MARCH Edition # 21, 2001

A NOTE FROM THE EDITOR

As we go to press, the Federal Government is experiencing difficulties on a number of fronts, including controversy through the lobbying effects of global pharmaceutical manufacturers, and their infiltration of the Pharmaceutical Benefits Advisory Committee (PBAC).
Rollo Manning discusses some of the implications for community pharmacists.
It was also thought that Australia had some of the best legislation for control of food labelling and the development and marketing of genetically modified foods with associated health claims.
The government appears to have capitulated to the global food industry lobby, and is now set to appoint five industry representatives on a total panel of ten of the Australian and New Zealand Food Authority (ANZFA). This is a similar process to that involving the PBAC and Australians are beginning to fear that their democratic systems are being hijacked by global interests.
The government is in deep trouble because of the above, and other moves, which appear to weaken traditional Australian systems.
The survey results from the last edition are in regarding the use of Medicare numbers.
They are published at the foot of Rollo's current article, and you will find a new survey on the PBAC controversy. Please take time to complete this easy survey (only one click and it's done) as the results will be of interest to some of the decision makers.
This month, I have covered the human resource problems of pharmacy, compared what we have, what we will need, and what our corporate equivalents are planning to do.
The range of human resources will have to be completely realigned as pharmacy moves to a corporate structure (albeit at a painfully slow rate).
I have also looked at another range of micro movements that have been generated from global impacts and how pharmacy is positioned to meet these impacts. Unfortunately, we seem very weak and disorganised, but perhaps we may get over the line with a bit of hard work and planning. Certainly some outer western Sydney pharmacists are making a move, filling a hiatus created by official pharmacy indecision in mail order and e-commerce policy areas.
Jon Aldous looks at another aspect in his continuing articles on pharmacy education. This month he looks at what we need to be learning.
Leigh Kibby continues his series on some of the soft management skills required in the corporate arena. This month he looks at mentoring as being the corporate success tool of the new millennium.
Finally, our rural and remote guest columnist "Roundup" looks at the devastating effect that online pharmacies are beginning to have in an already besieged environment.
What can be done?
You are invited to submit your thoughts in this regard, because all those pharmacists in the "outback" would dearly like to hear from you.

Neil Johnston
March 1st, 2001

Back to Top

PHARMACY POLITICS

	FROM ROLLO MANNING: Time to recognise good public relations THE PHARMACEUTICAL INDUSTRY - A POWERFUL LOBBY

"Has the pharmaceutical industry broken the scheme which delivers Australians cheap medicines?
Did the Federal Government succumb to industry pressure in dumping its own expert advisers?" asks the TV program "Four Corners".
The past three months has seen a large dose of media directed to the Pharmaceutical Benefits Advisory Committee.
Medical professors, former bureaucrats, have made comments, along with consumer advocates and disenfranchised medicine takers.
But where were the pharmacists?
Surely at a time when the business of pharmacy is being attacked it could be expected that the official representatives of the pharmacists of Australia would have had a say.
The squeeze which will be put on the health dollar by the listing of drugs such as "Celebrex" will have to come from somewhere, and that could well be the PBS remuneration of pharmacists.
It will not take long to come out with the fact that pharmacists are benefiting to the extent of some 25 percent of total PBS cost of in excess of $4 billion.
The industry lobby is well aware of this, as evidenced by the lack of comment from industry when pharmacists' remuneration has been under fire.
Could it be that the industry wants the retail lobby to be silent when it is under attack?
Sometime have a look at the "forum" which followed the program on ABC on February 19, and ponder on the level of support the retail sector would have under similar pressure.
Visit at http://www2b.abc.net.au/4corners/sforum39/
Comments such as the following can be read:

"Before tonights show I was a Liberal supporter. This has really been the straw that has broken the camels back."

"Bye bye Wooldridge, bye bye Howard - just like the libs that were kicked out in WA in an election they shouldn't have lost, u guys are gone."

"On the surface it would seem that consumers (voters) will potentially be worse off if drug prices increase - this surely has a negative political impact - so what is the sweetener?"

"It is deeply concerning that the Government can be influenced as such to quickly undo the enormous good work & skill base of the PBAC."

