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  • Can anyone help?

    Hello Everyone!

    I am currently a fourth year student at The University of Brighton. I have just discovered this forum while browsing online for some starting points for my fourth year project. I was wondering if anyone here may be able to offer any help.

    I would like to look into issues of attitude, opinion and trust between patients and Pharmacists, but also perhaps between other healthcare professionals and Pharmacists. Why do people have the views that they do about our profession, what factors influence them? How much do people actually know about the skills of a Pharmacist. Why do patients seldom seem to trust what a Pharmacist says? What needs to be done to improve relationships with patients and other healthcare professionals? It would also be very interesting to look at how these points have changed over time and how they vary geographically now and why. What will the profession become in the future, is the proposed evolution of the profession in clinical roles actually feasible considering all of the above? These are still only vague ideas but I would very much appreciate any ideas anyone may have.

    I found this forum by reading a thread about a Pharmacist in an episode of the BBC's Holby City:

    http://www.pharmacy-forum.co.uk/phar...character.html

    I was shocked by this! Do we ever get any good press in fiction? Why? Why does it only seem to be the doctors that get all the glory? Wouldn't it be fun to petition the BBC to include a good guy Pharmacist character in Casualty or Holby City! I can see it now, a young sexy Pharmacist bursting through some double doors to save the day! Hmm.... as if. If anything, it'd be a dottery old man Pharmacist who nearly kills some one by mixing up some vials of some drug and a hip young house officer that saves the day. It's not fair!

    I am looking for any opinions anyone may have on these points, anthing at all would be brilliant to read. I was also be especially grateful if anyone could point me in the direction of any good sources, online or otherwise, to give me anymore information on any of this.

    If you leave a comment would you possibly also be able to leave your age, sex, what field of Pharmacy you work in and where you work just so I can get a better feel of who and where any comments come from.

    Thank you so much for your help. Hopefully we can do what we can to improve our profession.

  • #2
    Re: Can anyone help?

    Originally posted by Jobaho View Post
    I would like to look into issues of attitude, opinion and trust between patients and Pharmacists, but also perhaps between other healthcare professionals and Pharmacists.
    Just a small request, then. Actually, if this is for a thesis, I would first suggest that you focus on one small part of this, and for an undergraduate paper, just check that you have some kind of independant and dependant variables in mind. So you could check reports in a particular paper over a couple of years, perhaps, or on-line reports, which might be easier...and compare, say pharmacist mentions and podiatrists mentions, or whatever.
    Originally posted by Jobaho View Post
    Why do people have the views that they do about our profession, what factors influence them?
    Well, its about psychological conditioning. This is a result of our perceptions of our personal experiences, initially through the eyes of our parents and "significant others" and gradually as we grow up through our own direct perceptions, which, however, will be seen through the filter of our previous experiences. The easiest way of modifying this in other people, as we know, is through advertising, both overt (billboards etc) and covert (TV shows), over many years. It has little to do with reality, you will have noticed.
    Originally posted by Jobaho View Post
    How much do people actually know about the skills of a Pharmacist. Why do patients seldom seem to trust what a Pharmacist says?
    see above. Some do, some don't. Actually in the "trust" stakes, pharmacists come out very well indeed, and better than doctors, journalists and of course politicians: its just that the public don't believe we have the knowledge that a doctor does about their possible illnesses, or the ability to treat them in the way that a doctor can. Things are changing slowly.
    Originally posted by Jobaho View Post
    What needs to be done to improve relationships with patients and other healthcare professionals?
    Because of the way pharmacists are perceived by the public, as compared with other professionals and tradesmen, there is an imbalance in perceived status. The status of doctors has been unrealistically high due to years of overt and covert advertising, which means that an evidenced-based campaign can never raise us to the levels of status that doctors enjoyed a few years ago. This is particularly apparent with consultant physicians, IMHO. It is unlikely that these demigods will deign, or be allowed by the public, to lower themselves in people's perceptions to the more realistic status accorded to pharmacists. It is actually that the artificially high status of doctors needs to be lower - which is happening - before an equilibrium can be reached.
    Originally posted by Jobaho View Post
    It would also be very interesting to look at how these points have changed over time and how they vary geographically now and why. What will the profession become in the future, is the proposed evolution of the profession in clinical roles actually feasible considering all of the above?
    I think that at long last the government is seeing through the spin that has surrounded the medical profession for generations, and are going to force change through if they can get us to do the jobs. However, most of us in the community are better businessmen than the politicians seem to believe, and won't be drawn in to provide yet more services without concrete evidence of increased funding.
    Originally posted by Jobaho View Post
    Wouldn't it be fun to petition the BBC to include a good guy Pharmacist character in Casualty or Holby City! I can see it now, a young sexy Pharmacist bursting through some double doors to save the day! Hmm.... as if. If anything, it'd be a dottery old man Pharmacist who nearly kills some one by mixing up some vials of some drug and a hip young house officer that saves the day. It's not fair!
    Its been suggested before. If it ever happens, the battle will have already largely been won. I suggest that we get someone to start writing the books (Linnear?) on which such a series could be based. I suggest that it be about a gardening cordon-bleu pharmacist who has an interest in using clairvoyance to help Hercule Poirot solve his crimes. Sort of Rosemary and Opium Poppy meets Gordon Sherlock Ramsey And Mystic Jamie Oliver. (copyright DavidS 2008)
    Originally posted by Jobaho View Post
    If you leave a comment would you possibly also be able to leave your age, sex, what field of Pharmacy you work in and where you work just so I can get a better feel of who and where any comments come from.
    Yes, I am broken down by age and sex. Late 50s and male. Community locum, independent groups, and with an interest in psychological conditioning, Jung, Rogers, NLP etc.
    Originally posted by Jobaho View Post
    Thank you so much for your help. Hopefully we can do what we can to improve our profession.
    The profession has consistantly demonstrated that it will provide services over and above the extent that funding can be provided, to show what can be done. This appears to contrast well with the doctors, and is why we have been in everyone's better books! Thus far, however, the government have shown that it cannot be trusted to ensure provision of funding, resulting in a loss of faith and goodwill.
    ....just my opinion

