SEPTEMBER ,Edition # 34 , 2001

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It always amazes me that……………
As pharmacists, have you ever thought of the contradictions that occur in both our profession and that of the medical fraternity?
It always amazes me that our two professions continually advise our patients/customers to "take it easy and stop doing too much" but are the worst offenders ourselves.
Community pharmacist friends tell me of long hours worked, the stresses they have to contend with and the difficulties to be overcome in running their businesses. The media is full of stories about doctors and the 12-14 hour days they work.
In my former life as a hospital pharmacist it always concerned me when I saw surgeons with theatre lists of 15-20 operations, running over fifteen hours throughout their operating days.
How can people continue to function efficiently and safely, day after day, for periods of twelve hours or more?
Personally, I would worry if I was number twenty on the surgeon's theatre list for the day or if my prescription was being dispensed by someone who had been on their feet for twelve hours straight.
It says a great deal about the health professions and their expertise that so few serious errors are reported.
Either we, as a group of professions, are very skilled, very lucky or very adept at suppressing adverse news stories.
You may ask "So what, it's always been like that" but times change.
My fellow contributors have, over the past few weeks, been calling for pharmacy to look towards working smarter rather than harder, or longer.
Our profession is teetering on the edge, not only here but also throughout the western world.
In Perth, the pharmacy course is attracting greater numbers of students but WA still has a shortage of over 150 FTE positions for pharmacists (more than 25 of these in the hospital area).
High script volume pharmacies continue to operate with insufficient qualified staff to allow appropriate (or even adequate) counselling activities for those scripts dispensed.
Never mind carrying out consultant pharmacy or pharmaceutical care activities, in many of these pharmacies the pharmacist is lucky to even be able to talk to the majority of patients having scripts dispensed.
In the US, a story appeared on the Medscape Website from an ex-pharmacist telling why she had left the profession - the same story, too much work, too few pharmacists and professional burnout.
One of her major concerns was the lack of time to counsel patients and become involved in total care of her customers. The lack of pharmacists in the US is not restricted to community pharmacies but also extends to hospital pharmacy.
As an experiment I checked the situations vacant section on the ASHP website, concentrating on the Veterans' Affairs hospital system, 155 positions were listed! I think that this indicates a problem of major proportion in the US hospital scene, wouldn't you agree?
My daughter, who is currently working in hospital pharmacy in the UK, was telling me about a friend of hers, forced to work on his own until 11.30 p m in a community pharmacy.
The reason for this - the only way he could be relieved would be for the chain to shut another of its shops in the area!
In the UK, too, Pharmacy is obviously teetering on the edge.
These stories appear to have a common refrain, too few pharmacists being expected to do too much for too long.
Professional exhaustion, disenchantment with pharmacy in general and a desire to do things differently are the common threads leading to multiple problems for the profession.
So, where does Australian pharmacy go from here?
Pharmacy chains, with backing from organisations such as Woolworths or Mayne, have been advocated by some of my colleagues, but would this address the problems?
I think not, given the stories coming out of the US and UK where chains are the norm.
Boots, with more pharmacies than we have in all of Australia, still cannot attract sufficient pharmacists to adequately staff its shops to prevent the situation mentioned above.
Possibly, a better solution will be to change he way in which pharmacy operates to free up pharmacists to do what they are trained to do - ensure patients get the best out of the medicines.
A number of pharmacy organisations are now running courses for pharmacy technicians, training them to carry out many of the more mundane, mechanical jobs in the pharmacy.
Hospital pharmacies successfully utilise technicians to carry out most of the dispensing procedures, freeing up the pharmacists for more professional activities. Imagine how rewarding a similar procedure would be in the community setting-trained, licensed, technicians dispensing most of the scripts with the pharmacist only having to check that all is safe and appropriate.
The pharmacist would then be able to counsel fully, review total health care and educate patients on how to "Use Medicines Wisely" (the basis of the DVA MediWise Program).
It is very rewarding professionally to be able to do this.
I know, I moved from the pressure cooker of hospital pharmacy management to the Veterans' Affairs' QUM programme.
I am now able to apply myself to those educational needs of patients without the pressures being experienced by most of my colleagues in community and hospitals.
Pharmacy, as we all know, has so much to offer the Australian public but is being swamped by workload and shortage of qualified staff. Unless we can find some means to allow pharmacists to apply their expertise in their chosen profession the current problems will become worse.
The UK and US professions are bleeding, Australia is rapidly heading in the same direction.
The Computachem Newsletter has attracted a number of forward thinking pharmacists who are trying to address pharmacy's problems and proposing new directions.
Some I may not agree with but unless something is done soon my beloved profession may not survive here any better than it has overseas.
My desire is to be a health professional, teaching patients how to get value from their medicines, not a mindless machine churning out hundreds of scripts per day. I'm lucky in the fact that DVA pays me to do this, many others are not so fortunate.
Pharmacy needs to get off the treadmill so that it can progress professionally, my fellow columnists are offering ways of doing that and for this I am eternally grateful.
Ends

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