Pill machines ease prescriptions

Mechanical pharmacies made by Pleasanton company help patients in remote locations

By Lea Blevins

MEDIANEWS STAFF

PLEASANTON - Imagine living in a place with no drug store for miles around but still being able to obtain prescription drugs and consult face to face with a pharmacist.

PickPoint Corp., based in Pleasanton, is making that possible. And co-founder Richard Lee promises that it's only just begun to revolutionize the pharmacy world.

Lee is a resident of Volcano, about 60 miles east of Sacramento, but co-founders Kevin Delaney and Peter Swidzinski are from the Tri-Valley. Lee works about three days a week in the Pleasanton office.

Lee has a background in factory automation and was interested in working on packaging for drugs when the PickPoint idea began.

The products are designed to store and dispense prepackaged medications of various types that will increase pharmacy efficiency and provide access to drugs for people in remote locations.

PickPoint's main product resembles a vending machine but is filled with bottles and pill packs instead of candy bars and chips -- and it has bulletproof glass.

The security features allow the machines to be placed in distant locations, such as Alaska's Aleutian Islands, where they may be situated in a hut out in the middle of nowhere.

Doctors and other care providers use PickPoint's computer technology system to request a prescription from a pharmacist in Anchorage, who can speak to the providers via video cameras in real time. The computer program also allows for close-up measuring and viewing of pills to ensure that the prescription is correct.

"This is truly the next generation," Lee said.

In its few years of business, PickPoint has already attracted a wide customer base.

The military uses PickPoint's machines to run what is called a "telepharmacy" for its troops serving in remote locations, including ships.

The machines are installed in more than 125 U.S. Army, Air Force, Navy and public health service locations around the world.

The Alaska Native Medical Center, which uses PickPoint's technology, established the Southcentral Foundation Telepharmacy Program, based in Anchorage, with more than 36,000 patients in a 2,000-mile area.

"You can be anywhere, and we can give you pharmacy assistance and control," Lee said.

In addition to setting up machines in remote sites, PickPoint sells them to hospitals and pharmacies to keep behind the counter. The machines are the same except for the front door, which doesn't include bulletproof glass and allows pharmacy personnel to reach right in and grab the filled prescription.

The pharmacy inside Safeway near the Blackhawk community in Danville features PickPoint's machines behind the counter.

The pharmacy has the vending-machine-style model as well as a set of drawers that light up to direct pharmacists to the location of a prescription.

The machines allow pharmacy staff to save time by reallocating what work they do and when, said pharmacy manager David Flower.

Although pharmacists still have to fill individual bottles of pills and load the machine, the process is speeded up by filling multiple bottles at once instead of filling them as each prescription comes in.

"The best advantage of this thing is when we do have downtime, we're using it up," Flower said.

Lee said PickPoint is currently working on other technology to improve the pharmacy world, but it won't be ready for a few months. He said people can begin to imagine getting their prescriptions filled in seconds rather than what now is often an hour's wait.

"The technology we have coming is so dramatic," Lee said. "This is stuff that people have never seen or heard of."

Source

Pharmacists group honors Phil Montgomery

State Rep. Phil Montgomery, R-Ashwaubenon, has been named Pharmacy Society of Wisconsin 2007 Legislator of the year.

Montgomery has been a vocal advocate for Wisconsin pharmacy on issues such as the state budget and licensing of out-of-state pharmacists, according to the group.

He was instrumental in stopping legislation that would have placed serious restrictions on the ability of pharmacies to purchase prescription drugs from licensed wholesalers. And he is working to develop legislation that would allow for remote dispensing of prescription drugs, according to the group.

Montgomery will be honored at a reception on Wednesday at the Inn on the Park in Madison. The award is presented each year in conjunction with the annual Pharmacy Society of Wisconsin Legislative Day.

