Workforce woes: Part 2


A controversial report argues “absurdly low” wages of pharmacists are the elephant in the room

Read Workforce Woes: Part 1 here.

Last week AJP spoke with pharmacy recruitment specialist and CEO of LocumCo Sue Muller, who is struggling to keep up.

“We are flat out with urgent jobs. They are leaving the profession in droves!” she said.

“I’ve been doing this for 30 years and I’ve never seen it like this, ever.”

Now business consultant and director of Rhodes Management, Michael Rhodes, who has previously levelled criticism at the Pharmacy Guild of Australia (PGA) and argued for supermarket ownership, has again written about higher wages and less work pressure on employee pharmacists.

In the second installment of his report series, ‘The Future of the Pharmacy Industry: The Compelling Need for Change’ released in June, Mr Rhodes says research conducted by his company revealed a cumulative loss of pharmacists, with 14% of the turnover occurring with pharmacists who are at the peak of their knowledge and experience (ages 35 to 49).

But if this is true, what is behind the high exit rate and turnover?

Mr Rhodes believes pay rates are simply too low to retain pharmacists, and there is lack of recognition for what pharmacists do versus what they get paid.

“The remuneration level was the prime reason for leaving and was overwhelmingly the most prevalent reason amongst male pharmacists,” he says.

“The problem is further compounded when women leave to start families and in some cases, don’t return to the profession.”

Mr Rhodes refers to “absurdly low” wages of pharmacists as an “elephant in the room”, given their initial training, ongoing training and general responsibilities on the job.

“This does not bode well for the profession and the industry.

“We recommend that portions of the dispensing services fees are paid directly to the pharmacists who provide the service in addition to their normal salaries and daily retail outlet responsibilities,” he says.

“The median pay scale for pharmacists in Australia is $65,464 per annum. This is less than experienced plumbers and electricians make who have level 4 TAFE certifications and can choose their working days and working hours.

“For an industry that trains so much for its profession and endures ongoing training it is a woeful level of compensation.

“The entry level pay for Australian graduating pharmacists and interns is also desperately low at below $40,000 per annum, which is actually 12% lower than the starting salary in New Zealand.

“Canada and the USA have entry level pay at 23% and 184% higher than Australia respectively.”

AJP readers tend to agree. While we have received a deluge of comments regarding wages over the past few years, here a select few from just the last week:

“The current model of community pharmacy is not clinically challenging or financially rewarding, making all of us dissatisfied and in despair… This is going to be the last year for me in Pharmacy. I’m starting a new degree next year, one that will not be so divided and broken. Good luck to all of those pharmacists that are finally seeing the reality and are seeking a career change. All I can say, don’t be scared and know that you’re not alone.” – SW

“In my group of 20 or so Pharmacy friends, all but 2 have stopped working full-time. Some are studying full-time again while others are working weekdays in a variety of roles like: Pharmaceutical repping, Veterinary nursing, Laser hair removalist, Radiology assistants, and Finance. We do some weekend shifts or a shift here or there just to stay registered. And we’re all pretty recent graduates as well (6-7 years since we graduated). The truth is, we all heard about the appalling conditions while we were studying, so we kept an eye out for other opportunities as well. Most of us got a pretty good picture of the pharmacy profession within 2-3 years out. TBH, these other roles are far less stressful, pay much better and actually allow you to have a work-life balance. As a young pharmacist, you have to work every weekend, a lot of night-shifts or go out rural. Pays are in the low 30s and there is no pay rises or bonuses to speak of. Plus, the allure of pharmacy ownership has rapidly faded making the only financially rewarding career progression obsolete.” – SFOT

A race against time

Research by Rhodes Management, conducted via a confidential questionnaire, also found that pharmacists spend more than 90% of their time dispensing – leaving little time for professional services.

And this doesn’t take into account that many pharmacists work longer than the eight-hour day and without a lunch break.

According to the questionnaire results, there is a two-hour-per-day deficit to provide even the most basic of reimbursed services.

“While the PGA extracts from the government additional funding for services for pharmacy owners, employee pharmacists are struggling to provide those services,” argues Mr Rhodes.

“Many of the single pharmacists we spoke to dispense more than 230 scripts per day and often over 300 on some days.

“Providing any sort of advice or counselling service in this instance is simply a fantasy.”

He believes pharmacists are being subjected to undue work pressure and risk when analysing and dispensing medications, as well as pressure to undertake training to provide the additional services.

Some AJP readers would agree with him.

One ex-pharmacist told us:

“I finally left pharmacy last year after I developed severe anxiety and hyperventilated until I fainted.

“Ever since I registered 7 years ago, I’ve been chasing the magical land of pharmacy to no avail. Every pharmacy I ended up working at (in Syd) was a slave yard, flogging pharmacists to check 60+/scripts per hour, while simultaneously expecting you to put a dozen tubs of orders away. I was valued purely on my companion selling skills over product knowledge and advice. On weekends, I was left alone to do 350+ scripts as a sole pharmacist, while joggling a million patient queries in store and on the phone.

“I kept thinking this is normal until one Sunday, during a busy rush hour, my eyes went blurry, my chest started pounding and I hyperventilated till I fainted in the back of dispensary. I woke up in the back room to ambulance officers and my technician. I got to go home that day feeling broken and inadequate. I was so embarrassed and resigned from my job after that shift. I thought about going back to pharmacy but every time I decided to apply for a role my anxiety came back. I’m now re-training and back to my old self. Happy, cheerful and laugh again.

“If I have any advice to new graduates, don’t bother. Use your degree to get you to a better profession, because pharmacy is no longer a long, fulfilling career it once used to be.” – RK

Mr Rhodes suggests changing the pharmacy business model so there is less of a focus on selling and more of a focus on professional services.

“By all means reimburse for the services, but ensure a quality of service environment to do so.

“Is there room in the market for predominantly pharmacy only prescriptions and medicines and services? Possibly yes. This would allow for clear branding, consumer understanding and better provision quality,” he says.

