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Australian Pharmacist February 2013 I ©Pharmaceutical Society of Australia Ltd.
Consultant patients in
The practice of consultant pharmacists
working as part of a multi-disciplinary team
within a medical practice has been the
focus of many words of considerable heat
and angst in recent times.
On the basis of approximately 12 months'
work in surgeries joined to my work
in ACFs as well as home visits, I think I
can claim without fear of refute that an
on-site pharmacist can save lives, or at
least significantly improve them, precisely
because they are there at the surgery
and, via a practice intranet, can solve
many crucial issues immediately, thereby
averting a (possibly) tragic, or at least costly
treatment due to delays that would have
occurred had the pharmacist, patient and
doctor not been able to collaborate in-situ.
The following vignettes serve to illustrate
• A patient came to see me for a review
after seeing her doctor. The dose of
warfarin was to be increased because of
a low INR. In the review I uncovered the
fact that the INR was low because tablets
were not being taken. A quick email to
the doctor meant that a serious problem
• An elderly patient had not had any
verapamil for two day. He had ventricular
tachycardia. He planned to see the doctor
'in a few days' for a new script. Again, a
quick email to his GP who was on duty
at the surgery meant that a script was
waiting for him when the interview was
completed, and no more tablets would
be missed. A significant medical problem
• An elderly lady presented her meds at
the interview at 10.30am. She was taking
six 'different' tablets including Minax 50
an appointment with her cardiologist
at 3pm. Her problem is obvious. Again,
a quick email to the GP, and within one
minute there was a knock on my door
and the doctor came in to assess the
issue. The problem of generic confusion
was corrected and the GP sent an urgent
faxed letter to the cardiologist, at my
suggestion, outlining the problem.
• An elderly lady asked me to look at her
sore great toe on her left foot, after her
Letters to the Editor
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PSA ignites pharmacy leaders'
PSA has launched a program aimed at
boosting the leadership skills and career
opportunities of Australia's early career
PSA's ignite: Pharmacist Leadership
Program has been structured to develop
high-performing early career pharmacists
into future leaders who will drive strategy,
change and innovation.
The name ignite was chosen because
PSA feels that, 'Leaders ignite the spark to
inspire and influence others...'
ignite focuses on developing leadership
skills to assist early career pharmacists
to innovate, inspire others and influence
future pharmacy. It combines interactive
workshops, experiential learning, distance
learning, inspirational speakers, personal
mentoring, networking opportunities and
a practical workplace project to develop
you as a future leader.
said ignite offered a
will broaden early
understanding of leadership and aims to
develop their leadership skills, taking into
account their personal leadership goals.
'Whether you wish to advance your
career within a hospital, community,
industry, government, non-government
or academic setting, the ignite program
will give you the platform you need to
succeed,' he said.
This innovative program has been
made possible through the support of
Alphapharm and PDL. Full details of the
program, including an application pack,
are available on the PSA website:
www.psa.org.au, under the
interview. 'Of course,' I replied. She took
both her socks off. Her toe was fine,
but the BBC excision on her right shin
was red and purple under its dressing,
and weeping. I spoke with the practice
manager who called in the doctor. The
patient's wound was reassessed and a
new treatment modality commenced.
pale blue grey and said he felt 'bloody
awful.' Upon reviewing his medication
chart from the doctor on the HMR form
and comparing it to his webster pack I
could see that there were discrepancies
for Bicor, Atacand and Magmin. He had
a history of LVF, pulmonary HTN, plus
aortic and mitral regurgitation. I brought
this matter to the urgent attention of
the practice manager, who spoke with
the patient's GP, for prompt assessment.
He was placed on a 12 lead [ECG] and the
ambulance was called. He was transferred
to RPAH cardiac unit for assessment.
In my view, the expansion of medication
reviews into surgeries, as an option selected
by the patient, has been a serendipitous
event that should not be crushed because
some, it is alleged, are misusing the new
provisions granted in October 2012.
The gains via this new professional pathway
are multiple. The doctor's perception
of the pharmacist has been elevated,
professional satisfaction is off the graph and
-- the truly telling point -- patient lives have
It would be an undiluted tragedy if federal
fiscal issues meant that the putative poor
behaviour by some was used as an excuse
to scuttle a program that has delivered
so many hitherto unforeseen benefits
John Wilks, Consultant Pharmacist
(since 1997), Baulkham Hills NSW
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