The voters are speaking.
They do not like this interference by lobbies on Government direction.
It also showed how the truth will come out in the end, especially if the issue is felt by the media to of significant impact on the ordinary person.
The reason why pharmacy spokespersons were hard to find in this controversy is worthy of some attention when analysing the interplay between media and the professionals.
Could it have been because they did NOT want attention directed away from the manufacturer to the retailer, and for the public to find out the monopoly situation which exists for pharmacist owned businesses to profit from the decisions of the PBAC?
Or could it have been that it maybe highlighted the need for a tendering process to decide who should dispense PBS items?
Does Australia really need 5,000 odd outlets to dispense PBS to the Australian public?
These questions are ones the public may want answers to if the opportunity came for them to be asked.
So take heed.
If enough money is spent on the lobbying process, success can be expected.
But if that success comes at a cost, consider the alternative.
If the alternative could mean a change in Government, is it really what is wanted? Was that part of the initial objective?
It is easy to spend money when you have it.
In the case of multinational drug companies wanting to set a precedent, this is not a problem.
But consider your partners, friends and accomplices.
Don't bring them down with you.
ends

Poll for the month:
Do you agree/disagree with the lobbying actions of the pharmaceutical manufacturing industry in their approach to Government for greater representation on Statutory Committees?

PBAC LOBBY SURVEY YES             NO              Q: "Do you agree(YES),disagree(NO)with the lobbying actions of the pharmaceutical manufacturing industry in their approach to Government for greater representation on Statutory Committees?"

Last poll:
"Should Medicare numbers be used as a forerunner of the Better Medication Management System through pharmacy?"
76.2% voted Yes and 23.8% voted No (2.3% of subscribers responded)

The comments and views expressed in the above article are those of the author and no other. The author welcomes any comment and interaction that may result from this and future articles. The editor would be pleased to publish any responses.

Back to Top

HUMAN RESOURCES

FROM NEIL JOHNSTON Future Pharmacy HR SUCCESSION PLANNING AND THE NEW WAVE OF MANAGERS REQUIRED

When I first started out in pharmacy, business was more stable, and it was quite common to find permanent employees in pharmacies and other small businesses who had worked in the one environment all their life, right up to retirement age.
Succession planning consisted of little more than pharmacist proprietors waiting for their children to grow up and take over the reigns, or sell out to another pharmacist for ten times average weekly sales as goodwill.
With the introduction of National Health dispensing, an explosion of pharmacy numbers began, and family succession was replaced by working partnerships.
Pharmacists moving upwards through the ranks, quite often found that management opportunities, which had existed in more leisurely times, were just not available, having been replaced by partners or individual proprietors.
So they moved on to open their own pharmacies, shrinking the available employees pool in the process, and increasing the demand for locum and manager employment.
During this period of rapid growth in pharmacy numbers, pharmacy ownership was encumbered with a number of restrictions which did not apply to other businesses, principal among them being the inability to incorporate.
This process has resulted in a number of pharmacies, particularly in rural and isolated areas, that are unable to be sold. This resulted because lack of corporate structure restricted efficient amalgamation and organisational development.
The larger than necessary, total number of pharmacies, has fuelled severe shortages of skilled pharmacists within each unit.
An imbalance in the distribution of pharmacies has also contributed to the shortage in some geographical regions.
The cry over the years of "too many pharmacies" from government sources was correct in respect of the management of human resources, but incorrect for the reason given viz. increased National Health costs.
In other words, the government should not have been involved in this process in the first place.
Guild promoted partnership amalgamations were never an answer, and restriction of NHS approval numbers, another clumsy method, has distorted the market.
The result of all this inadequate planning is a community pharmacy entity that is too small in scale to compete against future competitors, with an inadequate differentiation of management functions and training required to deliver such functions.
There also exists an inadequate profit base to attract and recruit, train and develop, the people required to deliver a pharmaceutical service of best-practice world standard.
Now, Australians generally are regarded as entrepreneurial.
They rate near the top of 21 countries, in a recent study of new business generation, known as the Global Entrepreneurship Monitor, funded by the London Business School and Babson College, in the United States.
However, they rate almost last in the area of "growing a business".
As a result, more than a quarter of the business startups fail within five years, with the balance suffering from an overestimation of where their business would be after five years.
Only five to seven percent of all small businesses are considered high growth (defined as three times the industry average growth rate).
This poor small business management performance is strongly reflected within pharmacy, as we ponder the succession problems and the inadequate staffing availability that currently exists.
While licensing of pharmacies through approval numbers has fuelled the process, it has also acted to create artificial capital gains, and to inhibit new graduates from being able to buy into a practice at a reasonable cost.
We recently heard of a pharmacy changing hands for $6 million, funded by a wholesaler.
Where can a new graduate obtain, and manage, that amount of capital?
This capital inflation has not attracted a pool of new graduates as one might expect, but has generated an outflow to industry, other professions or to another vocation causing a permanent loss to pharmacy altogether.