“If the remuneration model changed to reflect some portion of direct payment to the pharmacist, the organisation, motivation and attention to provide these services would increase as would the profitability of the pharmacy itself even when part of that payment goes directly to the pharmacist.”

Pharmacists’ Support Service is available to provide a listening ear from 8am to 11pm EST every day: call 1300 244 910 for anonymous and confidential support from a pharmacist colleague over the phone.

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85 Comments

  1. The Cynic
    10/07/2017

    Sobering stuff. The profession is unrecognisable from where it was when I first registered in the late 80s.
    Workload is up enormously, many owners are using pharmacy as a cash cow without regard for the profession and employees. Tighter market conditions over the past 15 or so years has encouraged many to simply swing the leather strap harder. Pharmacists are dispirited, resentful.

  2. Amin-Reza Javanmard
    10/07/2017

    “Many of the single pharmacists we spoke to dispense more than 230 scripts per day and often over 300 on some days.”

    That’s well above the Board guidelines on safe dispensing. Where’s the Board? Other than doing desk audits on CPD?

  3. United we stand
    10/07/2017

    We have 3 major pharmaceutical bodies (PGA, PSA, PPA) that charge significant amount of money to their members, but they’ve all failed to address this huge mammoth of an elephant in the room. No plans have been put forward, no blueprints to speak of, not even a review board has been suggested.
    PSA simply said remuneration is our single biggest issue. What did they do about since this statement you wonder? Zero.
    The Guild callously managed to cut the pay even further by axing Sunday rates.
    And PPA has not been able to impact a single issue.
    Whenever you speak to your colleagues outside of work, they sound sad and broken. Most have stopped trying to change things for the better and many are either leaving the profession or are simply working to make ends meet, with little interest in making a difference in the lives of their patients. We’ve reclused ourselves to the mechanical dispensary tasks instead since we don’t feel remunerated well enough to take on the emotional burden and level of intellect necessary to tackle a myriad of medical and social problems our patients are facing. Graduates coming out see it in their preceptors and continue down the same path thinking it is normal.
    Sad times indeed 😞

  4. Usman Hameed
    10/07/2017

    I am not a guild member, I am not even an owner. I would urge all the pharmacists calling for supermarkets to enter pharmacy to have a close look at how supermarkets operate regarding staff hours and work loads, self serving computers replacing humans in the name of efficiencies and then having more systems for avoiding theft.

    • United we stand
      10/07/2017

      I fail to see the difference. In many ways, they abuse their employees just much as community pharmacy does.
      Lets see, they have both successfully managed to lobby the lowest award wages in Australia. Profit is their major drive and have a very short sighted approach.
      It’s incredible to see Pharmacy sharing such characteristics with their enemies. We lost our way and most probably it’s too late to turn back.

    • John Smith
      10/07/2017

      Supermarkets run pharmacy business more professionally in USA than here in Australia. Pharmacists get to focus more on the dispensed meds and hence better and more effective clinical interventions. Add to that pharmacists get paid more than double compared to Australia.

      • Usman Hameed
        10/07/2017

        Well we are not living in USA. Have you even checked the prices of medication in States? Just check online and see how much the patient pays for some common antibiotics. It’s a simple phenomenon, you make more profit and you may get paid more. It comes down to how the remuneration works. Is it the government or insurance company that is your biggest customer.
        Oh by the way in USA people pay for EVERYTHING unlike here in Australia

        • John Smith
          10/07/2017

          Out of pocket expenses on pharmaceutical retail in USA is less than Australia as per OECD 2014 report. Yes I did check the prices of medications in USA, how about 100 caps of amoxycillin 500mg for $14.00, is that expensive? Supermarkets are more efficient in running businesses, this is simple 🙂

          • Jarrod McMaugh
            10/07/2017

            Ramez that doesn’t mean that there aren’t greater profits.

            The prices paid by insurance companies (is before the out of pocket cost) is far greater than what the PBS pays.

          • John Smith
            10/07/2017

            Jarrod, I responded to your mate when questioned the antibiotics prices, and yet no response because most of his statements are false and been called out by all colleagues. Does 100 caps of amoxicillin 500mg for $14.00 seem expensive for you compared to here?
            Out of pocket is out of pocket, if insurance companies are paying far above than pbs here, that means the cost is higher, doesn’t necessarily mean the profit is higher. Let’s stick to the facts. Pharmacists are more clinically focused in USA and getting paid more than double compared to here.

          • Jarrod McMaugh
            11/07/2017

            Sorry Ramez I’m not sure which mate you’re referring to.

            And I’m not arguing with you on the point – there have been a few claims in the comments here that I think are a bit unrealistic (like $100k profit for the busiest pharmacy – that’s underselling it a bit since most cafe’s in Melbourne have a NP before owner wage higher than this…).

            But I would point out that wages being higher in the USA and other countries must be driven by something….. these business (who you point out are very efficient) aren’t paying higher wages just because they’re nice. The overall GP must be higher if they can afford to pay higher wages, or they have very different workloads (ie there is a lot of work done by technicians).

            I’m not an expert on the US pharmacy payment system, but there are a few things I would want to look at before judging whether their system pays higher wages based on lower prices… like what is the out-of-pocket on chronic meds (as opposed to amoxycillin). What is the price on smaller pack sizes (as used here – volume lowers costs), and what is the price of medications for those who don’t have insurance? The phenomenon of pharmaceutical tourism by US citizens without insurance isn’t happening for no reason….

