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WWW (Who, What, Where) and
E-Vents
Where
did the year go to?
From the start of the new millennium, it seemed that pharmacy had a new
challenge every month, starting with the Y2K bug and finishing with the
BAS, somehow squeezing in accreditation and now Christmas.
This is the second last edition for this year, edition #18, the last issue
for this year, will be published on the 15th December next. We then go
into recess for six weeks, to emerge once more on the 30th January, 2001,
with edition #19.
During this time we will be redesigning both our website and the newsletter
format, the latter in order to deliver a more compact version than what
is currently offered
This publication began in February of this year and from humble beginnings,
is starting to be well accepted on many desk tops throughout Australia,
with a sprinkle of global desk tops as well. The address book has increased
five-fold in that time and is modestly expanding on a weekly and monthly
basis.
Thank you for those people who have given time and support, and who have
highlighted issues for Australian pharmacy that might never have been
covered, except for their intervention.
I am especially thankful for the hard working columnists who contribute
to each edition with topical issues in their own unique style.
In this edition we highlight the ongoing problems between the Pharmacy
Guild and mail order/Internet operator, Peter Brown, and we speculate
what unnecessary cost and concern this must be causing all parties involved.
It is time to resolve more amicably the perceived problems, and move on
to the real issues that pharmacy is still to come to grips with.
Pharmacy structure is discussed at length using the CoAG Review as a backdrop,
and a view is formed of who is to be serviced and what models may best
do that. Competitive and different models, as per CoAG intent, are already
forming and providing stimulus to community pharmacy.
In our e-commerce articles we discuss further developments with Australia
Post's online climate controlled delivery system and the reason why you
should be considering an online and an offline catalogue to promote your
business.
Consultant pharmacy is again viewed through British eyes, as they continue
to create professional development pathways for consultant pharmacists,
and we look at a draft continuing education model from the Institute of
Management Consultants in Australia. Leigh Kibby changes pace and develops
the concept of mentoring as a management tool, and our final article deals
with the value of medicine to indigenous people and questions if it is
necessary at all.
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From
Rollo Manning
The Pharmacy Guild of Australia is continuing to try and make life
difficult for Mr Peter Brown of Pharmacy Direct. The market has changed
since the Trade Practices Commission forced the Guild to stop publishing
a price list quoting only one price.
It said this was anti-competitive. Is it time the Guild accepted Internet
marketing of medicines and started to spend it’s energy and money on developing
an Internet marketing presence of it’s own?
Pharmacists are invited to join this debate with their comments in the
last edition (edition #18) of the e-newsletter for 2000.
COMPETITIVE
MARKETING OF PHARMACEUTICALS .......A FACT OF LIFE
The
Pharmacy Guild and Mr Peter Brown of Pharmacy Direct are still at loggerheads.
You have to give it to the Guild, it never lets up on behalf of it’s members
business interests.
Where would the upwards of 5,000 pharmacists in business be if it had
not been for the Guild.
Fighting the Commonwealth over PBS remuneration; arguing with NCP reviews
threatening to open ownership to others; contesting moves to change the
scheduling of drugs restricted for sale in pharmacy; and still trying
to stop one of it’s own (Guild member Brown) from marketing a less expensive
product.
Quite a list with success written all over it.
But what about the consumer?
Is any consideration given to their needs?
Everyone knows the consumer of the year 2000 is more informed in making
purchasing choices than they were in the 1970s.
With the Internet, consumer medicine information leaflets; current affairs
television; information radio shows (the talkback pharmacist); the Self
Care program of PSA; and, generic public advertising of pharmacy only
medicines, it is no wonder the consumer is informed. When the time comes
to purchase, not only does the consumer know what to buy, but also wants
to decided if further information is needed in making the purchase. The
value-added role of the pharmacist may be decided to be used, or it may
not.
If it is not then a conscious decision will be made by the consumer to
obtain the product at the best possible price.
And why not?
We all do the same when purchasing any consumer product.
Then why not with medicines, especially those available at only a pharmacy?
It is now the familiar old catch-phrase is trotted out that "pharmaceuticals
are not ordinary items of commerce".
This has been around for nearly as long as the Pharmacy Guild itself!
But times have changed.
Items of commerce have been subject to the Trade Practices Act since the
1970s.
This was when the Guild was stopped from publishing a price list with
one price recommended.
Why? Because competition was being sought.
Just because an item is a medicine does that mean it cannot be promoted
like a packet of washing powder?
Time will tell the reader it does not.
