Article Index

Computachem
E-Newsletter

Editor:
Neil Johnston

Regular Contributors:
Rollo Manning
Leigh Kibby

1. WWW (Who, What, Where) + E-VENTS

2. From Rollo Manning
* Guild Brickbats and Boquets
* Criticism from the Pharmacy Guild
* Questions to the Guild and responses from Kos Sclavos
* Comments from Readers
* Personal message from Rollo
* Rollo's Year in Review

3. E-COMMERCE
* What is the Best Pharmacy Model?
* What of Our Traditional Competitors?
* And What of our Global Competitors?

4. GLOBALISATION
* Severe Impacts Likely

5. BANKING
*GuildBank and Medical Centres

6. MANAGEMENT
....From Leigh Kibby
* Finding New Leaders

7. RURAL AND REMOTE
* Roundup
..Remote Frustration-Still after a "better than dosette" invention

WWW (Who, What, Where + E-VENTS

Here we are almost at Christmas, and our last edition for the year 2000.
All of us associated with Computachem would like to thank the quite large number of subscribers who allow us to visit your pharmacy, or office, twice a month.
Love us or hate us, we promise to keep you informed of our view of the world in our own inimical style. We are not frightened to defend a point of view and we are quite willing to publish yours, as you will see in this edition.
So, Rollo Manning covers some of the responses from the last edition and reviews our coverage since launching in February 2000.
Medweb, the alliance partner to the Pharmacy Guild, has just sold out to Ehealthcareasia in an all share transaction, transferring any Australian ownership, and discounting the selling price. The ANZ bank is rumoured to have pulled out, so does that leave a vacuum for Australian pharmacists in the e-commerce area?
In an attempt to fill the void, we propose a model for the pharmaceutical industry, and we hope that individual pharmacists take up the challenge and get involved in the "new economy". Some already have, and we are listing them in the Interweb Directory if you want to check them out.
We also look at non-pharmacy (but competitive) e-commerce models based within Australia, and without.
We also examine the effects that globalisation has had on Australian pharmacy to date, and some of the "bombshells" that are in progress. We also speculate where this may all lead us.
Certainly, our view of traditional pharmacy is rapidly changing, and this must eventually translate into some spectacular infrastructure changes in the immediate future.
We also look at the GuildBank concept and couple it with a model for Medical Centre Pharmacies.
Looking for a locum, then click here, as we begin a new free service to be promoted in the New Year. Where else will you be able to get Positions Vacant and Positions Wanted, delivered to your desktop twice a month? If anyone is interested in listing, they should contact us by e-mail at neilj@computachem.com.au

Leigh Kibby discusses management issues in corporate leadership, opportune in the lead up to developing corporate models for pharmacy.
Our Roundup columnist discusses a continuing rural issue.
Please enjoy your Christmas and New Year break in a safe an peaceful manner, with your families and friends. We will be back in late January with a revised and condensed format backed by a new and more efficient website.

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The end of the first year of a new Millenium
By Rollo Manning

Agenda set for next five years –
"Bouquets" to the Guild

The challenges facing retail pharmacy were presented with a narrow focus early in the new Millenium.
The greatest challenge came with the Third Community Pharmacy Agreement, which voted to curb the increase in dispensing fee and used the money saved to improve quality standards.
This came close behind the final NCP report into pharmacy regulation, which proved the strength of the Pharmacy Guild lobby to Government. A draft report had advocated 49% ownership of pharmacies be held by external sources, but this changed to the status quo in the final report.
So the Pharmacy Guild of Australia started on a high, with the intensive lobbying undertaken paying off.
This "win" early in the year set the scene for the remainder of 2000.
The challenge from now to the year 2005 is to prove to Government the value of a pharmacists service.
The final report against NCP guidelines of the Poisons legislation is still to be released, but is certain to also advocate the status quo in scheduling restrictions on medicines with the proviso that statistical data be produced to prove consumer benefit before the year 2003.
The benchmarks for "value add" are set.
It remains to the entire retail pharmacy community to establish the fact that improvements can take place that will demonstrate the cost benefit of all regulation pertaining to the conduct of the business of a pharmacy and the product it sells.

"Brick bats" late in year"

Late in the year the Guild was in for "brick bats" with its failure to acknowledge the growing e-commerce sector of the health market , and continued it’s criticism of the "Pharmacy Direct" operation, itself a Guild member.
One senior Guild official referred to this as "Guild bashing" to this publication.

It has since been pointed to that official that:

"The Pharmacy Guild of Australia is an industrial organistion. As such it operates in a "political" sense to obtain a better deal for it's members. The Guild does an excellent job for it's members, and like any political organisation is concerned to please it's electorate so as it's elected officials (like Parliamentarians) will get voted back in at the next election. For this reason the long term goals are sometimes made to take a back step in the planning process. Services like Computachem, through the e-newsletter, see a role in reminding the Guild of the longer term ramifications of its lobbying actions. The debate over Internet pharmacy is one such example."

Editor's Note:
Following on from this editorial, we received a communication from Kos Sclavos, of the Queensland Pharmacy Guild.
[Kos Sclavos]
Your statements are contradicted by the fact that at Guild elections 18 months ago there was a shortage of candidates in 4 states (Qld and Vic are still short one committee member) and the fact is that all presidents of each and every state were elected or re-elected unopposed.
There is no push to get good results for members so that 'they will vote for you'.
There are just not enough candidates.
Additional to this there are no longer any factions in pharmacy on a state basis or national basis.
If pharmacy was factionalised like medicine then I agree with you that elected officials would search for short term gains. I can only speak for Queensland in that we have succession planning in place and we are trying to encourage active pharmacists to join the committee structure. This aim and position is stated in newsletters for all members to see on a regular basis.
Hardly a 'vote me back in' positioning!
The Guild/ Govt agreement included such arrangements as Pharmacist facilitators in Divisions of General Practice. This roll out (60 pharmacists employed across the 123 divisions) will not occur until after the next Guild election in July 2002. If we were focused on short term results we would have taken the extra 40c per script instead of this measure. We didn't because that is not in the long term interests of pharmacy.

