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On the Labour Day Holiday Weekend, I spent 16 hours locked up at a Domiciliary Medication Management Review (DMMR) Workshop.
This is the first step to being Accredited to do DMMRs, - although for me, - I think there is a lot of work still to be done, bringing my knowledge up to date - especially in the area of interpretation of lab results and pathology.
At least, during that weekend, we were given a simple definition of Pharmacodynamics and Pharmacokinetics, and I also found out that I was not alone in my ignorance!
It is easy to become negative about DMMR, but it is just as easy to be positive. The two presenters Debbie and Lisa, were excellent.
I thought I had lifted my act by "doing" Pharmacist Advice.
I am quite comfortable with the face-to-face sit-down counselling.
However, it seems I need even more skills!
Does it EVER end?
These two girls educated us in the different skills and protocols required to review the patient in their own residence.
They are actually doing it, and already have years of experience.
We were always taught to ask open-ended questions, but dementia patients - who will be a large part of DMMRs -cannot cope with open-ended questions.
The financial bits of the DMMR process were explained in detail - the benefits were explained to us.
There are only BENEFITS, fellas …. The docs are being paid a decent sum of money to refer these patients.
They cannot get their hands on the money unless we are ready and prepared to do the job as well.
Some docs are doing it already, and sending the referrals to the Pharmacy, but we have only been able to "file" them until now. It is time for us to start proving what we can do, and to get paid for it, at a rate which remunerates us at an average $60 per hour for those of you/us who can do it!
There were a few other things, which came out over that weekend.
The main problem ( I think) we, as pharmacists have, is the "four walls syndrome".
It is good for us to meet with our peers - it gives us a chance to evaluate what we are doing and how we do it.
There were a few young pharmacists there - these guys are taught this stuff at Uni - these guys leave the Old Farts for dead!
My generation struggles with a lot of the things we have to know for DMMR, but then we have the communication skills….. don't we??!!
I met a guy from a Pharmacy which has three pharmacists - a visionary older pharmacist with the dough, and a whiz kid young partner, plus a salaried pharmacist.
This will be the pharmacy of the future.
We were shown how to use the Internet as a reference source.
That for me, was particularly interesting - I had written off the Internet as a reference source, but that live demonstration has forced a rethink.
Debbie Wee Lassie has obviously put a lot of work into finding the best sites, and the manuals we were given, has them all listed (www.aupharmacist.net is the best starting point - all credit to the guy in Tassie who maintains this site out of the goodness of his heart …. Well done!).
Debbie could tell us from experience what worked and what did not - using mainly free sites.
I have long been an advocate of Micromedex (MDX), but Deb showed us that MDX is now on line - yes ..at a price - but $3000 buys a lot of logins.
I have recently made my laptop Internet capable, so all I need in your pharmacy is a phone line.
If you don't have a dedicated line for this purpose, you should consider it, while there are still lines available.
Maybe immediate Internet access is not a huge issue, because with DMMR s you have time to think and research your report, so you could wait until you get home etc. The laptop can also "talk" to the Internet through your mobile phone (infra red port), but that is slow and relatively expensive.
You need another (data) line, which will cost you $5 a month even if you don't use it.
A good toy, which is sometimes useful.
We spent a bit of time on how to deal with doctors.
Remember, they have been paid to participate.
They have to perform.
We have to perform.
We were told not to diagnose, and not to seem to be judgemental.
Don't threaten them, and they will not threaten you.
The general feeling is that there will not be a lot of DMMR s to be done out there initially, but this really is an opportunity for Pharmacy.
It is easy for me to say that, because I am a free agent as a locum.
DMMR s might become a professional area for contractors like me.
The figure being suggested is $20 to the Pharmacy and $120 to the contracted pharmacist. However, I heard nothing over that weekend which altered my opinion, which is now shared by many others, that the days of the single pharmacist pharmacy are numbered.
I think the decision was made years ago, and, when you think about it, it makes sense.
No other professional practices the way we do - single handed doctors are fading away - it must happen to us also, if the profession is to grow.
It is good to read Warwick Plunkett of PSA (NSW) in the NSW Pharmacist (Sept), realising that pharmacists need a LOT of help to bring on this New Age Pharmacy, and that they are already programming this help.
So …… DMMR ???? ….
Not so daunting as I thought it might be … needs work …. Lots of work … but then life was not meant to be easy……

Would readers and lurkers please be advised that my psychiatrist tells me that the medication will control my various psychoses,ONLY if Roy Krusty Stevo does not acknowledge the existence of Roy Lokum Stevenson.
So if you rock up to that good looking guy at a meeting, and start talking about the Computachem articles, the alter ego will not respond.
Thank you for your cooperation.

Fantastic Facts I discovered during the meal breaks!

*If you yelled for eight years, seven months and six days, you would have produced enough sound energy to heat one cup of coffee. (Hardly seems worth it!)
* If you fart consistently for six years and nine months, enough gas is produced to create the energy of an atomic bomb. (Now that's more like it!)
* The human heart creates enough pressure when it pumps out to the body to squirt blood 30 feet. (OMG!)
* A pig's orgasm lasts for 30 minutes. (In my next life I want to be a pig!)
* Banging your head against a wall uses 150 calories an hour. (Still not over that pig thing!)
* The ant can lift 50 times its own weight, can pull 30 times its own weight and always falls over on its right side when intoxicated.
* A cockroach will live nine days without its head, before it starves to death. (Creepy!)
*The male praying mantis cannot copulate while its head is attached to its body. The female initiates sex by ripping the males head off. ("Honey, I'm home. What the....")
* Some lions mate over 50 times a day. (In my next life I still want to be a pig...quality over quantity!)
* Butterflies taste with their feet. (Oh, geez! I really didn't need to know that)
* Elephants are the only animals that can't jump. (OK, so that would be a good thing ...)
* A cat's urine glows under a blacklight. (I really didn't need to know that either) * An ostrich's eye is bigger than it's brain. (I know some people like that.)
* Starfish don't have brains. (I know some people like that too!)
* Polar bears are left handed. (Who knew....?, Who cares!)
* Humans and dolphins are the only species that have sex for pleasure. (What about the pig?)

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Editor's Note:
With a unique brand of humour, a capacity for expecting the unexpected and a high degree of professionalism, it is obvious that Roy is providing a first class service as a locum.
I am sure there are a number of prospective employers who would like to meet him. He now has a website located at: http://www.computachem.com.au/locums/RoyStevenson.html
You can arrange more information, and a locum booking, from this site.

Roy S.Stevenson Ph.C. M.P.S.,
Locum Pharmacist
40 Northminster Way
RATHMINES 2283.
Tel 4975 5548 Mob. 0402 406 691 Fax 0249 75 2334
ABN 11 585 465 385

Also, check out the human resource and employment sections located in the Computachem site.

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