The changes since the 1970s have seen:
Heavy bonusing of OTC medicinals Incentive buying through gifts Television
advertising of S3 products and continuation of brand advertising of s2
products Front of shop and window displays of the same products. The Internet
marketing of prescription medicines
Hardly a scenario for marketing products which are NOT ordinary items
of commerce.
If they really were wanted to be in this category then the legislators,
or regulators, would not allow any advertising, point of sale displays,
impulse purchasing placement on shop shelves and so on.
Wake
up Australia, pharmaceuticals ARE ordinary items of commerce, the marketing
activities of the drug companies are telling us so.
The
pharmacists who accept the offers and conform with the mass media advertising
campaigns are also telling us so.
If pharmacy did not want this to work, it (probably through the Guild)
would have told the marketers where to go and driven the product off their
shelves.
But no, they accepted. A contract was made.
Now we have Mr Brown offering the consumer another choice in where to
purchase the product.
And it is cheaper.
A logical extension?
Of course it is.
The consumer has a right to a choice. They are getting a choice. If the
consumer wants to pay a higher price for advice, they will. One thing
is certain. They will not pay a higher price and no advice.
A case in point of a pharmacy charging in the order of $45 for an antihistamine
s2 product and NO advice, against the Pharmacy Direct price of $19-90
and no advice. Which would you choose?…honestly?
Now it is your turn to have a choice. Do you agree with the Guild stand
over Pharmacy Direct?
Would you prefer the energy and money to be spent in developing an opposing
model? C’mon Guild. Australia has now woken up to the fact pharmaceuticals
ARE ordinary items of commerce.
When are you going to wake up to the fact that if you can’t beat him,
join him! Comments from readers welcomed on this debating point in the
last issue for 2000 (edition #18). Send your comments to: neilj@computachem.com.au
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. The editor would be pleased to publish
any responses.
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PHARMACY STRUCTURE
The Millennium-3 Pharmacy (M3P)
One
of the hoped for outcomes, as stated in the CoAG Review of Australian
pharmacy, was that Pharmacy should change its basic structure.
The homogenous model that existed prior to the review, would, by freeing
up a number of perceived strictures (identified by the review process),
be able to evolve into a complex of differing presentations.
Consumers, it was reasoned, would then be able to access a wider and more
competitive choice of goods and services.
Already, we are seeing the genesis of a new breed of pharmacies opening
up on the Internet, with other models set to emerge. The Internet is only
one element in a smorgasbord of components that can be "mixed and matched"
to provide a diversity of models. The challenge, as always, is to find
the best models.
What is your vision for your M3P?
M3P's and the Internet
Internet
pharmacies have extended the reach of some pharmacy operators into their
local or regional catchment, with a few extending to national and international
catchments.
In the process, they have increased the level of competition.
All the Australian versions are operating as an extension of their "bricks
and mortar" pharmacy, and all appear to be attempting to operate within
the existing legislative framework (unlike some renegade overseas pharmacies).
Legislation has not yet been adapted to fully suit the Internet models,
and this needs to be urgently rectified.
This has caused some friction between Internet operators and their pharmacy
governing bodies, which appears to be developing into a particularly vindictive
and bitter dispute. One particular operator, Pharmacy Direct, is bearing
the brunt of the onslaught.
Official pharmacy in Australia seemed to initially view the concept of
Internet pharmacy as a threat to policies and procedures that were being
developed for patient communication, particularly in respect of face-to-face
counselling.
A lack of direct patient contact, it was deemed, meant reduced patient
education, and potential non-compliance in taking medication.
No alternative seems to have been considered and the genuine advances
made possible by the Internet, seem to have been downplayed.
The result is a conservative pharmacy population hesitant to embrace the
"new economy" and Internet pharmacists not being given any real leadership
and direction. The real issue with Pharmacy Direct is monetary.
The deep discounts offered to consumers, results, in some instances, the
offering of a medication at a price well below a competitor's wholesale
price.
This is naturally, causing a degree of indigestion among those pharmacists
affected, as they feel powerless, as individuals, to negotiate a similar
purchase price with the same manufacturers. They either have to emulate
Pharmacy Direct, or develop an entirely different model, which involves
the heavy expenditure of time and capital.
There is a natural reluctance, given official attitudes.
It is reminiscent of the earlier battle instigated by supermarkets against
pharmacies, where many traditional pharmacy products were unable to be
purchased below the retail selling price in supermarkets. That battle
is still ongoing, but the gap has closed through the development of marketing
and buying groups.
The "dust up" between Internet operators and official pharmacy is also
reminiscent of a past fight between pharmacists who wished to trade extended
hours.