The best example is the Quality Care Pharmacy Program.
I get regular abusive phone calls and letters from members nationally saying that the program in onerous and that they will not do it.
Many members have resigned over the program requirements.
"I went to University for three years and I practice at the right standard. I don't need QCPP to tell me what to do."
This is a common reaction.
The Guild is backing Quality Care because it is the right for our profession.
It is not easy.
It is not a soft program.
It required significant effort.
The Guild makes no apologies for that.
If we were just seeking to please members and and not look after the long term benefits of the profession then we would have opposed accreditation just like the AMA opposed Australian General Practice Accreditation (Lim)(AGPAL)
The planning process is not a 'back step' issue for the Guild.

You can print that!

A further series of questions were posed to Kos, and the answers are published below.

Editor:
* Would medical centre developers bother with doctor dispensing if they were able to have a pharmacy on site?

[Kos Sclavos]
The Guild is not opposed to medical centre pharmacies per se. In fact I have owned a medical centre pharmacy, sub-leasing from a corporate medical centre group for over 12 years.
A special rule for medical centres was looked at in the Guild/ Govt negotiations but in the end they all had loopholes for medical centre developers and unethical pharmacists to get around.
Do you base it on size of the medical centre. Do you base it on the number of doctors or do you base it on the number of patients seen per week?
A right of refusal to the local pharmacist was considered. (Why would you move from 250m2 to 1000m2)
In any of these cases I could do a deal a deal with doctors in a couple of days and have a medical centre up. I would then apply for an approval number and I have my pharmacy. Three months later the surgery closes but I still have my approval number. The whole exercise would cost me no more that $50000. A cheap approval number I suggest.
The fact is that all models had loopholes.

Editor:
* Would doctors be bothered with dispensing medication in volume to conform to all legal requirements, or simply employ a pharmacist?

[Kos Sclavos]
Corporate doctor groups will look at anything that makes them money. That is why they give their employee doctors patient targets to reach each day. That is why the large groups charge for medical detailers and pharmaceutical companies to visit their centres. (up to $50 for 15min visit) That is why they make pharmacists subsidise their rent. (One of the big three doctor groups charges over $1000m2).
That is why they aggressively sell vaccines including flu vaccines. (They sell the flu vaccines to general patients even though they were supplied free of charge to give to pensioners under a national scheme)
That is why they vertically integrate with pathology and radiology services.
That is why they will amalgamate practices and are not concerned by loss of services in a whole area.
All the above cases are factual all have occurred on numerous occasions.

Editor:
* How long can the Guild oppose Medical Clinic pharmacies, especially as the CoAG Working Group examining the NCP Pharmacy Regulation Review, has endorsed the Review recommendation and is supporting this to be possible from 1 July, 2001?

[Kos Sclavos]
The Guild/ Govt Agreement is between two parties. The agreement chose not to treat medical centre pharmacies any different than other pharmacies.
The criteria rules were agreed to by both parties.

Editor:
* Would a better tactic be to allow this to occur, and meet the challenge by, say, creating a "rider" on the approval number and having it offered to local pharmacists collectively first?

[Kos Sclavos]
Name your model and I will tell you the loophole.

Editor:
* Given that the pharmaceutical distribution market is about to enter the global "village" with a takeover of a major wholesaler imminent, can this trend be stopped?

[Kos Sclavos]
The PBS scheme is uniquely Australian model. The pharmacy wholesaler distribution scheme is uniquely Australian model. The pharmacy ownership scheme is largely a uniquely Australian model. Under your statement PBS would go because no other country in the world has a 92% coverage under one national government coverage. Brave call.

Editor:
* When will the Guild be proactive and shore up markets from competitors, rather than fight a rearguard action after the event?

[Kos Sclavos]
We'll do our best.

Editor:
* When will the Guild enter e-commerce, rather than debate the need for such a move?

[Kos Sclavos]
The Guild is in e-commerce up to our necks. Can't show our hand yet because as you know 95% of e-commerce ventures to date have failed.
Source (Time Magazine Sept 00)

Editor's Note:
We have written articles in this newsletter, in a proactive form, to cover any deficiencies observed in the responses above.

Rollo Manning continues:

It is not possible to sit back and hope this (The Internet Pharmacy Debate) will go away. It will not, is here to stay, and will become more sophisticated.
The approach needs to be analytically devised, ("strategic" some may say), for this is a new media, uncharted waters, and the fools will be left behind in the wake of a fast moving ship if they do not get on board.
E-newsletter received the following comments from readers:

"On Line Pharmacies have the capability to offer advice through their 1-800 numbers - people who want advice can get it - in most cases people are wanting costly private Rx's eg. Singulair that people have already obtained at the local pharmacy & are wanting continuation of supply at the lowest price - an extension of shopping around. Also it's not just Pharmacy Direct - there is also epharmacy at www. epharmacy.com.au & probably others as well - don't think that it will disappear - think that the net effect is that private Rx prices will drop everywhere- the are few places now that can charge a full 70% mark-up + Full Dispensing fee - otherwise most businesses are unaffected - PBS Rx's aren't attractive pricewise through E-business especially for Health Care Card Holders / Pensioners." PD – name and address supplied

And from another reader:

"Really enjoy your newsletter and particularly its honesty.
The Medweb info is a bit out of date.
Medweb has been bought by a Hong Kong group. ANZ I understand have pulled out of the venture. This does make the future plans of the Guild venture unclear." MG – name and address supplied

There are some thinking people in the audience.
If you have a view, put it in writing and e-mail it to the editor.
This discussion will continue into 2001 and your views will be published in a new format e-newsletter.

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A personal message from Rollo

This is an independent publication contributed to by people dedicated to the future success of "pharmacy" as a dynamic heath profession.
I use this end of year to thank Neil for the opportunity to contribute to his e-newsletter and wish all readers the compliments of the season.
This is the only independent newsmagazine available electronically to pharmacists and those interacting with the retail pharmacy industry.
Pharmacy needs a voice not influenced by political, commercial or self interested motives.
Neil has provided this to readers this year, and I look forward to being associated with his venture in the future.
The newsletter has given me the chance to air some of my views, and to try and give others some thought provoking ideas to stimulate discussion.
If at times I offend I do NOT apologise.
My thoughts have been expressed to make you happy, sad or annoyed.
If they have made you think, that is better.
Modern technology is a wonderful tool – we must learn to use it to our advantage – and not try and stop it from advancing.
Control what we can – and accept what we cannot.

