Game-changing technology will force dramatic shifts in pharmacy practice at a pace faster than lobby groups prefer or policy can keep up with, according to a new Productivity Commission report, ending the current retail model.
The 'Shifting the Dial: 5 year productivity review’ studied factors likely to affect Australia's medium term economic performance, and predicted that technology will lead to increased mechanisation and job losses for pharmacists.
“Disruption and automation appears likely to produce job losses for some health occupations, notwithstanding growth in the healthcare sector,” the review found.
“Pharmacy is a key occupation where technology, antiquated regulation, and changing models of integrated care converge at significant unnecessary cost to the nation. A fundamental policy shift is desirable, and again technology more than policymakers’ efforts is poised to change the game. This would go well beyond the shifts raised in the recent Australian Government review of pharmacy.”
The Shifting the Dial review said the remodelling of industries is expected to occur wherever technologies produce higher quality services for patients and are less costly.
Innovations that already exist mean pharmacy is ripe for changes that could see the healthcare discipline move away from “incompatible” retail incarnations towards more clinical uses for their skills.
“A new model of pharmacy would adopt now-available technology — for example, e-scripts and machine dispensing of drugs — and recognise retailing as incompatible with a genuine clinical function for pharmacists,” the review said.
“As one party put it to the Commission in this inquiry, the availability of unproven and sometimes harmful medical products and confectionary at the front of the pharmacy is not reconcilable with an evidence based clinical function at the back.”
The Productivity Commission advised pharmacists to prepare for the “inevitable” industry revolution.
“Machine dispensing (now a well-proven technology) will, absent government and pharmacist moves to prevent it, overtake retail dispensing simply due to its inherent commercial efficiency benefits.”
In the new world order, drug dispensing would fall below the expertise of pharmacists, the Commission found.
“Its oversight would be better placed in the hands of a new occupation. This would involve people with good social skills and trustworthiness (with support from information technologies), but who would not need the clinical and scientific abilities of pharmacists.”
This new model would not require “anywhere near” the 20,000 pharmacists who currently provide clinical services and “would require a transition to a much smaller employment base”.
The Commission advised the creation of new Vocational Education and Training (VET) qualifications for those overseeing machine dispensing, and that universities should be warned against ignoring the upcoming changes.
“The Australian Government should also signal to the various university departments of pharmacy that the industry structure sustained through government fiat is likely to eventually crumble, leaving young pharmacists exposed to large occupational risks.”
While the move away from community pharmacy as principal drug dispensers could alarm those currently in the job, the review said the reconfiguring of the practice could lead to a more collaborative role for them working alongside other primary health professionals.
“Recognising this at an early stage, the Commission advocates preparing for the inevitable via development of a model that would increase the role of pharmacists in the multi-disciplinary management of complex and chronic conditions.
“New pharmacy could translate into a genuine role in chronic disease management, suited to the capabilities of its professional membership.”