Companies outside of pharmacy have also experienced shortages of skilled people, particularly in the Information Technology (IT) area. The rise and rise of the Internet and the expansion of B2B type activities has fuelled this process.
This activity has also generated a demand for skilled human resource managers,which is set to increase exponentially over the next five to ten years.
Management experts predict that IT and e-commerce activities will move from a management area, to one where technology will be regarded more as a commodity, rather than as a line management responsibility.
There are some strategic lessons here for pharmacy.
The majority of pharmacists are yet to engage the newer IT systems and e-commerce, and have started to focus on clinical specialties.
Many see the new focus on clinical services as being a total replacement for the distribution-oriented managed environment, and are not planning future management skill upgrades in their knowledge.
However, management underlies all delivery processes, whether they be goods or services, and it would be a mistake not to contemplate a continuing education process, in parallel, to the acquisition of clinical skills.

Outside of pharmacy, the corporate experts are planning to invest in knowledge/human resource managers as the best strategy for maintaining growth and profitability.
Knowledge managers will have the responsibility of collating and categorising all the processes and knowledge within a company, storage and access being controlled through Intranet or Internet based systems. This represents the competition of the immediate future, where knowledge and ideas can be reused by a company to save the high operational cost of reinventing ideas. Knowledge management embraces all aspects of human resource management, and the two areas will be amalgamated with a number of specialty management areas being spawned as a result.
The experts have selected the following areas:
* Intellectual capital....the function of collecting, collating and categorising all the processes and knowledge of a company.
* Data mining....the function of extracting information from large databases in respect of customers.
* Futurism...the function of identifying trends and predicting changes.
* Talent...the function of identifying opportunities, career enhancements, development, and skills training for individual workers. The process includes acting as a talent scout, mentor and agent.
* Retention...the function of developing strategies to minimise staff turnover
* Evangelism..the function to ensure that the company's vision is continually reinforced.
* Environment and resource allocation...the function of deciding where to allocate scarce resources.
* People and culture...the function which makes the company a good place to work within.
* Administrative...the function that oversees the administrative components of human resource.
* Contractors and casuals..the function of looking after workers who are not part of company core staff.
* Diversity...the function of looking after the multicultural aspects of a workforce.
* Privacy...the function ensuring no misuse of customer personal information.
* Customer resources...the function of ensuring that the company is dealing with its customers effectively.
* Troubleshooting...the function of dealing with problems in any area of the company and its activities.

While a large company has the ability to appoint a manager to focus on each of the above areas, smaller companies, including pharmacies, will not be able to afford such a luxury.
As always, one person will need to be trained to absorb all or some of the above functions. If it is the average community pharmacy, that will be a solo performance by the proprietor, adding to his/her already vast range of daily activities. The only alternative is to contract out the various functions, provided there is an adequate profit base to support it.
Perhaps there is one glaring omission from the above list, which is not factored in by the experts and it could be described as:
* Social and environmental....the adverse impacts a company has on the lives of people that work for it, and the community in which it resides.
This may include unexpected redundancies or total relocation of a company to another region or the way in which the company recycles its waste or disposes of waste.
Too many companies, particularly those in the global economy, impact on a larger number of people than was previously possible, causing social and ecological dislocation and damage.
Perhaps pharmacy could build this function into any future corporate structure.