    Comment


    • #3
      Re: Can anyone help?

      I think quite a few points in pharmacy law render pharmacists impotent.
      For eg emergency supply of pom medicines? Without all the criteria in place a pharmacist breaks the law if he supplies a ventolin inhaler to someone that may be choking from asthma without a prescription. If someone requires omeprazole for acid reflux or ranitidine, we can only sell a sub therapeutic dose. We are marketed as inferior to nurses because are hands are tied. We can not sell a decent cough bottle anymore due to the inclusion of a schedule 5 cd inv (see my message)
      anyway a local labour councillor came round to my place looking for votes and he called me a shopkeeper. I was deeply offended. Alas that is how the politicians see us, but if they can commercially manipulate us they throw any role they can at us.
      I think being responsible for correct filling in of fp10 scripts adds to patient mistrust of us, we may be perceived as govt informers to have an unhealthy interest in a patients social status and what benefits they are on before they recive their medication. This is hardly fair when all scripts are free in scotland and this prejudice of people's ecconomic status does not require verification.
      When i first qualified,25 yrs ago, pharmacists did command far more respect than they do to-day. My opinion was respected by other proffessionals and the health authority.
      I think unethical practices from big business has filtered down into pharmacy and diluted our professional standing.
      I think murs are a good way to promote our knowledge and proffessionalism to the public, again the public need to know that our knowledge can be helpful and that we know a lot more than a shop keeper.
      If there any other issues send me a message i shall try and help
      good luck with the thesis

      Comment


      • #4
        Re: Can anyone help?

        I don't accept that we are any less thought of by other professionals or eg PCT staff (it would have been FPC 25 years ago!) than we were. I don't accept that we would be prosecuted for supplying an inhaler to an asthmatic without a prescription (emergency supply?).

        Who markets us and who markets nurses? How are our hands tied? All health professionals have restrictions on how they promote themselves.

        What decent quality cough mixtures are there? Even with CDs in the brew there is bugger all evidence to indicate that they are effective.

        What unethical practices from "big business" have infected us and damaged our status? The recent, admittedly flawed "Which" report indicated that independents gave poorer advice to patients than "big business".

        The question was posed in all innocence by an undergraduate wanting information. I think your negativity and, quite frankly, incorrect information has done him/her no favours.
        http://uk.youtube.com/watch?v=Hmbyj0XFUhA

        Comment


        • #5
          Re: Can anyone help?

