prices" and the constant monitoring of any respected opposition.
I’ll drink to that.
Independents, according to Peter Jeffree, Principal of Con’s Liquor Group in Western Australia, have never been more important to liquor suppliers in Australia, perhaps with the exception of high volume, discount beers.
Currently, twenty five independent retail liquor stores in Western Australia generate some 70% of retail wine sales of all independent liquor stores in WA
By a Staff Writer - Publications to Note
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.