I’m not sure I have the right idea of a professional, but I believe that to be a professional one must possess more than just the basic unique skill that differentiates them from lay people or other skilled people. As a pharmacist, you should never allow anyone else to play your role, or if they attempt to, it should be clear to all watching from the sidelines that an impostor is on the loose. If I can then borrow the definition from elsewhere, a professional is that whose competence can 'usually' be measured against an established set of standards. The word usually here is very important because many professions may not be clearly defined. I do not know if pharmacy is one of them.
I want to share further a few aspects that are generally accepted as belonging to a professional. And I really want to put them in two distinct categories. The categories are as simple as the Dos and the Don’ts . In this way, the professional codes of conduct or ethics are made so simple and less boring to the young Kenyan pharmacist reader’s mind.
So let’s get on:
Things to Do
• Do return value to your customer (internal and external) in all ‘business’ decisions
• Do return value to your community locally and globally
• Do deliver quality in a timely fashion
• Do be honest in your work by telling the client, customer, or boss that the task or project you are working on will not meet the target date.
• Do ask for help in order to meet the project or task deadline. A professional will not feel slighted if he or she acknowledges that he or she needs help.
• If the employer wants respect from employees, he/she should treat all employees as professionals in their own right. Remember, if you treat someone as a professional, they will (hopefully) treat you like one too.
• Promote your profession
• Do things for the good of yourself, the customer and the profession. You are not a true professional if you don't deliver outcomes that satisfy all three of these areas.
Things to Not Do
• Do not tell the client, customer, or boss that you can do something when you cannot.
• Do not steal from your employer.
• Do not underestimate your capabilities
As good as these points are, my world of pharmacy, a small world indeed, still has so many gaps and an army of non-aligned individuals with conflicting priorities. The most basic professional virtue that is lacking in pharmacy, the Kenyan chapter, as I have lived so far is the scarcity of ‘professional goodwill’. Let me explain. A professional body like the PSK exists so as to define, promote, oversee, support and regulate the affairs of its members. Even if an individual pharmacist is not a PSK member, an organization of voluntary membership as of now, that pharmacist must be seen to observe all of these values. A pharmacist who observes these tenets elicits ‘professional goodwill’.
Let me bring another dimension. Every profession has minimum admission requirements. For pharmacists, the minimum requirement is a recognised basic pharmaceutical degree. Most pharmacists actually possess only this minimum requirement, and that is ok and acceptable. Pharmacists can also seek more specialized knowledge and ability through further training for the benefit of the individual and the profession. Naïve pharmacists at the decision making level, with the narrowest view of the world I can ever imagine, administratively, or procedurally, or plainly in an uncouth manner block younger and more ambitious pharmacists from pursuing their dreams. This is done intentionally for the fear of losing jobs to sharper and more competent minds. Let’s all agree that pharmacists are also human beings, and they are therefore subject to normal petty human jealousies. But then why don’t they do things for the good of themselves? I really don’t mind someone staying at the helm ‘forever’. What I mind is him not doing things for the good of himself (as a distinguished professional), the customer (the patients et al) and the profession (of pharmacy). I won’t tolerate the sight (and smell) of such a person, not even for one lousy second!
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Now Kenya usually has two rules-the one on paper and the one that carries the day. Pharmacists are the only health professionals who zealously protect what is on paper; the 8-5pm working hours rule, and as it goes, it takes a pharmacist to enforce this work ethic among the other pharmacists. Dentists, medical officers, nurses, clinical officers and all the others let their members go in shifts. Not even a letter from the ultimate authority will water down their resolve. Whether what they are doing is right or wrong is not for me to decide, but whatever they are doing, their members are happy. I do not know if there is a pharmacy version of open professional ‘rebellion’ that is only good to the pharmacists and is protected to death by our bosses. In short, our work is quantitative and not qualitative. We are not allowed to make ‘extra money’ on the side lest we lose focus on the ‘very important job’ we were employed for. This is a very good rule, but look where it has taken us?
No wonder everyone is going public health.
Monday, September 28, 2009
Sunday, May 3, 2009
Is branding a solution to inflitration of pharmacy profession by quacks?
PSK annual scientific conferences and/or symposia have recently attracted increasing attention of the Pharmacists at the policy making levels in the Pharmacy and Poisons Board (PPB) unlike in the past. Together with the increase in subscription membership to the PSK that has been achieved due to cooperation by PPB in issuing licenses only to Pharmacists who participate in Continuous Professional Development (CPD), PSK have become a soft and probably effective pressure on the Authorities to institute desired changes and attitudes among the Pharmacists.
