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From the desk of the editor - Introducing current ideas, perspectives and issues, to the profession of pharmacy
Issue 67: December 2007
Welcome to the December edition of i2P – Information to pharmacists.
The hype and bulldust around the recent federal elections has seen one of the most embarrassing defeats for the Coalition ever recorded for a government, with the prime minister actually losing his own seat.
The government had simply reached its “use by” date and was not representative of the majority of voter’s and their issues any more.
How the new Rudd government shapes up to manage pharmacy is still a question mark, but there is not much anxiety being detected currently.
Therefore the signs are positive.
The Health and Ageing portfolios will certainly look different, as they are now under the control of three women – Nicola Roxon (Minister for Health), Justine Elliott (Minister for Ageing) and Senator Jan McLucas (Parliamentary Secretary for Health and Ageing).
Nicola Roxon has actually worked in her parent’s pharmacy packaging Dose Administration Aids, so she will have some basic knowledge of pharmacy.
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.
* Remembrance Day reminder about optimising the use of medicines
* Dr Lisa Nissen elected as PSAQ President
Bob Bowden - Media Contact for the Australian Self Medication Industry
For over 30 years, the Australian Self-Medication Industry has represented companies involved in the manufacture and distribution of non-prescription consumer healthcare products and related firms.
ASMI is the peak industry body for the Australian self-care industry including consumer healthcare products ranging from over-the-counter medicines (OTC) to complementary medicines.
Also represented by ASMI are companies providing manufacturers with services, such as advertising, public relations, regulatory consultancy, legal advice and industry statistics.
Topics for this month:
* Call for National Alliance to Promote SELF-CARE in Australia's Health System. -
* Reaction to Federal Opposition National Obesity Plan -
* ASMI marketing awards honour excellence in innovation and education -
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 comment on any news item by contacting the editor through the "Contact Us" panel located on the home page.
News items and topics displayed 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 will be published through the "Letters (Your Say) " column.
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.
By a Staff Writer - News Items, Background Information and Items of Interest
Organisations with pharmacy connections are invited to share their news, product releases or opinions in this column.
* Durolax Name Change
* HIP Newsletter Update
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 event information will be found here, but PSA news 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).
* Patient Safety & Quality Improvement - Embedding a Culture of Safety in our Hospitals & Health Organisations
Two Day Conference: 4 & 5 December 2007 - Venue: Sydney
* National Pharmacies-Calendar of Events - Pharmacy 2008 Conference
Letters to the Editor - A Reader's Perspective
Your Say is the column reserved for subscriber (or other source) comment relating to i2P articles, or reportage or general comment on the profession and industry at large.
All posts must be identified, but the editor will suppress name and contact details if there is a sensitive reason.
Rollo Manning - A Regular Column Reporting the News Behind the News
Pharma-goss - With Rollo Manning
EVERY YEAR IS MADE TO LOOK MORE EXCITING THAN THE PAST – BUT…
2007 will not go down in the annals of history as the most exciting year yet for the pharmacy profession.
In fact it could well be one of the most boring when it comes to hallmark events or sensational breakthroughs.
Neil Johnston - Management Consultant Perspective
Waking up these mornings is not the “full of life” experience we all once may have experienced.
After years of government investigations and attacks on the income base of pharmacists, both morale and relative income are at its lowest ebb.
The government that has just been voted out of power (because of flaws in some major policies and lacklustre leadership qualities) has been responsible for a number of serious “hits” on the entire pharmacy profession, using the PGA as its “blunt instrument” in the name of “reform”.
Is it not reasonable then to assume that the PGA leadership and its policies are similarly flawed, because they were the compliant conduit?
They endorsed, supported and promoted the flawed “reforms” with the entire pharmacy community bearing the full cost – because the PGA has been propped up as the “ manager” of all government grants to pharmacy and has been the organisation controlling and implementing policies and processes that have impacted on all pharmacists – including the 65% silent majority.
And as a range of community pharmacies (large and small) begin to count the cost of these “reforms” when performing that mundane task of paying bills at the end of the month (with insufficient cash reserves), they may well ponder the fact that a large slab of their lifetime invested in the “blood, sweat and tears” of business-building, is looking very precarious and depressing.
Cash flow and profit base are now at levels where it is causing constriction of movement.
The ability to invest in new markets or services is determined by an expectation of increasing cash flow volumes – a process that has peaked or is even beginning to look negative.
Pharmacists now appear to be imprisoned within their four walls of complacency and neglect, through their original protectionist legislation and internal policies.
