JUNE,Edition # 28, 2001

What will new pharmacy graduates be doing in 20 years time?
Graduates of the new four year programs have more education and training than any before them, and are going to be seeking jobs that offer more than what is currently available.
Already letters are appearing in pharmacy publications from new graduates who feel that their skills and training are underutilised. The problem is not unique to Australia, and is occurring in Britain as well.
With a wealth of scientific and clinical training behind them, a decreasing proportion are seeking a business-oriented career.
So what opportunities are available now and what sort of opportunities are going to appear in the coming years?
The existing structure of community pharmacy has reinforced the idea that pharmacists offer their information and services to customers for free, and in return pick up income through the selling of drugs and other shop lines.
The PBS dispensing fee does seem rather small when you consider the counselling many pharmacists offer to their patients. The issue is of course clouded by repeat prescriptions which earn the same reimbursement for less work.
Other health professionals earn their income from consultation fees, but would consumers be willing to pay a pharmacist for a complete run-down on their medications and the lifestyle adjustments that should go hand in hand with them?
What level of service would you expect when you consider what you get for free now?
It is obvious that a high degree of knowledge and training would be required to enable pharmacists to offer an expanded service to their customers in return for a fee. The government has recognised this with the Domiciliary Medication Management Review (DMMR) program, but cannot service the entire population. How can pharmacists gain reimbursement for their professional services from the remainder of the population?
New pharmacy graduates are ideally placed, with their expanded training, to offer this kind of service.
With the training we already have, we are told that accrediation as a consultant will be easier because of the volume we have already learnt.
Frustrations are emerging in this group with the "glorified shopkeeper" role that many find themselves working in.
Clinical work in hospitals can be far more rewarding professionally buut the pay constraint of public hospitals and the limited number of jobs which can ever be available in the hospital setting will limit the number who can work in this field. So how can they work to gain professional satisfaction and earn a comfortable living?
The answer to both of these problems is probably a fee-for-service consultation setup, which could co-exist within a community pharmacy, as an additional service.
But what would people be willing to pay?
I know I'd have no complaints about this service if it was free, but Medicare doesn't give rebates for it.
Few, if any pharmacists, would be accredited with private health care funds. Yet, naturopaths and others offering similar services are being increasingly accepted in the mainstream.
It is almost the chicken and the egg scenario.
It requires pharmacists to start these services for payment, without any outside reimbursement to get the structure in place.
Once the benefits of the service become obvious, private health care funds, or even Medicare could become interested. Surely a Medicare-funded review of any polypharmacy patients outside the scope of the DMMR program could produce a net saving for the Federal Government on PBS expenditure, and reductions in public hospital spending by the states for medication-related admissions.
All it will probably take is for someone to bite the bullet and start...
Ends

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