A symposium of such a stature cannot be successful without the participation of Pharmacists who have less than 10 years experience post registration, the ones I will call young. The kinds who have fresh ideas and motivation to pursue the value addition practice, a pharmacy service that has become elusive for the several decade old profession in Kenya. These are the pharmacists who see themselves practicing in the next 20 years or more in the only trade that they know and have everything to gain from implementation of the new National Pharmacy Policy. Of course that will only be possible if the policy makers consult widely and make policies in the interest of the pharmacy profession.
Unfortunately this group of young pharmacists, who have seen non-professional competition too many, and whose future is in grievous danger, do not have resources that participation in such forums demand. It is however noteworthy that some of the pharmacists in the public sector and especially those at the PPB, the National Quality Control Laboratories (NQCL), and Government Chemist successfully get backing from their pharmacists led departments to make their contributions in such forums. Those working for the programmes may also be able to secure the support of their non-pharmacists directors because of the close working relationships among the lean staff and availability of funds for travel activities in the programmes. The mainstream civil service is a sea of push and shove and professional rivalries stand in the way of ambitious pharmacists in the sector and so it would be difficult for the hospitals to devote their precious travel and accommodation cost sharing funds for the benefit of pharmacist, even for only once every two years.
The pharmacists in the private sector may or may not be able to secure such sponsorships from their employers if it was not negotiated as part of their contracts. It might be now important for me to point out to those young pharmacists who will want to seek greener pastures that they should talk about professional development as part of the employment benefits. Professional development includes sponsorships to PSK scientific conferences. Those in private hospitals also depend on the benevolence of their administrators, and may sometimes not participate in the annual symposia because of work constraints, and not necessarily lack of funds, either private or employer provided. This leaves such forums to older pharmacists who may have made substantial investment outside pharmacy and do not put so much stakes in the improvement of pharmacy professional environment.
The branding of pharmacy concept that I had helped develop in my PSK branch must find itself in the floor of the hospital and community sector sessions. The branding concept allows for an interim measure of collaboration with lower tier pharmaceutical professionals who have been enrolled and are members of the Kenya Pharmaceutical Association (KPA) to fill the gaps that have been exploited by quacks for far too long. The branding will recognize these two groups of professionals who are recognised by the law effective from the year 2000 or so. The signatories of the branding concept in PSK and KPA must however accept to allow the branding concept to make a clear differentiation between a registered and licensed pharmacist and a pharmaceutical technologist by use of colour codes. Some of the suggestions are green colour theme for pharmacist run pharmacies and blue colour theme for pharmaceutical technologists run pharmacies. The onus will then be on the pharmacists to acquire new skills that will clearly them in the leadership position and be associated with quality.
The pharmacist must be seen to add value to the current practice and all over the world this has been through more patients and health care providers’ information. It is also a good practice to select and carry out medication use reviews (MURs) of, may be, ten or more prescriptions or a day. The concept started in UK, allows a pharmacist to intentionally go into much more detail of the select patients’ condition, biodata and treatments prescribed and advice on the medication as well as related lifestyle changes or preventive or prophylactic measures that may fit for the individual patient. It may even require contacting the patient’s doctor, this time not to request for prescription changes, but to show concern on the general health of the patient. MUR data is then documented by the pharmacist for the sake of follow up and/or learning. MURs are known to take up to four times longer than the normal prescription filling time, and may jeopardize the revenues in a busy pharmacy. They however guarantee more long term benefits to the pharmacies that have made it part of the work requirements because the image that the patient gets is that of a professional and not just a businessman. Such measures may need the superintendent pharmacists to discuss with their employers or partners to achieve wider acceptance and to justify for the additional costs that such a measure may put on the business when an additional staff member may need to be hired.
PHARMACY BRANDING: IS IT ACHIEVABLE? WHAT ARE THE BENEFITS?
Yes it is achievable; and now more than before very necessary. The regulation of community pharmacy practice in Kenya poses great challenges to the relevant authorities. Remember private hospital pharmacies must also meet the same licencing requirements as the community pharmacies. This is due to the proliferation of unauthorized drug outlets all over the country manned by untrained and unscrupulous individuals. A survey by the Pharmacy and Poisons Board in 2006 showed that there are over 15,000 outlets of which only about 3000 are licensed.
