"The hot pot restaurant lost money, so it opened a pharmacy." For a long time, such a saying has been popular in the retail pharmacy industry.
"100,000 will not be sold." Wu Rong, the manager of a retail pharmacy in the county, refused the other party's request to purchase his practicing pharmacist certificate on the spot.
In order to open a pharmacy, Wu Rongtuo was looking for someone, and the pharmacy in the county town is now finally open.
Practicing pharmacists have become a "necessity" for opening retail pharmacies, which has led other pharmacies that do not have a practicing pharmacist certificate and are reluctant to hire practicing pharmacists to choose pharmacists to "hang up" or buy certificates at a heavy price.
On the other hand, with the promotion and landing of the "dual channel" favorable policy, retail pharmacy giants have invariably carried out DTP business, and the demand for professional pharmacists has surged.
According to the latest data from the State Food and Drug Administration, although the total number of registered practicing pharmacists in retail pharmacies has exceeded 584,000, there is still a large gap in the number of practicing pharmacists in Chinese retail pharmacies compared with the standard of 2 practicing pharmacists in each pharmacy in the United States.
In fact, according to Kang Zhen, deputy director of the National Development research center for practicing pharmacists of China Pharmaceutical University, even if it is required to have 1 practicing pharmacist, it is not enough. "Because if pharmacies operate Chinese medicine, they must have practicing Chinese medicine teachers, so in fact, there are more practicing Chinese medicine teachers, and at the same time, practicing Chinese medicine teachers can also operate Western medicine, which is obviously unreasonable."
In reality, it seems that pharmacies with scarce resources of practicing pharmacists are not very precious, so that practicing pharmacists bear the pressure of selling drugs.
Selling drugs should not be the destination of practicing pharmacists, as the last link of the "white coat", practicing pharmacists should play the role of service providers in the future, not drug salesmen.
Points of contradiction stirred up
The gap in the number of practicing pharmacists is more obvious under the promotion and continuous implementation of the "dual channel" favorable policy.
In April 2021, the "dual channel" policy of the national medical insurance negotiation variety was implemented, allowing pharmacists to see new profit growth points.
The "dual channel" has become the door to officially open the circulation of prescriptions. It is understood that after the release of the policy, pharmaceutical companies such as BeiGene and AstraZeneca have laid out the out-of-hospital market.
However, there is still a large gap in the number of licensed pharmacists registered in retail pharmacies.
In order to make up for this gap, as early as 2015, the Former Food and Drug Administration of the People's Republic of China (CFDA) Licensing Center for Practicing Pharmacists put forward the concept of "multi-site registration of practicing pharmacists" (referred to as multi-site practice) when undertaking major research projects in the early stage of the 13th Five-Year Plan of the People's Republic of China, in order to solve the shortage of practicing pharmacists in retail pharmacies.
In 2017, the General Office of the State Council issued the Several Opinions on Further Reforming and Improving the Policy on the Production, Circulation and Use of Drugs, which formally established this concept. In this regard, many places have already launched pilots.
On August 31, 2015, Guangdong Province took the lead in issuing the country's first "Multi-site Practice Certificate for Practicing Pharmacists", began to try the multi-site practice model of practicing pharmacists, and emphasized that the multi-site practice of practicing pharmacists in Guangdong Province was carried out under the principles of "not lowering standards" and "not changing administrative licensing conditions".
In September 2018, the General Office of the Chengdu Municipal People's Government issued the Notice on Several Measures for Further Reforming and Improving the Policy on the Production, Circulation and Use of Drugs, proposing to "strengthen the training of pharmacists in retail pharmacies and explore the filing of pharmacists' multi-institutional practice".
......
However, these pilots did not work well.
The reason is that a relevant person from a traditional chain pharmacy said that practicing pharmacists generally work in pharmaceutical factories or pharmaceutical companies, and rarely have time to go to retail pharmacies to practice at multiple locations; in addition, the general understanding of practicing pharmacists in retail pharmacies, the professional role that pharmacy graduates should play for practicing pharmacists in retail pharmacies is not clear, and the practicing pharmacists in retail pharmacies have become "drug salesmen", carrying the sales pressure of selling drugs, and the status of retail pharmacies is low in the general cognition of society.
Proof is hard to find
The scarcity of licensed pharmacists has left the rapidly expanding retail pharmacies "stretched to the limit", and some even "hang up" in order to meet the requirements.
Recently, the Tianjin Municipal Drug Administration issued the "Notice on Further Strengthening the Use and Supervision of Licensed Pharmacists in Pharmaceutical Retail Enterprises" (hereinafter referred to as the "Notice") to encourage the diversified use of practicing pharmacists.
Some media interpreted that the "green light" was given to practicing pharmacists to "hang up their certificates".
The Notice clarifies that, as a supplement to the absence of practicing pharmacists, unregistered personnel holding the Professional Qualification Certificate for Practicing Pharmacists may refer to the provisions of the Measures for the Administration of the Registration of Licensed Pharmacists, submit part-time contracts, register as practicing pharmacists, engage in prescription review and allocation, rational drug use guidance and consulting services in pharmaceutical retail enterprises, and participate in the prescription review and medication guidance of the remote examination room of pharmaceutical retail chain enterprises.