Rollo Manning Pharmacist,
Member of the Public Relations Institute of Australia
Darwin, Northern Territory
Home phone 08 8948 1126
Mobile 0411 049 827
PO Box 527 Parap NT 0804
Rollo@topend.com.au

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Rollo Manning highlights:The Year 2000 in Review

April
The Better Medication Management System (April)

The opportunity presents for pharmacy to be involved in the new era of electronic patient management through a smart way of monitoring medicine use.
This will change the quality control aspects of the prescribing and dispensing of medications.
The system development is in response to a need brought about by the fact that each prescribing and dispensing event happens in isolation, giving rise to the possibility that patients are at risk through the possibility of adverse interactions between medications and inconsistent prescribing by different doctors.

May
Public Hospital Outpatient/Discharge script dispensing

The "Better Medication Management System" is also to rely on the success of the hospital venture to capture a more complete data picture for patients who opt in to the system.
This will be offered to patients as a complete picture capitalising on the introduction of the Commonwealth/State proposal to dispense PBS from Public Hospitals.

June
Payment for Medication Reviews

The signs are good that pharmacists will embrace the "new age" of providing professional medication management services and receive payment for it through the PBS. The training for a degree in pharmacy practice should equip a pharmacist for the task, and "medication reviewing" should be a part on everyday practice.
The opportunity to be paid for the

July
Third World countries miss out

The need for a social responsibility in the pharmaceutical manufacturing sector is called for by the influential "New England Journal of Medicine".
African countries need the support of ALL pharmacists to help alleviate their massive health problems, which are starved of modern drugs due to cost.

August
Remote Aboriginals need follow up

Pharmacists are urged to take attention as to whether a medicine is being taken by patients, and not just supply.
Persons in remote communities are suffering from a lack of a suitable compliance aid and having to be satisfied with a culturally inappropriate "dosette box".

September
Health service providers to prove their worth

Pharmacy is a provider of services.
Its efficiency will be further under scrutiny as time goes by and more health planners and authorities introduce this philosophy to the planning of "health gains".
A service will be required to show that its cost is justified in order to be immune from the rigours of competition.

October
Technology is a challenge in itself

The task of "dispensing" in the traditional sense will disappear with the advent of electronic data transmission, bar code scanning and "smart card" technology.
A patient ID will be checked against a magnetic strip, a drug ordered by a doctor through electronic messaging, product selected by bar code ID and label printed as part of the data entry process.
The input of a pharmacist will no longer be at the coal face with the patient but in the system design, training of technicians and quality control checking and evaluating process.
The scope here for new career paths presents a unique opportunity for diversification.

November
Internet Pharmacy is here to stay

The Pharmacy Guild of Australia continues to make life difficult for Mr Peter Brown of Pharmacy Direct. It is 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.
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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E-COMMERCE

What is the Best Pharmacy Model?

Next year promises to be a difficult one for pharmacy, with retailing set for a possible downturn.
Whether it becomes a recession, as some commentators are stating, remains to be seen.
We hope you took our earlier advice and will take this Christmas opportunity to clear out as much inventory as possible to start the New Year in a liquid state. One of the major opportunities available to improve business activity is in the e-commerce area. Pharmacists should not be hesitant to embrace this new form of business, because pharmacy already has a number of attributes that almost guarantees an e-commerce success.
E-Pharmacy and Pharmacy Direct, as positive examples, have demonstrated complete commitment. They are getting the results.
There has been little direction from Official Pharmacy, so we would like to suggest a model which embraces the entire community of pharmacy, without limiting market opportunities, and a model where each segment of the industry contributes in a positive alliance.

B2C.... (BUSINESS TO CONSUMER)

This area should be reserved almost in its entirety for each individual pharmacist to develop. Just as your "bricks and mortar" business has evolved as an extension of your personality and creative ideas, it is no different in the online world.
While you might discuss the design of your existing "bricks and mortar" shop with a store planner or shopfitter in its initial construction, you do not allow these people to take charge.
You specify your needs, while they suggest and endeavour to bring your vision into a tangible form. At all stages of consultation, you own the entire process and take direct responsibility for it.
No different with an online pharmacy construction, except this time you talk to a new set of service providers, such as website designers, programmers marketing consultants and Internet service providers (ISP's).
Again, you need not have the individual skills, although as much knowledge as can be accumulated, is important. You do, however, own the entire process and have the opportunity to project a vision of your business in an entirely new presentation. Suddenly, display space is not restricted, and you can put up as many departments and products as you like, construct virtual showcases of all your specialties, and promote all this, plus professional services, to a wider audience than was previously possible.

When you initially commenced your "bricks and mortar business", you invested in a size commensurate with your available capital, ensuring that you had sufficient monies to trade, and to provide a basic marketing program.
Because of these constraints, the physical size of business able to be constructed, may have had limitations on size. Rental costs, relating to where you could site your business, may have also been a consideration, to enable sufficient cash flow to trade with. With more modest rentals, visibility tends to be lower.
These restrictions disappear with an online business, because the real estate you occupy in cyberspace is very cheap in comparison, and expansion is not limited. However, as for your regular business, when you expand, you have to back your online operation with additional staff and develop different management skills.
For example, the management of your site gets more difficult as you put more goods and services on it.
This increases maintenance time and costs.
Efficient online pharmacy management is characterised by good navigation design, and this element is central to success. Without proper navigation, people will be unable to find what you have to offer and will leave your site without a purchase, usually never to return. Navigation is equivalent to a proper store design and layout, a process that is (or should be) under constant review in your normal "bricks and mortar" business.
You would never place your slowest selling goods or services on the opening pages of your site. But given intelligent navigational signposts, most customers will be able to drill down through the site and find their exact requirements.
The design, signposts and the general ambience of your site have to be updated and reviewed at regular intervals. Just as you would change your specials baskets or dress your front window, or re-arrange any of your showcases in your regular business, you must do exactly the same for the online business.
Before you even start your online business, you must have a commitment to all the above and be prepared to plan, and properly finance it.
Without such preparation, you will fail.
This is the reason for the high failure rate of online business, and it must be said that if you personally had presented a bank or other financier, with some of the "blue sky" proposals that have emerged in the recent past, you would be escorted off the premises. All the failures were empty promises, had no basic planning and were people who had no previous retail experience.
Everyone simply got caught up with the possibilities and not the substance of proper business plans, marketing projections and practical budgeting.
For all the above reasons, no market group, wholesaler, Pharmacy Guild or storefront provider can provide you with a suitable online structure in their own right.
They are not you, and cannot even begin to conceive of your aspirations, needs and wants.
They can back you in various components, but not the total.
With your existing pharmacy, you subcontract out a number of activities which are better able to be provided through other service providers.
So there is an area for market groups, The Pharmacy Guild and Pharmaceutical Society, wholesalers and a myriad of other service providers, to give you back up and support for your online venture.
Remember that your online business, exactly as for your "bricks and mortar" business, will be representative of your total activity, which includes dispensing.
Market groups may find it difficult to provide promotional support for some of the professional activities in total, nor should they try.
Many of you may have considered joining a storefront groups such as Online Pharmacy, e-Chemist or the proposed Guild/MedWeb operation.
While this may look an easy entry into e-commerce, bear in mind that the homogenous appearance that binds all the pharmacy participants on basically a single site, with only a "storefront" page proclaiming who you are, will not be too inspiring for your customers. They want familiarity, which will not be available, because all the design elements are under the control of the storefront provider.
Entry to the site is more cumbersome (more key strokes), and you do not give the appearance of "owning" your site.
Your customers will quickly lose interest.
Your business is yours, and you should only farm out those areas which will boost productivity and profit.