The PPB has in the few years tried various intervention measures but has borne no fruits so far.
These include inter alia:
a) Annual licensing of pharmacies and use of professional bodies to vet the licensees i.e. PSK and KPA.
b) Increasing the number of officers and professionalizing the drug inspectorate.
Despite the measures, Kenyans still access most of their medications from individuals who cannot bear any professional responsibility whatsoever. Part of these is the issuing of licenses by culpable PPB officials or low cadre and poorly remunerated drug inspectors who find fortune in the discipline of endangering patients’ lives and betray the same cause in which they were hired for. Unfair competition to qualified persons and the defeat of the purpose of years of pharmaceutical training, registration and annual licensing at a huge cost to the professional is just but one of the effects of this. Other more grievous effects are a wide open window for drugs abuse and misuse and incredible endangering of patient’s life.
Branding is not a new concept in the world of business and it thrives on giving a certain product unmistakable identity. This has worked out very well for the clients of banks, petroleum companies, telephony service providers and retail shops like Bata Shoe Company and Nakumatt and Uchumi supermarkets. This is what I propose to be done in all outlets run by professionals and has the physical presence of the professional or hired professional locum pharmacists at all times.
A brand allows us, the pharmacists and the stakeholders to police ourselves, with little regard to who gets phony licenses or is allowed to practice by the PPB. The distinct symbols, emblems and insignia are then widely advertised and publicized in all the PSK forums and KPA can then choose to fund their own publicity campaigns. In other words, it frees the drug inspectors from the responsibilities of allowing who remains open or not and rightfully transfers that responsibility to the sensitized and well informed public. The brand is then registered as a trademark and the users are then protected from infringement by unwelcome elements by making such act a criminal offence. Such individuals will be prosecuted by the State as criminals. The pooled subscriptions by members can then provide substantial resources to support legal proceedings against such offenders, with the support of the government.
THE BRANDING PROCESS
The principle behind the branding process should be sold to both PSK and KPA. This will involve the following activities:
i. Establishment of a PSK/KPA Joint task force
Upon approval by the PSK Council, the largest decision making organ in PSK, the national chairman will initiate the process of appointment of a joint task force with KPA which will implement the concept.
ii. Identification of brand mark
The task force seeks out for sponsorship of the exercise. The activities will include the advertisement to paid-up members and to the associate members like pharmacy students for suitable designs and offer cash awards for the winning designs. That includes the 1st runners up and the 2nd runners up. The participant will also be issued with a certificate of participation in or contribution to the development of suitable design of the pharmacy brand.
iii. Registration of the approved design
The winning design is presented to the PPB, which as a body corporate can register the emblem with the relevant government body and then publish it in the Kenya Gazette. This will make it a legal entity for use in all outlets approved by the Board.
iv. Branding of outlets
The branding costs can be shouldered by the individual pharmacies or a sponsor is sought to contract the services of a firm that can make unique branding that must only be done to members. An allowance can be made for individual pharmacies to have their own identity but must embrace the new mark of quality. A mix of the two can be achieved with much consultation.
v. Aggressive print and electronic media publicity campaign
It will most likely be a two tier process, with contribution of a sponsoring pharmacy advocacy initiative and the stakeholder pharmacies. All information sources to the public are flooded with the insistence on obtaining medications only from the branded pharmacies. This will include the use of radio, television, print media (newspapers and niche magazines), internet, billboards, road shows and other modes of public information for the benefit of the pharmacists run pharmacies. This is the point where the two cadres solicit for their own support at their own level as permitted by the law.
vi. PSK policing of pharmacies
This is to ensure that the concept does not remain at the magnanimous doors and the appealing mark of quality pharmacy that this branding brings. The professional running the premises will be expected to exceed the ethical and professional expectations expected of a registered pharmacist. The pharmacy must never be left to be under the control of any lesser individual. The patients/clients will then have a right to complain to the PSK about the quality of service of a pharmacist through the toll free number that will be available within the premises. PSK can then treat such a matter as malpractice and recommend for disciplinary measures by the PPB. Difficult professionals who are in the register and licenced can be made to forfeit the professional brand immediatelly as the society awaits for PPB action.