As pharmacy takes its tentative steps towards correcting some of its management deficiencies through a corporate structure ( where is the legislation?), the workplace changes are currently being factored into existing pharmacy entities very slowly (except for clinical), and without much of an overall vision.
Jobs for life are basically extinct and the hire of multiskilled people under short term contracts will be the norm. These contractors will take their skills from company to company, and eventually from country to country, now that the APEC economies are moving towards recognising professional practice certificates between individual countries.
Aspects of this are occurring in pharmacy now, as a consultant pharmacist is retained by different pharmacies to provide medication review services. Others forms of contracts are springing up in the IT area as some pharmacies move into e-commerce.
The average contract will be for two or three years.
Contractors will vary their activities, building to an expert within one activity, but entering another as a novice to broaden a skill base. This is a totally different process to that of ascending an hierarchical structure, within the one company, for a period of up to 20 years. It will be a zigzag process into a number of ventures and companies.
The more skilled and mutiskilled will deal with larger companies and command larger monetary returns. The process will be more rewarding and motivating process, and depending on an individual's limitation, could result in a more highly stressed work environment than originally envisioned. Thus the process of self-management will be an important skill acquisition.
Talent managers will emerge to act as agents for these contractors and will involve themselves in spotting opportunities and helping with development and training.
Companies will base their recruitment on a portfolio rather than a position, and will identify what they want the person to achieve and the portfolio of skills required.
Employers will be looking at skills and employability, not just jobs.

Globalisation will begin to influence employment in a number of unconsidered ways.
For example, with more and more people working across national borders, it will become increasingly difficult for the Australian Taxation Office to work out where income was generated. This aspect will drive the process of income tax gathering to consumption tax gathering, and will change the traditional role of accountants.
It will also change the method of record collection within a pharmacy, and the job skills and training of bookkeepers within all organisations.
And this is only one aspect.
Job titles will begin to disappear and this will result in corporate culture changes.

Meanwhile, back in the world of today, pharmacies are struggling to get a simple locum service or a manager.
Where is our national retention strategy?
What is being put in place to encourage current and considering, retiring pharmacy owners to stay within the profession in another capacity?
What is being done to support female pharmacists, with children, to remain active?
Well, maybe work has to be broken up into "sessions" of say three or four hours, and the total number available, offered under contract.
A retired pharmacist may be prepared to work one session on a Thursday, or another on a Monday. Remember, these people may be getting tired, and while they enjoy the work, the joy goes out of it if it goes on for too long, or they miss out on their game of bowls each week.
A session starting with a retired pharmacist, with another session grafted on in the middle of the day for a working mother, may tap a resource that is currently wasted.
And what about the rural shortage?
Well, if this was tackled on a community basis, where,say, a retired pharmacist and partner could go to a rural community for two weeks as a working holiday, you may tap another resource. The secret is that the partner would have to be entertained by members of the community (tourist officer, Rotary, Probus etc.), and accommodation would need to be of a good standard.
Different communities could combine and transfer one locum through to the other in a straight line, and provided the pharmacists being serviced can agree to a roster, then you may have a viable source of continuing locums.
In the same way you can attract overseas pharmacists for a working holiday.
If it is publicised as a "holiday package" with two weeks in each location, then this would represent another resource.
Current employment agency services are not filling the actual need and are oriented more towards the employer's perceived needs.
But what about the employee's needs?
The range of aspirations here are rarely met, and it is necessary to break this nexus and restructure the entire workplace. Lifestyle considerations are now paramount.
Hospitals are a prime example.
Apart from not paying suitable market rates, they have become uncreative workplaces, dumping more and more work on pharmacists without going through any semblance of a negotiation. The rigid hierarchical structure means that employees must endure years of uncreative activity before they can rise to a position of making even a basic decision.
The solutions must arise nationally, for all areas of pharmacy, and with government assistance.
It is acknowledged that some activity has occurred, but it is not focussed, it is not balanced between employer and employee, and it is definitely not enough.
ends

The comments and views expressed in the above article are those of the author and no other. The author welcomes any comment and interaction that may result from this and future articles.

Back to Top

 

GLOBALISATION

NEIL JOHNSTON

Food and Drug Industry Perspectives Part 2

This is the second article in a series which roams over the global impacts being experienced by the retail food and pharmacy sectors.
Developments in one sector intertwine with the other, and while the problems seem local, their genesis is from global impact.