          • John Smith
            11/07/2017

            Hi Jarrod,
            I am sorry I was referring to the same person who claimed the busiest pharmacy earns 100k as you replied to my comment on his comment lol 🙂
            Anyway, 30 caps amoxicillin 500mg is $10.00, 30 tabs atorvastatin 20mg is $12.96, 100s gabapentin 400mg $18.76, 100s metformin 1000mg $12.80 and the list continues ( these are out of pocket with no insurance )… add to that some pharmacies offer a list for free if you have membership (not expensive membership) and because they are part of supermarket, consumers do memberships anyway for other goods ( double benefit ) …
            You are correct GP is high, the question would be how?!! could be a few things, no location rules leads to low rent, less expenses, etc.. supermarkets don’t pay extra rent, utilities, etc.. pharmacy is just a department within a huge store. Supply chain is more efficient, paying money within 6CPA to wholesalers is just a joke, such a waste of taxpayers money, it is simple wholesalers have to be innovative or if they can’t make it, leave the business to someone who can make it. Business Process Management is the key, focus on the processes that adds value to the value chain, modify or delete the processes that do not add value to the value chain. No employers want to pay much wages, let’s face it, but when employers realise the scarcity of the employees, they start paying higher as it is happening here now and when employers know how to generate profit without extra loading the staff, they pay extra to retain good quality employees and to have a career pathway for those employees and that is what is missing here. Many employers advertise vacant jobs with partnership opportunity, but no one states a well defined criteria in the contract. When PGA submits a claim to cut penalty rates, that is not very friendly and will create a barrier between employers and employees ( I am talking from HR perspective ) This will lead to more people might leave the industry in the next few years, not wanting to work on weekends, not as motivated as before, etc.. I am only naming examples but what is happening in the profession now is not pleasant and I am sure you can see more pharmacists nowadays are not as happy as 10 years ago … Have a good day Jarrod

          • M M
            11/07/2017

            That’s the point. You are not an expert. Studying the US market and number of pharmacists join the market each year, workloads and other factors will reveal why pharmacists get better wages over there.

            Studying their market structure will tell you that we can have better structure. For both patients, pharmacy business.

            The only problem is that we don’t want to see anything but the guild way.

            Based on facts CPAs don’t guarantee a sustained business model.

          • Jarrod McMaugh
            14/07/2017

            Mina, your tone is always so combative. How about your chill out a little bit.

            As I said, I’m not an expert in the US market, but I have a number of colleagues who do work in the US, both in corporate pharmacies and in independent pharmacies.

            I’ve asked them to consider the issues raised in this discussion and give us all their perspective on the nature of the pharmacist employment landscape there.

          • M M
            14/07/2017

            I do like the way you conduct your research. 🙂

    • M M
      10/07/2017

      Innovation brought to US market was the impact of supermarkets entering the composition. Supermarket pharmacies in the US pay more than private pharmacies.

  5. Tony Soffer
    10/07/2017

    What RK says is shocking. I wonder how common it is.

    Today’s pharmacists are expected to do far more than pharmacists 10 or 20 years ago. But their remuneration has not increased. It has of course dropped in real terms. Every quarter bills and costs such as road tolls go up. Pharmacists wages do not.

    Many employee Pharmacists are frustrated with the Pharmacy Guild’s efforts to lower wages over recent years, especially with their successful submission to have penalty rates lowered. They have their reasons to do this. They represent the employers. Employers are doing it tough too with competition from discounters and price disclosure. But it is also the employers who are getting the bulk of the money for the 6CPA incentives from MedsCheck’s, Clinical Interventions and DAA’s. Many Pharmacies they are expecting their employees to do more for less remuneration.

    But opening up ownership may not lead to increased wages. Will ColesWorth pay higher wages and offer exciting new employment opportunities? Maybe? Maybe not. A better result would be for our professional organisations to show some respect and dignity towards employee pharmacists by paying them what they are worth. We had a round of Guild Elections recently. I am not aware of a single candidate who campaigned on this issue. Please correct me if I am wrong.

    • M M
      10/07/2017

      Opening up ownership will increase demand on pharmacists. It will change market demand dynamics.

      Reading Rhodes reports 1 http://bit.ly/2t9M2Sn and 2 http://bit.ly/2s87Azw , I get the idea that opening up the market will be better value for customers (the higher the competition, the better the service and the lower the prices).

      More pharmacists will join supermarkets (to attract community pharmacists “new market” you should offer them competitve advantages “wages and other benefits).

      It is a pure economics subjects, that is why most of us might find difficulty understanding it.

      • Willy the chemist
        16/07/2017

        May I just say one thing.
        Economics and market competition is not the be all and end all considerations.
        If that be the case, we will have no government schools, social welfare support and even prison reforms pathways. All these cannot be justified by economic rationale alone.

        And we all know of examples of places without good government social infrastructures and how things are…

        • M M
          17/07/2017

          That’s entirely wrong. It’s economics. You need to study economics to be able to talk and build a viable argument. Anthony can’t even reply when it comes to business and economics basics.

          I don’t care if you think of its economics or not because it purely is. The change is coming either you accept it poor not.

          From leadership perspective, Tully better lead the change poor you will be managed out. 🙂

  6. bernardlou1
    10/07/2017

    I’m always amazed reading the comments and it show true lack of knowledge.
    The pharmacy Infustry award is determined by the Fair Work Ombudsman, not the PGA or the PSA of any other organizations.
    The Fair Work Ombudsman has received 6000 submissions from various industry group. The Guild lodged 1 submissions re the penalty rate.
    If there are people lobbying to make a change then you guys have to be the driving force behind it.
    Stop complaining and start acting.

    • United we stand
      10/07/2017

      Fair works commission is not a health related or professional body. It receives advice from aforementioned bodies and acts upon the advice it receives.
      Unfortunately, over the last 20 years, your beloved Guild systemically provided submissions to the FWC that has proven to be highly detrimental and destructive to the profession. This was partly due to a lack of other bodies at the time to provide a counter argument and also the non-combatant placid attitude of the pharmacists at the time.

      • bernardlou1
        10/07/2017

        You’re information is incorrect. Again you need to get the right info. The PGA doesn’t lobby to reduce pharmacist wage.
        As a matter of fact the opposite will take place as members think it’s a joke. If you are that concerned you should be taking actions instead of critizising.

        • United we stand
          10/07/2017

          So the recent penalty rates cuts highly endorsed by the Guild was a fragment of my imagination.
          Stop shilling for them. We all know what they stand for.

