Each pharmacy, and the wider industry, needs to put their heart into professional services, writes Ian Fredericks
I firmly believe that community pharmacy has divided itself into two distinct models: the Chemist Warehouse-style discount model or the service-based model.
I manage a pharmacy which is strongly service-based; we certainly don’t price-match and don’t attempt to compete in the same sector as Chemist Warehouse; however, in order to justify this model and our position in the market we need to do much more than simply dispense and counsel.
I have come across pharmacies which market themselves as service-based when the most they offer is blood-pressure monitoring. I am convinced that, these days, this is nowhere near sufficient.
There are so many opportunities for pharmacists to offer interventions which are both evidence-based and offer additional income streams.
For example, a 2012 feasibility study piloted a newly developed Community Pharmacy Sleep Assessment Tool (COP-SAT) and found that it may be a good way to help pharmacists identify patients at risk of sleep disorders, including sleep apnoea.
As the most frequently-visited healthcare professionals, are we not in an ideal position to screen for a disease state which is both underdiagnosed and carries a massive increase in cardiovascular risk?
Similarly, there is a huge opportunity for pharmacists in the future to offer pharmacogenomic testing, an area which our pharmacy is branching into.
Again, there is a strong cost-benefit argument for pharmacogenomic testing in the psychiatric field, and we are working with psychiatrists at the moment to integrate this into clinical practice in Brisbane. This also offers an additional income stream.
Pharmacists surely must be one of the few professionals with this level of qualification who do not charge a fee for most services.
I think that it is extremely short-sighted of the profession for pharmacists as a whole to turn their back on all these opportunities to expand beyond simply moving boxes of drugs off the shelf and move towards a fee-for-service model.
We are fortunate, however; as a non-discounter, we have a larger budget for staff than most discount pharmacies, which is the key to allow us to offer these additional services.
Having said that, our bread-and-butter at this stage is still core dispensing; pharmacogenomic testing, sleep apnoea services and diabetes management offer additional income but they won’t pay the bills just yet.
However, demonstrating to other health professions that we are capable of more than simply dispensing (as the discounters seem to do) and that we have a strong focus on evidence-based medicine ultimately increases our professional standing; THIS is what will open doors in the future.
Ian Fredericks is a Brisbane-based community pharmacist with 15 years’ experience, 11 of which were gained managing a pharmacy in a highly competitive region. He has recently completed a research master’s degree exploring both antibiotic usage patterns in community pharmacy and consumer attitudes towards antibiotics.