Official pharmacy, representing a range of pharmacists who wished to keep
more sedate hours, lost that battle, and the current tactics against Internet
operators are uncannily similar i.e create disruption through legal threats
and court cases, then set up a competing model comprising, in the after
hours dispute, a pharmacy owned by all operators in a given area, but
only opening after hours.
These after hours partnerships, much to the surprise of their owners,
were highly profitable, which ultimately led many of the partners to reconsider
their local positions and embrace "after hours" in its own right.
This eventually resulted in a complete disappearance of the after hour
partnerships, more individual after hour operators, plus a withdrawal
of opposition by the Pharmacy Guild.
The Pharmacy Guild is currently "evaluating" a website in partnership
with a group known as Medweb. This is to be touted as a cooperative effort
for Guild pharmacists to be able to unite (in a similar effort to the
after hours partnerships), and compete against the Pharmacy Direct model.
It will provide additional services.
How this is to be achieved is still unclear, for it appears that patients/customers
will have to call at the pharmacy to pick up their purchases.
This negates one of the major reasons that people embrace Internet purchasing
i.e the convenience nature, and not having to battle traffic and parking
problems involved with conventional shopping.
It appears likely that the Guild model will not be individual enough for
entrepreneurial pharmacists, who will more than likely go it alone, or
link the Guild site in to their own, as a subsidiary service provider.
The concern for Guild members is that with ongoing legal costs and the
development of a website, costs could escalate rapidly.
The ANZ Bank is advertised as a partner in the website development along
with the Pharmacy Guild. Their capital contribution is noted at $3 million
and it is speculated that the Guild contribution would need to be considerably
higher to attract a bank partner (possibly as high as $10 million).
The Guild are yet to release details of these investments and costs, as
they are still "evaluating".
Evaluation tends to give the impression that a commitment has not yet
been entered into.
As a venture partner, there has to be an up front and very specific commitment.
Being able to "evaluate" and be a partner simultaneously is a curious
position to be in. The real need for Internet operators is to have a negotiated
(rather than an imposed) set of sensible guidelines which accommodates
some of the limitations of the Internet, compared to a "bricks and mortar"
practice.
The New Zealand Pharmaceutical Society was forced to develop an accreditation
process to eliminate some of the unsavoury practices developed within
New Zealand pharmacy sites, and this is now operational.
Perhaps an amnesty needs to be extended to operators such as Pharmacy
Direct and tap their valuable experiences, to enhance future Internet
pharmacy start-ups.
Like the Federal Government and Telstra, it is increasingly difficult
to regulate an industry and own a substantial component of that industry
simultaneously.
Separation is needed, and official pharmacy needs to regain the moral
high ground so that effort and resources (human and financial) are not
squandered.
The introduction of Internet pharmacies and all the potential service
extensions should not be impeded by a lack of imagination on the part
of officialdom.
It should be nurtured and encouraged, with official pharmacy actively
involved with facilitating and investing in strategic and existing Internet
alliances, rather than spending money on developing non-competitive models.
M3P's and the Consumer
There
is one fact that should be clearly and indelibly etched on all areas of
pharmacy (as well as medical and allied health) and that is consumers
are taking control of the buying process, primarily because they have
lost confidence in the institutions on which they have historically relied
upon.
Consumers began to assert themselves in the early 1980's and pharmacies,
G.P and other practices have continued to lose control of the agenda since
that date.
The process is accelerating.
Note that consumers endorse the principle of mail order, Internet medicine,
complementary medicines, competitive prices and value-for-money products.
This is not going to go away and is the reason why consumer groups support
Pharmacy Direct.
It would be foolish to oppose their expectations without some form of
consultation and an offer to provide a "value for money" alternative.
In formulating a new M3P model pharmacy, consumer needs are paramount.
Recent research by Research Partners, indicates that consumers are looking
in the nutrition and health area for quality, depth and breadth of range
and ideas.
There is continuous pressure for one stop shopping, ease of access, extended
trading hours and convenience.
The process is driven by smaller households, working women, longer working
hours and more travel time to work.
By 2050, the over 65 years are expected to triple in numbers and represent
25% of the population (compared to 12% now).
Those over 85 years will be five times as many, representing five percent
of the population (currently 1.3%).
The remaining population in the 15-64 years will decline as a percentage
of the population and the median age will be 45 years (currently 35 years).
Population growth is expected to be a low 1% per annum in 2050, with a
total population of 24-28 million.
Stress is a key social factor and is driving the trend to diet and nutrition
(quality fresh foods and, balanced diet and nutritional supplements) and
preventive medicine.
