E-drug: pharmacy drivers, counselling (cont)
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Dear e-drug colleagues,
My practical professional experience is mostly from involvement with
private, non-state institutions and what I want to debate here does not
necessarily have to be of equal importance to the state and district
health scenario. However, some of the arguments are basic to pharmacy as a
whole and will therefore apply, I believe.
Having started the debate around pharmacy drivers and the role of the
pharmacist regarding counselling, and having read much of what was
afterwards said, I am still of the opinion that pharmacists are the main
role players in the scenario of drug counselling, simply because they
have the four years of intensive pharmacology training as a basis.
However, the bottom line is that for decades we have not been living up
to that goal as well as we could have. Financial and profit motivations
(often, I realise, to ensure survival) have caused us to neglect skills
that are paramount to this very survival. Continued Education efforts by
our professional organisations are offered but are poorly supported, to
the extent that one sometimes wonders why a small group of enthusiasts
should even bother further with attempts to get colleagues to attend
lectures and seminars. It appears as mostly we are happy with our state
of ignorance - so, why bother?
My experience as a locum pharmacist in various retail pharmacies over a
period of ten to fifteen years has proved to me that some of my
pharmacist colleagues prefer to simply carry on dishing out scheduled
drugs like sweets in a cafe, makes no attempt to understand their role
in curbing antimicrobial resistance and drug dependency, bedevil medical
funds, try to run lucrative dispensaries with the minimum staff which
simply prohibits any quality time spent with a patient to allow the
necessary counselling, and this is by far not the end of the list of
what I have seen through the years up to this day...... though I haste
to add that I have also experienced the opposite from very dedicated
colleagues whose patient service is far removed from what I have
described above. I personally want to acclaim those - they deserve a
monument from pharmacy - they are the front runners with the concept of
Pharmaceutical Care which is fotunately gaining wonderful momentum.
My point, however, is that retail pharmacists in the new millenium will
have to be put in a position by an authority like the Pharmacy Council
where they will have to practice what they preach. Continued education
(and evaluation thereof) as a prerequisite for obtaining annual
registration should not be left on the backburner for much longer. We
are currently in the position where new and potent drugs appear on to
the market almost on a daily basis, some of which can be poison if not
used correctly. All of us know the older examples such as ergot,
lindane, antihistamines, antimalarials, warfarin, digoxin, but do we
alway know about potential problems with the newer ones such as
cisapride, azole antifungals, AIDS-drugs, quinolones, ACE-inhibitors,
and many more? The old drugs are mostly not disappearing from our
shelves, so the amount of knowledge we require does not remain constant!
How can any pharmacist keep up with the wealth of new knowledge required if
he/she only tries to rely on information gained from company
representatives? Hiding safely behind the counter, feverishly typing labels
on the computer, letting the assistant issue all medicine and allowing the
(untrained) driver to counsel the patient, is not my idea of pharmacy for
the 21st century. Taking action is. That means actions like properly train
staff up to realistic level where they can
supplement service without being dangerous, becoming Internet literate,
or enrolling for an Honnours or Master's course in Pharmacology as
offered by many training institutions currently (soon also
Internet-based which will make it accessible to everyone with computer
access). To start by subscribing to and getting involved with one or
more of the various subgroups of our Pharmaceutical Society, supporting
their continued education evenings and seminars, attending conferences and
becoming enthusiastic again about the avenues opened by knowledge, can be
very rewarding in personal growth as well as financial terms. Patients and
customers recognise counselling that is based on sound knowledge and word
spreads quickly about a knowledgable pharmacist in the area.
This way we may change the public perception of pharmacists being
shopkeepers, data capturers, pill counters... Recently I heard a woman
say: "Advice? My pharmacist never advises me on my scripts? The front shop
lady issues or sends my prescription and what I know about my medication I
read in Huisgenoot or YOU...." (perhaps even that's better than nothing!)
Recently I was struck by the enthusiasm for, and attendance rate of a
very informative two-day Hospital Pharmacy seminar in Kentucky, USA,
where pharmacists are awarded points towards annual registration by the
relevant authority for their participation in such events. We owe this
kind of attitude to our public if we want to improve health services
in South Africa. Funding problems (I know we live in South Africa, not
the USA!) must be overcome for the cause. We seem to lose perspective
and hide behind "unaffordability", also losing sight of the overall
benefit for all.
Let's grow, not shy away from our primary responsibilities!
Rina Meyer
Potchefstroom
South Africa
"Rina Meyer" <FKLCLM@puknet.puk.ac.za> [manually added , BS]
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