It should be emphasized that although the Notice clearly states that part-time pharmacists can undertake professional functions such as reviewing prescriptions, it is not equivalent to encouraging practicing pharmacists to "hang up their certificates" and become "shadow pharmacists".
The so-called "shadow pharmacist" refers to a person who has obtained the professional qualification of a practicing pharmacist who places his certificate in a pharmacy to "exchange" a certain fee, but the person does not provide pharmacy services in the pharmacy.
Violations of the "hanging certificate" will be severely punished once they are investigated. The "Notice" also clarified that "strict investigation of practicing pharmacists' certification behavior" is also clarified. Once the "hanging certificate" behavior is investigated, it will be notified to the unit where the practicing pharmacist belongs, entered into the national licensed pharmacist registration management information system, revoked its certificate, and will not be registered within three years.
By encouraging practicing pharmacists to practice more, it is only to further improve the efficiency of the use of practicing pharmacists and fill the gap of practicing pharmacists in the surge of retail pharmacies.
"The so-called multi-site practice of practicing pharmacists is divided into two forms: one is that a pharmacist registers multiple stores at the same time and serves at different times; the other is to hire an external pharmacist to practice at a fixed time." Kang Zhen added.
Practicing pharmacists work primarily
More than 60% of them are drugs sold
Retail pharmacies do not have a good understanding of practicing pharmacists, and the role of selling drugs in reality is the biggest reason for the shortage of pharmacists.
At the closed-door summary meeting of the Pharmacy Guardianship Practical Skills Training Program for Practicing Pharmacists in Community Pharmacies of China Pharmaceutical University (Phase II), Kang Zhen delivered a report on "Investigation of Pharmacy Management Services Carried out by Practicing Pharmacists in Community Pharmacies in Mainland China".
Through the survey, it was found that practicing pharmacists have carried out certain forms of pharmacy services in community pharmacies, and the willingness to carry out MTM is very high, but at present, practicing pharmacists in community pharmacies do not have a comprehensive and systematic understanding and learning of MTM, and the professional skills to carry out MTM are insufficient, and it is necessary to increase training.
The so-called MTM, that is, drug treatment management, refers to the pharmacist with the advantages of pharmaceutical service technology to apply various types of clinical tools to provide patients with professional pharmaceutical services, discover, solve and prevent drug treatment problems, improve patient self-management ability and medication compliance, and ultimately improve the clinical outcome of patients.
From the distribution of 1832 questionnaires, 1713 were effectively recovered, and the effective recovery rate was 93.50%. Among them, 245 are males and 1468 are females, 51.37% are 31-40 years old, 42.73% have pharmacy professional backgrounds, 44.37% are college degrees, and there are fewer master's and doctoral degrees in practicing pharmacists in the survey.
70.11% work in community chain pharmacies, and 67.48% of the main tasks are to sell drugs. 67.60% of the performance appraisal is for sales tasks.
Most of them have heard of drug treatment management services, but have no systematic understanding, practical skills in pharmacy monitoring; drug reorganization, prescription streamlining skills; pharmacotherapeutics and other aspects of knowledge are relatively lacking, and practicing pharmacists as a whole have awareness of pharmacy services, but lack systematic learning and understanding.
Kang Zhen said that the evaluation system for practicing pharmacists in community pharmacies to carry out pharmaceutical services should be established and improved as soon as possible, and pharmaceutical services should be added to the performance appraisal to enhance the enthusiasm and professional status of practicing pharmacists.
Selling medicines should not be the destination of practicing pharmacists
Many pharmacies have licensed pharmacists, but they have not been able to play their value, and the pressure to sell drugs on practicing pharmacists is prominent.
The person in charge of a chain pharmacy said that most of the practicing pharmacists in retail pharmacies are trained by pharmaceutical companies themselves, but they are usually busy at work, and the learning courses of pharmaceutical services are often unable to keep up.
The epidemic is constantly changing people's drug buying behavior, unlike big cities, prescription drugs either go to the hospital or go to online pharmacies; the drug buying habits of fourth- and fifth-tier small cities, mostly go to retail pharmacies or go to small clinics.
A resident of a fourth-tier city told the health community that three of the four drugs they bought in retail pharmacies were generic drugs, and different people went to buy the same drug, with a price difference of more than ten yuan.
From the perspective of drug safety and treatment effect, it is necessary for practicing pharmacists in retail pharmacies to conduct comprehensive inquiries on chronic disease groups, reorganize or adjust drugs according to their conditions and drug control, and periodically follow up monitoring and evaluation, and carry out rational drug use to better control the patient's condition and achieve the goal of optimal efficacy.
The destination of practicing pharmacists is not to sell drugs, but to do a good job as a gatekeeper of the health of the grass-roots people by providing pharmaceutical services.
In the long run, the scientific, comprehensive, standardized and professional "patient-centered" pharmacy monitoring service model carried out by pharmacies at medical service terminals is the direction of professional transformation of pharmacies in the future.
Resources:
1. The Food and Drug Administration issued a document: practicing pharmacists can "hang up their certificates"! Search for medicines
2, 2022 pharmacy industry new trend: practicing pharmacists have increased their salaries, selling drugs also rely on Internet celebrities? Health Bureau
Sources | the health community
Written by | Four Hi