Dalam banyak tulisan di portal ini saya dengan tidak bosan bosannya selalu menulis bahwa apotek adalah tempat pengabdian profesi bagi seorang apoteker. Karena menurut saya ada perbedaan mendasar antara tempat pengabdian profesi dan tempat bekerja.

Dalam konteks tempat pengabdian profesi saya menafsirkan sebagai tempat dimana profesional mengaktualisasikan keahliannya. Artinya, semua aktifitas ditempat tersebut tidak akan berlangsung tanpa kehadiran profesional yang bersangkutan. Kalau tempat bekerja, meskipun pegawai ada yang tidak masuk kerja, aktifitas dapat tetap berlangsung karena tanggungjawab pegawai yang tidak masuk bisa digantikan oleh pegawai yang lain.

Kondisi apotek pada saat ini, diakui atau tidak, lebih bersifat sebagai tempat bekerja apoteker. Dengan atau tanpa kehadiran apoteker aktifitas apotek dapat berlangsung tanpa hambatan. Bahkan meski apoteker hadir di apotek masih perlu dipertanyakan juga seberapa bermakna sentuhan profesionalnya mewarnai aktifitas apotek. Ini menjadi relevan karena kehadiran apoteker di apotek semestinya bukan hanya menggugurkan kewajiban saja.

Dalam rancangan Peraturan Pemerintah tentang Tenaga Kefarmasian yang sedang dalam proses penyelesaian akhir, disitu jelas dirinci mengenai tugas dan peran apoteker diberbagai bidang, termasuk apotek. Diantaranya adalah keharusan apoteker hadir di apotek selama apotek buka, yang oleh ISFI diistilahkan sebagai TATAP (Tiada Apoteker Tiada Pelayanan). Maka bisa dibayangkan bahwa TATAP adalah hasil akhirnya sedangkan prosesnya adalah cara penyelenggaraan apotek yang baik (good pharmacy practice/ GPP).

Melalui penerapan PP tersebut diharapkan nantinya apoteker bisa menjadi tuan rumah di apotek sehingga apoteker harus bisa juga berperan sebagai Chief Executive Officer (CEO). Peran ini membawa konsekuensi luas. Diantaranya, kalau apotek bukan dimiliki oleh apoteker maka, pemilik apotek statusnya adalah pemegang saham. Dia tidak berhak turut andil dalam kegiatan operasional apotek. Pemegang saham hanya berhak mengawasi jalannya apotek melalui wakil yang ditunjuk (komisaris).

Pertanyaan berikutnya bagaimana menentukan sistem remunerasi bagi apoteker? Mudah saja. Apoteker berhak mengusulkan kepada pemegang saham sesuai dengan keinginannya. Lantas apa kriteria pemegang saham untuk menyetujui usulan apoteker? Mudah juga jawabannya. Sepanjang tingkat kembalian dari investasi (ROI) lebih besar atau sama dengan alternatif instrumen investasi yang lain, pasti mereka setuju.

Disinilah tantangannnya. Sistem remunerasi bisa dibuat sebaik mungkin untuk kesejahteraan apoteker sepanjang apotek mampu memenuhi dari kegiatan operasionalnya. Mirip dengan konsep bisnis rumah makan padang. Bayar yang anda makan dan makan yang anda bayar.

Mudah mudahan proses seperti ini bisa menjadi batu loncatan bagi proses transformasi profesi apoteker.

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Dalam konteks harmonisasi ASEAN dibidang farmasi, isu paling fundamental, karena menyangkut hajat hidup para industriawan, adalah adanya kewajiban bagi setiap industri untuk memenuhi standar current Good Manufacturing Practise (cGMP). Aturan aturan yang ada dalam cGMP (dalam bahasa Indonesia diterjemahkan Cara Pembuatan Obat yang Baik) mencakup perangkat lunak maupun perangkat keras. Keduanya memang terkait langsung dengan kualitas obat yang diproduksi.

Tidak ada yang perlu dipermasalahkan dalam program harmonisasi tersebut karena program ini bertujuan agar ladang persaingan menjadi seimbang sehingga pertukaran produk antar negara yang terjadi memiliki standar kualitas yang sama. Bagi pelaku bisnis obat di Indonesia program tersebut bisa dipakai sebagai sarana untuk memperluas pasar. Kesempatan mengedarkan obat hasil produksinya tidak terbatas diwilayah Indonesia saja, tapi mencakup negara negara Asean. Tidak hanya untuk 225 juta penduduk Indonesia saja, tapi lebih dari 350 juta penduduk ASEAN.

