Let
me first say, that I have always been a community boy. Saturday
mornings at the local pharmacy is where you'd find me. Getting to
know the regulars and offering that all-round service which no other
profession seems to encounter. I advise on drugs and gifts; process
scripts and photos; dress wounds and hair; improve symptoms and
cash flow; counsel on medications and love-lives!
So here was the chance to branch out into hospital life, the brave
forefront of clinical pharmacy application.
Yes, I was excited.
Manly hospital
is a comparatively small public facility, with an even more cramped
pharmacy department. My experience, to date, has been rewarding
and varied.
The major learning outcomes have derived from the documentation
of an MMR every week - a method introduced to students in third
year.
This concept is a more recent inclusion in the Bachelor of Pharmacy
degree, responding to the changing needs of an evolving pharmacy
profession.
At the completion
of my three clinical placements this year, I will have submitted
twelve MMRs for assessment, and would have prepared many more.
The review process is a combination of components - data collection
(including pathology) and collation, patient interviews, fact
finding, referencing, identification of problems and determination
of solutions.
By December 2003, I believe I will have acquired these, arguably,
life-long skills.
This makes me curious of one thing:
Application for accreditation for conducting MMR, as a pharmacist,
requires evidence of at least two years of pharmacy practice experience.
The argument
appears to be based on the insular reasoning that a pharmacist
will become better at forming judgements if they have been churning
out scripts in a semi-comatosed state for two years. Are you kidding?
I propose a convincing five-point case for why an abolishment
of the 'two year experience rule' is necessary and in the best
interest of pharmacy and the public.
1. Changes
to the material studied in the pharmacy degree have meant that
recently graduated pharmacists possess more MMR potential than
ever! They are assessed on all the skills of the review process
and have extensive practice.
2. Pharmacy experience won't ensure better practice of MMRs; MMR
experience will ensure better practice of MMRs. A simple concept
but true.
Already this year, I have confirmed reports of students' medication
reviews being graciously received by prescribers, who are then
implementing some of the recommendations!
Surely this highlights that no amount of experience can substitute
for a solid therapeutic knowledge and refined researching skills
derived from practice.
3. Pharmacy is about the forward provision of services.
Why are we holding back these capable graduates?
This seemingly empirical two year delay is not encouraging or
supportive of the profession.
An issue in pharmacist fall-out has often been that newly graduated
pharmacists have become disenchanted with the impact they can
make on a patient's health.
MMRs can have a double benefit of improved patient treatment and
increased job satisfaction.
4. The accreditation associations, such as the AACP (Australian
Association of Consultant Pharmacy), independently assess applicant
pharmacists to the MMR procedure.
I agree that newly registered pharmacists should be assessed in
the same way.
Remember, the AACP will only accredit pharmacists on the basis
of proficiency in submitted MMRs. This testing procedure is present
for a reason, and it doesn't show much faith in the system if
we outwardly exclude certain groups from applying.
If the graduates don't have the enough experience or knowledge
to handle the review process, then they won't pass, will they?
5. Allowing
pharmacists to apply for MMR accreditation immediately following
registration is logical. Why class pharmacists fit to be a registered,
if they are unable to fulfil all the roles of one?
Medication
reviews have been instrumental in redefining the professional
responsibilities of a pharmacist.
In the end, only those that have a strong willingness to conduct
MMRs will apply for accreditation.
This proposal is not going to open the floodgates - it will just
level the playing field.
Let's hope a little common sense will prevail, and this application
glitch will be swiftly brought in line with current day pharmacy
reform.
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