Pharming out responsibilities
The 2004 “Choosing health through pharmacy” programme envisages that by 2015, pharmacy will be our first stop for health matters. Pharmacists will be qualified to identify disease risk factors, suggest the appropriate treatment steps and refer practitioners when necessary.Going hand in hand with this is the increasing switch of prescription-only-medicines (POMs) to P status - medicines that can be provided by a pharmacist without the need for a doctor’s script. This is good for the drugs bill and so far, good for patients - with a pretty clean slate for switches so far in terms of safety.
Mixed reactions come from pharmacy itself, however. On paper the industry are largely positive but seem reluctant to practice on real life customers. This is not the proactive response that government and industry had hoped for.
Some believe it is too much, too soon, to expect pharmacists to accomplish a GP consulting approach. The first and biggest hurdle may be acceptance. To quote a pharmacist I recently spoke to: “If I had wanted to be a GP I would have become one”.
But the cost of switches must be recouped. So are we doing something wrong? Pharmacists know that switch products have met stringent risk-benefit criteria - I believe so. They value the training on offer - yes. Should we be more aggressive - less trusting of their professional instincts, less patient?
I don’t think a macho upbringing makes strong people. So we need to think hard about support. While the NHS is the main driver of change, we cannot expect that our responsibilities end with branded training. Instead, we’re going to need to co-create opportunities with government and pharmacy to build the secure, confident community practitioners of the future. Watch this space.
Blog posts
Bambi said (February 10th, 2008 at 8:31pm)
‘If I had wanted to be a GP I would have become one’. MD has traditionally carried a lot more weight than pharmacist - in terms of prestige and good old-fashioned ‘cash money’. It seems to me that pharmacists are being offered greater responsibility with POM-Ps but we can’t assume that this automatically converts to reward. And we all know that it is reward that will ultimately drive them.
To begin with the money thing. I’d be interested to know the difference in margin for a recently switched product and a more established OTC competitor. Take migraine for example. Recommending sumatriptan over Migraleve doesn’t just mean altering established behaviour patterns - there is admin involved, not to mention responsibility for someone becoming dependent or suffering an adverse event (even if not legally). If I was a pharmacist I’d want it to be worth my while… I think training is all well and good but short term financial incentives could be a useful catalyst to get new switches up and running.
Which brings me on to the other kind of reward - social recognition. We all know that what drives us goes beyond money but again we can’t assume that greater responsibility automatically converts to kudos for the pharmacist. I believe they’ll embrace their new role once perceptions of pharmacists genuinely shift - the way they’re seen by their customers and most importantly by themselves. So what can we do? Branded training will help to build confidence but getting customers to think differently about pharmacists (through blogs and more traditional comms) and enhancing the interaction at the counter will be more powerful I think. Assisting and accelerating this shift in perception will help to build secure, confident community practitioners of the future. I’m watching.