The marketplace in Australia is changing at a rapid pace.
Driving the change is the development of e-commerce, particularly in the Business-to Business (B2B) area, and the entry of global businesses into the local economy.
For some time we have tracked the introduction of Aldi, the German supermarket operator, as being a pointer for pharmacy in Australia.
Aldi, now open for business, and with its total reliance on its own name generics, has triggered a response from competitors, Woolworths and Coles.
With little fanfare, both these retailers have been quietly slotting products next to the national brands on their shelves, only highlighting with shelf-talkers and using words like "quality and unbeatable value" and "Savings".
The Woolworths generics have no obvious connection with their retail brand names, using labels such as "Bowman's", "Ark", "Cafe Lane", "Hillendale", "Starmark" and Avora, across a range of products competitive to Aldi.
On average, the Woolworths offering is still 17 percent more expensive than the Aldi range, which is down from approximately 30 percent from its previous price point.
The difference reflects the cost of conducting the respective businesses, with Aldi being a "leaner and meaner" competitor, basically competing on its ability to run with lower operating costs.
Coles managed to come in under Woolworths in their generic basket by a couple of percentage points.
The whole process is almost identical to when supermarkets first took off in Australia, leaving pharmacies and corner stores in their wake, because of their superior management and ability to operate with lower costs.
Some corner stores survived to become independent supermarkets in their own right.
They emerged, however, with a much reduced market share (from over 50 percent down to around 18 percent currently).
Pharmacy survived by virtue of being able to keep its core business of prescriptions intact, but market share of products held in common with supermarkets has plummeted, and continues to do so, with more manufacturers expanding previously pharmacy restricted products, into the major supermarkets.

Woolworths has recently released a media statement saying that they were now planning to roll out pharmacies as part of their supermarket offering.
Not much comment has been made about this public statement, and we all know that under current legislation, location rules and ownership provisions would severely hamper the ability of Woolworths to place pharmacies in their prime locations, unless they could persuade some adjacent pharmacists to relocate.
Why would Woolworths do this?
We all know that they have had the ambition to own pharmacies in their own right since the early 1960's.
Just before the CoAG review commenced, they conducted another campaign to own pharmacies in Queensland.
Then they suddenly backed off.
Why?
Were they promised something we were unaware of?
Given the pressures generated by Aldi, it is not surprising that Woolworths is again looking at the soft option of pharmacy.
This, plus the fact that the working party coordinating the details of the final draft of the CoAG review were not happy with pharmacists being the sole owners of pharmacies (not publicised, except in this newsletter), nor the location rules, does this mean inevitable adverse change?
More directly, is the Woolworth's lobby involved in promoting this view to government?
Given the apparent weakness by the current Federal Government in its dealings with global drug manufacturers and the Pharmaceutical Benefits Advisory Committee (PBAC) and allowing manufacturer representation in such a sensitive setting, what will be the real fate of community pharmacy?
I note that our pharmacy leaders recently received medals for their work in negotiating the Guild/Government agreement.
Will they give them back if their agreement is bombed?
And do they realise that the front line has been overrun by the enemy and literally passed them by?

As the e-commerce revolution begins its expansion into the Business to Consumer (B2C) arena, new pressures are emerging, both for independent supermarkets and for pharmacists.
Already Coles and Woolworths have a well developed model for an online Internet business under way. The Woolworths Homeshop, modeled on the English supermarket operator Tesco, is almost at break-even point.
Coles also seem to be successful in their online venture as they are currently fitting out a 5000 square metre fulfillment centre at Turella, not far from Sydney airport.
The incentive reward is that the online shopping basket is four times the value of the "bricks and mortar" basket, which is the current Tesco experience.
As we reported in an earlier newsletter, the people patronising online supermarkets appeared to be the elderly and infirm, mothers with young families and married couples with both partners working. These types of consumers are all medically intensive and are exposed to the large range of pharmaceutical products contained in the inventory offered by Coles and Woolworths.
Few independent grocers have made it to the online arena yet, but one has in Brisbane.
We previously reported that Food Direct had set up shop and was progressing cautiously. They started in September last year and they now report that they have 800 online customers within a 20km radius of the Brisbane CBD.
They also report their predominant customers as being mothers with young children.
The business is promoted by word of mouth, with a small amount of local newspaper advertising. They currently charge a $9 delivery fee and they include a $5 voucher to be used on a future order.
This model is probably one that most pharmacists will adopt, when they eventually get round to opening their own online business.
Recent research released this year indicates that 10 percent of consumers were likely to purchase online groceries in the future, with a further 17 percent "somewhat likely" to buy online.
As nearly 8 million Australians have home Internet access and nearly 30 percent of consumers possibly online this year, the market looks promising.

