JULY,Edition # 30, 2001

I am attempting to build up an ideal model for a community pharmacy consulting practice, fully integrated into the physical pharmacy environment, but totally separate from the normal range of pharmacy services.
The separation continues into the range and type of human resources required to staff a consulting practice, to ensure that patients have a very clear idea of what is on offer, because they are going to be asked to pay for this service.
However, for marketing purposes, the consulting practice builds on the traditional environment of a community pharmacy, using the staff associated with the "free services" of the pharmacy as a directing force for the "paid services" of the consulting practice.
I have endeavoured to illustrate the model using a floor plan, which I extend with each article. I have also drawn from other writers to this newsletter, specifically the concept that dispensing procedures should be totally delegated to trained and qualified pharmacy assistants.
The problem with this approach is that in the past, there was no planning as to where the pharmacist would go, and what he/she would do.
Feeling insecure, the pharmacist always sought refuge back into the structured world of dispensing.
In the model I am developing, there is a clear pathway for the pharmacist to the role of "Forward Pharmacist", where income depends on prescription volume, to "Consultant Pharmacist", where income is generated by marketing a range of clinical services.
To ensure that dispensary delegation takes place, there is a need to develop and train two qualified human resources. The first, I will designate as "Primary Practice Assistant", the second as "Dispensary Technician".
A Primary Practice Assistant will need to be qualified to a certificate level to legally handle S2/S3 medications, while the Dispensary Technician will need to be trained to a diploma level, to legally dispense and sell medicines by prescription, in an approved pharmacy, independent of the pharmacist.
Of course, the pharmacy is always envisaged as being totally owned and controlled by a registered pharmacist, incorporated as a company, or in any other legal structure.
It is further envisaged that the certificate assistant can gain academic credits to proceed to the diploma level, and that the diploma can gain academic credits towards a pharmacy degree course.
This means that a major stream of pharmacy human resource can be recruited locally, and a clear career pathway is created, right through to consultant pharmacist.
This may be thought by some as a radical departure from the traditions established in pharmacy, but if you think it through, it represents a consolidation of resources and an end to the fragmented nature of community pharmacy enterprise.
It may also represent another method of solving the chronic shortage of registered pharmacists.
In this article I am focussing on the Primary Practice Assistant and you are referred to the evolving floor plan below:

Private Room		Paneling separating private room and open consoling area is opaque and floor to ceiling i.e. patient cannot be seen from dispensary.
Entrance Area	Open Counseling Area with Privacy Glass Panels	Forward Pharmacy Desk	Dispensary (Technician's area)
			Bench
	Reception Desk
Reception area is completely open, with a chest high opaque panel and a soundproof glass extension, separating it from the dispensary. A soundproof glass panel separates reception from counseling and a floor to ceiling opaque panel is installed between the counseling area and the private room. Forward pharmacy area may be separated from the reception desk with a soundproof, free standing, portable panel		Location for sales assistant, designated as Primary Care Assistant Information Desk FRONT SHOP AREA

You will note that I have added an "Information Desk" to the front shop area, strategically located (but not hindering line of sight) to the dispensing bench, the forward pharmacist area, and the consultant pharmacist reception area.
This desk area is the home for the Primary Practice Assistant, whose function is to provide information for patients requiring prescriptions to be dispensed, to assist customer/patient purchase of medications (including S2 and S3 medications), to provide basic information on health (Self Care Cards, complementary medicine kiosks etc.), to provide information on health aids (exercise equipment, ambulatory aids etc.), to promote health associated services (medical insurances) and to assist/promote miscellaneous health related goods, services or functions.
However, the most important function would be to market the professional services provided by the pharmacy, principally the forward pharmacist and the consultant pharmacist.
To do this professionally requires that a formally written presentation be prepared for both areas, preferably separate publications. This would take the form of a booklet or pamphlet, professionally written and designed, and presented on quality paper.
Both documents must be unambiguous, and the consultancy services must clearly display any fees and charges up front.
The primary care assistant must develop into the major marketing and referral source for directing patients to the chargeable consultant area, or the free forward pharmacy area.
This is because the largest potential source of patients will derive from the existing customer pool, and it is cheaper to develop this source rather than rely on new streams of patients from GP practices.
There is a reluctance by GP's currently to enter into referrals, such a medication reviews.

So it could be stated that the principal function of a primary practice assistant is to convert customers to patients, and refer them to the most appropriate human resource located within the pharmacy (consultant pharmacist, forward pharmacist or dispensary technician).

While I have taken three articles to arrive at this point, I must stress that I feel that the starting point to any serious consulting practice is the Primary Care Assistant, because this person intimately knows and relates to customers/patients within the pharmacy. This person will know personal family histories and will be involved in community organisations, sporting activities etc. thus providing an informal channel to commence a professional engagement.
This human resource infrastructure must be in place to "sell" the professional services in a friendly, informative and interactive manner.

One of the strengths of community pharmacy is that it is the only health professional area that people can walk into without the obligation of having to pay a fee.
It provides the "common touch" in a generally attractive and inviting environment, with no obligation to engage any service personnel or purchase any goods or services. Privacy and discretion are also guaranteed.
It is the free advice that the general public have come to request and respect. This should not be lost, because it is a formidable marketing weapon not found in other competing professions ( and it has to be noted that doctors and nurses are competitors, as well as being part of the "health team"). But free advice must be time limited, because traditional margins are disappearing at a rapid rate.
Complex information and extended consultations must be paid for by the patient, and they will, provided value is given.
By offering a clear choice of services for patients to engage, there will be an increasing take-up of consulting services. The rate will be totally dependent on the professionalism of the consultant pharmacist, the quality of the service provided, and the needs of patients.
Cost of services, and the ability of the patient to pay will be discussed in future articles, and it is not insurmountable. Remember, the Naturopaths are already doing it along with a host of other Complementary Therapy Practitioners.

It would not be too difficult to put together a TAFE course suitable for a Primary Care Assistant, and it could be delivered in a range of convenient modules to include Internet, Distance Learning, or face-to-face instruction, depending on the type and complexity of educational material. I am sure that this would be a popular course in local communities, particularly rural areas. The educational standards set would ensure that intelligent, and quality human resources, would graduate from such a system.
Certificate holders would have little difficulty gaining local employment.

In the next edition we will look at the consultant receptionist and how this person interacts with the pharmacy mosaic, plus the special requirements for dispensary technicians.

For those people wishing to review the earlier articles in this series, please follow the links

Article 1

Article 2

Ends
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