It has been a decade-long journey in arriving at this point, with more to follow.
Why is this so?
Four value-adding propositions are discussed to assist you in repositioning your pharmacy service.
Con Berbatis - A Pharmacy Researcher Perspective
Editor : Community pharmacy in the USA is filling big gaps in the primary care system there . State by state prescribing authorities for pharmacists , expanding vaccination programs in pharmacies , increasing pharmacy-based clinics, collaborative arrangements and new services recognised by insurance payers and the FDA’s November 2007 hearings into a new ‘Behind the Counter’ class of pharmacist-only class of non-prescription drugs , altogether signal a US-style transformation of community pharmacy in the 21st century.
Con Berbatis presented research in the annual meeting of the US Nonprescription Medicines Academy (NMA) in Cincinnati and to the USC LA school of pharmacy which shed light of the impact of these events on the possible future of pharmacy in health care.
Neil Retallick - A Friendly Society Perspective
As I write this, we are between Governments in the same way that some of us have been, at various times, between jobs.
There used to be a Government, and there will be another soon but, enmeshed as we are in today’s challenges, our thoughts tend to drift to what might be.
If the letter Kevin Rudd sent to pharmacists prior to the election is any indication, his focus is on re-arranging the deckchairs without rocking the boat.
I hope his strategy of ‘shadowing’ the Howard Government does not limit his Government’s capability to see the broader landscape that confronts community pharmacy in this country.
Dr David More - From a Medical IT Perspective
Well, it seems we now have Ms Nicola Roxon as the new Federal Health Minister.
Also in the health frame is Justine Elliot as Minister for Ageing.
Sadly, and worryingly, it seems Health has lost its Parliamentary Secretary.
With all that Hospital reform Ms Roxon will be a busy lady!
Correction - 2:15pm 30/11/2007. Somehow I missed that in fact we do have a new Parliamentary Secretary for Health and Ageing - Senator Jan McLucas from Queenland!
The Australian and the SMH some how seemed to have missed the fact yesterday - .
What are the big things that should be on Ms Roxon’s E-Health to-do list.
Harvey Mackay - From an International Speaker, Author, Columnist and Consultant Perspective
Editor's Note: I have been a subscriber to Harvey Mackay's e-newsletter for some time.
His writing is direct and simple , with a "homespun" philosophical style.
But there is nothing simple about his underlying message- it is very much "to the point".
While reading this month's message from Harvey, it struck me that the principles espoused could very easily apply to Australian pharmacy.
The story that Harvey relates is how a group of people learned a simple skill - how to feed each other and thrive, or contrasted to the alternative - think only of one's self, be greedy and slowly die.
That also seems to be the story of our national election just completed, and subsequently the complete wipeout of the Coalition Partners.
There are many differences between pharmacists in Australia, and we have a healthy method of self analysis.
This is why i2P was born.
But isn't it time we began to think about "Team Pharmacy" and welcome the diversity by sharing information to help each other along the way?
This way we can meet head on the challenges posed by big retailers and predators from other health professions, and any other miscellaneous threats.
We will be probably exploring this issue as we move into 2008.
Barry Urquhart - International Conference Keynote Speaker
Two words. Big meaning. Compelling sentiment.
Too often intent, decisions and actions are ill-founded, because of a lack of information. “If only I knew then what I know now” is a common phrase with significant implications. Imagine an environment in which apologies, retractions and remedial actions were not necessary.
The pursuit and attainment of optimal efficiency and effectiveness, as well as quality customer service would be and is more readily and consistently achieved when all the pertinent information is willingly shared. No one individual, department or sector is precluded from the philosophy or process.
Evolving, establishing and sustaining positive relationships are typically centred on mutual respect and trust, which facilitate timely open, ongoing, two way and complete exchanging of information.
Qualified, filtered and edited communication leads to suboptimal performance and stress in relationships, private, personal and in business.
The reality of much commercial sensitive information and supposed intellectual property is one of subjectivity, rather than objectivity. Upon reflection much of what was considered to be a must for confidentiality is in reality not that essential. If only … the information was provided at the time.
Carl Peeters - A Robotic Dispensing Perspective
Automation isn’t coming to Australia – it’s here.
Webster packs, Pyxis, sachets, and other individual dose devices and procedures have been around for a while, with new devices being introduced to the market in the first half of next year. One interesting newcomer is the Rowa Select “chaotic storage” robot, a machine that can improve the running of the whole store.