Is this all relevant to pharmacy?
Well, for starters, there are a lot of generic drugs coming on to the market with government encouragement.
Is this an Aldi-like response to mail order operators?
A lot of the brands are owned by major drug companies and we appear to have a healthy homegrown market with Alphapharm and Arrow going head-to-head.
The pharmacy market appears to be gearing itself up to deliver a large range of drugs, on private prescription.
With government encouragement for patients to hold private health cover, the system may provide an alternative to the Pharmaceutical Benefits scheme.
Is this a discrete form of prescription discounting that most pharmacists would feel comfortable with?
Will the government move to absorb lower price generic benefits into the Pharmaceutical Benefits scheme in a more aggressive (and costly to pharmacists) manner?
Who knows!

Official pharmacy is policy silent on a number of major issues, particularly mail order and e-commerce, and the hiatus is causing frustration in some quarters.
The publication, Retail Pharmacy, reports that pharmacists in Sydney's outer west have formed the Neighborhood Pharmacist's Association, which has called for a government inquiry into pharmacy mail order operators.
The association is aiming to recruit members nationally, with the aim of advancing the cause of neighborhood community pharmacy throughout Australia, and promote the professional and commercial development of community pharmacies operating from retail shopping centres, shops and in private hospitals.
The organisation is to seek strategies that will allow neighborhood pharmacies to compete effectively with mail order and direct marketers, in all areas of pharmacy sales, including dispensing.
Is not the function of this new association identical with the Pharmacy Guild function?
This has only arisen because the Guild has had a "knee jerk" reaction to mail order and e-commerce and has set out to crucify the pioneer in the field, Pharmacy Direct. In so doing it has lost lead time in steering community pharmacy into the new economy.
By building itself into a corner it has become bereft of policy and direction.
For this new group to be successful, it would have to tackle niche markets competitively and systematically.
Dispensing, success may lie in lining up a reliable generics manufacturer to provide cheaper prices than Pharmacy Direct and others.
It could succeed, and with each operator building their own website and backed with a mail-order catalogue, there would definitely be a clawback of market share already lost.
Therefore the Neighborhood Pharmacists Association is to be applauded for taking matters into its own hands, and we wish them every success.
If they are receptive, we would like to suggest that they concentrate all their energies on developing that "point of difference" model, and operate by example.
Do not waste valuable time and resources by encouraging government intervention.
Remember there, is room for more than one model and that the CoAG review preached that pharmacies should evolve into alternative offerings.
The ability to incorporate, would help drive at a faster pace, individual and collective models...but where is the legislation?
Keep in mind that those operators who do not run ethically, will self-destruct automatically, when consumers begin to experience that "point of difference".
ends

The comments and views expressed in the above article are those of the author and no other. The author welcomes any comment and interaction that may result from this and future articles.