Source

Board approves MCH renovations

Operating rooms to undergo major overhaul

Operating rooms at Medical Center Hospital will be looking a bit different over the next two years.
The Ector County Hospital District Board of Directors voted Monday to fund $2.5 million toward the first phase of operating room renovations.
The renovation will turn two of the hospital’s 12 current operating rooms into one state-of-the-art endovascular suite, officials said.
“It’s just time,” Medical Center Chief Executive Officer William Webster said. “Our current O.R. is 30 years old.”
By the time the entire operating room area is renovated in 2009, Webster said it would bring Medical Center’s inpatient facilities up to the standards of its Wheatley Stewart Medical Pavilion, which opened in 2004.
The board also approved the purchase of 26 McKesson CarePoint-RN carts for $249,356. Lisa Corley of Medical Center’s clinical informations system said the robots pick out medication and put it in envelopes for patients.
The machine eliminates errors by reading bar codes, she said.
“That makes it almost impossible to give the wrong medication to patients,” Corley said. “That’s really the purpose, to improve patient safety.”
The board also approved a $150,000 contribution to Texas Tech Health Sciences Center’s new Women’s Health Research Institute at the Permian Basin. The amount equals a contribution made by Midland Memorial Hospital last month.
Board Member Fred Martin expressed concerns about the institute’s ability to attract women’s health care business that has gone to other hospitals.
“I cannot tell you (that) you will have a huge shift in obstetrics care,” Texas Tech Regional Dean Dr. John Jennings said. “But it’s an opportunity to do something that will put the name of both our institution and Medical Center out there in women’s health.”
In other action the board:
>> Differed discussion on emergency room/trauma call agreements until its April meeting.
>> Approved a maintenance agreement with Trane.
>> Approved an off-site nighttime pharmacist agreement with Alpine-based telepharmacy Envision-Rx for 18 months at $240,000 annually.
>> Received an update on being accredited for two years as a provider of continuing medical education.
>> Received an update on the 5 Million Lives campaign, which aims to cut 5 million incidents of medical harm at 4,000 hospitals over the next two years.

Source

Business fills drug orders anywhere, anytime

Pleasanton firm creates vending machines that dispense prescriptions

PLEASANTON — Imagine living in a place with no drugstore for miles and miles but still being able to obtain prescription drugs and consult face-to-face with a pharmacist.

PickPoint Corp., based in Pleasanton, is making that possible.

And co-founder Richard Lee promises that they've only just begun to revolutionize the pharmacy world.

Lee is a resident of Volcano, which is about 60 miles east of Sacramento, but his co-founders Kevin Delaney and Peter Swidzinski are from the Valley. Lee works about three days a week in the Pleasanton office.

The idea for PickPoint started in 1999 and the business opened in Danville in 2000. After outgrowing that office, PickPoint moved to Pleasanton's Hacienda Business Park three years ago.

Lee had a background in factory automation and was interested in working on packaging for drugs when the PickPoint idea began.

The products are designed to store and dispense prepackaged medications of various types that will increase pharmacy efficiency and provide access to drugs for people in remote locations.

PickPoint's main product resembles a vending machine, but is filled with bottles and pill packs instead of candy bars and chips — and it's got bulletproof glass.

The security features allow the machines to be placed in distant locations such as Alaska's Aleutian Islands where the machine may be situated in a hut out in the middle of nowhere.

Doctors and other care providers use PickPoint's computer technology system to request a prescription from a pharmacist in Anchorage, Alaska, who can speak to the providers via video cameras in real time. The computer program also allows for close-up measuring and viewing of pills to ensure the prescription is correct.

"This is truly the next generation," Lee said.

In its few years of business, PickPoint has already attracted a wide customer base.

The military uses PickPoint's machines to run what is called a "telepharmacy" for its troops serving in remote locations, including ships.

The machines are installed in more than 125 U.S. Army, Air Force, Navy and public health service locations around the world.

The Alaska Native Medical Center, which uses PickPoint's technology, received the 2006 Award for Excellence in Medication-Use Safety from the American Society of Health-System Pharmacists.

The center established the Southcentral Foundation Telepharmacy Program based in Anchorage, with more than 36,000 patients in a 2,000-mile area.

"You can be anywhere, and we can give you pharmacy assistance and control," Lee said.

Even patients in the Valley can be served by PickPoint.

In addition to the machines set up in remote sites, PickPoint sells them to hospitals and pharmacies to keep behind the counter. The machines are the same except for the front door, which doesn't include bulletproof glass and allows pharmacy personnel to reach right in and grab the filled prescription.

The pharmacy inside Safeway near the Blackhawk community in Danville features PickPoint's machines behind the counter.

The pharmacy has the vending-machine style model as well as a set of drawers that light up to direct pharmacists to the location of a prescription.

The machines allow pharmacy staff to save time by re-allocating what work they do when, said Pharmacy Manager David Flower.