          • bernardlou1
            10/07/2017

            Penalty rate was reduced by 5% as of 1/7/17.
            The Guild advocates for it’s members.
            I believe pharmacist wage should be a minimum of $60.00 per hr.
            That what you should advocate for.

      • United we stand
        10/07/2017

        The short term solution is to raise the minimum wage by 30-40% as suggested by the PPA and combine that with a commission for the number of services a pharmacist provides to the community.
        Next step is to open up membership to the Pharmacy Guild to non-owners.
        The long term solution is to devalue pharmacies to at least half of the current prices they are going for. This will require removal of some of protectionist, very conservative red tape that currently exists preventing innovation and placing ownership on a pedestal open only to those with deep pockets.

        • Andrew
          10/07/2017

          >>>Next step is to open up membership to the Pharmacy Guild to non-owners.

          Already is.

          The problem with bureaucracy is that eventually the only role they play is to ensure their continued existence. That’s how it’s been for some time and the choice seems to be either the retail pharmacy edifice crumbles with the guild remaining, or vice versa.

        • bernardlou1
          10/07/2017

          Minimum wage must be increased there is no doubt about this.
          Penalty rate should be adjusted accordingly to allow community pharmacy to serve the public at the unsocial hours.
          PGArepresent proprietors who have taken a financial and a professional risk. If not for them we would all be working for the supermarket these days but we have the option.
          Constitution of the Guild doesn’t allow members if the member isn’t committed financially. It’s not just about talks rather actions.

    • Andrew
      10/07/2017

      There is an appeal against the FWC ruling by the AWU on the grounds of the commission not adequately considering the case of low paid workers.

      Pharmacy Assistants are expected to be highly trained, ethical, and diligent professionals while simultaneously being some of the lowest paid employees in Australia. They’re the lifeblood of pharmacy and for their employers to take time out of their apparently very busy days to write a submission that argues they’re being paid too much and that recouping less than $5 per hour per worker for a single day of the week would allow them to trade longer, or employ additional staff is as misguided as whatever financial acrobatics they’ve done to convince themselves of this fact. Shameful. Have any of these owners admitted their submission to their staff? I’d love to know how that went down.

  7. bernardlou1
    10/07/2017

    Taking about penalty rates, are you aware that supermarkets do not pay penalty rates???? That is right they’ve signed a deal with the Unions to allow them to pay ordinary rate to all shifts and days.
    I bet none of you knew that?
    Did you also know that it was the PGA that has started initiative such as HMR, RMMR etc.
    Did you know that it was Tony Abbott that started the price Disclosure. Did you know that a community Pharmacy gets paid $70 to dispense a 22k Hep C drugs?
    Again I bet you didn’t know.
    Did you know that the King Review approached the ATO yo get hold of members tax return without Members approval?
    Did you know that the biggest, busiest Pharmacy is earning around $100k in profit?
    Did you know that there are around 20 small pharmacy that makes no profit and that according to the kind review there is around 200% price differences in pharmacy. If that is not competition I don’t know what it is.

    • United we stand
      10/07/2017

      If it’s impossible to make money under the current protectionist system then it’s time to knock it down and start again. Hand it over to the supermarkets and let them figure it out. But don’t strangle the life out of all of your colleagues because you’re desperately trying to make a living running an unsuccessful business model.

      • bernardlou1
        10/07/2017

        There is a way out maintaining the current system.
        1) Pharmacists remuneration must be adjusted to reflect current standard.
        2) Gov has to appreciat the saving generated by community pharmacy.
        3) The public knows its value.
        We just need to reinvent constantly and adapt which we have been considering the current atmosphere
        We discounters who undervalue there time and knowledge and sell it for nothing.
        No other profession does that.

        • M M
          10/07/2017

          Why do we have to maintain a non viable system?

          • Willy the chemist
            16/07/2017

            It is weird but one keeps harping on a non viable system. The system is one of the world’s better ones, certainly a million miles better than the deregulated privatised system that many advocates are singing their praises. The ol’US of A healthcare system is broken, actually not just broken but beyond broke.

          • M M
            17/07/2017

            I’m not sure why PGA and their advocates keep linking PBS to healthcare system in US. We are talking about the business model. Confusing people will not serve you just so you know. You have been implementing the UK system with all its drawbacks you didn’t even learn how to fix them. That’s pathetic.

          • Willy the chemist
            17/07/2017

            The capitalist system which forms the basis of our world economy will be replaced, just as agrarian, industrial. Just as information era is being replaced. Just as socialism, communism, capitalism is being replaced. Democracy will be replaced as well. Business in the future will be very different.
            Business alone today cannot solve healthcare needs or social ills.
            You weren’t talking about business model because you weren’t offering a better alternative. The current model is still far superior to the model many espouse to which is privatised and deregulated.

            One day a model may supersede but not from what you were able to glimpse.

          • Willy the chemist
            17/07/2017

            Oh and it really is a better system. You refuse or is unable to see evidence. In the previous reply, I provided link to show that australia is one of the most efficient (in business matrix, cost equates to market efficiency) of OECD countries.
            We also have one of the best outcomes (in health, outcomes is a top hierarchical order in efficiency. In economic 101, outcome is efficiency)
            Hence on both front, ie. both traditional market economy measure and health outcome measure, Australia is sitting near the top. That is a success.

            So on what basis do you say it does not work?

        • Andrew
          10/07/2017

          Bend everything to fit pharmacy, rather than pharmacy bend to fit what’s needed/available?

          Got it. Good idea.

          • bernardlou1
            10/07/2017

            Pharmacy does what it needs to looks after patients.
            To do so it needs to remain viable. If you think working for supermarket Is better then let me assure you supermarket do not pay penalty rates.

          • John Smith
            10/07/2017

            bernard, you need to know that whatever business you are talking about, employers would follow the award and law for that category of employees. Employers now penalty because the law says so. PGA submitted a claim to reduce the penalty rates and they would submit a claim to cancel it if they can. It is all about the award rate not the employer mate

          • Andrew
            11/07/2017

            I think, with the reallocation of funds from the evidence based HMRs to MedsChecks, pharmacy has prioritized itself over patient outcomes. I’d like to see public health KPI’s built in to the next round of CPA negotiations to make the funding administrators more accountable.