There is a strong concern for biotechnology issues (genetically modified
foods and drugs), and food safety.
It should also be noted that 60 percent of all Australian men are involved
in household shopping, and 28 percent are the main food buyers in their
households, with 63 percent of men involved in cooking and 32 percent
being the main cooks in the household.
Consumer trends have to be factored in to the M3P pharmacy model, both
in location, design and in range of goods and services.
Support for the above current and future trends is revealed through another
research group.Shopping trends are changing according to research recently
publicised by AC Nielsen, in respect of supermarket shopping. There is
an increase in the number of people who have no specific day for shopping,
with the result that Thursday, although still the busiest shopping day,
is decreasing, and Sunday trading has not increased over the past two
years.
Of more significance, shopping under the one roof has increased, with
more "one-stop-shoppers" compared to four years ago.
When polled as to what shopping enhancements to the basic food purchases
would increase customer loyalty, consumers specified toiletries, pharmaceuticals,
post office and banks (in order of preference) as requirements.
This is no surprise, because all these markets are at the high end of
the "convenience market" and are synergistic. All are compatible with
an M3P model pharmacy, including foods that have a health component or
are regarded as a nutraceutical.
Consumers may even look to pharmacists to provide information on genetically
modified foods.
This trend means also that shoppers are committing more of their weekly
shopping budget to just one store, and the competitive issue is how to
commit a customer to your store, because the relationship is becoming
more long term.
It is no accident that supermarkets have developed a range of "loyalty
schemes" and no secret being made of supermarket ambition to eventually
own a total pharmacy structure.
As an alternative, they simply target traditional pharmacy markets and
become pharmacies without a dispensary.
"Baby Clubs" are a recent rollout by a major supermarket, targeting a
traditional pharmacy market.
There is no good reason why an M3P pharmacy model could not provide a
similar range of goods and services tailored to a health environment.
M3P's and Incorporation
Yet
to come is legislation enabling pharmacies to incorporate.
This promises to be one of the most exciting recommendations to emerge
from the CoAG review, and the outcome is likely to be a number of large
scale M3P models. Incorporation liberates the capital structure of community
pharmacy, which will enable strategic mergers of existing pharmacies to
occur through an exchange of shares, without the necessity of a bank or
pharmacy wholesaler acting as an intermediary.
Its promise is to provide a scale of pharmacy that will support a range
of clinical specialty services, a skilled managerial line structure, a
competitive retail environment, a career path for young pharmacists, and
would sustain a system of formal continuing education.
Because it concentrates human resources from merged pharmacies, pressure
will be taken off the inability to fill pharmacy positions.
Investment from retired pharmacists could be encouraged to provide a continuing
capital base, new pharmacists would be enabled to buy in to a practice
on a progressive basis at an affordable price, female pharmacists could
be encouraged to invest on a scale well in excess of the current level.
Stress levels within pharmacists would reduce through shared responsibilities.
Scarce human resources would be conserved, not only through mergers, but
by attracting senior pharmacists to the board of such a company structure.
Their skills would be transferred in an interesting and challenging fashion
into the policy structures of a company, providing for a transition of
core values.
The current crop of pharmacists who have just retired or who are considering
retirement in the near future, may find that this level of participation
to be less onerous, and that any re-investment of capital might provide
better returns than the open market.
This new breed of pharmacy could stand tall against all predatory forms
of competition. including supermarkets, chain stores and global operators.
Coupled with an Internet extension, such a model would be a worthy entrant
into the "new economy".
M3P's
and Friendly Societies
Emerging
from the recent CoAG review was the view that pharmacy ownership would
be confined (at least for the moment) to pharmacists.
The one anomaly in this thinking is the existence of the Friendly Society
Pharmacy. Because of the favourable taxation arrangements for Friendly
Societies, and the fact that they control and invest substantial amounts
of monies on behalf of their members, these entities are in a position
to concentrate pharmacy market share, if allowed to multiply unfettered.
CoAG decided to retain Friendly Society pharmacies at their current level,
even though it runs contrary to the principle of pharmacist ownership
and control.
An examination of their activities proved that even without direct pharmacist
control, they were running at a high professional standard when compared
to a regular community pharmacy.
In fact, the first pharmacy to achieve Guild Accreditation was a Friendly
Society Pharmacy, and as a percentage of their population, have a greater
rate of accredited pharmacies than their community counterparts.
Had this not been the case, CoAG recommendations might have been different.
The reviewers were concerned that market share concentration could occur
if the restriction on the number of pharmacies owned was derestricted
at the same time as eliminating approval numbers.