While pharmacists still have to fill individual bottles of pills and load the machine, the process is sped up by doing multiple bottles at once instead of over and over as each prescription comes in.

"The best advantage of this thing is when we do have downtime, we're using it up," Flower said.

Lee said PickPoint is currently working on other technology to improve the pharmacy world, but it won't be ready for a few months. He said people can begin to imagine getting their prescriptions filled in seconds rather than what is often an hour wait.

"The technology we have coming is so dramatic," Lee said. "This is stuff that people have never seen or heard of."

To learn more about PickPoint Corp., visit http://www.pickpoint.com.

Source

University of Maryland School of Pharmacy Expanding to Montgomery County

The University of Maryland School of Pharmacy will take its nationally-ranked Doctor of Pharmacy program to The Universities at Shady Grove this fall. Responding to a critical pharmacist shortage in Maryland that is expected to become more severe as baby-boomers age and use more medications, the School will enroll 40 additional students at the Montgomery County campus. The School is well beyond its maximum student capacity on the UMB campus. The plan will enable an enrollment increase of one-third in the entering class.

The expansion will be supported through enrollment increase funds provided by the Governor at the request of the Board of Regents and a substantial capital investment by the University of Maryland, Baltimore to construct specialized facilities for pharmacy at Shady Grove.

UMB President David J. Ramsay says, "Such an investment is worthwhile to support the University's mission to meet Maryland's need for the vital health profession of pharmacy. Moving our PharmD program to Shady Grove also gives our research-intensive School of Pharmacy a foothold in the heart of Montgomery County's 270 research corridor."

School of Pharmacy Dean David A. Knapp says, "The Shady Grove program will eventually enroll a full four-year complement of 160 students, drawing upon the rich resources of clinical facilities and government and industrial laboratories in the region to support the doctoral program. The new location will also provide an alternative to the main campus in Baltimore for students residing in Montgomery and Prince George's counties, as well as somewhat easier access for students from Western Maryland."

The Shady Grove expansion is part of an ambitious expansion plan by the School of Pharmacy to double its PharmD enrollment over the next 10 years. Central to the effort is construction of a new pharmacy building on the Baltimore campus to house the additional faculty, students, and educational and research facilities essential to support the growth. The School received initial planning funds for the building during last spring's General Assembly and has engaged architects to begin work on the building.

It is important that the General Assembly provide continued planning and construction funds to complete the building as quickly as possible. "The new building is a critical piece of our enrollment expansion," says Knapp.

Source

Pharmacy school expands to Montgomery campus

University of Maryland, Baltimore, aims to meet demand with new four-year programs at Shady Grove

This fall, the pharmacy school of the University of Maryland, Baltimore, will offer its four-year degree programs at the university system’s Shady Grove campus for the first time.

The school’s expansion into Montgomery County will help meet a shortage of pharmacists in Maryland and nationwide by enrolling 40 pharmacy students each year, said university officials. The school is also planning to double the size of its classroom and laboratory facilities in Baltimore.

‘‘The move to Shady Grove is also giving the school of pharmacy a foothold in Montgomery County to establish economic development here in collaboration with the biotech community and other health care organizations,” said David A. Knapp, dean of the pharmacy school. ‘‘That can only be facilitated by moving our program down here.”

The school’s doctorate of pharmacy program requires four to six weeks rotation in a community hospital, pharmacy, company or health care agencies such as the U.S. Food and Drug Administration or the National Institutes of Health.

Rockville, Prince George’s County and Southern Maryland are among the areas in Maryland running short of pharmacists, according to a July 2006 survey of 63 drugstore chains by the National Association of Chain Drug Stores. The survey also revealed shortages in Baltimore, Arnold, Prince Frederick, the Eastern Shore and Eldersburg.

On a scale of 1 for a large shortage to 5 for large oversupply, the state of Maryland scored 1.91 on the survey, compared with its score of 2.19 in the same survey in January 2006.

Knapp said the pharmacist shortage, which began several years ago, is likely to grow bigger as the leading edge of baby boomers age and require more medications.

‘‘The need for professional pharmacists trained in the discovery, development, and use of medicine rivals the need for nurses and other health care professionals,” William E. Kirwan, chancellor of the University System of Maryland, wrote in an e-mail,

Extension of the pharmacy curriculum to the Universities at Shady Grove campus will ease a logjam of students applying in Baltimore for the 120 slots open each year, while offering a more convenient location for students in and around Montgomery County.