Ditengah semakin majunya program pengendalian kualitas obat ada pertanyaan yang menggelitik saya. Dengan alasan mendapatkan kemudahan (convenience) dalam mengonsumsi, di apotek masih sering dijumpai adanya resep racikan. Biasanya resep racikan datang dari dokter spesialis anak (puyer) dan dokter spesialis kulit kelamin (salep/bedak). Pertanyaannya adalah, mampukah apotek menerapkan standar CPOB dalam membuat resep racikan?

Kalau mau jujur jawabannya adalah tidak. Pedoman penerapan CPOB tidak mungkin diterapkan di apotek. Dalam CPOB, selain obat kuasi, semua obat harus diproduksi minimal dalam ruangan grey area. Merubah bentuk sediaan (seperti membuat puyer) analoginya sama dengan memproduksi. Karena sediaan oral maka dibutuhkan ruangan dengan standar grey area. Mustahil apotek memiliki grey area. Kalaupun ada berapa biaya operasionalnya? Selain itu skala ekonomisnya terlalu besar.

Oke. Pertanyaan kedua, apakah kombinasi obat dalam resep racikan bersifat rasional? Jawaban sementara belum tentu. Artinya perlu dilihat dulu kasus per kasus. Mengapa saya pertanyakan demikian? Mudah sekali jawabannya. Bila kombinasi obat dalam resep racikan rasional, tidak mungkin para industriawan melewatkan begitu saja kesempatan mengembangkan produk. Industri farmasi lokal butuh produk baru. Untuk mengembangkan molekul baru belum mampu. Yang paling mudah adalah pengembangan formulasi. Kalau kombinasi obat dalam resep racikan bersifat rasional pasti industri farmasi tidak akan menyia nyiakan kesempatan itu. Dan Badan POM tentunya akan memberi ijin untuk memproduksi secara massal.

Dengan dua argumentasi diatas apakah masih relevan meracik obat di apotek?

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By : Erin Albert, PharmD, MBA College of Pharmacy & Health Sciences, Butler University

To the Editor: Paul Hawken said, “All is connected…no one thing can change by itself.”¹ The face of pharmacy is changing as the healthcare system itself changes. With the recent opportunity of reimbursement for cognitive services through Medicare Part D MTMS legislation, to the ongoing battle for the pharmacy dollar from the consumer with free or $4.00 generic prescriptions, to more pharmacies becoming full service healthcare centers and providing onsite clinical assessments, the evolution of pharmacy is rapidly morphing. These new opportunities are a mixture of good and less than good ideas for pharmacy as a profession. When thinking about other professional areas, what could pharmacy learn from others? More importantly, as pharmacy educators, how can we integrate different professions’ thinking into our curriculum?

Legal and Accounting. When was the last time you walked into your lawyer’s office or your accountant’s office, unannounced, without an appointment, and asked for immediate service? The answer to that question is most likely never. Nearly all other professions require appointments for consultative services. Pharmacy is one of the most trusted professions in the world; however, can we purvey quality services prn with unknown prescription dispensing demands, particularly in community practice? With MTMS now established, pharmacists should begin considering fee-for-service consultative appointments. It firmly establishes professional value with customers and provides the opportunity for uninterrupted, higher quality service for the patient. As educators, the more opportunities during IPPE and APPE we can expose students to regarding professional services by appointment, the more students will feel empowered to initiate this type of model into their practices after graduation. At Butler, we have brought in pharmacists performing such services by appointment and exposed students on community practice rotations to their ideas and thoughts, as we do not yet have enough sites for all students to experience such practice opportunities.

Public Relations and Advertising. If you have ever had the opportunity to meet with a public relations or advertising representative for hire, the first thing they would show you is a portfolio of their work. With continuing professional development now on the horizon, there is every opportunity for pharmacists to begin providing the same to potential employers – a portfolio of their work. This could include not only a CV, but writing samples, a hero file with letters of recommendation, any certifications or classes taken (both CE and non CE), and annual performance reviews. Any recruiter will note that documentation in site will be much more tangible for visual learners and hiring managers. The method to integration of this portfolio idea into the curriculum could best be served by providing outside professionals with more experience in writing portfolios that share their ideas with pharmacy students. This could easily be integrated into a professional practice course or an Introduction to Advanced Pharmacy Practice Experiences course.