Certainly, these types of sites can be utilised to provide information that is time consuming for you to generate, or they can be linked in as a subsidiary to your site, but they should not be seen, or be, the dominant partner.

For many years the Pharmaceutical Society has been developing the "Self Care" program, and to me this would be an excellent tool for those pharmacists wishing to have a health information component on their site.
While it may not be as developed as some American counterparts, I would personally like to see a "home-grown" version on Australian sites, and the Pharmaceutical Society should be encouraged to make this resource available in web format, along with any other suitable consumer information material that would enhance a pharmacy website. Health information is one of the more popular reasons people surf the Internet, and a quality resource, with some form of official endorsement, would promote confidence.

Choose your services carefully, and have ownership of your market.

Another important consideration is the catchment area that you will be servicing. With your new extended reach, are you staying within the confines of your town, or will you become a regional player, or even a national player?
The answer to this question will influence the extent and range of your marketing activity, variety and cost.
The best e-commerce operators began life as mail order distributors, and the product catalogue that developed from this activity became the central marketing focus. Catalogue production and distribution is expensive, but once established, it creates an easy jump-off point for e-commerce.
The catalogue then promotes the site and the site promotes the catalogue.
Pharmacy Direct is probably the best pharmacy example of this process.
Catalogues have been the basis for pharmacy marketing groups since their inception, ranging from simple handbills, colour brochures to magazine style productions.
While the range of catalogue items is relatively small, all market group participants can agree to promote the same range of products, at the same time and at the same price.

As the number of products begin to increase within the catalogue, so do the problems of matching your individual customer needs.
Some products simply will not sell in your location, other products may be inappropriate and not marry with your marketing mix, and the marketing group suddenly becomes limited in its ability to match your needs.
Therefore, you have to produce and own your catalogue, because this must reflect your entire shop (though not necessarily all products in one single publication).
When customers walk into your "bricks and mortar" shop, they expect to see a large range of products in the shortest possible time.
Catalogues and websites are simply a replacement of this experience.

In producing your online catalogue, you will need to have an efficient database editor that can manage a wide range of products, graphics and presentation features (font style and size, colours etc) and also one that will marry up with your inventory/pricing, system to enable regular price updates.
Computachem Services has been working on this problem for the past 12 months, because while it was not difficult to design and launch a website, it was difficult to maintain it with updated products and prices.
We now have suitable software which allows untrained pharmacy staff to maintain catalogues and price lists quickly and efficiently.

Sales within a regular shop are conducted through highly visible and courteous staff. Sales from an e-commerce site are conducted through invisible and hopefully, courteous staff.
Because customers of e-commerce are also invisible, the effort invested in courtesy, through communications and fulfilment services, assumes greater importance.
To make these customers feel needed and wanted you have to develop some interaction with your site and also be willing to make staff more tangible through telephone contact or a physical delivery service.
People must always be acknowledged, otherwise they will click off your site and click on to a competitor.
A lack of personal involvement makes this process very easy and gives customers greater power. If you are not prepared to acknowledge this power shift, then you will not succeed.

Intelligent marketing programs involving such things as loyalty clubs assume more importance in e-commerce, because they provide a more tangible link with customers. Any approach which reinforces customer linkage is the approach that will win and retain business.

Again, while various service providers can deliver segments of the above activities, it is impossible to deliver a total package to satisfy your clientele. You must fill in the gaps personally.

B2B...(BUSINESS TO BUSINESS)

This is a separate site that has to be developed and kept separate from the B2C site. You need a site to manage your current and future contacts with doctors, nursing homes, allied professionals and support businesses.
It would also include links and alliances with professional bodies such as the Pharmacy Guild, Pharmaceutical Society, market groups, wholesalers manufacturers and other suppliers.
Links to directory services (including those that efficiently provide professional data) will be a feature so that information can be accessed in an orderly and efficient manner. Connectivity with your internal inventory and financial management systems would be desirable, and the facility to link to any proposed "gateways" with suppliers or online bankers (including the interesting concept of Guild Bank).
It is this site which offers the potential for the Pharmacy Guild to develop a range of support services for their members and interconnectivity at a varying levels.
The site would need to have different levels of password security established for different staff members to operate, and management processes developed to ensure an orderly flow of information, in and out.
It should also be obvious that staff with a range of IT skills have to be trained as a matter of urgency to help manage and develop pharmacy sites. University students studying IT courses are a valuable resource during vacation times and can double as pharmacy sales or service assistants.
Basic skills now need to be built in to pharmacy courses in universities and other educational providers for all levels of pharmacy staff. In previous years, graduating pharmacists were perceived to have a shortage of formal management skills.
This has been corrected, and the need has now shifted to IT skills.

With the advent of the Internet, all "old economy" activities will be gradually transferred and given a facelift to appear in the "new economy".
If staff are not multi-skilled, even those people who had high skill levels in the "old economy", may not make it into the "new economy" if they do not invest in a bit of learning.
Like it or not, we are all being driven by a global process which is unable to be stopped. I don't necessarily agree with what is happening, but I have to defend myself, by being as knowledgable as possible to ensure survival.

