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As the season of ‘the busy’ approaches, Ultan Molloy ponders how pharmacists can resource and support each other and their staff to prepare for the future of the profession

With the clocks changing in about a week from when I’m writing this, and sunrise getting later and later, it feels like hibernation is on the cards again soon. The Christmas party, Santa day, radio adverts, Christmas stock, and all that stuff is fast becoming the talk of the day again. We’ve had a third baby nearly two months ago, and a new pharmacy opened one week after she arrived, so we’re heading toward Christmas in what feels like a relentless frenzy of ‘the busy’, which interestingly, I’m getting progressively more comfortable with. I think I’ve resigned myself that trying to ‘control’ things is just a folly. ‘Resistance is futile’, as mother Teresa, or perhaps was it Gandhi, once said? A day as a pharmacist now is really quite a pleasant ‘break’ from the chaos of home life with toddlers and a new-born! 

Light at the end of the tunnel

Other than mentally leap-frogging into January, and starting to look forward to the summer, there is plenty to look forward to over the coming months, not least the host of new graduates coming onto the register at the start of December. Somewhat of a present from Santa for those of us who are finding it challenging to get good locum cover and support pharmacists at the moment. A reminder that when we have someone good, we need to take care of them. This should of course be the norm, in so much as we can take responsibility for our part in creating the environment the ensures another adult’s level of contentment in the workplace.

Cutting teeth

There is of course the challenge of getting someone on-board, or covering as a pharmacist, who will present with some level of experience, cop-on and context, when applying their newly-gleaned knowledge and pharmacist superpowers. The Dunning-Kruger effect comes to mind, demonstrating that a little bit of knowledge can be a dangerous thing, and there will be no substitute for on-the-job experience. Perhaps this bias is covered in the final modules of the pharmacy internship course this year? The internship year, in fairness, ticks a lot of boxes here. 

Far hills

To those newly-qualified pharmacists thinking about going into medicine or into the pharmaceutical industry, I ask, why would you? Answers on a postcard please to the PCRS, the PSI and the IPU. My ego considered medicine and I interviewed as a mature student some time back at one institution in Dublin. When I couldn’t articulate clearly why I wanted to ‘help people’ by being a doctor, and explain why my studying medicine was going to be any different to my parents ‘helping people’ as teachers, my goose was cooked. I had been out until the early hours the night before in what may have been an act of self-sabotage. In any case, I wasn’t invited to join the club, and having recently read Adam Kay’s book This is Going to Hurt, which documents his training to become a specialist registrar, I can’t say I have any regrets. I have a much greater appreciation of what’s involved and the fantastic work, and challenges, that most doctors undertake in their daily toil. I don’t think I would have the patience for the patients’ requests and demands, emotionally, physically and mentally, or the resolve to overcome my frustrations with the status quo with many aspects of our healthcare system. 

What hurts now

Dealing with the public can be stressful, and often thankless. I’ve alluded to this before, and while we can educate our customers, and set boundaries, if you’re looking for thanks and words of appreciation, they’ll be few and far between. 

What we can do to resource ourselves as pharmacists, and pharmacy teams, includes the following: We can support one another as part of the pharmacy team, communicating positively and respectfully with one another. Say ‘please’ and ‘thank you’ with colleagues on an ongoing basis. Celebrate daily, weekly and monthly achievements. Stay aware of colleagues’ moods and experiences, and offer a word or a cup of tea, if that’s going to be the kindness they need at that time. We need to manage customer expectations. Medicines are a serious business, so their delivery to customers needs to be treated with an amount of reverence and respect. If competitors are willing to put up with demanding and aggressive customers, then perhaps they deserve them. 

We need to back our more vulnerable team members, and perhaps step in more often when customers are imposing unreasonable demands. Safe and effective medicines, at a reasonable cost, in a reasonable time frame, is a healthy aspiration. It’s interesting to note that one of the ‘pile them high, sell them cheap’ merchants has ex-staff members berating their performance as people-leaders online. Poor communication, little respect for ‘support’ staff, and pushing staff to meet targets, when their business model relies on them unnecessarily giving away much of their bottom-line profit through loss-leading, and commoditising a professional service, is nothing short of stupidity. Innovation for the sake of innovation is unnecessary and costly when it fails to address a need. 

With locum pharmacist rates inflating up to 25 per cent in some areas over the last two years, well, perhaps having enough profit to cover those wages, I’d suggest, is a practical business need. 

A community pharmacy for the future

Arguably, no-one really knows what pharmacists want, ie, reversal of FEMPI, to quote a more recent headline that limped tentatively into the public domain, other than pharmacists. That’s maybe two or three thousand people caring to a greater or lesser extent in a population of nearly five million people. Joe and Josephine public sensibly care about their own needs and that of their loved ones, and Simon Harris, Leo Varadkar and all the others in their position likely care most about what Joe and Josephine public care about, as they are public representatives. I’d say there is a limited number of them crying themselves to sleep at night wondering if the local pharmacist is going to be able to put food on the table should FEMPI cuts not be reversed!

So what could best serve the public healthcare needs in primary care? A network of nearly 2,000 community pharmacies, efficiently and effectively, delivering patient care, open long hours with readily accessible healthcare professionals. Surely that deserves investment rather than misguided cuts? Extended services, such as the flu vaccination, appear to be going well through pharmacies, with some of the chains now advertising it extensively as a professional service. The appetite for similar service innovation from the public or PCRS appears to be limited to date. Other extended services such as care and
management of chronic ailments, a new medicines scheme and minor ailments
service are all proven in other jurisdictions.
The use of technology, online, AI, and dispensing robots are all in the ‘future of pharmacy’ mix. I wonder, where will the big and impactful innovations be for the patients? If it doesn’t add value for the patient, then we shouldn’t be doing it, or so the theory suggests. With so much added value and untapped potential available to deliver for patients, if not now, then when?