          • bernardlou1
            11/07/2017

            That is a great idea to apply if it isn’t applied already. The Gov has already saved in excess of 600m based on the past two years of the 6cpa.

          • Willy the chemist
            14/07/2017

            Hi Andrew, I’m wondering if HMR accredited pharmacists could submit to MSAC for Medicare listing.
            There is really no reason to discredit one over the other. And really as pharmacists we know our interventions do improve outcomes.
            Ultimately HMR should be funded outside the envelope of CPA because
            a) this is more equitable as it creates a sustainable pathway for accredited pharmacists, not just to cut another slither of a slice from our diminishing returns to our community pharmacists’ remuneration,
            b) this will definitely open up the doors for a lot more accredited pharmacists,
            c) rules for HMR should be procedural, not depending on a doctor only pathway to request a HMR? It’s so inequitable and quite a many GPs see this as a “rival” service. Not all, some are very supportive.
            There should be some business rules that determine who is eligible for a HMR based on medical conditions, complexity, age, language barrier, number of medications, recent hospitalisation, discharges, etc…

            I’ve asked the question, it would be great if one of our accredited colleague would see this as a opportunity worth pursuing.

            There’s a lot of people bashing the Guild, but sincerely, has the other organisations done anything? If I were not wrong, even the HMR was a service canvassed originally by the Guild.
            PSA, ACCPA, PPA, SHPA should really do something for accredited pharmacists. All everyone can say is give me a slice of the CPA remuneration? We should create a new avenue, after all this is a service that is basically performed outside Community Pharmacy settings in the main.

            Am I wrong to think like this?

          • Andrew
            17/07/2017

            >>>There is really no reason to discredit one over the other. And really as pharmacists we know our interventions do improve outcomes.

            There really is – HMRs are proven, MedChecks are not (and preliminary evidence suggests no real benefit). If the pot of money is limited then we should ensure best bang for buck – and in pharmacy services are not that. To do anything else is to ignore the evidence and public health outcomes at the expense of the retail pharmacy business model.

            If we’re going in that direction – moving HMRs away from CPA funding (I’m agnostic in regards to this) – why not go the whole hog and set up accredited clinical pharmacists in medical clinics and fund via MBS. Seems like a no brainer and probably the most effective place to do these non-home medicine reviews/checkups.

            I’d love to see some of the other associations involved in allocating CPA funds, but while the guild remains the sole negotiator and administrator of the funds I’m not expecting to see a great deal of sharing going on.

            At the end of the day the question should be, how do we get the best health outcomes for the public per $ of CPA funds spent. The viability of a shop should never be a consideration.

          • Willy the chemist
            17/07/2017

            Andrew, the VALMER report that HMR cost benefit does not stack up in the main. It’s only in the upper quartile.

          • Andrew
            17/07/2017

            Fair call, but my understanding of this outcome is that the study follow up period was too short to effectively measure outcomes and cost savings – this was the reason the period between reviews was lengthened to 24 months.

          • Willy the chemist
            17/07/2017

            Hey I agree Andrew but still “evidence is evidence” some would say.
            I’m pragmatic and a rationalist. There are certain things I know that is worthy, I don’t have to suck eggs to know.

            If a MedsCheck is performed as intended, it is beneficial. This is the same for a HMR. And normal day to day interaction with a pharmacist including interventions and counselling which shockingly are free are a huge community beneficial.

            Andrew, I sincerely am of the opinion that we pharmacists offer one of the best value for dollars now, especially with our low pays. It’s disgusting.
            And which profession offers their main services for free, without expectation of a consideration and being so accessible without a need of an appointment?
            Would you try to get advice from a doctor for free? How about a lawyer? Oh, it’s just this small rash on my neck, couldn’t you just have a quick look and tell me what it is? How about an advice on my legal obligation regarding capital gains tax on the sale of my home which has a small home office that I worked as a HMR pharmacist?

            Tell me now. What is the cost benefit of paying $80 to see a GP for a simple consult, maybe for a sprained ankle?
            Hell, can you even get an IT specialist to give you advice on how to configure your home network for free?

            Sure mate! Everyone expected to be remunerated. We pharmacists have been giving free for so long.

        • M M
          21/07/2017

          Why do you want to keep a non working system and keep fixing it?

          • bernardlou1
            21/07/2017

            Is the system consumer focused?

            Is the system saving the tax payers billion of dollars?

            ARE Pharmacists one of the most trusted professionals?

            What other industry has saved the tax payers billions of dollar?

          • M M
            22/07/2017

            Is the system consumer focused?
            No, it is not
            Is the system saving the tax payers billion of dollars?
            No, it doesnt save taxpayers money ..
            ARE Pharmacists one of the most trusted professionals?
            Pharmacists are but they don’t receive direct remuneration for the services they offer
            What other industry has saved the tax payers billions of dollar?
            All the industries that govt doesn’t subsidise its services.

          • bernardlou1
            22/07/2017

            You’re replies are unfounded and lack evidence. Check DOHA website for correct answers.
            Community pharmacy through several CPA have saved the tax payers billions of dollars.

            Scripts # are declining.
            Another saving there.

            You need to attach avidence to your replies not simply disagree.
            And you will find none.

      • bernardlou1
        10/07/2017

        First the system is well placed and ready to deal with more.
        Just because you seem you have unfounded issues doesn’t meant the system is broken.
        In the current system everyone needs to be the treated, rewarded and appreciated from employees, to tax payers to proprietors.
        No one needs to loose.

    • M M
      10/07/2017

      it is a non competitive market. It is a non viable business model and the accelersted price disclosures were stsrted by Julia Gillard.. just so you know 🙂

      HMRs and clinical pharmacists (you havent told the whole story) how the PGA want to get rid of HMRs and replace them by pharmacy based services.

