‘You are not in a dying profession.’


Professor Lloyd Sansom touches on the future of pharmacy, pharmacists in general practice and prescribing rights at NAPSA Congress 2019

Student delegates heard from speakers representing a variety of pharmacy backgrounds at a career pathways panel session at NAPSA Congress in Adelaide on Wednesday.

The panel included Emeritus Professor Lloyd Sansom AO who presented his own talk earlier in the day, as well as SHPA vice president Dr Jacinta Johnson, Pharmacy Guild national councillor Arn Doan, Australian Defence Force pharmacist Fares Al-Sarawi, geriatric pharmacist Juliet Richards, and pharmacist Peter Nguyen who is now working in the business sector.

Panellists agreed that the future of pharmacy is facing a lot of change but looks bright—if opportunities are taken.

“You are in a field which has an insatiable demand and you can make a difference. You are one of the few people in society where you can go home and say you made a difference to that person’s life today,” said Professor Sansom.

“The world is what you make of it,” he told students.

You are not in a dying profession, you are in a profession whose needs will continue to grow.

“The future of pharmacy is as rosy as you want it to be, both personally and professionally. Force organisations to give you the pathways where that knowledge base can be extrapolated into healthcare. Be outspoken when you have to, because it’s your future [and the future health of others].”

Peter Nguyen said: “We’re at the tip of the iceberg at the moment and the world is your oyster. Don’t pigeonhole into community pharmacist, hospital pharmacist, business owner, researcher…. Don’t define your state. Go somewhere you’ve never been before. I think we’re in a really exciting time, a new renaissance when it comes to pharmacy.”

When questioned by a delegate about pharmacists in general practice, Professor Sansom was quick to speak up and highlight some challenges facing the sector.

“Pharmacists in general practice is not a threat to the community pharmacist. It’s a liaison pharmacist between primary healthcare practitioners and community pharmacist,” he said.

“The Guild has made it quite obvious, quite overt, that it’s averse to pharmacist in general practice.”

However Professor Sansom added: “That’s because we haven’t defined a model for pharmacists in general practice – so that they’re not seen as a facilitator but as a threat.

“So to exclude the community pharmacy as a primary healthcare centre – which gets so many visits every day – as being isolated from that, it’s not going to fly.

“We need to force the Guild to the table to discuss what model for pharmacists in general practice that they would be happy with and what pharmacists would be happy with,” he said.

The career pathways session panellists.

“We all want this – why wouldn’t you use that opportunity? – but come up with models which are pragmatic models. If we don’t get it right in this next agreement that’s another four years gone – wasted.”

Guild national councillor Arn Doan acknowledged that the Guild negotiates pharmacy funding through the Community Pharmacy Agreements representing mostly pharmacy owners, but added that the Guild “cares for the pharmacy profession deeply”.

“What Sansom said about pharmacists in general practice, we go against that because our whole profession relies – in our point of view – on the community pharmacist,” said Mr Doan.

“He is correct that the model needs to include the community pharmacist. What we’re trying to do with the CP2025 project is to change from just dispensing to a focus on health services. Personally why I don’t think pharmacists in GP will be the best solution – my pharmacies are in rural areas, I find it hard enough to get a pharmacist to work in them. I have to give them wages, accommodation, car, petrol etc.

“If the government is providing incentive for general practice to have a pharmacist say part time, firstly I can’t get that pharmacist work part time for me in the country where there is a need for pharmacists to work. I don’t see how that system will work.

“I think we all agree that the most need is in rural areas. If that incentive was provided to my pharmacy, we could all work together where the pharmacist could provide work part time one day here [in the pharmacy] one day there [at the general practice].

“If the funding was coming from outside that would be fine. But because we’ve got a finite amount of funds [provided through the CPA] we need to be wary of what we agree to.”

Pharmacist prescribing

A student delegate also broached the topic of pharmacist prescribing.

Professor Sansom warned that opening up pharmacist prescribing to include Schedule 4 would open up the floodgates to medical practitioners taking on dispensing.

“I personally don’t believe in pharmacists prescribing. It’s got to be separate from dispensing, you can’t have community pharmacists prescribing,” he told delegates.

“Some colleagues of mine believe the solution to the profession is prescribing. I speak in the minority.

“To prescribe we have to have appropriate diagnostic skills. The only professional trained in diagnosis is a medical professional and even they’re struggling.