Therefore, expect a loosening up of approval numbers, perhaps even total
elimination, as a progressive response as to how concentrated pharmacy
ownership becomes.
The reviewers also see that having a non-pharmacist owned model gives
a clear comparison and that if pharmacists wish to retain total ownership
and control, then their own pharmacies must show a point of difference
and be clearly superior, particularly in the professional area.
It is not the first time that Friendly Societies have been viewed as a
threat in the history of pharmacy, and that threat remains in the event
that pharmacists cannot lay claim to their profession.
So the potential for an emergence of a Friendly Society M3P model has
to be factored in, because at some future date it may emerge from a blind
spot as an awakening giant.
M3P's and the Medical Centre
This
model has been rapidly developing in line with the corporatisation of
medical practices.
With an injection of capital, the like of which is beyond the average
pharmacist or G.P, medical practices have emerged in which demarcations
between the various medical, pharmacy and allied health services have
been blurred.
This is because the entrepreneurs developing this model want the highest
returns on their investment, so as much in-house promotion is done, with
the minimum of "leakage" to the outside world.
What worries professionals, including pharmacists, is that in the progressive
quest for maximum shareholder returns, commercial pressures may eventually
intervene with professional standards. The potential certainly exists,
as shareholders generally have a minimum level of social conscience.
It is likely that when reviews of approval numbers occur, an automatic
allocation will go to a medical centre, irrespective of how close an existing
pharmacy may be.
Therefore, this M3P model is set for a fairly rapid expansion, once the
approval number restriction is removed, and this will occur, despite strenuous
Guild objections.
Perhaps the long term result of this type of model will see groups of
professionals collaborating in their own right, once they have been shown
how to do it by the entrepreneurs.
It is this "softer" model which will have the potential for maximising
professional activity, providing satisfaction for both practitioners and
consumers, and it may develop along the lines of the British "Primary
Care Trusts" detailed further along this newsletter.
The
Global M3P
It
is a little early to speculate what is likely to emerge here.
Certainly, for the short term, pharmacy ownership and control will be
secure.
What needs to occur, despite CoAG concerns, is a concentration of ownership
of Australian pharmacies to a level where there is still active competition
between different models of corporate pharmacy groups.
These groups need to be of a large size ,and have a scale of economy to
provide management and clinical expertise, sufficient to fend off any
global competitor.
The global pharmacy will not emerge in Australia until the battle of the
supermarkets has been decided.
The first truly global supermarket operator in Australia, Aldi, has launched
its operation and is here for the long haul.
Pharmacists should observe what strategies Aldi undertakes to gain its
stated objective of ten percent of the Australian market, and simultaneously
check what defences the big three supermarkets (Coles, Woolworths, Franklins)
mount to combat the enemy. Should Aldi win the battle, then pharmacy is
on notice that it too, will be subject to global takeovers and competition.
Pharmacists are well advised to begin formulating strategy on a "what
if?" basis for their own M3P model, and ensure that a "plan B" is in place
after determining major strategy. With the pace of business activity these
days, survival,as always, will belong to the fittest.
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E-COMMERCE
Australia Post Extends Online Delivery Options
In
our last edition we highlighted a range of online fulfillment services
being promoted to e-retailers by Australia Post, with particular attention
to small business operators.
This would not have occurred without major infrastructure changes and
the development of large scale contracts with major operators to cover
costs.
Now, Australia Post, in conjunction with major retailer Coles, has developed
a delivery service specifically tailored for the delivery of groceries
ordered online.
Titled "Post Online Groceries Delivery", the system has been developed
over 18 months and trialled in 22 of Coles' Melbourne stores.
The heart of the new system is a fleet of specially designed trucks which
contain multiple chill zones which can deliver goods ordered over the
Internet within a two hour timespan.
The trial limited consumer orders to a minimum of $60 per order and charged
a delivery fee of $12.27. With the flush of initial success in Melbourne,
the system was then rolled out in Sydney, and during the month of July
this year, 330 deliveries were effected in Melbourne, 351 deliveries in
Sydney, all with a 99.8% accuracy rate.
On the strength of this trial, Coles have awarded Australia Post with
a national contract for ongoing delivery of all Coles' grocery operations.
Cold chain delivery has previously been a problem for Internet and mail
order companies, including pharmacy enterprises. Australia Post appears
to have solved this problem by designing and building vehicles with three
temperature zones--minus 18 degrees for frozen goods, two degrees for
items such as dairy foods and vegetables, and ten degrees for most other
items.