      Busy pharmacies make high profits. You need to provide reliable sources for your claims.

      • bernardlou1
        10/07/2017

        The accelerated price disclosure was initiated by Tony Abbott when he was the health minister during the Howard’s era. Julia Gilard started the ball rolling and Kevin rudd did the simplified disclosure.

        • United we stand
          10/07/2017

          Bernard, I’m not here to have a verbal argument about whether the Guild is the devil in disguise or the virgin Mary.
          I’m sure everyone reading this article is incredibly moved by the stories and feedbacks we are receiving from our colleagues. If these are not signs for a change and a drastic one at that, I don’t know what is.
          We all need to stand together on this to fix the issue.

          • bernardlou1
            10/07/2017

            I’m agreeing with you. Community pharmacy needs to be rewarded according to the services it’s delivering.
            To discount prescriptions it’s like undervaluing its services. Pharmacists employees need to be rewarded according to their skills and accountability.
            Gov needs to recognize this as it’s in the best interest of the Tax Payers.

          • United we stand
            10/07/2017

            Agree 100%

        • M M
          10/07/2017

          And why do we need price disclosure agreement in first place?

          • Jarrod McMaugh
            10/07/2017

            Is that a rhetorical question Mina?

          • M M
            11/07/2017

            This is the core question, mister

          • Jarrod McMaugh
            14/07/2017

            OK so since you are going to be combative in this discussion, would you care to give us your understanding of the purpose of price disclosure?

          • M M
            21/07/2017

            That is what i wanted to hear, if you dont know then why are you DEFENDING CPAs.

            Having said that and ur name has MPS .. So.does your comments represent you or PSA?

          • Jarrod McMaugh
            21/07/2017

            Mina I think you’re a little confused.

            First, MPS is a postnominal representative of membership to the PSA. All members have this post nominal….. Don’t you?

            Second, I don’t speak for PSA… Only the president, the board, and the CEO can do this.

            Third, I have neither defended nor criticised the CPA. I have my opinion, but I haven’t delivered it in this conversation yet. I am interested to know your understanding of the CPA though – you don’t ever address it, you just say it’s not necessary without backing it up with explanations (or even an opinion)

            Id also like to see you demonstrate your understanding of the purpose and history of price disclosure. You comment on it, yet it’s not clear from these comments that you understand it.

            If you are unsure on these topics, perhaps you could consult a clairvoyant

          • M M
            21/07/2017

            I’m not confused, i want you as a supporter for guild and CPA to tell public what you understand. You can attack me the way you like. But i don’t okay this game. Pour simply, CPAs were discussed in details in kings report and in Rhodes reports one and two. I refer you back to them.

            CPAs are not needed because all PBS pharmacies must deliver pbs services. Any agreement must be between consumers and government because the whole pbs service is for our patients funded by Tax payers.

            The ones whos bit sure about the topics is the one who doesn’t understand my comments nor to where I’m taking this conversation to. So yes, i understand why you are a bit cautious.

            Economics is hard not everyone can understand it. You need to have a degree for this.

            For you pharmacies are doing well under CPAs but you haven’t told your people that CPAs will end soon, there may not be any CPAs after 2020.

            Pharmacies are suffering and that’s because of CPAs not that CPAs are protecting pharmacies, CPAs don’t match NMP because they restrict supply, stop innovation and a lot more. This is a bit economics subject I’m not here to teach economics.

            Finally, its better to share positively n the conversation because your comments reflect nothing but lack of knowledge.

          • Jarrod McMaugh
            21/07/2017

            Mina you didn’t address some of my question. I’ll ask them again before moving on:

            1) will you be consulting a clairvoyant?
            2) will you display your MPS post nominal a like other PSA members?
            3) will you provide the readers a demonstration of your understanding of the concepts you have raised (Community Pharmacy Agreements, price disclosure policy, National medicines Policy, even the nature of the PBS; perhaps even supply & demand!)

            I think it’s really important that you demonstrate an understanding of the basic concepts Mina, because you demonstrate 3 traits that make me doubt that you do:
            1) you are very critical & argumentative without providing any depth to your comments
            2) you refer people to other people’s work, & no other established analyses; you focus on the recent news-grabbing king report & the mystical Rhodes opinions as if these are the only discussions on the topic.
            3) you use circular arguments wherein you inform the reader that you have expertise & the capacity to understand the concepts in this conversation better than other, but then you refuse to discuss anything in more depth. The few times you have mentioned anything from an economics field it has involved basic economic theory – certainly not of the complexity and sophistication I would expect from a consultant to Deakin University’s Business & Law School.

            If/when you’re happy to put some depth into your responses (perhaps even ask AJP if they’ll publish an opinion piece for you) then maybe we can discuss the issue of the CPA and price disclosure. Until then I will remain cautious in providing my thoughts…. Not because the topic is too complex, but because I don’t think discussion is your motivation here.

          • M M
            22/07/2017

            Nice try. Guild and PSA couldn’t respond to ant of our comments and replies. I don’t play this game mister 🙂 everyone its mistical but guild .. That’s pathetic. You can ask whatever questions you want. You won’t go anywhere.

            Six months ago many of our colleagues were not aware of what’s going on. Now, its different, my opinions and understandings were posted many times on psa forum. You couldn’t even provide answers or clarifications to them. (It is understandable).

            If you think that playing the same game every time will be beneficial to you then you must be wrong.

            Our Colleagues now are better informed. Look at their comments. They are quite smart.

            Their comments and inputs are impressive and outstanding.

            I enjoy watching you criticizing the person rather than positively contributing in the discussion.

            I enjoy the fact that you dont have neither the courage nor the knowledge to respond to my very simple question that I have started with.

            Checkmate

          • Jarrod McMaugh
            22/07/2017

            I advise you not to use “checkmate” as a closing sentiment in replies online else you’ll attract comparisons to a very famous quote about pigeons.

            So, the question that you asked above was this:
            “And why do we need price disclosure agreement in first place?”