Back to Top

EDUCATION

FROM JON ALDOUS PHARMACY EDUCATION WHAT WE NEED TO BE LEARNING

We all hear a lot of talk about continuing education and lifelong learning through pharmacy magazines, newsletters and other promotions.
Nearly everyone seems to agree that some sort of ongoing education is essential in a field that progresses as rapidly as pharmacy.
But what exactly do we need to be learning?
Pharmacy is one of those professions where your knowledge is already out of date by the time you graduate and leave university.
Modern medical thinking has already changed many of the rules I learnt just two or three years ago.
What chance is there for a pharmacist who has been practicing for twenty years or more, unless they make a concerted effort to stay up to date?
When asked what they'd like to be learning as part of continuing education, most pharmacists would probably say they'd just like to get back up to speed, let alone look at the future. It would be irresponsible of pharmacy educators to just move headfirst into the future without allowing us all to start from the same baseline.
The recent launch of what I call the "second wave" of pharmaceutical medicines, such as the COX-2 selective inhibitors (the "improved" NSAIDs) and angiotensin receptor antagonists (the purported next evolutionary step from ACE-inhibitors), saw the expected onslaught of advertising and media bombardment which may have confused us all.
Despite what the media spin might have implied, the evidence is starting to suggest that the benefits are marginal if present at all, over existing medicines.
Surely this needs to be the focus of education for pharmacists today.
If we don't gain a solid grip on existing therapies, what chance do we have of remaining the reliable source of drug information into the future?
How many of you knew that Celebrex has so far shown no advantage over traditional NSAIDs in patients taking low dose aspirin to prevent clotting?
Judging from the scripts I've been seeing, a lot of doctors need to be educated.
But they are stuck in the same position as pharmacy, seeking to merely stay up to date, as new drugs hit the market at a frantic rate.
Impartial sources of evidence-based medical information are only now starting to swing into full gear and target the profession as a whole. The National Prescribing Service has adopted the marketing tactics of the large pharmaceutical manufacturers in a bid to spread the word, with encouraging results, but their resources are limited.
Specialisation has become something of a buzzword in pharmacy in the last 10 or 15 years. We now have a range of specialties from renal to psychiatric, to cardiovascular management. Perhaps by picking an area to focus on we best stand a chance of keeping in touch with one part of our profession.
This means a greater amount of faith being placed in our colleagues to do the same in their own area of expertise. This idea seems to have worked in medicine around the world and is now well entrenched in the pharmacy departments of large hospitals.
This leaves a lot of community pharmacists in the same position as GPs: the generalist pharmacist who needs to know something about everything, and where to find out the rest.
Did I mention there are also specialist drug information pharmacists to help you find out the rest?
One semi-retired pharmacist that I've worked with has decided that after years of management and ownership in community pharmacy, to update his knowledge through the Australian College of Pharmacy Practice's postgraduate program.
He certainly has no illusions about the difficulty for pharmacists like himself to start using their clinical skills, after being focussed on management for most of his career. With the trend towards decreasing returns in pharmaceutical distribution and increasing returns possible through professional services in Australia, educating large numbers of pharmacists who have been pigeonholed into management roles in the past is a major priority.
The steady organic growth of marketing groups such as Pharmacist Advice and The Medicine Shoppe is testament to a growing desire amongst community pharmacy owners and managers to return pharmacy to its traditional position as the major point of contact between patients and the health care system.
The challenge for pharmacy educators is there, to produce programs which can give these people the chance to get back up to speed with those of us who have the advantage of more recent training. It would by foolish to expect pharmacists to give up weeks at a time to undertake this sort of training, when they are still trying to run businesses. Perhaps some of the ideas about online education that I raised last issue need to be considered to enable pharmacists to both learn about the Internet and to keep their professional skills and knowledge up to date.
Next time - Biotechnology - a turning point for pharmacy education?
ends
The comments and views expressed in the above article are those of the author and no other. The author welcomes any comment and interaction that may result from this and future articles.

Back to Top

MANAGEMENT

FROM LEIGH KIBBY The Mentoring Millenium EXPLAINING THE CORPORATE TOOL FOR 2021

Any CEO or manager truly interested in change and/or improving workplace performance must also become deeply committed to the Mentoring process.
In fact, Mentoring is fast becoming the most efficient and cost-effective way for delivering corporate outcomes and achieving corporate growth.
It enables more effective management whist assisting the ease of enacting, and speed of, strategic moves.
Changing the course of the Queen Mary required miles of travel and corporations are sometimes just as sluggish. This is not necessarily due to management inability, it merely reflects the nature of the beast.
Human nature, which is (in some ways) essentially habitual and focused on predictability, sees change as a threat which induces a fear response - fight or flight.
Both of these are an anathema to improvement.
The smart executive knows this and institutes systems, processes and styles that overcome resistance to change.
This is where Mentoring provides the vehicle for the systems and becomes that process.
Organisational culture, and commitment to working towards corporate goals, exists at the behavioural level and often in one-to-one interaction where culture lives through personal expression. Change, and willingness to move, happens at this personal level also and comes alive through one-to-one interaction.
Enacting change is a personal act that embodies and demonstrates both belief and commitment.
Such acts require:
· risk taking (in terms of changing personal patterns) to step outside a personal comfort zone;
· a willingness to explore new territory; and
· the capacity to face fear and still act.

