The long and winding road

How can pharmacy find its ‘Picasso moment’ and break through its constraints to find a pathway that benefits patients, pharmacists and pharmacies?

In the 1960s and the 1970s, The Beatles was the biggest band in the world. It still is today. According to Business Insider magazine, The Beatles are the biggest selling artists of all time with sales of 183 million units.

Written by Paul McCartney in 1968, The Beatles’ song, ‘The long and winding road’, was released a month after The Beatles broke up. It is a song that almost serves as a fitting epitaph to The Beatles’ journey.

To illustrate the significance of that journey and the influence that The Beatles had on the industry, Rolling Stone magazine compared The Beatles with Pablo Picasso, as people “who broke through the constraints of their time period to come up with something that was unique and original”.

Needing a ‘Picasso’ moment

Australian pharmacy has been on its own long and winding road, and it is now time for it to have a ‘Picasso’ moment. The industry, in collaboration with the peak bodies and universities, needs to deliver something that breaks through the constraints of our time.

There is a clear need to create a pharmacist career path re-designed for now and for the future. It is something that will either be developed and delivered by peak industry bodies and universities, and the future of pharmacy will be bright. Or it won’t.

If it is not, the careers of pharmacists will be less well remunerated, add less value, and de-humanised to that of a mere transaction—‘the commoditisation of the profession’.

We constantly encounter owners cutting wages and hours because that increases profit. It may, in the short term, but it accelerates commoditisation of their business and demotivates pharmacists. It’s not a great long‑term strategy.

The profession has existed since ancient times but now finds itself at a tipping point, thanks to industry structure and changing technology. There is a window of time for the peak bodies and universities to re-shape the industry and the profession.

That shape should focus on delivering valuable patient health outcomes along with value in the form of patient health benefits.

But the window is closing. For the time being, the industry will continue enjoying the excellent dispensary remuneration afforded by the 7CPA.

Can pharmacy continue lurching from one agreement to the next, hoping for the best?

The new thinking

In our view, the new way of thinking needs to encapsulate five things:

  • focus on the patient experience
  • specialisation and specific role(s) in the pharmacy where the purpose is patient health experience/outcomes
  • pharmacist role doesn’t begin with administrative aspects of the role
  • ongoing education standards
  • appropriate professional service remuneration.

Interestingly, consumers recently rated Chemist Warehouse highest for customer satisfaction. If community pharmacy is to thrive, offering the points of difference noted above will ultimately determine success or failure.

New model

Government will drive remuneration towards development of patient health solutions, so controlling that destiny makes enormous sense.

The four requirements for delivering a ‘Picasso’ moment and change are:

  1. New Model: To quote another Beatles song, the peak bodies should ‘come together—right now’ and collaborate to construct an innovative pharmacist practice model. This isn’t novel or new. It exists already. Our friends Samantha Kourtis (Capital Chemist Charnwood), Rebecca Young (Capital Chemist Chisholm), Nick Logan (Pharmacist Advice, Artarmon) and the 777 group are all examples of this in action today.
  2. Universities: Courses need to be adapted to reflect the need for patient health and conversing with people as noted above. Degree courses need to start with the traditional technical knowledge before branching off into clinical and conditions. A great course would move to learning how to engage and communicate with patients.
  3. Layout: Pharmacists need to redesign their dispensary layout to reflect the patient focus and increase in patient services. Government incentives to invest in new layouts are available, as we’ve written about before.
  4. Range: Focus on health-related categories. We’ve long explained, sundry items do not stack up financially. Replace with health‑related categories.

The need to review roles

The role of the pharmacist: Pharmacists must supplant shop assistants as the giver of the script, advisor, patient health advisor, patient engager, etc. Assistants need to revert to their role of being, well, assistants. Pharmacists cannot continue being over-educated dispensary technicians, they must add value by being healthcare professionals.

Recruitment of pharmacists comes down to ‘make or buy’. In other words, if you can’t hire (buy) the right people, you make them. It takes longer, but that’s the world we operate in. Often it means getting people who are more pliable in terms of their thinking. Saying the right people are hard to hire is an excuse. If the reality is there is a shortage of the right people, then you have to invest in re-training existing people—albeit those with the ‘right’ attitude.

Formal pharmacy technician role: Contemporaneously industry, with government, must develop the roles of the dispensary technician and dispensary manager (senior dispensary technician, a non-pharmacist).

These are specific dispensary roles, who must learn how to integrate with the pharmacists. These roles need formal peak body training supported by on-the-job pharmacist training, formal (legal) recognition of the technician role and, ultimately, appropriate remuneration ($25 to $30/hour, up to $35). One independent pharmacy group has already created their own internal dispense technician training course.

In many countries, including most of the EU and the UK, the pharmacy technician is a well-recognised role. In our part of the world, because dispensary remuneration is so large, pharmacists have stuck to the technical job, leaving assistants to engage and advise patients. This isn’t what customers want and it does not deliver optimal financial outcomes.

We all know that government will continually reform PBS remuneration. The government wants to prevent illnesses—it’s much cheaper to have a healthy population who don’t need hospitalisation. The focus will increasingly turn towards health-focused service and services. The reward for dispensing scripts will, over time, decrease.

To an extent, our neighbours in New Zealand have done this already so there is a local template to investigate.

Industry philosophy

The industry philosophy needs to be ‘patient first’—we already know that those pharmacies with this philosophy are more successful financially—the table below illustrates this.

The long and winding road

Pharmacy in Australia has been down a ‘Long and winding road’. To just ‘Let it be’ isn’t going to result in the outcome that the industry wants. The current situation doesn’t optimise patient health outcomes, nor does it help the government change to a situation where it reduces PBS costs.

The way ahead is clear—a ‘Picasso’ moment, where patient health outcomes and the right roles are the focus—otherwise in a few years all we’ll talk about is ‘Yesterday’ and what we could have done.

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