            This is the one that made me ask if you were being rhetorical…. because as far as pharmacy is concerned, we don’t “need” a price disclosure agreement. It exists to ensure equitable value to the PBS for the supply of medications that are no longer on patent.

            The method of funding medications on the PBS throughout the 90s and early 2000s was such that there was a large gap between when wholesale prices dropped & when PBS remunerated fees (based on agreed wholesale prices) dropped to match them. This created a situation wherein the government was agreeing to pay a fee that may not have reflected the real cost in the market.

            Price disclosure didn’t occur due to CPAs; it occurred due to a confluence of events such as block-buster medications being listed on the PBS, and a proliferation of competition among manufacturers of off-patient medications –> this created dramatic price variation in a system that was not designed to respond nimbly to price pressures. Whenever government policy is used to make a resource affordable to consumers, this kind of situation can occur. Government policy was slow to respond to market changes, but has caught up (significantly) now.

            So, here I have answered your original question in this thread. Would you answer any of the three in my last response? You now have an opportunity to “put your money where your mouth is” and show that you are more than some guy in a Boston bar named Clark…

          • M M
            11/07/2017

            It is the core question.

          • Willy the chemist
            14/07/2017

            Mina, I replied to you a few days ago in another thread “Threat to Certainty”.
            Price Disclosure is a mechanism to improve the prices to Government. You said that the CPA is defunct and agree with Rhodes that our PBS Rx prices were high.
            It seems you have an agenda to obfuscate and distort.

            Firstly 2014 is like light years ago in pharmacy universe, the report that Rhodes quoted was very much out of date (shame on them! It’s irresponsible reporting based on their ideology, not objective reporting).

            Secondly as I pointed out, Australia was for a very long time one of the lowest priced for Rx in the OECD countries until it gradually deteriorated up till 2011. Again I pointed out that this has nothing to do with competition or privatisation but GOVERNMENT POLICY.

            Has this been too hard to comprehend? Do you need a lesson or are you just obfuscating?
            I also gave a random list of Rx prices from 2011 and current which show that a majority of the prices have halved & some by even more.
            This is a success of the CPA agreement and a result of the price reforms.
            Ultimately we all want a sustainable healthcare system. We want world class universal primary healthcare, but this cost money and we have to be vigilant in guarding against user pay system.

            Do we need price disclosure? Yes. Do we like price disclosure? Pharmacy No. Government Yes.
            But it is necessary.
            Pharmacy is suffering from the collateral fall out.

            It is a bitter pill. Yes we need price disclosure Mina.

          • M M
            15/07/2017

            In terms of business and economics all what you mentioned is counted as ZERO ..
            Fact is we dont need CPAs and consequently, we wont need price disclosures.

            You can write as many replies and articles as you like. What doesn’t match economics shouldn’t be there.

          • Jarrod McMaugh
            15/07/2017

            Mina price disclosure isn’t a consequence of the CPA, it’s a consequence of th PBS.

            The more you make these types of comments (or broad claims without basis, details, or facts) the clearer it becomes that you aren’t actually as familiar with the topic as you would like trying r to believe.

            When your response to someone else’s comments is ‘everything you said means nothing’s but you don’t ever back it up or justify why this is the case, then you aren’t actually contributing to the discussion.

          • Willy the chemist
            15/07/2017

            Saying it is just economics and business doesn’t cut it, no matter what academia or economists might like to say. Health is not just economics.

            Besides we know that the system many espouse to is failed and inferior despite what they might like to say. Saying antibiotics might cost less to a patient, provided they have a health insurance to pick up the tab is misleading.

            It’s like the gun lobby of America.

            The Commonwealth Fund “Mirror, Mirror 2017” on international comparison. The conclusion is that the United States of America health system falls short.

            http://www.commonwealthfund

            Saying economics or business rules even contradicts their own statement. It is the 1% elite that controls the businesses and economy, inspite of the business and economic competitions. The US system overrides competitions because the 1% is too powerful. They write the rules and they make the competition. Give anyone overarching power and they will be the competition but as a result you will stifle innovations and real competitions.
            Read “Microsoft” of the 1990s.

            In fact if anyone bother to read the article, it goes on to say that aAustralia has one of the best outcomes but is low on equity. We are also sitting on the bottom of OECD countries directly opposite USA which is highest. So if it is economics and cost, Australian system works and USA fails. But big businesses the 1% have an interest in maintaining the status quo.

    • Andy Harris
      10/07/2017

      What rubbish are you speaking about with regard to profit?

      Pharmacies earn well above 100k per year profit unless they are a desperately small pharmacy dispensing very few scripts.

      Most pharmacies dispensing 400 or more scripts per day will be profiting at least 600k per year.

    • John Smith
      10/07/2017

      I can’t help myself but laughing mate… busiest pharmacy earns $100K a year? if assuming a pharmacy dispensing 200 scripts a day would be sold for 2 mil, and you are saying that it would earn $100k a year??? what bank would lend that amount of money to a business that cost $2 million and earn $100k a year? Re: other assumptions you have, you better get evidence for them, because they are not accurate

    • GlassCeiling
      10/07/2017

      BS on the 100k profit for busiest pharmacies.
      King approached pharmacists directly for financial info after being told repeatedly that the industry is suffering. No response. I wonder why!
      Pharmacies making no profit are like all small business making no profit- bad decisions have been made!
      The PGA did support HMR and RMMR – they didn’t create it. The PGA saw dollars for their members – their primary motivator.
      I bet you didn’t know that your false statements are transparent and embarrassing.

  8. Tim Shelton
    10/07/2017

    What a load of Rubbish. We advertised for months (Just ask Sue Moller) for an experienced pharmacist of even a few years and were offering 100k per year and then bonuses for performance. Challenging, clinical role, very little “selling shampoos” and got almost zero applicants. My Friend down the road was offering even more and he’s been advertising even longer. The problem? 2.5 Hours from Melbourne. Open your eyes pharmacists – the world does not end at the outskirts of whatever overpriced, overpopulated, over-supplied job market city you live in.