‘‘This came together when the Board of Regents encouraged us to deal more dramatically with the pharmacy shortage,” Knapp said. The curriculum at Shady Grove will be ‘‘a hybrid” of distance learning and live instruction.

‘‘This is a sizable expansion into this region and will expand the number of pharmacists statewide,” he said.

Maryland hospitals had a 10.5 percent vacancy rate for pharmacists in 2005, up from 8.5 percent in 2004, said Nancy Fiedler, a spokeswoman with the Maryland Hospital Association. She said 2006 figures are not yet available, ‘‘but we see no indication from the data that the vacancy rate did not continue last year.”

While the drugstore association survey showed an increase of vacancies for full-time pharmacists nationally from 3,941 in January 2006 to 4,044 in July 2006, the trend radically reversed for part-time vacancies. The survey showed only 389 vacancies for part-timers in July 2006, versus 3,558 part-time vacancies only six months earlier.

As more male pharmacists ‘‘prepare to retire and men and women opt for part-time work” the U.S. pharmacy profession ‘‘could face a worsening shortage,” according to the National Pharmacist Workforce Study in the May⁄June 2006 issue of the Journal of the American Pharmacists Association, sponsored by the nonprofit Pharmacy Manpower Project Inc.

Source

NEOUCOM adding pharmacy school

North Eastern Ohio Universities College of Medicine is opening a new college of pharmacy this fall.

The Accreditation Council for Pharmacy Education granted North Eastern Ohio Universities College of Pharmacy pre-candidate accreditation status for its Doctor of Pharmacy program, which will allow the developmental program to admit its first 75 students for the fall semester, 15 of whom will be chosen from Kent State.

The school is expected to progress in accordance to a stated plan within a specified period of time before reaching candidate status and graduate its first class before attaining full accreditation, according to a NEOUCOP press release.

The new institution is the only professional pharmacy school in the eastern half of the state.

"We've always needed one in this part of Ohio," said Jim Hostler, chief pharmacist at DeWeese Health Center.

Prescription: Communication

The institution's goal is to appease the need for more pharmacists in Ohio and set a national standard for pharmaceutical education by training students in a setting that mirrors the professional workforce, said David D. Allen, dean of pharmacy.

"I think the vision relates to creating a program based on excellence and having a significant impact on patient care in Northeast Ohio," Allen said. "That's very important to us in terms of the faculty we'll bring in that will be participating in patient care at various hospitals and community pharmacy settings."

Communication between doctors and pharmacists is often minimal. The process in which one calls in the prescription, the other fills it and then hands it off to the patient, is simply protocol.

"Sometimes I feel like the patient is just stuck in the middle," said Michael Kelley, doctor of osteopathic medicine. "I think the patient would benefit through better communication between doctors and pharmacists."

Exposure to each other's respective fields, such as on-site visits to offices and labs or just a sit-down dialogue between professionals, could assist health providers to better understand one another, Kelley said.

Interdisciplinary education

The idea of a well-rounded curriculum is to provide common ground for the future health care professionals and teach them effective communication to enhance patient care, Allen said.

NEOUCOM plans to integrate the College of Pharmacy students into its annual White Coat Ceremony scheduled for late August.

Through the combined white coat event, Allen expects to convey to students that their education is not about them as individuals anymore, but about the patient.

A patient depends on doctors and pharmacists for his or her health and well-being, Kelley said.

Many patients ask their doctors about various medications and herbal remedies, but doctors may not be aware of all the options.

"There are so many new drugs, it's hard for doctors to keep up," Hostler said.

The colleges of medicine and pharmacy requires students to participate in a Pharmacotherapeutics and Practice of Pharmacy sequence in which they interact with individuals who are trained to portray an illness or medical condition to students.

Specialty and opportunity

NEOUCOP's curriculum includes extensive laboratory work to complement patient care training. Doctor of Pharmacy students will learn compounding, which is making drugs from scratch.

The college requires students to participate in eight rotations before they are eligible to graduate. In this stage of education, students will gain real-life experience at various pharmacies, hospitals, and laboratories.

The Bureau of Labor Statistics reported employment of pharmacists is expected to grow through 2014 because of the increasing demand for pharmaceuticals from a growing elderly population.

"The job outlook is phenomenal, I mean the shortage of pharmacists is one of the reasons why we're here," Allen said. "So if students come in our program and graduate, they're going to be able to pick and choose job offers."