On a more general note, the Boston Consulting group report that in Australasia there is a boom in B2B commencements which will not begin to level out until 2004. So it seems that it will become increasingly difficult to do business with suppliers if you do not have the platform to link in with.

B2G.....(BUSINESS TO GOVERNMENT)

This is a similar site to the B2B site, but is devoted exclusively to government activity at all levels, and is also managed as a separate entity.
Links to the Health Insurance Commission, the TGA, The Australian Taxation Office or any other government agency that you have dealings with, or which can provide a useful service.
It is possibly the site that you may link to various gateways for National Health claim purposes, or the transmission of patient information for clinician access.
For certain, you will lodge your GST, BAS and Annual Company Returns via this site and its associated links.

Governments at all levels are looking to deal only via the Internet to reduce paperwork and staffing levels.
By only dealing in this way they hope to drive the entire e-commerce process, even though they have had a few hiccups in developing internal technology to cope.
This type of site has the potential for the Pharmacy Guild to provide support services to. The provision of timely information and advice in the handling of government problems has always been a Guild strength, and with the efficiency of desktop delivery, communication can only be enhanced.

SO WHAT IS THE BEST E-COMMERCE PHARMACY MODEL?

In summary, three separate sites, B2C, B2B and B2G all developed and managed separately by the pharmacist.

B2C....Where the pharmacist owns the shopping trolley and the site content Supported by a range of service providers to provide the best mix of goods and services. Suppliers may include the Pharmacy Guild and the Pharmaceutical Society, plus traditional suppliers such as marketing groups, wholesalers etc

B2B....Where the pharmacist owns the basic site, but the content may be heavily skewed by what support level official pharmacy gives and what the industry at large provides. Local business to business will be totally controlled by the pharmacist and alliance partners.

B2G.....Where the pharmacist owns the basic site and nearly all the content provided by government and official pharmacy, directly to the site or by link. By nature, it would be a more passive site relative to actual pharmacist content.

Utilising the above model (or similar) all participants in the pharmaceutical industry can play a part and develop useful alliances where they would be accepted by pharmacists. It is necessary to form constructive alliances to ensure overall success of pharmacy e-commerce, and avoid destructive processes that cause cost and uncertainty. Successful pharmacy sites should be encouraged to share their experiences and should be left alone to pioneer new pathways for pharmacy enterprise.
This requires a new mindset for official pharmacy, but the leap is not so great, once initiated, because logic begins to take hold.

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What of Our Traditional Competitors?

We have kept you up to date with the developments of our traditional competitors in the retail arena (supermarkets) in previous editions of this newsletter.
We would now like to introduce you to the model which will be the one most closely approximating the evolving pharmacy model....arch rival Woolworths!

For three years, Woolworths has been steadily building its e-commerce extension to supermarkets they call "Homeshop".
Until recently, it had not been showing any great signs of activity, but earlier this year a commitment was made.
The share market had made a value judgement on Woolworth's shares and deemed them not quite so valuable, because of the lack of e-commerce development.
This problem crystallised management thinking, and e-commerce was tackled systematically.
The sharemarket responded upwards immediately.
The entire city of Sydney is currently serviced by five Woolworths supermarkets. The service was extended to Canberra in July 2000, and four supermarkets service the entire city area there.
The manager of Woolworths' Gungahlin supermarket (in Canberra) has found that adding electronic customers has made a big difference to the way he has to manage his store. Revenue has increased by 30 percent, and the store is now open 24 hours per day, because Internet orders are packed through the night for delivery the next morning.
It is permanently busy.
To service Internet customers, the employee base had to be increased from 200 to 228. The additional people were applied to administer Homeshop orders, pick the goods from the shelves and pack them for delivery.
Management has observed that the concept involves very much the management of two separate stores on the one site, which are closely intertwined.
Each shop requires the same intensity as the other in terms of management resources. Staff have had to be trained to shop as if it were their own order being prepared. Products are carefully selected and packed with care, with meat and bread being added at the last minute, before delivery.
Deliveries are effected by a national transport carrier, also with carefully trained drivers to ensure a high level of customer service.
The alliance is a genuine team effort.
Filling orders is very labour intensive, but software is currently being developed to produce orders according to shop layout.
Hand held scanner will tick off each item of order as it is selected.

Consumer patterns are still emerging, but there is usually a rush of Homeshop orders placed between 6pm and midnight.
These are packed during the night and delivered early the following morning, commencing at 7am and ceasing at 9 pm, seven days a week.
Saturday and Sunday mornings are the most popular delivery times.
Who buys online?
Workers with limited time, elderly and disabled and mothers of young children make up the major customer groupings, with customers drawn from all income groups.
Sales of baby food and nappies are volume sellers through Homeshop.
Liquor sales are also increasing, generally to clients involved in office parties.

The biggest management challenge?
Coming to terms with the "phantom shoppers" who create overnight gaps on the shelves which have to be frantically filled before the start of a new trading day.
The addition of an extra night fill service has basically solved the problem.
Both Sydney and Canberra customers can order from a range of 19,000 products online. Minimum orders are $60, with a $12.50 delivery fee.

Homeshop is now gearing up to be launched in all other capital cities, however, progress is to be cautious and measured, and Woolworths are striving to become the Internet shopping service of first choice.
It is to be serviced by existing supermarkets, as the economics and logistics do not dictate the need for specialised warehouses at this stage.
All current assets and equipment are being utilised to get the business off the ground, which gives an advantage over new startups which don't have a network of "bricks and mortar" infrastructure.

The range offered online is identical to the in-store range. Woolworths acknowledge that they have still a number of problems to solve, because selling fresh foods and groceries by Internet is more costly than selling items such as books and CD's.

Things to get right yet, are the look and feel of their Internet home page, the integration of online and in-store systems, management of orders, packing and delivery. However, they are well into the solutions and pharmacy will find it difficult to match, because even if you started to build an e-business today, it would not be fully functional for at least two years.
Even the established pharmacy sites are experiencing some difficulties, but they at least have a head start and can compete on a more or less, equal footing with Woolworths.

If you examine the main consumer groups that are using the Homeshop service, you can readily see that they are all major pharmacy customer groups, particularly the elderly, disabled and young mothers.
All are medically intensive and therefore represent a major leakage from pharmacy, if there is not active competition.