Telemedicine and remote dispensing are establishing themselves, through Queensland Health and Bluepoint.
There are also the Korean, Japanese and European machines that have not yet been seen in Australia, but are expected to be here in 2008.
So the question isn’t “Will you automate or not” but is rather, “Which path will you take?”
Garry Boyd - From an Intellectual Capital Perspective
Well, the silly season is upon us, so this writer will depart from the usual ramblings that place readers at risk of falling into a comatose state.
I dare not be serious at this time of the year.
As I write this, I’m listening to a very frustrated Neil Mitchell on 3AW in Melbourne attempt to solicit a sensible comment (or any comment) from any politician (or aspiring politician) in the country, regarding the fate of a group of boat people, as they stream towards Darwin.
Pat Gallagher - An IT Consultant Perspective
Editor's Note: The following article, written by Pat Gallagher with a style and wit that I could not let go.
After turning me down in terms of producing an article within the i2P deadline for November, Patrick found that he had a restless night to fill and decided to do a bit of creative writing.
The only problem was that the article was sent after i2p was transmitted, and was never received in the editor's in-box due to a corrupt email address.
Patrick's article concerns the political landscape of early November, and a landscape that we have all put behind us by now.
The issues that Patrick talks about however, are still with us post-election, so the article is highly relevant.
Read and enjoy the article that kept Patrick awake.
Ken Stafford - A Consultant Pharmacist Perspective
“Pharmacists have again appeared near the top of the latest most trusted professionals poll.” How often have columnists for this newsletter written these words?
I know I’ve used them many times over years but we can sometimes become a bit blasé about what they actually mean for us as pharmacists.
I suddenly realised yesterday what a humbling experience it is to have someone trust you enough to open up their life to you.
I know, we’ve all been told private, personal details about customers’ lives (even things we really didn’t want to know) but just think of the level of trust people show us in our professional lives
Stephen Carbonara - From an Independent Professional Pharmacist Perspective
I don’t think that I have ever been “mystery shopped” throughout my time working in community pharmacy.
I hope I never do!..
I don’t say this to be negative or unpleasant, but I would feel professionally raped if I ever was!
Rollo Manning - A Special Report on Indigenous Health from Northern Australia
Pharmacy has a long way to go
More money given for supply and still no cognitive services
Pharmacy has a long way to go before it can be seen as playing a role in arresting the continuing downward spiral in Aboriginal health. In the area of kidney disease in the Northern Territory there is an increasing rate of admission of Aboriginal people to end stage renal failure through dialysis. This is the direct result of the health systems failure to manage these people in the early stages of kidney disease associated with diabetes and cardiovascular disease. Part of the reason is cost and not enough money in the Australian Health Care Agreement for the Territory Government health department to allocate sufficient resources to preventative measure that will arrest the slide to end stage failure. The cry is that there is not the money to employ pharmacists.
Chris Wright - Dispensary Systems Perspective
A friend (We’ll call him Billy, ‘cos he’s far from silly) has just sold his Pharmacy, well, one of them anyway.
The Pharmacy is in an area best described as “Kath & Kim” country.
Located in a lonely little nondescript shopping strip, surrounded by the monolithic battleships of today’s culture, such as Terry White, My Chemist and Chemist Warehouse, this Pharmacy is atypical of how many perceive the future of Pharmacy to be
Bob Bowden - From a Public Relations Consultant Perspective
Editor's Note: The recent conference "Market Dynamics of Self-Care" held by the Australian Self-Medication Industry highlighted some of the dilemmas faced by community pharmacy in a market that has traditionally been a primary focus, and a market that is potentially being torn in two different directions.
One direction has the major retailers dominating this market, another has manufacturers supporting the concept of clinical areas in pharmacies as a means of retaining and expanding the market through pharmacies.
A call has been made to involve a range of stakeholders in a new alliance.
Heather Pym - A Division of General Practice Perspective
Our network of General Practitioners got off the mark quite early after Item 900 was made available on the MBS schedule.
Initially as pharmacists became accredited, pharmacies became registered and GPs became interested in medication reviews for their patients in the home there was a slow uptake and logistic problems you would expect when resources were not universally distributed.
However some six years down the track our network has achieved above National average figures for HMRs done each month although the number of HMRs processed by network pharmacies falls below this figure.
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.
In this edition of i2P, Dr Byrne comments on alcoholic monkeys, ‘antagonists’ fail opiate and cocaine users (again), methadone success in US prisoners, buprenorphine/benzo interactions and hep C.