Sales and Marketing. Pharmacists are in demand. The average student graduating still receives multiple offers for employment upon licensure. Students therefore do not have to market themselves actively for a job after college. Also, the major pharmacy chains are battling over pricing of prescriptions rather than focusing on high quality service or providing other ancillary services to their customers which in turn develops a unique market position for their companies. What if pharmacies took the Steve Jobs’ approach to providing excellent, unique appointment-only service as a separate section within the retail store? Many Macintosh computer owners will never go back to a PC simply because of the unique genius bar service that is provided by appointment at each and every Mac computer store. Pharmacists and students need to understand they are selling themselves each and every day. Everyone has a unique brand. In the new economy, it is not the product, but the customer’s experience that will make the inedible mark and keep the customer over the long term. Also, many pharmacists are incentivized for generic substitution. What if pharmacists proactively presented new generic switches to nearby physicians as a value-added professional service? We have addressed these issues at our institution with a new seminar series program that addresses marketing of a community-based pharmacy by bringing in pharmacists that have actually performed sales and marketing practices within their communities and offered discussions with students currently on community practice rotations about such practices.

Teaching and Education. Theoretically, all pharmacists, not just pharmacists in academia, are educators. Not only do we have to learn a lot of scientific details, but we also have to be able to communicate those ideas back to the customer at a level relevant to the customer. All pharmacists can learn from reading and studying great educators. To be a great educator means that one must also be a great life-long learner. Moving beyond just continuing education to a broader scope of customized continuing professional development will provide more educational and intellectually challenging areas for pharmacists to master and in turn better serve their patients and profession. Also, as pharmacy educators, are we teaching our students how to teach others? Each pharmacy school should offer an academic rotation within advanced pharmacy practice experiences (APPEs) and require it for all students. Preceptors in this arena are easy to find, for they are teachers at schools of pharmacy.

Coaching. Life coaches, wellness coaches, and business coaches are everywhere. In order to establish and foster long-term relationships with patients and retain business, pharmacists should focus on preventative services and coaching their patients around wellness rather than just discussing the treatment issues at hand with a prescription. Pharmacists are trained on how to help their patients create a wellness plan, a medication plan, long-term disease management plans and even diet and exercise plans for better health. At Butler University, we have APPEs for students in the campus wellness center called Healthy Horizons and directed by Dr. Carrie Maffeo. During this APPE, students check blood pressures, body composition, and perform other tests that expose them to the opportunity to coach patients in the realm of wellness without simultaneously focusing on dispensing.

Entrepreneurs. Entrepreneurs tend to have a great combination of vision, technical knowledge, and ability to get things done. These are qualities from which any profession, including pharmacy, can benefit. Pharmacy used to be an entrepreneurial profession with independent community pharmacies being the rule rather than the exception in practice. However, we need to hold on to the entrepreneurial mindset firmly for future generations of pharmacists, as creativity and right-brained thinking will be the new commodity for employers in the years to come. At Butler, we have provided opportunities for students to not only create new over-the-counter products in the self-care course, but also assign them to “sell” their products to the class. Students need to understand the creative process in projects that not only allows them to break the ice among their team members, but more importantly, teaches them the creative process and the ability to think outside the box.

Artists. Finally, each and every one of us has the ability to be an artist in whatever profession we have chosen. The common thread among all artists is passion. In The Reinvention of Work, author Matthew Fox explains, “Jobs are to work as leaves are to a tree. If the tree is ailing the leaves will fall.”² He goes on to state the definition of the word job came from the Middle English word gobbe, which meant lump. Whereas, “work is about a role we play in the unfolding drama of the universe.” We need more rock stars in our profession. We should see them in the media, on television, on radio, online – talking about drugs and all the amazing pharmacology that we can best explain…no other profession provides as much training on pharmacology. According to Fox, by sharing our work, we share “part of our display, part of the parading of our beauty” in the universe. Our work is beautiful. Every university that has a communications department, television channel, or radio station along with a school of pharmacy should host a program with pharmacy students discussing hot topics in healthcare. This exposes them to media challenges and therapeutic challenges simultaneously. Students must be able to think on their feet and effectively communicate, as all in media must do.