“To me, I don’t know why pharmacists believe that prescribing is their soul. Quality use of medicines is their soul,” Professor Sansom said.

“If you start prescribing under S4 you cannot dispense it. If you open up prescribing and dispensing, doctors will also push for prescribing and dispensing.

“The distribution system is not just about access, it’s about quality use of medicines.”

Top tips for students from across the panel

Dr Jacinta Johnson: “Be a good pharmacist – maintain your professional standard regardless of the pressure you are under. Because we are in the profession trained by those already in it, it’s easy to pick up bad habits but it’s our job, as young pharmacists, to raise the bar.”

Fares Al-Sarawi: “To avoid falling into the trap [of becoming jaded]: Stay engaged with pharmacy organisations such as the PSA, SHPA etc. it’s a way to stay engaged with the profession itself. Continue to soak up everything like a sponge and that will make your practice more rewarding.”

Juliet Richards: “Think outside the square. The healthcare industry is evolving. There’s lots of problems and holes that need to be fixed. If you can find something that needs to be improved and you’ve got a solution – go for it. Don’t be limited in what you think is available.”

Peter Nguyen: “One thing I remember is feeling totally alone when I entered the workforce. And I’d like to remind you now that you’re not. Utilise resources such as the Pharmacists’ Support Service, Relationships Australia… self care is very very important. Another tip: build your network, get your face out there. Don’t underestimate LinkedIn.”

Arn Doan: “Spend as much time with patients as possible.”

Prof Lloyd Sansom: “The best thing you can do is take part of the organisations that run this profession. Do not be a passive participant in this profession. Be active. You can have an impact – don’t underestimate the impact you can have.”

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7 Comments

  1. Red Pill
    24/01/2019

    Oh boy, I remember them saying the same things when HMRs were being rolled out in early 2000s. Future is definitely looking bright for accredited pharmacists right now 😂
    All these new roles being talked about will be taking money away from Guild members. Expect them to be hindered and minimalised at every turn

    • Michael Dedajic
      24/01/2019

      Mind you, HMR accredited pharmacists didn’t help their cause by conducting HMR’s in GP clinics and pumping them out like Medschecks before there was a limit. They weren’t even asking for dispense histories from the pharmacy for the patients they were seeing.

  2. Larentina Brown
    24/01/2019

    The profession is definitely not dying. However, the pharmacists working in the profession are slowly dying from the inside.

    Enormous workload, low remuneration, increased professional services and non-stop fights with GPs are just a few examples of the pressure faced by many of us.

    • Michael Dedajic
      24/01/2019

      The profession is dying slowly. I see it like the TV repair man. There is still a need for us but not to sustain the current workforce out there. When we have to continually convince/lobby governments and other health stakeholders to obtain recognition of our work and appropriate funding then you know we are in trouble. When you have to expand practice scope (eg vaccination) and start doing jobs that other health professionals do currently to make the professional relevant and still cant obtain appropriate incomes for those jobs you know something is not right. When pharmacists are looking to transition to other careers at record numbers, you know again something is not right.

    • Bryan Soh
      24/01/2019

      A colleague of mine made a very good point. “If your profession has to justify its’ EXISTENCE, you know you are in trouble”.

  3. We have to remember who the audience was here – Pharmacy Students. It was nice for them to be provided reasons to be optimistic about their chosen profession. The reality of course is that the post graduates soon doubt the choice they have made. It was note worthy that Peter Nguyen recommended support groups. I am sure he would have said a lot of other stuff that would have been more orthodox and related to professional practice but nonetheless he telegraphed the soul searching that these potential new members to the profession will likely do. They will do it for a number of reasons but most likely once they begin to realise that Pharmacy is a profession that is consistently faced with new but unrewarding challenges.

  4. Kevin Hayward
    27/01/2019

    Pharmacy is not dying, it is just changing, and that provides new opportunity for those who want to take it. I have been working on a privately funded project for the last year as a GP based community pharmacist, which I have modelled on my previous role as a GP practice support pharmacist. Far from dying, my role expanded to full capacity within a few months of starting. I am professionally challenged and constantly learning, I am collaboratively engaged with the primary care team, I feel motivated and I am adequately remunerated. I am taking nothing away from community pharmacy. I am adding to patient care in terms of education, governance and quality evidence based prescribing. It would be great to have a formal place in the Medicare system, but so far I have lived without it!

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