On the other day, the Pharmacy Council of India president Dr. B. Suresh announced for - reaching decisions of PCI to revolutionise the pharmacy profession in India - (Pharmabiz special issue IPC 2009, page 27-29). He has mentioned in the above references that PCI is going to introduce a 2-year bridge course for working pharmacists (D. Pharm holders) to award the degree in pharmacy (B. Pharm). Also he remarked that PCI has spoken to MCI and the later has agreed to include in their rules to appoint graduate pharmacists in medical stores of big hospitals and in drug information centres. The Rs 100 crore under 11th five year Plan, the PCI got from Central govt, will be utilised to start drug information centres, he announced. Another important decision of PCI is to legally permit pharmacists in community pharmacies to charge a profession fee on each prescription, he/she dispense.
Simply superb, if implemented, all these decisions will take Indian pharmacy profession many step forward. All well meaning pharmacists will support these decisions. Can we expect any reservation from any quarter of the profession for these proposals?
Reservation
If at all any reservation is expressed on the above decisions it could be from community pharmacies. We should take them along with us for an inclusive growth. Though PCI has announced upgradation of qualification of working pharmacists it has not announced abolition of D. Pharm course. Since already surplus, unemployed D. Pharm holders are available, pharma trade need not worry about its requirement of pharmacists.
Moreover, it is immediately not necessary, to have pharmacy graduates in all the community pharmacies which has its own unique problems and circumstances. We must understand and accommodate the views of trade associations that, appointing pharmacy graduates and giving higher salary may not be viable for majority of the community pharmacies. Many pharmacies are not getting adequate business due to many reasons, the main among them is dispensing of medicines by prescribing doctors themselves in their clinics. Hence, pharmacies are getting few prescriptions a day. Doctors should be allowed to stock only emergency medicines in their clinic. If excess of drugs are stocked in their clinics, it should be brought to the knowledge of commercial (sales) tax department - as happened in Kerala - who will take action against sale without bill, tax evasion etc.
In developed countries, including Gulf countries, where this author has worked for a decade, such a ban is enforced well by Drugs Control Dept by raids and inspections. This rule is relaxed, if no pharmacy (medical shop) is available within a radius of 5 kms from the clinic, if one is opened eventually, the clinic should stop stocking drugs.
In India, when Drugs Control Dept started taking action on this front in some states, the clinics and hospitals circumvent the situation by opening pharmacies in their premises by appointing pharmacists and taking retail license.
Well, so far so good however such pharmacies inside or in the front portion of a clinic cannot serve society at large, they may not get outside prescription or business and hence very few may be opened or survive. So by ignoring this new development we can implement the ban. Thus other pharmacies will get improved business.
This apart, the new decision of PCI in permitting pharmacists to collect few rupees (say Rs 2 to 5) as professional charge on each prescription he dispense, will solve the problem of giving adequate and higher salary to the pharmacists by retail pharmacies. If educated the benefits, people will not object to it. Pharmacist may get at least Rs 50 to 100 per day as his professional fee directly from the public, without any burden what so ever to the proprietors of retail pharmacies. Hence, they can appoint full time pharmacists and even graduate pharmacists if there is considerable business. Another fringe benefit is, if pharmacist is available full time in the pharmacy, few 'sales boys' without qualification now employed can be eliminated, thereby reducing the risk of wrong and inadequate dispensing practices.
Thus, let the existing community pharmacies continue their business with D. Pharm pharmacists. At the same time they should be encouraged to appoint graduate pharmacist, by introducing a scheme of accreditations or grading. Pharmacies with certain facilities like graduate pharmacists, full air-conditioning, and patient counseling area etc. should be given 'A' grade and so on. Thus a healthy competition will be developed between pharmacies to get the highest grade. Let it take its own time say up to 2020, we need not force tough decisions.
Bridge course
PCI has also announced, the condensed bridge course it proposed to conduct for working pharmacist, will be implemented from coming academic year (June 2010). The reason for condensed degree course as per PCI is as these D. Pharm holders are already working as community or hospital pharmacists they need not be burdened with unnecessary subjects (Read: Industry-oriented subjects). Only hospital and clinical oriented subjects need to be thought to them, the PCI has argued, correctly. Those who want to pursue higher education (M. Pharm) or want to go industries in future need to join in the regular B. Pharm lateral entry stream, now available. It is presumed that this existing lateral entry arrangement will not be disturbed.
PCI has appointed a committee under Dr. Dipankar Chakraborty to frame the syllabus for the proposed bridge course. Hope the above committee will complete its job well in time so as to meet the deadline of June 2010.
So far everything is fine, expect for one hitch, that as per the PCI announcement, after the 2-year proposed condensed course and 3-year existing lateral entry course the D. Pharm holders will get the same degree B. Pharm. How the PCI is going to Justify it? The name - B.Pharm - may create lot of confusion and problems in the future. Already AICTE is also controlling the B.Pharm course. It may object. Why create unnecessary dispute? Another problem is, in future, pay commissions which has to fix salary on the basis of qualification, may face or create confusions. Better to avoid all these things in the beginning itself. Name the proposed bridge course as Bachelor of Hospital Pharmacy [B.H.Pharm] or Bachelor of Pharmacy Practice (B.Pharm.Pr) or Bachelor of Clinical Pharmacy (B.C.Pharm) and forward to all Indian universities to implement, as only universities are empowered to grant degrees.
Other announcements
PCI president has also announced that any institution want to start pharmacy courses should get prior permission from the PCI. It is a welcome decision and in fact long overdue. But it is silent whether the courses include 'M Pharm' also. If prior permission is not required to start M. Pharmacy course, our great deemed universities will play havoc with pharma education as pointed out earlier. So, he should explicitly announce that even universities should obtain permission from PCI to start professional courses like M. Pharm, B. Pharm as in the case of medical degrees MD, MS and MBBS, and PCI should control M. Pharm courses also.
However, all these announcements made by PCI has pleased almost all working pharmacists. I hope all of them will be solidly behind PCI in speedy implementations of these revolutionary decisions. Under Dr. B. Suresh a history is on the cards in the annuals of pharmacy profession to be written in golden letters.
(The author is Ex. President, Indian Pharmacy Graduates Association, Madurai, Tamil Nadu)