CHALLENGES TO THE OPERATIONALISATION OF SUCH BRAND
UNSCRUPULOUS PHARMACISTS
It is well known that some of the quacks that have infiltrated the pharmacy practice thrive because of support by unethical pharmacists. A system that allows the acceptance of the photocopied credentials of a pharmacist prominently displayed for all to see, mean nothing if the individual offering the service is not that pharmacist or equally competent employee of the pharmacist. It is a fact that a copy of academic and professional certificates given to the benevolence of a quack does not photocopy the acquired knowledge, skills and attitudes of the real owner of the certificates. But how can we handle such a situation for pharmacists who have made this habit a way of life and a source of easy income? That will clearly continue to be a challenge because the resistance will come from the ‘quack reincarnate’, the pharmacist who has put selfish, short-term, personal matters before the profession. Such pharmacists will be handled by effective and proactive PSK.
INCREASED PHARMACISTS DEMAND
There will be an increase in demand for qualified personnel, that might not be satisfied by the newly qualified pharmacists and pharmaceutical technologists. If this demand is not met in good time, then the quackery system may rear its head again. This will be partially mitigated by the involvement of pharmaceutical technologists for more reach, especially in rural areas.
UNCOOPERATIVE PPB
Some elements in the PPB who thrive in the chaotic state of Community Pharmacy practice will be expected to be resistant to the branding concept. However, the PSK as an influential institution with four of its members being appointed to the Board every three years, should be able to overcome such hurdles in the long term without much ado. The change agents, in this case the presiding PPB (Board) members, can then be rewarded for their achievement by extending their terms of service beyond three years.
DISPENSING DOCTORS
It is now a growing trend among the doctors in private practice to have fully fledged pharmacies in their clinics and surgeries in Kenya without meeting the PPB requirements. We all know that this is illegal but it seems that no law enforcement agency is acting like we would have expected one to act if a pharmacist had opened a medical clinic. The reasons here are varied with some just being plain ignorance of PPB and the police of the breach of law. Such doctor will continue to threaten the brand concept because the design of their clinics and surgeries is in such a way that the patients are cajoled to buy medications that are sold at unusually high margins, sometimes more than 100% of the trade price. Such doctors have been reported also to direct patients to buy drugs from non-pharmacists run pharmacies betraying the professional referral systems expected of a doctor.
CONCLUSION
It is my hope and belief that this concept will be given serious consideration. PPB alone cannot effectively enforce the law. A well informed public will give us the best support than we have ever imagined. I’m yet to find a human being who does not go for the best service possible if they know where and from whom to get that service. Take up the challenge and use it.
A symposium of such a stature cannot be successful without the participation of Pharmacists who have less than 10 years experience post registration, the ones I will call young. The kinds who have fresh ideas and motivation to pursue the value addition practice, a pharmacy service that has become elusive for the several decade old profession in Kenya. These are the pharmacists who see themselves practicing in the next 20 years or more in the only trade that they know and have everything to gain from implementation of the new National Pharmacy Policy. Of course that will only be possible if the policy makers consult widely and make policies in the interest of the pharmacy profession.
Unfortunately this group of young pharmacists, who have seen non-professional competition too many, and whose future is in grievous danger, do not have resources that participation in such forums demand. It is however noteworthy that some of the pharmacists in the public sector and especially those at the PPB, the National Quality Control Laboratories (NQCL), and Government Chemist successfully get backing from their pharmacists led departments to make their contributions in such forums. Those working for the programmes may also be able to secure the support of their non-pharmacists directors because of the close working relationships among the lean staff and availability of funds for travel activities in the programmes. The mainstream civil service is a sea of push and shove and professional rivalries stand in the way of ambitious pharmacists in the sector and so it would be difficult for the hospitals to devote their precious travel and accommodation cost sharing funds for the benefit of pharmacist, even for only once every two years.
The pharmacists in the private sector may or may not be able to secure such sponsorships from their employers if it was not negotiated as part of their contracts. It might be now important for me to point out to those young pharmacists who will want to seek greener pastures that they should talk about professional development as part of the employment benefits. Professional development includes sponsorships to PSK scientific conferences. Those in private hospitals also depend on the benevolence of their administrators, and may sometimes not participate in the annual symposia because of work constraints, and not necessarily lack of funds, either private or employer provided. This leaves such forums to older pharmacists who may have made substantial investment outside pharmacy and do not put so much stakes in the improvement of pharmacy professional environment.