In an announcement made earlier this week, Woolworths reported they had purchased a 26 percent shareholding in GreenGrocer.com, one of the most successful e-tailers of fresh foods, and foods requiring cold chain delivery.
It has cost them $12 million.
The move is logical, given the comments made regarding Homeshop problems yet to be perfected.
GreenGrocer.com seems to be a perfect fit.
This shrewd acquisition by Woolworths gives them access to the $20 million per annum turnover which is derived from Sydney and Melbourne only.
The deal gives Woolworths two of the seven seats on the board of GreenGrocer and also access to software being developed by Descartes of Canada.

Obviously, the scene is set for a future merger between GreenGrocer and Homeshop. GreenGrocer is immediately expanding its inventory by over 7000 additional specialty food items.
These are to be sourced from AIW, a Woolworths wholesale subsidiary, set up to service independent corner grocery stores and supermarkets.
Both Woolworths and their main rival, Coles, are expected to announce a small operating loss for the current year's Internet trading. The losses are considered well within the margin that would be applicable to normal start-up losses.

We have selected the Woolworths model to report on, because it is felt that this experience will closely approximate that of pharmacy. Pharmacists should, therefore, continue to observe Woolworths developments closely, and not hesitate to use any market intelligence that they develop.
Given Woolworths well known ambition to own a pharmacy, or transfer as many markets away from pharmacy as is possible, I would say they are again gaining ground.
They have positioned themselves to win the Internet battle against pharmacy, unless you are prepared to prevent it.
Remember, that to a large extent, the Internet is a more level playing field, with costs being more or less identical, pharmacy compared to Woolworths.
Surely with about 5000 "bricks and mortar" pharmacies nationally we can give them a run for their money?

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And What of the Global Operators?

For this exercise we have picked Tesco, a British-based global retailer, which currently owns the world's most profitable online retail business.
Tesco is known to want to be involved in pharmacy ownership and has future designs on the Australian retail food market (depending on Aldi success).
The comparison with Woolworths serves as a useful pointer.

Tesco's online business is making amazing gains in the retail world.
After five years of patient development and testing, Tesco can now deliver an order anywhere in Britain, reaching 90 percent of the population within a few hours from order placement.
There are a few natural advantages, compared say, to Australia, in that Britain has a very dense population of 60 million people concentrated in a relatively small area.
From this catchment, Tesco is extracting $1 billion in online sales, through 800,000 customers.
Like Woolworths, Tesco has stores located in every city of the U.K and uses them as distribution centres for their online retailing, relying on in-store stock picking, rather than high-tech warehouse order assembly.
It is a simple system, but has yielded impressive growth.
In December 1997, Tesco was filling 1,000 orders per week, by January 2000 this had lifted to 20,000 orders per week, and by September 2000 the rate had reached 60,000 orders per week.

If Woolworths are able to emulate this growth through capital and regional cities, what sort of devastation will this wreak on Australian pharmacy and other competitors, including Coles?
It could leave Coles very vulnerable, as they run their online business from a separate warehouse, and fulfil orders through Australia Post.
Thirty percent of Tesco's customers are totally loyal and will shop nowhere else.
The most astounding statistic is that the Tesco virtual shopping basket is four times the dollar value of the "bricks and mortar" basket, even with a $12 service fee (almost identical to Woolworths).

The marketing innovations that Tesco have pioneered include the establishment of an Internet cafe within each store, online personal financial centres, and a high tech loyalty scheme that tracks shopping preferences and alerts customers to special deals. Tesco's online future plans involve expansion into non-food business and investment into the world's largest mail order firm (Otto Versand).

The Tesco model has many similarities with the Woolworths model (or maybe vise-versa) and its success confirms what we have all felt, namely, that the convenience of the Internet will win larger unit sales and greater market shares even with a substantial service fee.
With the recent advent of petrol pump price increases world-wide, maybe this service fee is modest compared to private travel to the supermarket by car.
The simplicity of the Tesco model, operating out of local shops and capitalising on local trust and goodwill, is one that Australian pharmacy can well emulate.

The entire Australian pharmacy business is built on 5000 strategically located and trusted outlets.
To try and centralise this process would seem to be too expensive and not accepted by consumers, hence the collapse of the high-tech centralised models world-wide.
Market groups, wholesalers and the Pharmacy Guild should take note of this well publicised fact.
We repeat the message again to pharmacists....own your online business and make a true commitment to it. The rewards will be there, with effort and patience.

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GLOBALISATION

Severe Impacts Likely

The year 2001 will see the effects of globalisation begin to impact on pharmacy.
While some of these impacts will be relatively external (such as the growth in Aldi supermarkets), others will be internal and will affect pharmacy in ways we have not experienced before.
Community pharmacy is quite vulnerable, and the concern is that we have not even begun to develop strategies to handle this change.

Dotted throughout previous editions of this newsletter we have reported on global changes that have occured in various parts of the world, ranging from the rapid growth of global retailers, to the closure of John Smith and Son in Glasgow, the world's oldest continously trading bookshop.
The bookstore originally opened in 1751 and was a favourite of the poet Robbie Burns.
It was forced to close, due to pressure from online booksellers such as Amazon.com.

We also commented on seemingly unrelated items such as how American wheat farmers had become virtual slaves to global agribusiness (and similar effects are now being experienced in our local milk industry) and we have regularly commented on the predatory global supermarket operators encircling Australia through startups in Asia, poised to enter Australia at the appropriate time.
At the moment it is still "wait and see" for the majority of global grocers, as Aldi begins its penetration of the Australian marketplace.

Pharmacy has initially felt globalisation through the rapid amalgamation of drug manufacturers.
There are now only a handful of very wealthy and powerful drug manufacturers dominating the world marketplace.
Effects are being seen now, as for example, with the recent collapse of the Pharmaceutical Benefits Advisory Committee (PBAC).
One could be accused of being cynical when it is found that on one hand, the committee was accused of blocking important drugs from appearing on the NHS list, and on the other, you note that one of the drugs concerned was the lifestyle drug Viagra. The strenuous efforts that the manufacturer of Viagra has made to gain a listing (including legal action) are well documented, and you are left with the feeling that the entire approval process has been hijacked by global drug manfacturers.