          I don't accept that we are any less thought of by other professionals or eg PCT staff
          A pharmacist recently enquired about a Rx and suggested it might be appropriate if one of the meds was started at a lower dose, the doctor's reply I will paraphrase but put in quotation marks "who is he to tell me how to treat my patient, ive been doing this job for 35 years, are you going to give the patient their medicine or not". btw the pharmacist wasnt me, but all this was said to me, the doctor knew he was talking to the pharmacist on duty, although he didnt know how newly qualified i was.

          What happened i think is the day before the regular pharmacist (manager) wanted to enquire th rx but the surgery must have been closed, so he left a note on the Rx, so it can be looked at the next day so the Rx was taken to the doctors when i was locuming there the next day by one of the staff members. To be fair to the doctor I would have dispensed the Rx without enquiry as the other meds on the rx justified the high dose for this med (i even told the staff that), but I was surprised at just how the doctor responded, to a simple suggestion by the pharmacist.

          Something which makes this even more ludacris is that the surgery was only 2 or three doors down, and apparently the doctors were friendly with the pharmacist. I feel sorry for that pharmacist, he's not even in a position to stand up for himself coz if he falls out with that surgery, his bosses wont be impressed with him, they always want good relationship with the doctors.

          What decent quality cough mixtures are there? Even with CDs in the brew there is bugger all evidence to indicate that they are effective.
          I think codeine linctus is a very good remedy for a dry "tickly" cough, as for evidence, well i know it myself through experience and also once I went though all the evidence for coughs etc.. and it came out best, the only thing is too many people abuse it and if the word gets out your selling it, you get a queue of people forming who want to buy it but havent particulalry got a cough of any kind.

          What unethical practices from "big business" have infected us and damaged our status? The recent, admittedly flawed "Which" report indicated that independents gave poorer advice to patients than "big business".
          lets start with targets, and seeing everything as a profit making opportunity also see the first paragraph of this post.

          With the which? report i'm sure everyone knows one report doesnt prove anything. One out the two had be better than the other, it was unlikely both would be the same, so the multiples came out on top, thats the way the cookie crumbled, plus the study's sample was too small in my opinion to deduce anything from it or to take it seriously. Although I would want a word with the person who advised a patient they had IBS, after the patient complained of diarhoea after a trip abroad.

          Although I was surprised how well I was treated recently by a certain "chain" that is not really known for it's pharmaceutical services side, although medicines and cosmetics is what it deals with. I was pleasently pleased.
          Last edited by SolomonQ; 28, September 2008, 05:09 PM.
          We are the music makers, We are the dreamers of dreams and God damn we are that good

          Comment


          • #6
            Re: Can anyone help?

            Originally posted by Tony Schofield View Post
            What unethical practices from "big business" have infected us and damaged our status?
            The single supplier model of community pharmacy espoused by all the major multiples.

            The planogram culture which highlights medicines known to be abused.

            Irresponsible employment practices that place a pharmacist without any training in repeat dispensing as the manager of a community pharmacy
            Repeat dispensing is an "essential service" ffs.

            Jeff

            Comment


            • #7
              Re: Can anyone help?

              Sorry Jeff and Solly. I see no reason to change my opinions. I accept the points you make Jeff but as yet I don't accept that these developments mean that we are any less respected than we were before.

              Solly........? Targets? Have targets damaged the GP relationship with patients? No they haven't. QOF targets have meant that more patients are better treated than before QOF targets were introduced. Tragets per se are not bad for bad's sake.

              Cough mixtures.........? Your 'aving a larf aren't you? Is that the best response to a question about evidence based medicine you can come up with

              The example you quote is one anecdotal story and does by no means reflect how pharmacists are perceived by other health professionals. There will always be examples of inter professional bickering not restricted to pharmacists and doctors.

              However I agree that the Which report was based on a very small sample.
              http://uk.youtube.com/watch?v=Hmbyj0XFUhA

              Comment


              • #8
                Re: Can anyone help?