Source

Filling a need: More area pharmacists wanted soon

Aging population fuels demand for more drugs

As Americans age, they will need their prescription drugs. But will there be enough pharmacists to help them? The U.S. Department of Labor predicts that employment of pharmacists is expected to grow faster than the average for all occupations through 2014 and that the increasing numbers of middle-aged and elderly people — who use more prescription drugs than younger people — will continue to spur demand for pharmacists.

Pharmacist Jim Ray works on filling a prescription Wednesday for a Unity Hospice patient inside the main pharmacy at St. Vincent Hospital in Green Bay. Evan Siegle/Press-Gazette

The National Association for Chain Drug Stores — which had 36,231 members in 2006 — said there were 4,044 open pharmacy positions in July 2006. The association said 136,773 community pharmacists were employed in 2004 and 147,378 will be needed by 2010.

Locally, pharmacist staffing remains stable. However, those in charge of hiring pharmacists know it will be a challenge in the future as baby boomers retire and more prescriptions need filling.

Tiffani Bruce, a spokeswoman for Walgreens, which has four pharmacies in Green Bay, one each in De Pere, Ashwaubenon and Howard and one is planned for Bellevue — said there isn't a significant shortage of pharmacists in the area, but there is a need for more.

Some pharmacists are looking at retirement and others at taking leaves of absence, she said.

"We've been heavily recruiting," she said, "and we continue to do so."

In fact, she said, the chain is offering "pretty nice bonuses" for pharmacists to work in the Green Bay, Appleton and Oshkosh areas.

"We want to make sure we have plenty of coverage in our pharmacies at all times," she said.

Also in the works are plans to have another 24-hour pharmacy in the Green Bay area, she said. It currently has one at 1401 E. Mason St.

Walgreens offers overnight pharmacists a schedule of seven nights on and seven nights off.

"For some, that's attractive," she said.

Walgreens, she said, opens a new store every 19 hours in its quest to increase the number of stores from 5,611 as of Thursday to 7,000 by 2010.

That can't happen if they don't have the pharmacists, she said.

Little turnover

St. Vincent Hospital, Green Bay, has very little turnover in its pharmacist staff of 21, 15 of whom are full time employees, said Jean Marsch, director of human resources.

"Actually, we've been very fortunate," she said. "We've not had trouble filling positions."

But that could change.

"If we do have an opening, that could be one of our more difficult positions to fill," she said.

St. Vincent's pharmacy is open all the time. Satellite pharmacies by its pediatrics, oncology and intensive care units are open weekdays so doctors and nurses can easily confer with pharmacists while making their rounds. Pharmacists, she said, work with nurses and doctors as integral parts of health-care teams.

"They have the deep knowledge of the medications needed. When there are questions, they are the experts and you have to recognize that," she said.

When hiring pharmacists, she said, the needs of the hospital and pharmacists must be considered.

For instance, someone must work the overnight hours. That isn't always a popular shift.

"It's important to find people who like the night shift," Marsch said. "Some people do."

The hospital also has full- and part-time options, which help it meet individuals' scheduling needs.

"That seems to be a nice balance we can strike because some companies aren't able to do that."

Stable staff

Trent Zeitler, pharmacist and partner at Streu's Pharmacy, an independent pharmacy, 635 Main St., Green Bay, said his business has had a stable group of six full-time pharmacists and three who work several hours per week for the past several years.

He anticipates, however, that in the next five years, the pharmacy will need an additional two pharmacists as a result of increased business from aging baby boomers and increased number of medicines now used.

Zeitler said the pharmacy participates with the University of Wisconsin School of Pharmacy in a clinical program in which students work there for eight-week stints.

"They serve as pharmacists, and while they're here, they really see what it is like."

Zeitler anticipates when the time comes to hire a pharmacist, they will likely try to recruit from someone in that program.

"You get to know someone pretty well over that eight-week period of time," he said.

Zeitler said the pharmacy is considering entering a year-long residency program with the UW School of Pharmacy, which has indicated in the past that Streu's would be a good place to start such a program.

"We just need to follow up to find out what it would take to do that," he said.

Source

Stretched too thin

Expanded health care faces critical shortage of doctors, nurses

California's efforts to expand health care to all residents have drawn sharp warnings from the medical community that the increased demand for services will overrun a system already stretched dangerously thin.

