King report: You’re still a ‘chemist’

pharmacy staff

Consumers hold pharmacy in high esteem… but their understanding of the sector has flaws

The Review of Pharmacy Remuneration and Regulation has released four reports on the external advice provided to it by consultancies.

These include quantitative and qualitative research which examined consumer attitudes, expectations and experiences of consumers interacting with community pharmacy.

The quantitative report found that prescription, OTC and readily available medicines were seen as pharmacy’s core product offering, and that overall, many of the services provided in pharmacies were not well known.

And consumers were still reluctant to pay for pharmacist advice, the report found.

“Half of these consumers (48%) indicated they are well aware of the pharmacy services and programs that are personally relevant, but many others were uncertain (44%),” the report found.

“Most of this sample believe that little-known services, such as ATSI programs and outreach services, should be available (76% and 85% believing they should, respectively), though few expected to access them themselves.

“Least support is expressed for services such as wound care (69%) or the issuing of medical certificates (57%).

“For those interested in accessing particular services, there was a willingness to pay for some of these services.

“This however is not the case for pharmacist advice about treatment or medicines – the vast majority of these consumers (at least 90%) claimed to want to access this advice but few (just 10%) indicated a willingness to pay for it.”

This report also showed that there is “appetite” for a more clinically focused pharmacy environment. Dispensing or clinic-style pharmacies were preferred, usually by the majority, over a pharmacy environment with an equal or larger focus on retail.

Nearly half believed that creating a healthcare atmosphere instead of a retail atmosphere should a requirement of pharmacists, “given they receive government payments to dispense PBS medicines”.

The qualitative report, which drew on in-depth interviews with 196 members of the public, found that “pharmacies are often referred to as ‘chemists’ by the Australian public, especially so among older people. Indeed some did not immediately understand the term ‘pharmacy’ as applying to their familiar ‘chemist’.”

Most consumers accepted that a wide range of front-of-shop lines are available, with only people who had experienced different health systems internationally really noticing that personal hygiene needs and the like can be met alongside medical needs.

“By and large, this was seen as just the way things are, though some do query whether this has gone too far.”

One women described pharmacy as “a mini health clinic, as well as a mini supermarket”.

The report found that many consumers use pharmacy as a place to obtain guidance before going to a GP, or as a triage or referral point for other services, helping them decide whether to see a GP or emergency department.

It also showed that pharmacists themselves overall enjoy significant goodwill from consumers.

“Pharmacists (or ‘chemists’ as they are often known) are widely considered to be a positive component in the care of people’s health and a familiar fixture in the Australian health landscape – the ubiquity of community pharmacies in central locations no doubt impacts this familiarity.

“The position of the pharmacist is imbued with a sense of clinical trust, or trust in clinical knowledge and care, though the extent to which people hold this trust varies.”

Positive perceptions were particularly found among people who depend more heavily on medication for chronic conditions, or who at some point had depended on medicine for an acute condition.

“These people, who are regular pharmacy customers, can hold a view of pharmacists as being caring community health practitioners and, in some cases, develop strong relationships with their pharmacist. Many participants in this research mentioned instances where the pharmacist was seen to have extended themselves purely in the interests of the patient’s health and wellbeing.”

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  1. Patrick Mahony

    The King Review in my opinion, is looking for “Bunnings Chemists” model. A DIY (Do It Yourself) one stop shop for all Australians for health care that will dominate the market place.
    Just think about a Bunnings store;
    1. There are general items (open sellers) for anything from art, to building, to cooking,… to zoo equipment.
    2. Then, the more specialised lines (equivalent to Pharmacy Only) where access is controlled and staff with particular expertise are on the floor.
    3. Further along, there are certain items locked away (equivalent to Pharmacist Only), restricting access to particular people.
    4. They have a compounding area where your specific item is prepared (paint department).
    5. Then there are the items which are labelled, to be installed by a licenced tradesperson (not my responsibility you were warned).
    However as soon as you pass the checkout and put everything into their environmentally friendly cardboard boxes, and get into your vehicle you are on your own. Don’t know, don’t care attitude.
    The DIY model is already partly replicated in CWH.
    I am familiar with the Bunnings’ model however I also know it has shredded the competition, for WesFarmers Benefit. The stores are open long hours, BUT if you don’t have a car or don’t drive or live outside the major centres you may have to travel huge distances to obtain simple essential items.
    Furthermore, these large stores, like large shopping centres, are not practical if you are looking for a specific item or group of items or service.
    Very few clients in a pharmacy are window shoppers.
    I think it is an upside down model, where the consumer is treated as that, not a person.

    • John Smith

      what king report does is asking everyone to think out of the closed box that the profession has been operating within for almost 30 years… that is all

    • M M

      interesting, out of curiosity, do you know why masters failed?

  2. Amandarose

    We are very much seen as offering free advice. People try us first or if they can’t get into a doctor.
    We are at a real cross roads as we can only be available for free services if remuneration for other things is adequate. Is it fair the government finds this? Possibly if it saves other costs?
    Or do we go the discount model were it is subsidised by retail? Is it moral that Health advice and government PBS services are subsidised by consumerism and retail? Should our ethics be swayed to sell products that are not needed to fund all the traditional core pharmacy roles?
    Is it more honest to charge for advice then flog rubbish? How do we shrug off the “free” label and get paid by the public?

  3. pagophilus

    To me this is the most telling statement in the article: Nearly half believed that creating a healthcare atmosphere instead of a retail atmosphere should a requirement of pharmacists, “given they receive government payments to dispense PBS medicines”.

    • The Cynic

      The sentence in quotation marks caught my eye also Pago. A phrase possibly said by ‘one’ is used to suggest a sort of consensus amongst ‘many’. Has this phrase been used to support a particular argument by the authors of the report? Or has the journalist employed a little ‘journalistic license’ in what ‘they’ thought the King report suggested.
      I am generally skeptical of these types of reviews with an apparent neutral umpire appointed by a government looking for a favourable outcome. Vested interests are then urged to make representations within the constraints of narrow ‘frames of reference’. The favourable outcome is coaxed and cajoled out of the ‘evidence’ presented.
      Feel free to ‘quote’ me….

  4. Joe Lamhut

    I am concerned that a lot of the King findings and recommendations is based on a very small sample of consumers(270),and a very small sample of submissions from Pharmacy owners(less than 5%).

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