A Mentor is an invaluable tool for developing a personal investment in change and a commitment to it whilst supporting the individual through the fear, into the risk taking and then finally on to acting.
Whilst some organisations will tend to focus on the latest leadership trends, outstanding organisations know that:
leadership models are transient;
the mechanics of leadership are contextual and well established;
and that personal leadership and getting on with the job is "mission critical".

It is these organisations that use Mentoring and take it beyond a haphazard occurrence and turn it into a systematic, structured program that works for people at a personal level as well as for the organisation - the best of both worlds. Mentoring systems need to be well organised and share a common plan, language and themes whilst still nurturing individual expression and style.
A successful Mentoring program has the following attributes:
· a systematic approach to Mentoring with times allocated;
· a formula for guiding both the Mentor and protégé for planning action;
· comprehensive training of mentors;
· a Mentor peer support network; and
· a Mentoring Mentors system.

The cost of these processes is relatively low compared with their value and also saves on the time cost associated with unofficial networks. Additionally, the benefits are high at a human level as well as in terms of the "bottom-line".
ends

The comments and views expressed in the above article are those of the author and no other. The author welcomes any comment and interaction that may result from this and future articles, and can be contacted directly by
e-mail at kinematic@bigpond.com , or you can visit Leigh's website at http://www.kinematic.com.au .
Alternatively, the editor would be pleased to publish any responses directed to neilj@computachem.com.au .

Back to Top

RURAL AND REMOTE

FROM A GUEST COLUMNIST ROUNDUP Internet Pharmacies a Worry

A regular column devoted to Rural and Isolated Health Issues
(N.B.The photograph is taken from the Pinnacles, an unusual rock formation, just outside of Broken Hill, NSW. Australia)

How many clients have been telling you their prescription drugs are cheaper through the Internet?
Hardly a day goes by now that this is not said to staff in a pharmacy in remote Australia.
The prices being quoted do just cover cost, and that is cost, rock bottom cost price, like $3 for Deralin 40.
Obviously no mark up or dispensing fee and the scripts are called "private".
How does pharmacy in rural areas hope to compete with this service provided as a "loss leader" to get OTC business from the client.
It is time some discussion started on this before all remote pharmacies are run out of town by the "out of towners" on the Internet.
The price received from the HIC is the same price as pharmacists get in the city, and yet the competition rural pharmacies get from Internet Pharmacies is far worse. What can the remote pharmacy do about this?
ends

EDITOR'S NOTE:
e-Newsletter will publish all responses to this plea.
Please keep your comments to 100 words or less.

Back to Top

THE NATIONAL RURAL HEALTH ALLIANCE

Want to subscribe to another interesting newsletter?
The National Rural Health Alliance has a publication dedicated to news and reviews of all aspects of rural health. You can subscribe on the website at http://www.ruralhealth.org.au or you can contact the independent editor, Jim Groves, at grovesc@winshop.com.au

Back to Top

* If you have found value in this newsletter, please share it with a friend, or alternatively, encourage a colleague to subscribe at neilj@computachem.com.au .
* Don't forget to advise of any change in your e-mail address so that your subscription may be continued without interruption.
* Letters to the editor are encouraged, or if you have material you would like published, please forward to the editor.
* You are invited to visit the Computachem web site at http://www.computachem.com.au .
* Any interested persons who would like to receive this free newsletter on their desktop each fortnight, please send a single word e-mail "Subscribe" to neilj@computachem.com.au .
* Looking for an organised reference site for medical or other references? Why not try (and bookmark) the Computachem Interweb Directory , for an easily accessed range of medical and pharmacy links, plus a host of pharmacy relevant links.
The directory also contains a very fast search engine for Internet enquiries

Back to Top
Article Index 2000
Article Index 2001
Home