Maintenance of these temperature zones during delivery proved to be the
biggest challenge, but Australia Post has succeeded in providing a best
practice service which exceeds that on offer in other developed economies.
Currently, the fleet comprises 17 vehicles in Melbourne and seven in Sydney,
providing a delivery service between the hours of 9am to 9pm, providing
2900 weekly delivery "windows" in Melbourne and 340 weekly delivery "windows"
in Sydney.
A two hour window would allow for 8-40 deliveries.
Plans are in hand to continue expansion of the fleet to match the anticipated
demand over the next three years Australia Post is now set to offer the
service to other online retailers, and this should prove of interest to
pharmacies with strict cold chain delivery requirements e.g as for vaccines,
insulins etc.
Coles intends to fully roll out its online service in Sydney after Christmas
and its current level of activity is exceeding all expectations.
With recent surveys indicating that 80 percent of Australians are expected
to be using the Internet in one form or another over the next 12 months,
and with the rapid development of online fulfillment services, can pharmacists
hold out any longer?
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Develop
a Catalogue
With
the apparent continuing success of some pharmacists supplementing their
businesses with mail order catalogues, you may like to investigate.
Catalogue retailing has pioneered the way and set standards for e-commerce
and many non-pharmacy retailers are publishing catalogues as an integrated
approach i.e publishing online as well as offline.
The integrated approach allows you to send catalogues to customers, site
visitors or to a wider audience through targeted mailing lists.
If you do decide to go ahead a publish a catalogue, ensure that you have
a consistent brand identity. Your "bricks and mortar" business environment,
your offline catalogue and your e-catalogue should have a seamless style.
Designs, colours, logos should be such that your customers immediately
make the visual connection.
Offline and online catalogues should not be totally identical, with each
retaining a segment to reinforce the other.
Offline catalogues should direct customers to the e-commerce site, and
give them a free incentive to do so.
Online customers should be encouraged to secure an offline catalogue which
should contain some sort of a voucher which can only be completed by an
online customer, but the reward being converted in the "bricks and mortar"
store.
Producing a mail order catalogue increases visibility and the ability
to acquire new customers from outside your normal catchment.
Efficient fulfillment procedures will ensure that you retain those customers.
Adding a catalogue to your marketing armoury gives customers a multiple
choice to engage your business as a customer, by offering a multiplicity
of "front doors".
By becoming a multi-channel operator you increase the opportunity to gains
sales and profit from a variety of patrons who may not normally "see"
you.
Mail order has been with pharmacy for as long as I can remember.
When I originally began my pharmacy training at a Marrickville pharmacy,
I remember that my employer had a book of secret formulas that he personally
compounded for a myriad of customers. A large volume of these "secrets"
were delivered by mail order, and many were overseas customers.
Pharmacies, such as Pharmacy Direct, have just taken this old concept
and given it focus...much like developing "category killers".
It has taken hard work and a lot of capital to develop the success as
seen today, a lesson that many pharmacists could learn from.
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CONSULTANT
PHARMACY
For
consultant pharmacy to flourish, it needs unstructured time independence
and a clinical support base. None of these elements have been developed
to any extent in the Australian pharmacy scene as yet, but Britain seems
to be setting the pace in terms of modelling and management of the integral
components.
A brief outline of the British "primary Care Trusts" provides some illumination,
and what Australian consultant pharmacists may eventually aspire to.
British
NHS Primary Care Plan
By
the year 2004, 500 new one-stop "primary care trust" centres will have
been opened. So stated Lord Hunt (parliamentary under-secretary of state
for health) when he launched the "Pharmacy in the Future- Implementing
the NHS Plan" paper at the British Pharmaceutical Conference in Birmingham,
on September 12th.
The concept will enable pharmacists to work alongside general practitioners,
dentists, opticians, nurses and social workers and other allied health
professionals.
High quality pharmaceutical care and service, is seen as a vital element
for success of the scheme. Locally tailored remuneration contracts, with
minimal restrictions and terms are to be negotiated. It is this form of
environment where the British versions of "Forward Pharmacy" and "Consultant
Pharmacy" will be brought to maturity.
Over 30 million pounds is to be invested over a period of three years
to encourage these "primary care trusts" to invest in medication reviews
and other forms of medication management, involving the use of "action
teams" in the promotion of these activities, plus develop any good ideas
which may emerge from the primary care trust centres.
The action team will also be supporting a national trial of a medicines
management service to be operated exclusively from community pharmacies.
Local pharmaceutical services are envisaged to be a collaboration between
health authorities, primary care trusts and existing pharmacy contractors,
where pharmacists will be permitted to focus on patients and getting the
most from their medicines.
