Promoting Synergy In The Health Sector: The Role Of Pharmd Pharmacists

Promoting Synergy In The Health Sector: The Role Of Pharmd Pharmacists

INTRODUCTION: 

I Like to begin by thanking God for the privilege to be here today. It is such a pleasure to return to Benin. I was here many years ago to speak at a similar induction ceremony. Indeed last year as I campaigned for the opportunity to serve the Pharmaceutical Society of Nigeria in the office of President, I ran into a few Pharmacists who were in the graduating class that year and others who met me in Benin when I spoke on: PHARMACY PRACTICE: WHAT THEY DO NOT TEACH IN UNIVERSITIES 

For those who may not know, I began my professional career in this city. In 1978 I resumed in my position as a Pharmaceutical Sales Representative for Pfizer Products Plc covering the old Bendel and Ondo states. I cut my professional teeth here. And what’s more I got married at St.James Anglican Church Akpakpavah to a Bendel girl! So you can see why it is a great pleasure to return to Benin from time to time.

I wish to congratulate the graduands for conquering. It is not easy to go through the Pharmacy program. I used to think I was smart until I went into the Pharmacy School. In professional year 1, I received one of the biggest shocks in my academic life. The first test I did in Pharmacognosy, I failed. That was the first time I failed in my life- be it tests, term, semester or year- end exams. Truly Pharmacy disciplined me and I am still wandering if it was not excessive discipline. And that was a four – year program! So I can only imagine what discipline the current 6- year program inflicts. But all is for our good if we can translate the sacrifice and discipline into professional excellence 

SYNERGY IN THE HEALTH SECTOR

The healthcare system is structured to promote synergy. It is conceived as a team effort to offer the patient, qualitative healthcare. In the days of yore as medicine developed, one man did all the job. He diagnosed the sickness, decided on the prescription, went on to formulate and compound the remedy, then administered the medicine and sometimes looked after the non-ambulatory patient. This one-man show was fraught with many problems. First it was too slow and so many sick had to wait for too long to get the attention of the physician or apothecary thus causing increased morbidity or leading to high mortality. Second, there was no oversight or second opinion on any issue from diagnosis to drug administration and any mistake made at any point endured and could have led to inefficient healthcare with many dying from preventable or avoidable mistakes. Thirdly, the lack of specialization delayed growth in the healthcare practice as there was no focus and no time to do research as one man was busy doing many things.

That was how overtime, medicine was separated from Pharmacy and Nursing. Eventually further specialization threw up Medical Science laboratory Technology, Radiography, Physiotherapy etc.After this lateral specialization ended, a vertical specialization started. Medicine begin to create specialities -Paediatrics, Obys and Gynae, Surgery, Internal medicine, Psychiatry and then subspecialties- Geriatrics, Cardiology, enterelogy, haematology, oncology etc. This has allowed greater focus and research, improving skills and expertise, generally resulting in much improved medical outcomes.

PharmD & SPECIALIZATION IN PHARMACY 

Following the afore mentioned specialization in Medicine and the need to increase knowledge, skills and expertise in the Pharmacy practice, has evolved the PharmD program.  This program came about following the need to focus more on the Patients than on the products. It has brought additional humanity and compassion to the Pharmacy profession, necessitating the the introduction of Pharmaceutical care. It is for me the beginning of the needed development and specialization in Pharmacy which must be followed with the eventual creation of sub-specialties. It is envisioned that in no distant time, We shall have oncology Pharmacists, cardiology Pharmacists, Renal Pharmacists, Pediatric Pharmacists, Geriatric Pharmacists etc, just as has evolved in Medicine.

This evolving specializations and sub-specialties in addition to ensuring better health outcomes from the  use of medicines actually separates the Pharmacist from others who peddle or sell medicines. The Pharmaceutical space is infiltrated by all kinds of people who pretend to practice Pharmacy. Our focus hitherto on products did not allow consumers sometimes to separate ‘mechanics’from ‘madmen’. But the new trend makes the separation and differentiation easy.

An equally important fall out from the PharmD program is that for the first time it brings the Pharmacist face to face with other healthcare professionals. For so long, the Pharmacist was eschoned and largely confined in his ‘cage’ from where he looked up from time to time to hand dispensed medicines with some counseling to the patient. Even in some more modern

Pharmacies( Hospital and Community) where there is improved space and ambience to counsel patients, the Pharmacist remained separated from other health care professionals and was often forgotten in the scheme of things. But with the introduction of the PharmD programme and the associated Pharmacare, Pharmacists now readily interact with other healthcare professionals especially medical doctors and Nurses in managing patients medication. Pharmacists now discuss and even advice Physicians on appropriate drugs before prescriptions are written. Pharmacists now attend clinical meetings and participate in ward rounds where patient drug choices are made. 

This is a major shift brought by the PharmD program which in essence promotes synergy. The Pharmacist thus attends to the patients as he has always done but in addition relates to the other healthcare professionals on the wards or in other clinical settings where he participates in decision making or influencing such decisions that will in a big measure prevent  ab-initio medication errors, thus improving outcomes for the patients. Additionally the Pharmacist becomes more visible, his voice better heard and his overall contributions and capacity better evaluated and appreciated.

With this new synergistic development, walls between professional groups in the healthcare team are being  broken, suspicion is being removed and intra professional harmony is being enthroned. 

CONCLUSIONS 

We must however admit that this is work in progress. It has taken so much time for Pharmacists and their regulators to fully accept and endorse the PharmD program. Naturally it is taking some longer time for some of our colleagues in medicine first to come to terms that Pharmacists can be called doctors and second to allow them space on the clinical team. For so long, the place of the Pharmacist has been in the ‘cage’ acting as the last man (and often forgotten )before the ambulatory patient exits the hospital. So it is proving some kind of cultural shock for many to see doctors of Pharmacy in their clinical outfits walking with doctors of Medicine around the wards. But the good news is that from the leadership of the NMA and down the ranks, a new realization is emerging:  One healthcare profession can not be evolving, creating specialties and sub specialties while other healthcare care professions remain stagnant. It is this new realization that gives great hope that the PharmD program has come to stay.What a better evidence than this group of PharmDs who are being inaugurated into the Pharmacy profession today. This is .. th batch to be so produced by this innovative faculty that has led the revolution in reshaping Pharmacy. I doff my hat for the dean and the faculty while I clink my  glass for this class of Pharmacists. I am looking forward to reading about your exploits. Congratulations!!!

Thank you so much for your attention. God bless

Pharm (Mazi) Sam Ohuabunwa OFR,MON,FPSN, FNAPharm, FPCPHARM, NPOM PRESIDENT, PHARMACEUTICAL SOCIETY OF NIGERIA 

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