If this is true, then the system simply becomes a licence to print money.

Other efforts such as the marketing of combination drugs on the NHS (where one of the ingredients is due for patent expiry) involving a "back scratching" exercise between two global giants, again seems cynical.
The combination drug is inevitably cheaper than each component drug sold separately, but the net effect is to gain a higher price for patent expired drugs.
Why has NHS policy changed to accommodate this process when there has always been a clear policy of promoting only single ingredient formulations?

And what does the ACCC think of this marketing strategy?

In another sphere, the spectre of vertical integration of the Australian distribution system appears imminent. In financial circles, it has been rumoured for some time that Fauldings was being targeted for a takeover by a global drug manufacturer.
One strategic move by Fauldings, some months ago, was to form a distribution alliance with Baxter Healthcare.
Speculation suggested that this was simply a move by Fauldings to have a powerful friend close by, to help fend off a potential takeover bid.
Now it seems that a full scale effort is being made, by a global drug manufacturer, to capture Fauldings, and that a formal bid is not far away.
While all the above is unconfirmed, there are valid reasons why this could be true.
The Australian dollar has been at a record low level, with no apparent economic reason other than Australia has been downgraded as "old economy".
Many Australian companies, including Fauldings, earn a substantial component of their income in American dollars.
A takeover of an Australian company, denominated in Australian dollars, but with a significant income in American dollars, makes good financial sense.

But what impact would this have on Australian community pharmacy?

Would a company like Fauldings be dismembered, or would it be given a capital boost to ensure that it became the dominant wholesaler/manufacturer within Australia.
Would the new owner give Fauldings a price advantage on its own drug range and would this encourage other global manufacturers to bid for the remaining wholesalers left standing?
Following this line of thought, with all the retail brands attached to Fauldings, and with continuing pressure to have open ownership of pharmacies, what would inevitably follow?
Do you think that Australian governments would protect community pharmacists, given the ability of global businesses to move large scale economic activity offshore, to the detriment of the entire Australian economy?

If we now jump across to the medical centre issue, and view it in the context as a potential takeover target by global drug manufacturers, it becomes a very unpalatable cocktail.
We have previously reported on the rapid expansion of medical centres, where a developer supplies physical infrastructure and management services, then proceeds to buy out G.P practice companies.
Simultaneously the doctors are offered a contract to work on a percentage of the Medicare fee (usually 50%).
Doctors agree to work to a factory-like production concept, churning out patients every ten minutes.
Long term consultations are discouraged.
The concept is developed as a "one-stop" shop and involves centre owned x-ray services and pathology services, hospitals and anything else they can make money out of.

The current argument with the Pharmacy Guild, which effectively blocked NHS approval numbers being allocated to medical centres, has enraged the owners of these centres. The working group advising CoAG has endorsed the view that medical centres should receive automatic NHS approval numbers after July 1st 2000, even if restrictions remain in place for all other pharmacies.

Now the shadowy entry of dr.direct.com.

A recent issue of Pharmacy Trade highlighted the emergence of this entity, which is purportedly being utilised to promote doctor dispensing of vaccines and antibiotics.
It appears ideally tailored to the philosophies of medical centres.
The view we have formed at Computachem is that dr.direct.com may appear a potential threat to pharmacy dispensing, but it does seem impractical if a doctor has to churn patients out at ten minute intervals.
The sales percentage that a medical centre owner would receive for this activity, as rental, would be insignificant compared to a percentage of sales from a full scale pharmacy.
Therefore, we view the threat simply as a pressure point to free up approval numbers.

In all the interprofessional arguments, no one has looked at what the consumer wants.

As consumer weight will dictate what will eventually occur, recent research tells us that consumers want more "one-stop" shopping, they like the "on time" appointments that are rigorously maintained in medical centres, and really, they would be quite happy if all this was "one-stopped" in the middle of a food supermarket.
They are also beginning to enjoy the alternative Internet services added on to the "one-stop" structures.

The doctors employed in the medical centres are happy, so it appears that the only group out of step is the Pharmacy Guild and some of the pharmacists they represent, plus some (real) doctors who don't like medical centres.

Medical centres are incorporated as companies.

They are now listing on the stock exchange, because this is where they turn a quick profit.

It also makes them ideal takeover targets for global drug companies.

Herein lies the long term danger.
Medical centres are concentrating patients and the resulting prescriptions.
This trend will increase.
Pharmacies inside medical centres will gain the bulk of local dispensing leaving all others in the local area out in the cold.
As it seems unlikely the entire NHS approval number system will be able to continue in its present mode, and is seen by CoAG as anti-competitive, Official Pharmacy needs to formulate a suitable model to compete against medical centres, complete with a long term strategy to prevent manipulation by global companies.
Is this possible?
I don't personally have the answer, but a suggested model in contained in the following article relating to Guild Bank.

The very real spectre for pharmacy, despite formal government agreements, could come down to:

1. Globally owned wholesalers.....an imminent possibility.

2. Globally owned medical centres.......not too far away.

3. Globally dominated NHS......seems to have already arrived.

4. Globally owned pharmacies...what do you think?

Like the American wheat farmers and the Australian dairy farmers, are we set to become slaves in our own environment, constrained by economic locks and bars?

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BANKING

In an earlier edition of this newsletter, we commented on the up to 40% per annum increase in sales that had been achieved by a rural pharmacy installing a bank within its premises. The bank was coupled with a range of financial and insurance products alongside. We are now seeing the emergence of GuildBank, which on the surface, appears to be a creative and innovative model negotiated by the Pharmacy Guild and its partner, Bendigo Bank. We look at future potential uses and benefits.

GuildBank and Medical Centres

There is no doubt that banking services have a positive impact on the customer numbers entering a pharmacy, and an enhanced positive effect on turnover.
With an innovative marketing program to gain new banking customers, it is possible to create direct profit and valuable add-ons to general retailing turnover.