The state is already grappling with a critical shortage of doctors, nurses and other health workers, and experts say any plans to expand coverage must also include programs to boost recruitment, training and retention.

"We graduate about 6,000 nurses a year in the schools in California," said Jim Lott, executive vice president of the Hospital Association of Southern California, which represents 190 medical centers. "We need to literally double that amount to begin to supply the needs we have currently.

"And we have shortages in other areas, too, like physical therapy, laboratory technicians, respiratory therapists, pharmacists and pharmacy technicians.

"It's creating a huge void, and in some cases, the problem is not being able to provide the care we are asked to provide."

California hospitals already have about 14,000 vacancies for registered nurses - about 35 openings at each hospital. That shortage is expected to grow to nearly 50,000 by 2010.

The Los Angeles area has the greatest nurse shortage - about 10,000 - which is expected to double over the next two decades, according to a recent report by the Center for California Health Workforce Studies at the University of California, San Francisco.

The problem is exacerbated, experts say, because people without medical insurance often suffer from chronic illnesses, such as hypertension and diabetes.

"These are people who have many medical needs," said Dr. Neil Parker, senior associate dean for student affairs and graduate medical education at the David Geffen School of Medicine at the University of California, Los Angeles.

"That will drive up demand, and therefore your work force is going to be impacted even more. It will worsen the nursing crisis, worsen the looming physician shortage and accentuate the pharmacist shortages."

Solutions sought

Sabrina Lockhart, a spokeswoman for Gov. Arnold Schwarzenegger, said the governor is aware of the shortages and has been trying to resolve it.

Among his solutions is a $90 million California Nurse Education Initiative unveiled in 2005 to help colleges expand nursing education.

"It really took a multi-prong approach in addressing nursing shortages by expanding capacity, by not only training more nurses, but helping to keep them in the field," Lockhart said.

"And it created incentives for nurses to be part of the education process to help bring on new nurses. It's really about recruitment and retention."

Since Schwarzenegger took office in 2003, the Office of Statewide Health Planning and Development has awarded more than $6 million for medical professional training in areas where shortages are most acute.

Dr. Anmol S. Mahal, president of the California Medical Association that represents 35,000 doctors, said the governor's plan for expanded health care does not adequately address staffing, but he is hopeful changes will be made.

"This is just a proposal," Mahal said. "And he's really open to suggestions. I think the conversation on what needs to be done is just beginning, and it's going to be an ongoing conversation."

In addition to Schwarzenegger's, health care proposals have been offered by Assembly Speaker Fabian Nuñez, D-Los Angeles, Senate President Pro Tem Don Perata, D-Oakland, Senate Health Committee chairwoman Sen. Sheila Kuehl, D-Los Angeles, and Republican lawmakers.

Plans differ

The governor's plan to offer health care to all Californians would impose new charges on doctors, hospitals and employers to expand coverage to an estimated 6.5 million uninsured residents.

The plans proposed by Nuñez and Perata focus on covering working Californians, rather than all residents, and would impose no fees on employers who don't provide employee coverage.

Kuehl's plan calls for a single-payer universal system into which all Californians would pay. They would receive coverage through a new government agency.

Charles Idelson, spokesman for the 75,000-member California Nurses Association, said the association supports Kuehl's plan because it would not exacerbate the nursing shortage.

"None of the other proposals are genuinely universal, and in some ways (they) may make the present mess even worse," Idelson said. "If you had a real universal health system that did encourage preventative care, then you would end up with fewer people in hospitals."

Dr. Ralph DiLibero, president of the 5,000-member Los Angeles County Medical Association, said any plan that is approved must boost medical staff.

DiLibero said schools lack the capacity and funding to train enough students, many students cannot afford the state's high costs of living, and a growing number of foreign-born medical professionals are returning home with U.S. educations.

"We, in California, have never trained enough physicians for our own needs," Mahal said. "We have been net importers of physicians from other states and from the rest of the world. In the past, that import was easy to sustain because we have the California lifestyle and the great weather to attract people.

"Unfortunately, it's not working as well now. California has some disadvantages. Physician reimbursements are lower, and physician incomes are lower in California than (in) other parts of the country. When combined with the high cost of real estate, it's a major deterrent to young physicians who come out of training with large medical school debts."

New schools needed

California is the most populous state in the nation, yet it ranks 39th in the nation in the number of medical students per capita at 16 medical students per 100,000 people.

