Published by Computachem Services

P.O Box 297.
Alstonville. 2477
NSW Australia

Phone:
61 2 66285138

There is an apparent shortage of accredited consultant pharmacists in my local area.
There are a few very experienced pharmacists who have a range of different backgrounds undertaking this work, but they aren't enough to meet the needs of the local community pharmacists who rely on them to provide HMRs.
There is a pool of pharmacists in this area who would like to be involved in this process and become accredited but at the moment there are barriers to entering the consultant field.

Firstly there is a requirement for two years full-time post-registration experience.
This may sound fair when you consider the complex nature of some of the work being undertaken, but it does create a barrier for many newly registered pharmacists.
Pharmacists registered since 2001 have already received much of the training they require to provide these services in their new four year university degrees.
Given the lone-hand nature of much consulting work it is also hard for these pharmacists to gain an insight into this work unless they work with another accredited pharmacist who allows them to so some of the work under supervision. (Remember there aren't a lot of them to start with.)

Secondly, there is a monetary barrier to entering consultant work.
Yes, pharmacists are pretty well paid, at least those in the retail sector.
But younger pharmacists or those supporting a family on a single income might easily be dissuaded by the nearly $800 it costs before you even undertake your first review.
And that is before you include the cost of the additional specialist training required to become accredited.
There is an obvious incentive for a pharmacy proprietor who needs to value-add to his business and can best recoup this cost as with other business expenses.
But for a truly independent consultant who offers their services to any local pharmacy that may require them, the initial setup costs are a lot to make back within the $140 HMR fees when the owner takes a cut. You need to get adequate compensation for your time.

It is understandable that a professional organisation which seeks to promote itself as being specialist in nature will choose to erect some barriers to entry, as this is important for maintaining the quality of services provided by its members.
The AACP has appropriate controls on reaccreditation by requiring first-year consultant to present copies of some of their cases for review.
All accredited consultants are also required to complete sufficient continuing education.
These would represent appropriate controls over the membership, and reflect the requirements of consumers.
However in a time of pharmacist shortages and high demand for accredited consultants, it may be time to look at the first two barriers I mentioned, and what may be done about them.

There could be some form of mentored accreditation for those who doesn't have two years registered experience, who would be required to submit cases for review in their first two years of practice (rather than just one as for other accredited consultants).
These pharmacists would also be required to have another experienced accredited pharmacist in their area as a mentor who is available to work with them, if required, and provide feedback to the pharmacist and to AACP, as to their progress during those first two years.
If this scheme worked it could provide an alternative entry model for all pharmacists seeking accreditation.

Pharmacists seeking accreditation could always ask their employer for assistance in paying for the initial accreditation and training.
Given the "freelancing" nature of consulting work it is uncertain how may pharmacy proprietors would be prepared to invest in staff without a binding contract, ensuring they retain priority for the work of that consultant for some timeframe in the future.
It is hard to argue against charging accreditation fees, as AACP undoubtedly has its own staff to pay and overheads to meet.
But it must be ensured that this alone is never a barrier to accreditation.

The AACP has the important role of acting as an administrative body for the consultant workforce, and needs to ensure its requirements and controls reflect the needs of its members, as well as ensuring the quality of services they provide.

Editor's Note: How the AACP should reflect the needs of its members has been discussed at length in the past by other columnists in this newsletter. Jon Aldous is one of those pharmacists waiting in the wings until two years is up. I have had the opportunity to observe his work in a hospital setting, and he is well qualified right now to conduct medication reviews.