‘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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