The branding of pharmacy concept that I had helped develop in my PSK branch must find itself in the floor of the hospital and community sector sessions. The branding concept allows for an interim measure of collaboration with lower tier pharmaceutical professionals who have been enrolled and are members of the Kenya Pharmaceutical Association (KPA) to fill the gaps that have been exploited by quacks for far too long. The branding will recognize these two groups of professionals who are recognised by the law effective from the year 2000 or so. The signatories of the branding concept in PSK and KPA must however accept to allow the branding concept to make a clear differentiation between a registered and licensed pharmacist and a pharmaceutical technologist by use of colour codes. Some of the suggestions are green colour theme for pharmacist run pharmacies and blue colour theme for pharmaceutical technologists run pharmacies. The onus will then be on the pharmacists to acquire new skills that will clearly them in the leadership position and be associated with quality.
The pharmacist must be seen to add value to the current practice and all over the world this has been through more patients and health care providers’ information. It is also a good practice to select and carry out medication use reviews (MURs) of, may be, ten or more prescriptions or a day. The concept started in UK, allows a pharmacist to intentionally go into much more detail of the select patients’ condition, biodata and treatments prescribed and advice on the medication as well as related lifestyle changes or preventive or prophylactic measures that may fit for the individual patient. It may even require contacting the patient’s doctor, this time not to request for prescription changes, but to show concern on the general health of the patient. MUR data is then documented by the pharmacist for the sake of follow up and/or learning. MURs are known to take up to four times longer than the normal prescription filling time, and may jeopardize the revenues in a busy pharmacy. They however guarantee more long term benefits to the pharmacies that have made it part of the work requirements because the image that the patient gets is that of a professional and not just a businessman. Such measures may need the superintendent pharmacists to discuss with their employers or partners to achieve wider acceptance and to justify for the additional costs that such a measure may put on the business when an additional staff member may need to be hired.
PHARMACY BRANDING: IS IT ACHIEVABLE? WHAT ARE THE BENEFITS?
Yes it is achievable; and now more than before very necessary. The regulation of community pharmacy practice in Kenya poses great challenges to the relevant authorities. Remember private hospital pharmacies must also meet the same licencing requirements as the community pharmacies. This is due to the proliferation of unauthorized drug outlets all over the country manned by untrained and unscrupulous individuals. A survey by the Pharmacy and Poisons Board in 2006 showed that there are over 15,000 outlets of which only about 3000 are licensed.
The PPB has in the few years tried various intervention measures but has borne no fruits so far.
These include inter alia:
a) Annual licensing of pharmacies and use of professional bodies to vet the licensees i.e. PSK and KPA.
b) Increasing the number of officers and professionalizing the drug inspectorate.
Despite the measures, Kenyans still access most of their medications from individuals who cannot bear any professional responsibility whatsoever. Part of these is the issuing of licenses by culpable PPB officials or low cadre and poorly remunerated drug inspectors who find fortune in the discipline of endangering patients’ lives and betray the same cause in which they were hired for. Unfair competition to qualified persons and the defeat of the purpose of years of pharmaceutical training, registration and annual licensing at a huge cost to the professional is just but one of the effects of this. Other more grievous effects are a wide open window for drugs abuse and misuse and incredible endangering of patient’s life.
Branding is not a new concept in the world of business and it thrives on giving a certain product unmistakable identity. This has worked out very well for the clients of banks, petroleum companies, telephony service providers and retail shops like Bata Shoe Company and Nakumatt and Uchumi supermarkets. This is what I propose to be done in all outlets run by professionals and has the physical presence of the professional or hired professional locum pharmacists at all times.
A brand allows us, the pharmacists and the stakeholders to police ourselves, with little regard to who gets phony licenses or is allowed to practice by the PPB. The distinct symbols, emblems and insignia are then widely advertised and publicized in all the PSK forums and KPA can then choose to fund their own publicity campaigns. In other words, it frees the drug inspectors from the responsibilities of allowing who remains open or not and rightfully transfers that responsibility to the sensitized and well informed public. The brand is then registered as a trademark and the users are then protected from infringement by unwelcome elements by making such act a criminal offence. Such individuals will be prosecuted by the State as criminals. The pooled subscriptions by members can then provide substantial resources to support legal proceedings against such offenders, with the support of the government.