As mentioned in the last edition, pharmacists will be able to prescribe,
initially on a dependant basis, but eventually to go to an independent
status.
Perhaps a version of this model may find its way into the Australian Pharmacy
scene, as we appear to be on a similar track.
The British do seem to be ahead, however.
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EDUCATION
Continuing
education seems to be an issue with most of the professions these days,
in an attempt to keep pace and manage the explosion of information, which
makes knowledge obsolete at a rapid rate.
We were always promised the "information highway", but I guess few of
us realised how much it would impact on our own daily professional lives.
In an endeavour to manage, most professions are introducing the concept
of a practice certificate or some other continuing additional qualification,
so that the individual profession remains relevant.
The trick will be in providing the education in modular form at a convenient
time, and inexpensively.
The Internet promises to be the medium to deliver such a program, but
educational establishments are still coming to terms as to how they will
make that delivery.
It is always interesting to see how other professions cope.
Engineers have been highlighted in previous editions and in this edition
I am publishing a recent e-mail received from the Institute of Management
Consultants, canvassing my views on the subject, as a member.
From
the IMC
"Dear Colleague,
The
IMC Federal Council has been investigating an accessible, structured and
accredited professional development program with specialist consulting
units for its members.
After significant research and negotiation the opportunity now exists
for the provision of a Graduate Certificate (Consulting), Graduate Diploma
(Consulting) and MBA (Consulting) through an Australian University.
The courses can be offered on-line or face to face in groups where sufficient
numbers warrant (minimum of about 20).
The courses will be offered at normal commercial rates.
We are endeavouring to identify how popular these studies may be.
Please respond to the following four yes/no questions at your earliest
convenience.
To complete this survey, first click on REPLY to this e-mail and answer
the questions by deleting whichever answer (YES/NO) is not appropriate.
Then send the completed survey to the IMC.
1.
Would you support the concept of these graduate qualifications with a
Consulting emphasis for IMC members? YES/NO
2.
During the next few years, would you be interested in participating in:
a. Graduate Certificate (Consulting) YES/NO
b. Graduate Diploma (Consulting) YES/NO
c. MBA (Consulting)? YES/No)
3.
Would you prefer:
a. on-line YES/NO
b. face to face? YES/NO
4.
Do you know of anyone who might be interested? YES/NO
...If yes, please provide contact details for that person.
The results of this survey will guide the IMC on further negotiations
and anticipated commencement of these courses in mid 2001.
Thank you in anticipation of your response."
In
our last edition we commented that no Australian university was offering
a degree online to this date. It would appear that management schools
may be the first to provide, should the result of the above survey prove
positive.
Working professionals find it extremely difficult to fit extra duties
into an already crowded day.
Older professionals may simply find it too stressful.
It may herald increased professional fees, to bring to account the investment
needed to maintain a profession, with a lesser number of hours available
to practice, as a result. This should be a negotiating point in future
discussions under NHS arrangements for remuneration.
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MANAGEMENT
Making
Mentoring Work: Using the Corporate Tool of 2021
..............................by Leigh Kibby
The
wise leader knows that interpersonal relationships hold an organisation
together.
It is the glue that binds teams and the and essence that helps excellence
spring from mediocrity.
Of course, smiling faces and happy people are not the only elements of
success.
But, a balanced mix of task focus and cultural development forms a team
that can go beyond willing to skilling then thrilling. Obviously leadership
style has an enormous impact on an organisational culture.
However, it alone will not necessarily create the changes in culture that
produce excellence in performance, nor will directives that issue from
the management hierarchy. A well structured, well run and well organised
Mentoring program can make the difference.
Mentoring itself is not counselling nor an act of management.
It is also more than just friendship and is definitely not a forum for
brooding over problems or failure.
Mentoring is wise, objective support that provides a nurturing context
for personal review and reflection followed by action planning.
It is also an opportunity for modelling that builds a framework for the
protégé to develop attitudes and expand skills.
However, there are critical components of the process.
These must first be understood, along with a sound understanding of the
issues, so that a Mentoring program can be successful.
In organisations that want to enhance their performance by improving their
interpersonal skills (i.e. build teams, establish a sense of direction,
encourage a community within the workplace), the following factors are
in play:
the learned experience gap (LEG) - separates theory from doing (a key
reason why training programs often fail to produce "enacted" change);
the fear factor (FF) - where uncertainty results in reluctance and resistance,
sometimes associated with a lack of commitment as a personal protection
mechanism;
reciprocity in relationships (RR) - between the individual and the organisation;
balancing the Task/Culture mix;
the appreciation gap (AP) where there is an inability, unwillingness or
blindness to the benefits that are presently being provided by the organisation
(a critical issue and one where Mentors can gently provide some reality
testing);
and the social context which can instil attitudes that effect commitment,
loyalty and dedication.