There are 10 schools in California that are recognized by the state Medical Board as offering medical education. They admit an average of 1,340 first-year students annually and maintain an average annual enrollment of about 5,500 students.

But because of high teacher-student ratios, crowded facilities and other factors, there currently are far more people trying to get into medical and nursing schools than slots available.

"The waiting lists for students who want to go into nursing programs can be anywhere from six to 18 months long," Lott said.

UCLA has estimated that the growing pressures mean it needs to increase the number of physicians it trains by 30 percent in the years ahead.

"We need to increase the size of our schools for those that can increase," said UCLA's Parker. "And where we don't have the capacity in our current structures, we'll have to build more nursing schools, more medical schools and more pharmacy schools."

Source

Pharmacist shortage a bitter pill to swallow

By Myrtle Ryan & Melanie Peters

The long wait in queues for medication at public hospitals is a bitter pill to swallow for thousands of people, but there appears to be no short-term solution.

At some state hospitals the sick, the elderly and those on chronic medication can wait up to four days to have their medication dispensed, while hospital authorities struggle to fill vacant pharmaceutical posts.

The Western Cape appears to be better off than the other provinces, with around 50 of the 328 posts not filled. This compares with a shortage of 1 254 pharmacists in KwaZulu-Natal out of a total of 1 592 posts.

Miranda Anthony, spokesperson for the provincial department of health, said there were shortages throughout the country. "The main reason is the salary structure in the public service, which is not competitive with the private sector. This (sector) has grown in recent years and absorbed the majority of pharmacists."

This led to long queues in hospitals and frustrated patients. There was also a shortage of experienced pharmacists to train interns coming through the system.

The head of Pharmaceutical Services in KwaZulu-Natal's Department of Health, Cyril Tshabalala, said there were 1 254 pharmacy posts vacant in the province, but that this figure should be seen in context. Previously there had been 770 posts, but in 2006 it was decided to double the number of posts to cope with the HIV crisis and the general demand for their services. This meant there were now 1 592 positions, of which only 338 had so far been filled.

Although hospitals in all provinces are struggling to fill pharmacy posts, there does not appear to have been a reduction in the number of new pharmacy graduates. Andy Gray, senior lecturer in the department of Therapeutic and Medicines Management at Nelson Mandela School of Medicine in Durban, said while some pharmaceutical schools had seen a reduction in the number of students, this was not a countrywide phenomenon.

Between 350 and 400 pharmacists qualify in South Africa each year, but attrition of graduates had to be taken into account, said Gray. "Some decide to leave the country before doing their year of community service and many students from neighbouring states go home to do their internship and don't enter the profession in this country."

It was difficult to say how many pharmacists remained in the country, as many were registered here while working overseas, or not practising at all. He said of the 10 824 on the register of pharmaceutical practitioners, only about 9 000 were actually working here. Of these, only 1 746 were employed in the public sector, although 80 percent of the country's population was dependent on their services.

"There's a poor distribution of pharmacists, with too few in the public sector for the number of patients they need to attend to," said Gray. The allowance paid to people with scarce skills or to those prepared to work in rural areas had made a difference in some provinces, but in others this was not the case.

"At entry level some hospitals get no applicants. The Eastern Cape repeatedly advertises posts, but has few takers," said Gray.

Barbara Raftesath, president of the SA Association of Hospital and Institutional Pharmacists, said it had always been difficult to get healthcare professionals to work in the rural areas, and the Free State had been hit particularly hard.

Trying to get a precise breakdown of the salary differences between the private and the public sector had also proved almost impossible, as these differed not only from province to province, but also at individual hospitals within the province.

"There is no uniformity between private hospitals," said Raftesath. She pointed out that at Level 8 (an entry grade post) the public sector received very few applicants. At higher levels, where salaries were more on a par with the private sector, positions were easier to fill.

The department of public services is understood to be restructuring health workers' salaries in the public sector to attract and retain more health workers. No timeframe has been given as to when this will come into effect.

Aisha Suleman, a research pharmacist attached to the Reproductive Health Research Unit (a University of the Witwatersrand structure), cited salary discrepancies as the major reason for the shortage of public service pharmacists.

"The newly qualified community service pharmacists are leaving the public sector for the private sector in droves," said Suleman.

"The public sector is offering them about R130 000 a year and the private sector, such as Clicks, about R200 000."

Source