The pharmacy we originally wrote about used half the $20 commission generated for signing up a new bank customer customer to actually provide the first deposit for that customer of $10, or as an alternative, if an account was opened, a $10 voucher to spend anywhere in the pharmacy.
In the last year, Woolworths have run a similar scheme in partnership with the Commonwealth Bank.
By giving staff and customer incentives, and by taking a fresh look at recruiting bank customers, Woolworths have succeeded in recruiting over 200,000 new bank customers as at the end of November 2000.
This was achieved through a total of 640 stores nationally, which means that each store recruited approximately 313 customers each.
If the commission generated for each new customer was, say $20, then a commission in total of $6260 was earned by each store.
Now I know that because of pharmacy's trusted position in the community, and the public disenchantment with major banks, individual pharmacists can do far better than the Woolworths result.
In fact, the pharmacist we wrote about achieved 275 new customers in the first month, in the mid 1970's, promoting the State Bank of NSW, and earnt an initial first month's commission in excess of $5,500.
So the future looks bright with a pharmacy owned bank that is not attached to one of the "Big Four", where the Pharmacy Guild and individual pharmacists can become shareholders as well.
There is an obvious marketing advantage in promoting the social and economic benefits for entire communities, through providing this service.
Pharmacy would be seen to be filling the irresponsible vacuum left by the Big Four banks, in their departure from rural and city suburban communities.
We are all aware of the lack of social conscience and community disruption that has occurred, and it is pleasing to think that pharmacy can be at the coalface in rectifying the damage.
It also opens the door through the Bendigo Bank to enter into some infrastructure development.

One project we would like to suggest is the development of new medical centres that could be strata titled for individual tenant purchase.
It is obvious that the following trends will accelerate:

1. Medical Centre developments will increase and concentrate prescription business within their precincts, leaving other pharmacists (and doctors) at a disadvantage.

2. Medical Centre corporations will continually list on the stock exchange and open the door for global drug company (or supermarket) ownership.

3. Approval numbers will inevitably be automatically available for Medical Centres, through consumer pressure or other political lobbying.

If the Pharmacy Guild were to relent their stand regarding opposition to medical centre approval numbers some positive movement could result.
Try replacing it with the notion, that because of the special nature of medical centres, approval numbers could only be granted to consortiums of pharmacists located in the immediate vicinity:
The following might occur:

1. Existing pharmacists would be able to share in the new business and would not see immediate erosion of their goodwill and income.

2. The new Medical Centre business, as it expanded, would probably force the closure of businesses outside of the centre.

3. The end result would probably create planned mergers of a majority of local pharmacists, allowing the establishment of a properly resourced, large pharmacy.

This whole process could be accelerated if legislation was in place in all states of Australia, allowing for the incorporation of pharmacies (where is the legislation?).
As we have previously pointed out, businesses can be properly valued, mergers could then take place on an exchange of shares, which would result in a suitable model for a pharmacy, more able to deal with Medical Centre developers.
If the Medical Centre developer is the Guild Bank or the Bendigo Bank or some trusted partner, then there would be confidence to compete in the Medical Centre market, whether they were globally owned or not.
The model assumes that local G.P's will go along with the venture, and investment into radiology and pathology could also occur.

To us, this represents a "win-win" situation creating an ideal environment, collaboration with other health professionals and not having to worry about the greedy, grasping pressure of a corporate landlord.
This model may have flaws and may be able to be exploited in some way, but I would prefer that we were proactive and got off our butts, instead of trying to preserve a status qo that is not going to survive.
The above model fits the spirit of CoAG perfectly, and would be positive evidence to government and consumers that pharmacy was genuinely trying to follow the essentially sound guidelines laid down.

One last point for the legislators.
Please ensure that all pharmacy corporate structures can only exist as "exempt proprietory companies" , to ensure that direct or indirect public company influence cannot occur. This is in addition to the pharmacist-only shareholding and ownership provisions.

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MANAGEMENT

With corporate structures becoming an urgent focus in pharmacy, we asked Leigh Kibby to help us in developing the human resource model we may need.
Drawing from his corporate consultancy/coaching experiences he starts from the top down.

Getting the leadership right!

Finding New Leaders
by Leigh Kibby

Leaders are under constant pressure to perform, inspire and keep businesses afloat by blending a focus on task accomplishment with people caring.
So, they are required to be intellectually ambidextrous mixing right brain caring with left brain goals focus - east meeting west when never the twain shall meet.
We are also told that leaders are not made, they are born.
Yet, today we need good leaders more and more and we cannot wait for the birth rate to correct a deficit in leadership.

The dilemma facing corporate executives is how to create new leaders who are caring and sharing yet capable of bringing forth bottom-line results.
One simple answer is to have dual leadership in the workplace, one being the technically proficient and the other a personable team coach.
An elegant solution if these disparate individuals can work well together and submit to the ultimate authority of the CEO.
However, given the general industry contraction in numbers on the payroll, many organisations might find this erudite solution cost prohibitive.
What then do they do?
Talent spotting is another option.
In this scenario, the executive looks for likely candidates who then undertake intensive training followed by a period of leadership apprenticeship, often overseen by an experienced mentor.
This works well if the criteria for spotting the talent is clearly identified.
Unfortunately, the executive tendency of selecting mirror images of themselves has lead to some organisations having dysfunctional cultures and by clones of the CEO, which seriously limits the intellectual bandwidth and perceptual framework.
Fundamental to finding an individual with the right stuff is to have clear criteria for identifying leadership potential.

This should include:

an attitudinal framework, demonstrated by in-situ behaviours; proven results driven performance; and an objective measure of all these.

Whilst HR records should track performance closely, it is also useful to obtain anecdotal records bottom up, top down and laterally.
Then, make the best choice on balance, balance being the critical factor.
But, if I were to choose one characteristic over all the others, I would focus on attitude.

The mechanics of a role can be learnt, it is much harder to acquire the personal style that makes a leader different from the rest of the pack, and attitude drives style.
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)

Remote frustration
Still after a "better than dosette invention"

A media release crossed the desk last week and called for pharmaceutical action.
It was from the nurse in Alice Springs looking for an innovation better than a dosette box.
There has not been any interest in her call for help put through the Auspharmlist some months ago.
Pity pharmacists are interested in the supply part but not in what happens after that!
Only kidding, there must be some who are interested
.What about giving a bit of thought to a better than dosette invention everyone can benefit from.
One important thought is that what works in one society, or culture, will not necessarily work in another.
Aboriginals living in the desert cannot be expected to be suited to the same devices as people in the suburbs.
Want to help?
Let Neil know through the e-newsletter address.
Happy festive season to all and drive safely.
(All contributions to this column will be welcomed in 2001)

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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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* 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

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