A Mentoring program can bridge the LEG, reduce fear, create a sense of
reciprocity and can obviate the pressures of the external social context
to develop a powerful internal culture.
Training programs will not achieve these outcomes alone.
Inspired leadership at the top and inspiring management down the line
might.
Reality suggests that this is not the case and so Mentoring has a clear
role. Additionally, a well run Mentoring program can also produce erudite
managers/leaders with broader outlooks, more positive attitudes and an
expanded repertoire of skills.
The following are the key elements of a successful Mentoring program:
enacted support from the executive leadership; well trained Mentors who
have undertaken a program that explores attitudes, expands skills and
is designed to bridge the LEG; program co-ordination and oversight; a
system for Mentoring the Mentors which goes beyond program co-ordination
and provides support with high level skills and experience (this may be
required rarely but the resource needs to be available in the event of
difficult problems, interpersonal issues, referral etc.); a thematic approach
that links the Mentoring program with the organisation’s direction (e.g.
Alignment Plus model); and a model for creating "buy in" for proteges
based on personal interest (the Alignment Plus model works here also).
In general, these components are not difficult to put together nor organise.
Some require specialised experience and expertise, but most are readily
available.
The benefit of "getting it right" in the first place is that the system,
if designed and supported well initially, becomes self-sustaining and
independent.
The critical component, often overlooked by those focussing on program
structure, is the Mentor/Protégé interaction (interaction, not relationship
because the interaction precedes and forms the relationship).
The communication between the Mentor and Protégé and the dialogue form
the conceptual/world models through which the protégé views the world
(organisation), understands themselves and plans for a proactive future.
The structure and type of communication also delivers a powerful message
that can be productive or quite harmful.
Therefore, "Learning Organisations" have chosen to use the Mentor/Protégé
interaction as a fulcrum for developing leaders, building capacity and
increasing resilience in a changing and stressful world.
Additionally, the interaction can have a reciprocal effect for Mentors
who often become more insightful leaders with greater ability to harness
their own talents as well as those of others.
The outcome is increased prosperity for all , especially the hosting organisation
where turnover can be reduced, absenteeism declines, staff satisfaction
increases and line managers spend less time on people problems and more
time on performance improvement and success.
Ends
The
comments and views expressed in the above article are those of the author
and no other. The author(s) 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.
Alternatively, the editor would be pleased to publish any responses directed
to neilj@computachem.com.au
.
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RURAL
AND REMOTE
Roundup
A regular column devoted to Rural and Isolated Health Issues Roundup
(Written by Guest Columnists)
A
recent Conference organised by the Australian Medical Association looked
into the relationship between education and health in alleviating the
problems in Aboriginal and Torres Strait Islander health.
The Conference was told of a project whereby a healthier lifestyle through
diet and exercise paid a large part in arresting the complications of
diabetes.
The question may be posed as to "what value medicines?" in the Aboriginal
community. Would diet and exercise, or a return to a "hunter and gatherer"
lifestyle have the same result?
Pharmacists should be prepared to assist in evaluating this concept, rather
than watch the money roll in from the sale of prescription drugs.
Some of the Guild "quality use of medicine" money should be spent on properly
controlled trials to attempt to find an answer.
The crisis in Aboriginal health will only be arrested if there is clever
use of money available and not just being spent on sending medicines to
places which are showing that there is not a great deal of difference
in the health status of the people as a result.
Those pharmacists supplying under the s100 arrangements for PBS to remote
Aboriginal communities should be lobbying the Guild to include more research
funds to find out what has gone wrong.
This new opening of opportunity could be the contribution pharmacy can
make to this vital National issue and by doing so, show by example to
the suburban communities that mainstream Australia can learn lessons itself
from the problems in Aboriginal health.
How long since a pharmacist asked a patient in your practice if they were
on a balanced diet and getting enough exercise to prevent diabetes from
developing?
Education is the key, and the pharmacy is in an ideal place to provide
it – an alternative to drug supply.
Ends
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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
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* Letters to the editor are encouraged, or if you have material you would
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* You are invited to visit the Computachem web site at http://www.computachem.com.au
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* Any interested persons who would like to receive this free newsletter
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Why not try (and bookmark) the Computachem
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links, plus a host of pharmacy relevant links.
The directory also contains a very fast search engine for Internet enquiries
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