                Originally posted by Tony Schofield View Post
                Sorry Jeff and Solly. I see no reason to change my opinions. I accept the points you make Jeff but as yet I don't accept that these developments mean that we are any less respected than we were before.
                I think our standing with other professions has probably improved - it's self respect that has decreased.

                Jeff

                Comment


                • #9
                  Re: Can anyone help?

                  Spot on Jeff. Most people's self respect has diminished. Not everyone's.

                  However, I believe that most professional's self respect has diminished over the last 25 years. GPs are being held to blame for most of the ills in the health service despite the demonstrable improvement in quality that has fuelled their increased incomes. They are continually feeling threatened by non medical models to replace them. Solicitors have had almost every aspect of their professional lives opened up for competition but the "conveyancers" and drafters of wills etc do not have to answer to a disciplinary body. Talk to dentists about their new contract.

                  As I have said elsewhere George Bernard Shaw described a profession as " a conspiracy against the public". Since the 1980's the professions have been relentlessly attacked and deregulated. That is the reason for lower self esteem.
                  http://uk.youtube.com/watch?v=Hmbyj0XFUhA

                  Comment


                  • #10
                    Re: Can anyone help?

                    Sorry Jeff and Solly. I see no reason to change my opinions.
                    well, and you talk about evidence-based ....... ok in the above post i tackled the first part of your "I don't accept that we are any less thought of by other professionals or eg PCT staff " i.e. the gp thing, heres one for the pct bit

                    see Healthcare Commission criticises PCTs for forgetting pharmacies | PJ Online

                    i will quote a small snippet:

                    "The “Not just a matter of time” review looked at whether services worked effectively together and found that only 31 per cent of PCTs networked with community pharmacists. The review also found that, out of the 96 per cent of areas that had a strategy for future emergency care services in place or under development, only 42 per cent had discussed it with local pharmacists."

                    seems crystal clear to me, and about the negativity etc... it's not bad to keep future pharmacists informed of the developments in their future profession
                    We are the music makers, We are the dreamers of dreams and God damn we are that good

                    Comment


                    • #11
                      Re: Can anyone help?

                      Compared with what?

                      How does that demonstrate that we are less well thought of than before?

                      How many pharmacists saw fit to engage with their PCT in any shape or form? Did they leave it to the LPC? How was the LPC contact managed and quantified.
                      http://uk.youtube.com/watch?v=Hmbyj0XFUhA

                      Comment


                      • #12
                        Re: Can anyone help?

                        Instead of complaining do something about it!!!

                        Comment


                        • #13
                          Re: Can anyone help?

                          Absolutely.
                          http://uk.youtube.com/watch?v=Hmbyj0XFUhA

                          Comment


                          • #14
                            Re: Can anyone help?

                            Originally posted by Tony Schofield View Post
                            Have targets damaged the GP relationship with patients? No they haven't.
                            well, I could be a bit out of date on this one, but there is little doubt that when targets started to be introduced about 20 years ago the relationship between our local doctors and the PCT (LEC? I can't remember what they were called then) took a bit of a hammering.

                            Even then, the doctors were quick to catch on that it was easier to address the target itself, and access the cash, than the thing it was trying to achieve. That is why I'm not really objecting to the current open season with MURs - its just another kind of target.

                            But I guess you're right, it doesn't seem to have bothered patients, any more than MURs have. In fact, the shorter the MUR the better, is the usual reaction.
                            ....just my opinion

                            Comment


                            • #15
                              Re: Can anyone help?

                              The Quality and Outcomes Framework is a series of targets that has been devised to treat patients who have a disease or are at risk of contracting a disease. It pays money if the targets are met. It is a part of the "new" doctor's contract that came into force about 4 years ago. Because doctors hit the targets and earned a lot of money the Press have blamed the contract for funding issues in the NHS. However, if doctors qualified for these payments, their patients had been treated more frequently and more effectively than before the contract came in. The targets have delivered better care simple as that.

                              If patients who are not taking their medicines properly continue in this manner they are at risk. An intervention such as a MUR can a) improve the outcome for the patient b) save the NHS money in that there will be fewer wasted medicines. If incentivising pharmacists to perform MURs means that patients suffer less drug related illness is it not a good thing? Hence MUR targets.

                              Targets, if properly thought out .............work.
                              http://uk.youtube.com/watch?v=Hmbyj0XFUhA

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