off record
Shaukat Ali Jawaid

Pharmacists need to do
some soul searching


Pharmacists are considered as important members of the healthcare team and they are contributing a lot to the healthcare system in various capacities in developed world. They take round along with the physicians and surgeons in wards, help the physicians on selection of correct dose of various medications, monitor adverse drug reactions, they have a role in procurement of drugs for the hospitals besides drug supply chain management, advise the hospital management on designing their drug policy, hospital formulary just to mention a few. However, in Pakistan most of the pharmacists prefer to join the Pharmaceutical industry or are working in drug control departments but very few have opted to join healthcare facilities simply because hospital pharmacy and community pharmacy is not yet fully established in Pakistan. If the pharmacists are still struggling to get proper recognition to enable them to play an important role in our health system, they are themselves to be blamed because they lack unity, proper organizational set-up at the national level, lack of leadership with a vision and foresight, and above all absence of any continuing medical education or continuous professional development programmes to enhance their expertise. Of course there are few exceptions to the above but on the whole the situation is not a very happy one.

While attending the recently held annual conference of Pakistan Society of Health-System Pharmacists, one got the impression as if it was just an appendix of the pharmaceutical industry as a vast majority of the participants were from the Pharma industry and drugs control departments and only a few represented the healthcare facilities. However, it was heartening to note that the organizers had also invited some eminent members of the medical profession from private and public healthcare facilities who in their presentations’ as well as during panel discussion accepted the importance of pharmacists who play a vital role in patient safety.
Previously we just had B. Pharm courses but now many institutions have also started Pharm D courses and a large number of pharmacists qualify each year but many leave the country for better prospects. It is extremely important that the authorities take steps to establish hospital pharmacy on sound footings and qualified clinical pharmacists are appointed in all the healthcare facilities which will help improve patient safety. However, it is up to the pharmacists themselves and its leadership to come forward and plead their case at all appropriate forums. Apart from doing that, it should also concentrate on improving the professional skills of its members by organizing CME, CPD programmes and workshops. Some of the speakers at the conference were not fluent in communication skills and sending professionally immature people on the stage should also be avoided as it reflects poorly on the organization, hence it is advisable to be careful with “You Guys”. While working in hospitals, they are supposed to interact with professionally qualified elite and if they cannot communicate fluently, they may not be able to convince them of their utility and usefulness. It was also gratifying to note that many of the pharmacists themselves during the conference highlighted the importance of improving their professional skills to earn respect and recognition. Physiotherapists are also considered an important member of rehabilitation medicine team but they too are struggling for recognition and are faced with similar problems. However, at the same time we have physiotherapists and pharmacists who enjoy tremendous respect. Mr.L.K.Saleem was a well known and experienced Physiotherapist who was working at Civil Hospital Karachi and retired about ten years ago. He was in BPS 20 which was not available to many professors in those days. He enjoyed tremendous respect among all the senior faculty members of Dow Medical College simply because of his talent, expertise and professional standing. In Pakistan Aspirin Foundation, we have a multidisciplinary core group of founder members which includes many distinguished physicians and surgeons some of whom have also served as Vice Chancellors of Medical Universities and Principals of medical colleges. We also have Mr.Lateef Sheikh noted pharmacists as founder member who commands great respect in the medical profession and doctors are always keen to seek his advice. Not only that he has served and continue to serve on many important positions in advisory capacity in the Federal Health Ministry and many other medical institutions, established a state of the art pharmacy service at Aga Khan University Hospital and above all have trained a large number of pharmacists. He is known as a great teacher, trainer and mentor. Many pharmacists trained by him are now busy in establishing state of the art pharmacy services at various hospitals. Respect and recognition comes with expertise and professional standing and one should always try to earn this rather than demanding it. However, the problem with the new generation of medical profession as well as pharmacists is that they are too impatient, want to get everything too quickly going for the short cut but it does not work. First of all one has to improve one’s professional expertise, recognition and respect will follow them. The pharmacists need to listen to the advice given by Prof.Abdul Bari Khan, Mr. Aslam Shah, Ms.Samina Badar, Dr.Tufail and Prof.Ejaz Ahmad Vohra carefully. Go for innovations, and convince the healthcare establishments of their usefulness to improve the healthcare system.
One of the important functions of hospital pharmacists is that they ensure patient safety but unfortunately the pharmacists working at Punjab Institute of Cardiology failed to safeguard it. In fact it was a total failure on the part of pharmacists, treating physicians and surgeons as well as hospital administration and the provincial health department. They all can be held responsible for this tragedy which resulted in the loss of many precious lives. Pharmacists cannot get away with saying that they were not allowed to perform their job, why they did not assert but accepted to be a part of the clerical team. Had they asserted and sent a note of dissent to the PIC administration if they felt they were not being allowed to perform their duties, it would have made some difference.
Community pharmacy is another area which can absorb a large number of pharmacists if we can ensure that each and every retail pharmacy, chemist shop is manned by qualified pharmacists. However, the ground reality as pointed out by Mr. Salim Ishrat Hussain is that many girls won’t like to work in the retail pharmacies. In a male dominated culture and society as well as the prevailing working environment does not attract many female pharmacists to work in chemist shops. We now see a chain of pharmacies being established in big cities and at major Shopping Malls where they will find a comfortable working environment but it will take many years before we have such a network all over the country as it is all linked with the socio-economic development of the country. As suggested by Mr. Salim Ishrat Hussain, establishment of Directorate of Pharmacy in the provincial health departments and at the federal government level will be an important step in the right direction to safeguard the interests of pharmacists. This suggestion needs to be pursued further.
Yet another extremely important issue is of conflict of interest. Since while working at various hospitals, they will have an important role in drug purchases and making of hospital formulary besides those working in Drug Control Department will have an important say in policy matters, any slightest vibration of pharmacists association’s soft corner for any particular pharmaceutical company will not only destroy their credibility but it will also keep away many professionals who are keenly interested to safeguard their professional integrity and credibility. It is up to the leadership of the pharmacists to ensure that they have representation from all disciplines of pharmacy i.e. academia like pharmacy institutions, pharmaceutical industry, hospital pharmacy, drug control department, community pharmacy and also come up with some training courses, workshops to enhance professional expertise of its members. Otherwise, holding of such annual conferences will remain restricted to being social get-togethers and won’t help them in earning respect and recognition which should be the prime objective of the pharmacist’s community in general and Pakistan Society of Health-System Pharmacists in particular.{jcomments on}

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