SEPTEMBER ,Edition # 33 , 2001

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In the past few editions, this Newsletter has been focussing on how the role of the pharmacist in Australia must change if the profession is to survive.
The problems to be overcome to bring about these changes are many and varied as the writers have highlighted.
One of these is the concept of "free medicine" in Australia and the barrier it has raised to appropriate remuneration for clinical pharmacy services in the community.
Pharmaceutical Care never managed to get off the ground, foundering on who would pay for the service given that the general public showed little inclination to puts its hand in its pocket. Not insurmountable but will require a major change in the public's mind set.
A further barrier came to mind a couple of weeks ago, this one unfortunately being of the profession's own making.
Picture the scene-2.55 pm on a Saturday afternoon with a line of scripts waiting to be dispensed.
A repeat for Becotide 50mcg is handed in with the request "Can this be done straight away as my daughter is due at a birthday party at 3pm?"
When told that there were a number of scripts in front of hers the mother was upset, "I can't wait, we're late for the party, can't you rush it through?"
We dispensed it ahead of time (with some annoyance) then noticed that the last time it had been dispensed was three months previously, this being despite directions of two puffs twice daily on the script.
Obviously there had been a compliance problem, not unusual with asthma therapy, but when we attempted to counsel we were cut off mid-sentence as she paid for the script and they left.
A little like Lewis Carroll's White Rabbit's "I'm late, I'm late" I thought as I watched them go.
Reviewing the incident later I wondered why pharmacy has allowed itself to be trapped by the "fast food" mentality of the Australian public. The frustration of not being able to do my job to my own satisfaction because customers will not stop long enough to listen becomes very wearing.
How did we become trapped in the "get it in-get it out fast" situation we now find ourselves?
Why all the rush, surely our customers' health is worth a few minutes of our time? Remember that, unlike the fast food outlets, it is critical that we get it right first time, every time, or we can kill someone.
I do not know if this unwillingness to slow down to listen is specific to Saturdays or if it is a common occurrence but it worries me. The problem is compounded when you consider the number of high script turn over businesses that operate with only one pharmacist on duty. The pressure for a single pharmacist to get through 250+ scripts per day must be very frustrating if she/he has aspirations in relation to pharmacy consultancy services and pharmaceutical care.
As an ex hospital pharmacist, I have seen the benefit of employing trained dispensary assistants to carry out the physical act of dispensing the scripts, leaving the pharmacists free to do what they are trained to do -educate, counsel and advise on drug matters.
My fellow Newsletter writers have put forward this proposal in a number of columns and I am coming to agree that this is the only way that pharmacy consultancy will be able to progress.
Clinical pharmacists in hospitals do little actual dispensing, leaving this to the technicians, and apply their expertise to obtaining the best results from the drugs used.
In hospitals, Quality Use of Medicines is not just an idea, it often is a matter of survival. Drug costs are now a major part of hospital budgets so effective use is of paramount importance and pharmaco-economics has become an integral part of pharmacy services in the major teaching hospitals.
The Pharmaceutical Benefits Advisopry Committee (PBAC) has recognised the science by demanding evidence of cost-effectiveness before listing drugs on the PBS, thus confirming the importance of clinical pharmacy input.
Two of the main areas of pharmacy thus recognise that pharmacists are more than just dispensing machines so why does community pharmacy continue to under utilise its members?
Efficiency is not merely being able to dispense a prescription in the shortest time, I would rather described it as being able to dispense a drug in appropriate time and manner.
Some years ago there was a campaign to educate the public about what is involved in dispensing a prescription correctly.
As far as I can remember, this did NOT say anything about getting it done in 2.5 seconds!
So what will be the future of community pharmacists, fast food dispensers frustrated because they have not the time to counsel, or clinical professionals assisting their patients to get the best out of their medicines?
The future is in our own hands, let us not make the wrong choice.
Ends

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