Pharmacy can learn a lot from other professions. The examples above are few of many others from which we can learn. By connecting to other professions and extracting their best practices, we have further opportunity to elevate ourselves. As we change, develop, and morph as a profession into the new millennium, those with the audacity to pioneer new and better ideas will ensure a profession that will not only evolve, but endure.

Reference:

1. Hawken, P. Little Brown and Company 1999; Natural Capitalism: Creating The Next Industrial Revolution

2. Fox, M.HarperCollins; 1994. Reinvention of Work

(Source : American Journal of Pharmaceutical Education)

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We look at the ten of the most famous names to have graced the pharmacy profession.

Pharmacy has been a profession for hundreds of years, with the first actual pharmacies dating back to the 13th century. Medicine was still primarily the province of doctors and other healers until the 18th century, with pharmacies eventually morphing into the modern drugstores that sell everything from toys to hardware. The profession has been embraced by some influential people, with a few of them standing out as exemplary – and sometimes surprising – men of note.

The first professional pharmacies are said to have been in Baghdad in the 13th century. As a practice distinct from that of medicine and healing, modern pharmacies developed in the 18th century, and by the 20th century had expanded to include general merchandise and even food counters. Below we list several famous people who spent time behind the pharmacist’s counter, a sampling that includes apprentices to apothecaries, clerks for chemists, and owners and operators of the family drugstore.

1. Benjamin Franklin. Believe it or not, this Founding Father was a pharmacist before he was ever a printer, statesman, or infamous ladies man. Working as a clerk in a neighborhood mercantile store, he dispensed medicines, herbs and various curatives. The man who famously said, “An apple a day keeps the doctor away” apparently knew what he was talking about.

2. Henrik Ibsen. The renowned Norwegian playwright spent his teenage years working as a pharmacists apprentice. He left home at 15 and made his way to the coastal town of Grimstad where he lived for six years, eventually becoming assistant pharmacist. Ibsen studied to become a physician but wasn’t a very good student – fortunately for theater lovers.

3. Dante Alighieri. The great Italian poet and author of “The Divine Comedy” was an apothecary guild in the late 1200’s, but may never have actually dispensed medicines – at that time it was required that anyone involved in local politics be a member of a guild, so his membership in the apothecaries’ guild filled the bill. But since books were sold in apothecaries’ shops in those days, it was probably a good choice.

4. Sir Isaac Newton. The man who changed the world with his theory of gravity served as an apprentice apothecary in Grantham, England, living with the town’s apothecary and becoming engaged to the boss’s daughter. He left both, however, to study at Cambridge, where he began his illustrious career in physics and mathematics. Newton never went back to the pharmaceutical arts and he apparently gave up women, too – the apothecary’s daughter married someone else and Newton lived the rest of his life as a bachelor.

5. O. Henry. The brilliant American writer – born William Sydney Porter – worked in a number of diverse jobs before he became a writer. He worked in his uncle’s drugstore as a teenager and became a pharmacist at 19. During his writing career he supported himself for a time as a bank teller – and was later jailed for embezzlement. So perhaps he’s not the best example of a pharmacist to hold up, but he did write “The Gift of the Magi.”

6. Hubert H. Humphrey. The Minnesota democrat worked for a short time as a pharmacists in his father’s drugstore, later going into politics and serving as mayor of Minneapolis, a U. S. senator and, of course, Vice President of the United States under President Lyndon B. Johnson. His brief stint as a pharmacists was honored in 1966 when he was named Pharmacist of the Year by the St. Louis College of Pharmacy. The American Pharmaceutical Association bestows its annual Hubert H. Humphrey Award on pharmacists who are known, like Humphrey, for their commitment to civil rights and public service.

7. Wilbur L. Scoville. The American chemist is best known for creating “The Scoville Organoleptic Test”, now known as the Scoville scale – while working at Parke-Davis pharmaceuticals in 1912 he devised the test, which measures the hotness of chili peppers. He also wrote one of the most-used pharmaceutical reference books, “The Art of Compounding,” which was first published in 1895 and continued to be used in the industry until the mid-1960’s.

8. Charles Walgreen. After losing part of a finger in an accident at the shoe factory where he worked, Walgreen took his doctor up on his suggestion that he apprentice with a local druggist. He later studied in Chicago and became a pharmacist, interrupting his career to serve in the Spanish-American War. After his discharge, Walgreen worked for a Chicago pharmacist, eventually buying the store when the owner retired. He started adding more stores and built the famous Walgreen’s chain – and, along the way, introduced such drugstore staples as soda fountains and lunch counters.

