Pharmacists are saying it’s not possible to multitask professional services alongside dispensing and counselling, according to researcher
Preliminary research shows providing professional services is a different role altogether to the dispensing and pharmacy management, “and we should not be expecting pharmacists to do both,” says Faith Yong, a community pharmacist and doctoral candidate at the University of Technology Sydney.
“My research is really around how we can best support pharmacists, especially in their service roles which they’re being asked to do more and more,” she tells AJP.
Ms Yong has recently published review in the journal Research in Social and Administrative Pharmacy about factors affecting community pharmacist work, and is currently working on a study of community pharmacist service provision roles in Australia.
She is still collecting data for her study, however she says from the international literature “it is pretty obvious” that there is a lot of role overload.
“This was already happening and then when services came in, which pharmacists loved because they were able to help the community more, the problem was that they were finding they were under resourced and became quite frustrated with how conditions were, especially working conditions.”
Since this research was from countries with different pharmacy models than Australia, she is now focusing on exploring the Australian setting in her current study.
“I’m a community pharmacist myself, and when I came into research I realised we’d done a lot of research on all the other parts but we hadn’t actually looked at the pharmacists themselves and why is it that they were finding [professional services] so difficult,” says Ms Yong.
“What I found in the international literature is that it doesn’t matter which country people were from, they were all experiencing this. In Canada, in the US, in the UK, in New Zealand, all the pharmacists are struggling with how to implement a service role into pharmacy.
“There was a lot of role overload and job dissatisfaction, and it was related to how delegating a lot of tasks isn’t appropriate for non-pharmacist staff, and then in normal pharmacist work there’s a lot of multitasking – in most cases they’re being interrupted and distracted from the task at hand by other parties around them – so this leads to a cognitive and quantitative overload.”
Ms Yong says: “What I found in my research was that a lot of the tasks such as dispensing and counselling, doing phone calls and everything else in the pharmacy that a pharmacist does, like managing the staff and so on, they can be multitasked.
They often are multitasked and it’s part of the reason why people have thought, well services – no problem. We’ll just give them to the pharmacist to do and somehow they’ll fit it in their day.
“But what we were finding in the research was that providing patient-facing services such as medicine reconciliation, MedsChecks, these kinds of services can’t actually be multitasked in the same way. They require a person to sit there and have that one-on-one interaction with the patient, and their mind can’t be directing other things in other places, otherwise the quality of care is reduced.
“What that implies is that providing services is a different role altogether to the dispensing and the pharmacy management side of things. And we should not be expecting pharmacists to do both because what I found in my preliminary research is that pharmacists are telling me that it’s not possible and that’s why they need an extra pharmacist to do services.”
The Pharmacy Guild of Australia has commented that there should be no such a thing as a dedicated professional services pharmacist.
“The most frequently performed professional service in pharmacy in Australia is the dispensing of a prescription,” Guild acting national president Trent Twomey told AJP two weeks ago.
“The other professional programs are extensions of this core service. All pharmacists need to be performing all of these tasks, so all Australians have the same level of access,” said Mr Twomey.
“All pharmacists are professional service pharmacists. There is no such thing as a non-professional service pharmacist.”
AJP readers are split on the on the idea.
In our poll (n = 196) that asked whether there should be a dedicated role for professional services pharmacists, nearly half of respondents (46%) said: “No, I think all pharmacists should be doing professional services, not just a select few.”
Meanwhile about half (49%) of respondents supported the concept of dedicated professional service pharmacists: 32% said they should exist, “but only if there is more funding for these roles”, while 17% said they should exist as the current system stands.
Just 4% said they didn’t think pharmacists should be doing professional services at all.
But where will the money come from?
Some pharmacists have told AJP that the idea professional services pharmacists may be good in theory, but where will the money come from to fund such a model?
The PSA has called for additional funding to be injected into the pharmacy sector so that more professional services pharmacists can exist.
Small Pharmacies Group (SPG) questioned the PSA on what model of community pharmacy professional service delivery it will bring to 7CPA negotiations and how it would be funded.
“The PSA is saying the community pharmacy sector needs additional funding and ‘can’t keep doing more for less’ – but where is that money going to come from?” asked SPG spokesperson Katie Stott.
“What exactly will their service model look like?”
PSA National President Dr Chris Freeman told AJP: “There is disparity between the desire for pharmacists to have a greater health service delivery role and the current funding environment.
The profession must be empowered, and funded, to do more than the current system allows.—Dr Chris Freeman
“Pharmacy remuneration models should be in place to assist the profession to deliver consultations that support primary healthcare and medicine management programs,” says Dr Freeman.
“If individual pharmacist remuneration is to increase, we must seek an improvement in the application of the funding within the CPA to ensure a services or consultation model of pharmacy practice is worthy of genuine commitment by the community pharmacy sector.
“But the CPA should not be seen as the only funding source; we must also look to diversify. Action 8 in PSA’s Pharmacists in 2023 report addresses pharmacist remuneration, recommending the establishment of additional funding models and access to existing models that reflect the value of pharmacist care,” he says.
“The research that informed the report found pharmacists, no matter which setting, need to have remuneration and funding opportunities aside from those offered by the CPA.
“If we are genuine that as a profession we want to move community pharmacy towards a services-based model, then we need a fundamental shift in how we are remunerated so that greater amounts of our revenue are generated through the delivery of those services.”
This includes listing of pharmacist services on the MBS which PSA has called for, says Dr Freeman.
Ms Yong says pharmacy needs to look at how other industries organise funding for their services.
“We know that the government has given a lot of funding for services, maybe not enough. We did a preliminary analysis of the PBS expenditure and what we saw was that the amount of services funding available for each pharmacy was quite low, and in many pharmacies, not enough to hire another full-time pharmacist for – which could be why pharmacies may be having trouble implementing services.
“Now that services are expected to be done more, then we need to look at how in other industries are services funded and how they are implemented, how they are started up. That kind of implication is there,” she says.
“Other health professions obviously run by appointments and they run in that sort of model, and it’s very very different to dispensing and product supply.”