And...action!

I try my best not to use this blog as an outlet to vent. For two reasons. First, I have a very strong tendency to be intolerant and hot headed and I've never found that it serves me well. Second, it seems a bit self indulgent. Even if I am writing to an imaginary audience, I think it's important to assume they have some imaginary standards.

That being said, I can't go on with my day until I get something off of my chest. I need to comment on the public conversations that have been going on in the media, twitter etc regarding the negotiations of the 7th community pharmacy agreement. I've seen a lot of pharmacists making comments about the "pharmacy bashing" and lamenting that the value of the pharmacist isn't more broadly recognised and appreciated. I am really starting to find it tiresome.

Get. Over. Yourselves.

You might think I'm being harsh or unfeeling. Perhaps I am. I don't have ownership in a community pharmacy. I am not getting paid peanuts by a big pharmacy retail chain. I am not even employed on an ongoing basis by anyone.

Here are some of my specific issues.

1. You can't argue with people's feelings. Their perceptions are their reality and their feelings are valid.

We live in a consumer culture and consumers define the value of the services they receive, not the providers. If they don't see the value of Pharmacy, then maybe we're not marketing it right. We need to take responsibility for this.

Stop complaining about consumers. Because when you complain about consumers it sounds like you think they are too stupid to understand. And that is just not helpful in any way. It's about time we stopped bashing people over the head with the "value your pharmacist" bullshit rhetoric and start providing them with services that consistently meet, or even surpass (gasp!) their needs.

Consider this blog for instance. If you've stumbled across it and continued to read it's because there's something about it that you find interesting, either positively or negatively. You're not reading it because I've told you to.

Good singers don't tell people they can sing, they perform and the audience gives them a standing ovation or some polite claps. Comedians don't tell people they're funny, they either get laughs or they don't.

Now that's not to say that if they don't get a positive response then they're without any value. Maybe their an opera singer singing to a thrash metal crowd. A physical comedian performing to people who want satire. But if they're a professional, then their job is to entertain the paying audience. They have a responsibility to at least try to connect with their audience, respect their views and provide them with the entertainment they've paid for. Otherwise it's all about ego.

I'm not saying that it can't be about ego. Just own up to it. Don't present it under the guise of wanting to make the world a better place. That's simply not true. Achieving better outcomes makes the world a better place, and it doesn't matter who does it. This requires a group effort. And egos don't work so well in teamwork.

One of the structural analogies I've been thinking about lately is that of film production. It takes a large crew of people to produce a movie, but only a couple determine the resultant entertainment experience. The actors can put in the best performance of their lives, but the director might set up the shots poorly, or edit out their best scenes. Others, like sound engineers, cinematographers, editors etc do work that is essential to the outcome, but how many of us acknowledge their work, let alone know their names. But I'm sure the directors and producers know their names. I'm sure they seek the good ones out to work on future projects.

As pharmacists, we need to get better at seeing the bigger picture and being happy with playing our role in the team. Our role is not the one that gets the glory. We are not accountable for the decisions that get made. A lot of our work occurs behind the scenes or involves cognitive work that is unrecognised by patients and even other care providers. It is unlikely that pharmacists will ever receive widespread accolades and that doesn't matter. What matters is that we each optimise our individual contribution to the team and work together to achieve shared goals.

2. Reduced regulation doesn't have to mean de-regulation or result in de-professionalisation.

One of the articles I read this morning was about the Chemist Warehouse group ruffling the feathers of the PGA etc by suggesting that if the rules were relaxed they could provide some commonly used medications free of charge, as they do in New Zealand. Now obviously they are playing this angle because it will push even more of the small pharmacies out of the market. But in my opinion there really is no social argument that can support charging people for medicines if they could otherwise get them at no charge. It is straight up protectionism of community pharmacy owners.

That's not to say that I support removing all regulation. I just think there could be some merit in decoupling the supply services of pharmacy from the professional services. I think it could result in more meaningful regulation that could drive improved quality outcomes.

I think the only real reason people are opposed to it is because they feel bad for the community pharmacy owners. I feel bad for the good ones too. Just as I felt bad for the good taxi drivers when Uber came along, and the corner deli owners, and the video store owners. But it doesn't mean I don't use uber, or do my grocery shopping online, or enjoy Netflix. Community pharmacy are small businesses, and this the nature of small business. They involve risk and they often have a limited lifespan.

Say this was to happen and retail groups were able to own pharmacies as well. Does that really mean the end of pharmacy? It will probably be the end of making easy money from a community pharmacy. It will probably be the end of getting paid professional wages as a dispensary pharmacist. But none of this dictates that it will be the end of the professional role of the pharmacist. Maybe it will liberate us as a profession instead.

Professional pharmacy services do not need to be integrated with supply of medicines. Related, yes, but not integrated. If we know that the supply is not going to be covering anything but the bare bones professional service, then we can put strategies in place to ensure they are provided through other methods. But we need to get creative. We need to encourage innovative approaches and novel ideas. Support entrepreneurship. There's a whole new world of small business opportunities that could be out there for people to realise.

I really think it's time to stop complaining and start taking action. Have these difficult conversations rather than polarised debate. Take control of the only thing we have control of, ourselves. Your work, your interactions, your thoughts and actions. Stop focusing on everyone else and everything else and start focusing on you.