    • M M
      12/07/2017

      Try offering them their worth. 130K plus other benefits.
      There is national workforce shortage.
      Ask guild it’s on their agenda for next period to find “innovative solutions for the problem”

      At the moment you have one of three solutions 1-sell the business like many others who started to do the same.
      2- run the business yourself
      3-pay for locums.

  9. Jarrod McMaugh
    10/07/2017

    We seem to have a bit of a catch 22 with pharmacist wages.

    I assume everyone is aware that dispensing fees are tied to the award, so that those fees aren’t outstripped by rising wages.

    We also know that many pharmacies pay above the award, and are effectively punished by the fee being paid based on award, since the lowest paying employer is paid the same as the highest paying employer.

    Now it’s already been mentioned in the comments here that the penalty rates decision was made by a group of people selected by the last Labor govt, yet they basically did what the Govt wanted (despite being a liberal govt)

    So if awards are deliberated by a group who do what the Govt seems to want…. & An increased award costs the Govt more in dispensing fees, the. We have an issue….

    Btw the fact that the award influenced the dispensing fee is important to remember. Most owners I know want the award to rise, because they are already paying double or more….. Yet the discounters are not. If the award rises, this effectively drives discounters into a position where fewer of then will be sustainable, easing the pressure on the sector. Saying the the guild and members want wages low isn’t a fact, it’s an assumption made by people who don’t know any better.

    PS the idea mentioned in the article about paying the dispensing fee to the Pharmacist is difficult to fathom.

    • United we stand
      10/07/2017

      Sooner or later we’ll see the submission made by Guild regarding the award. Lets hope you’re right Jarrod.

    • Andrew
      11/07/2017

      >>>>Most owners I know want the award to rise, because they are already paying double or more..

      That would be close to $50/hour Jarrod…..seems unlikely.

      • Amandarose
        14/07/2017

        Pharmacists are getting that in my area. With holidays.

  10. Hany Aita
    12/07/2017

    I’ve been reading articles about
    shortage in pharmacists especially in regional areas. And I have to
    agree. Things are worst than I’ve ever seen since I came to Australia in
    2009. As an employee, I honestly don’t mind it. It means that employees
    might have the upper hand when negotiating new jobs or their contracts.
    I remember in 2010-2011 when I finished my internship, I couldn’t find
    any job anywhere. I called every pharmacy in WA (where I used to live)
    for any position with no luck. At the time, I replied to every ad in
    seek in every state in Australia with not even getting one interview.
    Finally, I ended up moving to Tassie and staying there for almost 4
    years. I remember when I started my first job, I was broke with only
    $100 in my bank account.

    Comparing this to late last year when I
    was looking for a new job, It took me only 1 month to secure a new place
    and I was offered 3 more positions all with higher pay than what I was
    earning and all in regional areas. This is of course in addition to my
    previous employer trying to keep me by offering 20% salary increase and
    potential future partnership. I understand my resume is stronger now
    than what it was 7 years ago but still the difference in response was
    amazing.

    I think low pay, lack of career progress and lack of job
    satisfaction are among the leading reasons why people are not very keen
    on studying pharmacy anymore. I used to work with a final year student.
    She told me that when she started her course they were 200 and now they
    are less than 40 in final year.

    The problem gets worse in regional
    areas. It doesn’t matter how hard you try to make it appealing, living
    in regional areas in Australia is not great compared to living in larger
    towns or cities. It’s definitely offers more relaxed lifestyle but
    there’s nothing much to do. When you move to a new town, you spend a few
    months exploring what it can offer then you are done. Same restaurants,
    same parks, same everything. It gets boring after some time. Of course
    you need holidays that mostly involve lots of traveling by car or plane
    which can be costly depending on which way to go. Finding a locum to
    cover you is not easy and mostly expensive. Shopping generally is hard
    and sometimes you have to travel a few hours for clothes, appliances,
    etc…

    The sense of isolation can easily get you if are living alone
    and with no family. I used to locum in a far town in WA and there were
    many TV ads targeting younger population to help with suicidal thoughts
    caused by isolation.

    I also think part of the problem is multiple
    ownership. I spoke to many owners who live in metro cities and own
    pharmacies in regional areas that they visit maybe twice a year. I think
    many young pharmacists will be more tempted to move to regional areas
    to own their pharmacy and be part of little community rather than work
    for someone who lives few thousands kilometers away. Moving to a
    regional place for a job offers no security as you know that eventually
    you have to leave. There is nothing to hold you to this place except you
    job and if you lose it for whatever reason, you have to pack your bags
    and leave.

    Finally, I think filling positions for owners in
    regional areas will be harder than ever and they should be ready to
    offer very lucrative financial packages especially to attract
    pharmacists with lots of experience. As for myself, I think in a few
    years, I’ll move with my family to a metro area as I had enough of
    moving between regional areas.

  11. Willy the chemist
    15/07/2017

    Saying it is just economics and business doesn’t cut it, no matter what academia or economists might like to say. Health is not just economics.

    Besides we know that the system many espouse to is failed and inferior despite what they might like to say. Saying antibiotics might cost less to a patient, provided they have a health insurance to pick up the tab is misleading.

    It’s like the gun lobby if America.

    The Commonwealth Fund “Mirror, Mirror 2017” on international comparison. The conclusion is that the United States of America health system falls short.

    http://www.commonwealthfund.org/interactives/2017/july/mirror-mirror/

    Saying economics or business rules even contradicts their own statement. It is the 1% elite that controls the businesses and economy, inspite of the business and economic competitions. The US system overrides competitions because the 1% is too powerful. They write the rules and they make the competition. Give anyone overarching power and they will be the competition but as a result you will stifle innovations and real competitions.
    Read “Microsoft” of the 1990s.

    In fact if anyone bother to read the article, it goes on to say that aAustralia has one of the best outcomes but is low on equity. We are also sitting on the bottom of OECD countries directly opposite USA which is highest. So if it is economics and cost, Australian system works and USA fails. But big businesses the 1% have an interest in maintaining the status quo.

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