9. George F. Archambault. Considered to be the creator of the consultant style most pharmacies adopt today, Archambault is truly a hero among those in the profession. He is quoted with the following vision for pharmacists everywhere: “It is the pharmacist’s professional responsibility to protect the public against iatrogenesis, physician-induced injury or disease in the area of drug prescribing especially as to overdosage, incompatibilities, contraindications, and synergistic drug actions.”

10. John Pemberton. While few remember his name, most drink a version of his tonic on a regular basis even today. Pemberton invented Coca Cola as a cure for headaches and nervousness. When it was mixed with carbonated water, it was sold as a fountain drink and a cure for morphine addiction.

While few of us think of the folks behind the pharmacy counter as famous, these individuals certainly left their mark on the profession.

(Source HealthCareerNet)

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Di kota kota besar seperti Jakarta misalnya, keberadaan sebuah apotek di mal (pusat perbelanjaan) sudah merupakan hal yang biasa. Biasanya apotek yang masuk ke mal adalah apotek jaringan. Jarang sekali ditemui apotek yang bukan jaringan ada disana. Kalaupun ada jumlahnya masih sangat sedikit.

Awalnya saya mempertanyakan apakah mungkin apotek yang beroperasi di mal bisa breakeven bahkan untung ? Wajar saja karena sewa atau harga ruang di mal tergolong mahal dan kemudian orang yang berkunjung di mal biasanya untuk berbelanja (bukan obat) dan rekreasi. Berapa omzet yang bisa didapat setiap harinya?

Tapi lama kelamaan saya jadi ragu sendiri. Soalnya hampir disetiap mal baru yang berdiri selalu ada apotek (jaringan) disitu. Rasanya tidak mungkin sebuah apotek dibuka kalau tidak ada prospeknya. Meski saya tidak memiliki data yang valid, ijinkan saya mencoba menganalisis fenomena tersebut.

Mayoritas pengunjung mal adalah orang yang membutuhkan barang yang dibutuhkan sehari hari. Selain berbelanja mereka juga berekreasi. Mereka yang bertujuan untuk belanja pastinya sudah merencanakannya dari rumah. Rata rata mereka akan belanja kebutuhan rumah tangga, baju atau barang elektronik. Mungkin sedikit sekali yang sengaja akan menebus resep dokter di mal. Berdasarkan asumsi tersebut saya berkesimpulan bahwa penjualan apotek di mal lebih didominasi oleh penjualan non resep.

Oke, kemudian dari pengunjung mal yang belanja obat di apotek mungkin bisa digolongkan pada 2 kelompok. Pertama adalah mereka yang memang berniat membeli obat dari rumah dan yang kedua adalah mereka yang membeli obat tanpa rencana. Bisa jadi kelompok yang kedua lebih banyak dibandingkan kelompok yang pertama. Dan menurut pengalaman saya belanja tanpa rencana terkadang bisa menghabiskan dana yang cukup besar. Belanja tanpa rencana biasanya juga tidak terlalu sensitif terhadap harga. Karena itu tidak heran kalau ada banyak sales promotion girl yang bertugas di apotek tersebut. Tugas mereka apalagi kalau bukan melayani pengunjung dan merayunya untuk belanja.

Keberadaan apotek di mal juga bisa dianalogikan dengan apotek yang juga menjual minuman ringan atau majalah. Apotek tersebut berupaya untuk menyediakan kebutuhan lain bagi konsumen. Sambil menunggu obat, konsumen bisa membeli minuman atau majalah untuk mengatasi rasa jenuh. Mal juga demikian. Mereka mencoba menghadirkan konsep one stop service kepada pengunjungnya.

Dengan analisa sederhana tersebut terbayang bahwa apotek di mal mungkin lebih profiatble. Hanya saja investasi yang dibutuhkan relatif besar. Bagi kita, apoteker, keberadaan apotek di mal merupakan sarana yang tepat untuk menunjukkan eksistensi profesi kita. Kesempatan untuk berinteraksi dengan masyarakat terbuka luas. Apalagi kalau kita memakai tanda khusus (seperti jas putih) agar mudah dikenali.

Bagaimana pendapat anda, sejawat ?

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