THE BRANDING PROCESS
The principle behind the branding process should be sold to both PSK and KPA. This will involve the following activities:
i. Establishment of a PSK/KPA Joint task force
Upon approval by the PSK Council, the largest decision making organ in PSK, the national chairman will initiate the process of appointment of a joint task force with KPA which will implement the concept.
ii. Identification of brand mark
The task force seeks out for sponsorship of the exercise. The activities will include the advertisement to paid-up members and to the associate members like pharmacy students for suitable designs and offer cash awards for the winning designs. That includes the 1st runners up and the 2nd runners up. The participant will also be issued with a certificate of participation in or contribution to the development of suitable design of the pharmacy brand.
iii. Registration of the approved design
The winning design is presented to the PPB, which as a body corporate can register the emblem with the relevant government body and then publish it in the Kenya Gazette. This will make it a legal entity for use in all outlets approved by the Board.
iv. Branding of outlets
The branding costs can be shouldered by the individual pharmacies or a sponsor is sought to contract the services of a firm that can make unique branding that must only be done to members. An allowance can be made for individual pharmacies to have their own identity but must embrace the new mark of quality. A mix of the two can be achieved with much consultation.
v. Aggressive print and electronic media publicity campaign
It will most likely be a two tier process, with contribution of a sponsoring pharmacy advocacy initiative and the stakeholder pharmacies. All information sources to the public are flooded with the insistence on obtaining medications only from the branded pharmacies. This will include the use of radio, television, print media (newspapers and niche magazines), internet, billboards, road shows and other modes of public information for the benefit of the pharmacists run pharmacies. This is the point where the two cadres solicit for their own support at their own level as permitted by the law.
vi. PSK policing of pharmacies
This is to ensure that the concept does not remain at the magnanimous doors and the appealing mark of quality pharmacy that this branding brings. The professional running the premises will be expected to exceed the ethical and professional expectations expected of a registered pharmacist. The pharmacy must never be left to be under the control of any lesser individual. The patients/clients will then have a right to complain to the PSK about the quality of service of a pharmacist through the toll free number that will be available within the premises. PSK can then treat such a matter as malpractice and recommend for disciplinary measures by the PPB. Difficult professionals who are in the register and licenced can be made to forfeit the professional brand immediatelly as the society awaits for PPB action.
CHALLENGES TO THE OPERATIONALISATION OF SUCH BRAND
UNSCRUPULOUS PHARMACISTS
It is well known that some of the quacks that have infiltrated the pharmacy practice thrive because of support by unethical pharmacists. A system that allows the acceptance of the photocopied credentials of a pharmacist prominently displayed for all to see, mean nothing if the individual offering the service is not that pharmacist or equally competent employee of the pharmacist. It is a fact that a copy of academic and professional certificates given to the benevolence of a quack does not photocopy the acquired knowledge, skills and attitudes of the real owner of the certificates. But how can we handle such a situation for pharmacists who have made this habit a way of life and a source of easy income? That will clearly continue to be a challenge because the resistance will come from the ‘quack reincarnate’, the pharmacist who has put selfish, short-term, personal matters before the profession. Such pharmacists will be handled by effective and proactive PSK.
INCREASED PHARMACISTS DEMAND
There will be an increase in demand for qualified personnel, that might not be satisfied by the newly qualified pharmacists and pharmaceutical technologists. If this demand is not met in good time, then the quackery system may rear its head again. This will be partially mitigated by the involvement of pharmaceutical technologists for more reach, especially in rural areas.
UNCOOPERATIVE PPB
Some elements in the PPB who thrive in the chaotic state of Community Pharmacy practice will be expected to be resistant to the branding concept. However, the PSK as an influential institution with four of its members being appointed to the Board every three years, should be able to overcome such hurdles in the long term without much ado. The change agents, in this case the presiding PPB (Board) members, can then be rewarded for their achievement by extending their terms of service beyond three years.
DISPENSING DOCTORS
It is now a growing trend among the doctors in private practice to have fully fledged pharmacies in their clinics and surgeries in Kenya without meeting the PPB requirements. We all know that this is illegal but it seems that no law enforcement agency is acting like we would have expected one to act if a pharmacist had opened a medical clinic. The reasons here are varied with some just being plain ignorance of PPB and the police of the breach of law. Such doctor will continue to threaten the brand concept because the design of their clinics and surgeries is in such a way that the patients are cajoled to buy medications that are sold at unusually high margins, sometimes more than 100% of the trade price. Such doctors have been reported also to direct patients to buy drugs from non-pharmacists run pharmacies betraying the professional referral systems expected of a doctor.
CONCLUSION
It is my hope and belief that this concept will be given serious consideration. PPB alone cannot effectively enforce the law. A well informed public will give us the best support than we have ever imagined. I’m yet to find a human being who does not go for the best service possible if they know where and from whom to get that service. Take up the challenge and use it.
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