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Australian Journal of Pharmacy : November 2006
editorial from the editor email@example.com EDITORIAL AND Shades of grey services O NE of the underlying themes of the recent Pharmacy Australia Congress in Cairns was whether community pharmacy was ready and capable of producing and sup- porting pharmacists who specialised in particular health disciplines, such as diabetes and asthma, better placing pharmacists to take a place in the primary healthcare team. The issue generated considerable discussion both in and outside lecture theatres. There are clearly defined camps in the debate; the questions surrounding the issue seem to relate to whether pharmacy has the appropriate support structures to produce and sustain spe- cialisation and, if it does, how should specialised pharmaceutical care be delivered. The strength of feeling surrounding the issue was obvious, with some delegates believ- ing this is a ‘black and white’ issue. I believe the solution lies somewhere in between; more like a shade of grey than a question of black or white. I don’t think there is any doubt that specialisation has to occur—for the good of the com- munity and for community pharmacy. As has been pointed out, specialisation in pharma- ceutical care has been happening in the hospital setting for some time and there appears to be appropriate structures in place to assure the veracity of the educational process. But does community pharmacy have the appropriate educational structures in place yet to assure the quality of its distribution, and is the network of community pharmacy equipped to effectively manage its delivery? I think the answer to both questions is: not yet. While a structure of education and accreditation to support the concept of specialisation can be built (and in the Australian Association of Consultant Pharmacy, community phar- macy already has an active body to assure the veracity of the deliverables), there is too much variation in the quality of community pharmacies to assure the effective widespread distribution of specialised pharmaceutical care. Perhaps this is too much to expect. After all, the majority of community pharmacies already find it difficult to define and deliver cat- egories of retail healthcare specialisation from the front of shop, let alone the more sophis- ticated professional service deliverables being discussed. And what about the slow uptake of home medicines reviews (HMR) by community phar- macies? Too many pharmacy owners obviously believe they’re not well enough positioned to take on board the responsibility of managing the process of a HMR service and this already receives adequate government funding (as soon as the agreed funding top-up mea- sures are implemented, but that’s another story) so further professional specialisation would surely be beyond them. The irony of that situation was not lost on Professor Lloyd San- som who, while moderating one of PAC’s panel discussion, made the passing comment: ‘I thought medication reviews were supposed to occur every time a script was dispensed’. So perhaps the future of community pharmacy-delivered specialist pharmaceutical care services lies with the capitalist driver of supply and demand. While the majority of com- munity pharmacies rely on their dispensary and generalist services to maintain their bal- ance sheet, some smart performers are making a difference to the health of their customers and their bottom line by using specialisation as a point of difference. Community pharmacist Grant Kardachi talked about his approach to delivering spe- cialist services. By relying on a systemised approach to delivering services and using spe- cialist mentors to guide advice, he’s able to assure the quality of the professional service deliverables. This gives him both the satisfaction that comes from being a healthcare pro- fessional and the comfort that, when he signs off on any medication review report, for example, that it is based on appropriate professional advice. No doubt Mr Kardachi will be well placed to extend his professional services if and when he’s given the opportunity. Whether it is worth his while or not will depend on his customers and the value they place on it. Sounds like a good point of difference to me and one which will keep him ahead of competition. MATTHEW ETON, EDITOR 12 ? THE AUSTRALIAN JOURNAL OF PHARMACY VOL 87 NOVEMBER 2006 ADVERTISING OFFICES: Suite F2, 1-15 Barr Street, Balmain NSW 2041 TELEPHONE: (02) 9818 7800 FACSIMILE: (02) 9818 7811 EMAIL: firstname.lastname@example.org WEB SITE: www.appco.com.au/ Managing Editor: David Weston Consulting Editor: Jack Thomas, OAM, PhD, MSc, FRPharmS, FPS Editor: Matthew Eton Journalist: Jayamala Gupte (02)9556 9815 Feature Writers: Megan Haggan, Kymberly Martin, Lisa Offord Advertising Account Managers: Rad Miller email@example.com Jeff Johnston (02) 9556 9821 (02) 9556 9819 firstname.lastname@example.org Vicki Davidson (02) 9556 9816 email@example.com Production Manager: Suzanne Watson Marketing and Promotions Coordinator: Sarwat Majeed BOARD OF DIRECTORS John R Coppock,(Chairman) FPS, FAICD, MAIPM Alan A Russell, OBE, FPS, MR Pharms S (Hon), FAIPM (HC), FAICD Leo Lewis, ASA, B Bus David Mattingly David Weston, BA, DiplM-Lib, DipEdPub SUBSCRIPTIONS Within Australia $93.50 pa GST inclusive All other addresses $145 pa Single copies: within Australia $9.35 GST inclusive Overseas $12.50 (includes postage) Inquiries (03) 9810 9900 The Australian Journal of Pharmacy is published each month by the Australian Pharmaceutical Publishing Co. Limited. ACN 004 082 053 Registered office: 40 Burwood Road, Hawthorn Vic 3122 Tel: (03) 9810 9900 Fax: (03) 9819 1706 Printed and bound by National Capital Printing ISSN 0311-8002 © 2006 APPCo Ltd. All AJP material is copyright. Reproduction in whole or in part is not permitted without the written permission of the publisher. PHARMACY’S OWN INFORMATION RESOURCE Member: Audit Bureau of Circulations Largest paid circulation of Australian pharmacy publications