Fantasy pharmacy: what Harry Potter, Gollum and the Cheshire Cat have to say

Where should pharmacy be heading? It depends where it wants to get to.

I apologise in advance if you were expecting me to reveal my innermost thoughts about what might happen in the pharmacy of my dreams. Rather I am going to reflect on a few experiences that have occurred over the summer which have put me in mind of some of the epic fantasy stories. I am sharing these experiences in the hope that we can all think of what we need to do to proclaim our presence and our rightful place in healthcare.

Cloak of invisibility

The power of the cloak of invisibility features in many novels, most recently in JK Rowling’s tomes, where it protects Harry Potter against his enemies. In fiction the cloak is protective; in reality the cloak that is worn by pharmacy seems more threatening. I often wonder why pharmacy is the hidden profession. This was highlighted by three experiences that I had over the summer.

As a London 2012 “games maker” I was proud to represent the profession in the olympic Village polyclinics and even more proud to see that at the rowing village at eton Dorney, in addition to having a pharmacy, staffed by pharmacists and a pharmacy technician, the whole polyclinic was managed, very ably, by two pharmacists. We worked as a team with all other healthcare professionals to ensure that the health of the olympic family was maintained. So imagine my surprise when I read the blog of one the GPs I worked with on several occasions: “Well it was great, I was a GP in the rowing village at the polyclinic, great team of Docs, Nurses, Physios, osteopaths, Sports Masseuses, Dentists and Chiropractors held together by some impressive volunteers doing admin and reception.” The invisibility cloaks we were wearing in pharmacy must have been working especially well.

Then just a few weeks later I was using an online form to register for some e-learning for healthcare professionals. The dropdown list featured 14 other healthcare professionals but not a mention of pharmacy. I had to opt for “other”.

Most recently I attended a meeting to discuss the partnership councils of the local education and training board (LeTB). In England, the LeTBs will have responsibility for the development of the whole healthcare workforce, not just those employed directly by the NHS. We were shown a slide of how the Department of Health sees the new health and care system, which will be up and running by April 2013. GPs and dentists are there in the inner circle listed as separate services, but no mention of pharmacy. I realise that we are there implicitly under the other services such as hospitals, public health and community health services, so perhaps this is just a case of the doctors and dentists wearing their high visibility cloaks. The Royal Pharmaceutical Society is doing a grand job of publicity in the media, but we all obviously need to do more to be noticed.

It’s mine, all mine

This idea of being noticed takes me on to my next theme which has been exercising a lot of minds and creating much debate over the year: the display of pharmacy medicines. There seemed to have been widespread outrage at the proposal from the General Pharmaceutical Council that P medicines could go on open display rather than being kept behind the counter. Many of my friends tweeted, blogged and even wrote letters to The Journal about the matter. The more they wrote the more I was reminded of Gollum in Tolkien’s ‘Lord of the Rings’ wanting to keep his precious, his ring, with his wizened grasping arms and somewhat scared look saying “it’s mine, all mine”. His life was extended far beyond its natural limits by the possession of the ring, and without it he feared he would lose his life.

Is that what pharmacy has come to? Hanging on for dear life to a dwindling number of medicines that have to be hidden away and only sold under the supervision of a pharmacist, which in some places is just an occasional nod.

Would we not serve the public better by openly displaying those medicines so that we can advise on their use and show off our expertise. We should be proud of our P medicines. We need to show them off and as pharmacists take a more active role in their sale.

I worked as a locum some years ago in a pharmacy that had no division between the dispensary and the public area other than the shelving which contained the P medicines. Customers would browse them and then speak directly with the pharmacist before their purchase. It seemed to be a far more professional approach to their display and sale than currently happens in many pharmacies. If the medicines the public see in a pharmacy, and the service they get from a pharmacy, are no different to the service they get at the corner shop or the local garage, then we are doomed. We need to see the changes proposed by the GPhC as an opportunity and not a threat.

Wonderland

Finally, I will reminisce about my favourite fantasy tale of all time: ‘Alice’s Adventures in Wonderland’. Lewis Carroll had a knack of being able to create such wonderful images of both order and chaos, often occurring at the same time. When asked by Alice which way she should go, the Cheshire Cat replied: “That depends a good deal on where you want to get to.”

I’m not sure pharmacy really knows where it wants to get to. We have employers heading off in one direction and professionals wanting to go a different way. In Alice’s case she ended up at the Mad Hatter’s tea party, where, when the Hatter wanted change, he just moved one place on. We need to think carefully about where the profession is moving and how we help others see our contribution.

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Citation
The Pharmaceutical Journal, PJ, December 2012;()::DOI:10.1211/PJ.2021.1.83403