decision time – Observer
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1 A few days ago, a group of almost eighty pharmacists signed a public manifesto warning of the gaps in the development of the Pharmaceutical Residency. Given the discreet intervention in the space of these professionals, other health areas are still significant for people, even more document – adding, among pharmacists, other support professionals and representatives of people with disease, in a very comprehensive way.
As you already have the opportunity to write in another article, the topic of specialization of pharmacists has been around for six decades, and, even with health technology on the other side of the table in this past period, its effective resolution continues to be delayed. Now, you don’t give a partial match to the Pharmaceutical Residency just because of data or geography. Should we think that the SNS is doing without differentiated human capital, formed by itself, in the last two years, when, even before the pandemic, there was already a lack of at least 250 doctors to guarantee the minimum operation of services?
two Although most subscribers are from the hospital pharmacy area, there are also pharmacists involved in primary health care – will you stop considering it if you think it is strange that the pharmacy is in health centers, like in several countries? – and in the laboratory area.
Special men must be made for these analyst pharmacists who, despite their social inability, are probably the most versatile health professionals in the determination of laboratory parameters. Its multipurpose training, due to the entire spectrum of classical and genetic chemistries, but also environmental chemistries, or even genetics – fundamental in precision care. And the validation of new analytical methods will certainly pass through them. Is it the profile of this knowledge and skills that the SNS intends to abdicate?
3 But the Pharmaceutical Residency is just part of a larger whole, the Pharmaceutical Career. The presentation of liability excuses, more than the legal issue, corresponds to an ethical-deontological position in the face of the lack of conditions for the practice of a differentiated professional act, legally established, with a direct impact on the lives of citizens. Faced with human resources, under more favorable conditions, even the best management cannot avoid the loss of efficiency of the service provided and the ability to keep up with technological innovation. The flight to the private sector, namely to the pharmaceutical industry and clinical trials, is becoming increasingly frequent. How not to find it natural to look for a better professional future?
4 Thus, the development – or lack thereof – of the Pharmaceutical Career, whose scope is limited for now to the SNS, will have an impact on other areas. The question of the full integration of other public health valences in this Career arises, at the level of Regional Health Services, Public Laboratories, or regulatory bodies in the area – the integration of the Regulatory specialty in the Career should be a natural step not mid-term. The academy itself will have a different look at the need to link research with scientific practice, it will have a knowledge of the two-way flow.
Also in the private and social sectors, Career development can be a stimulus for the functional development of the pharmaceutical activity. Private hospitalization, until now essentially focused on outpatient activities, is being faced with “growing pains” that imply the development of new pharmaceutical valences, until now very focused (competently, that is) in areas such as pharmacokinetics or a pharmacoeconomics. Likewise, the community pharmacy will have a model based on physical packaging of medicines for an approach based on the pharmacist’s knowledge of the process of using health technologies, with added value.
At the same time, due to the increasingly marked aging of the population, pharmaceutical technology in the social sector must also undergo a transformation, despite the reluctance of many to perceive a greater value of the medicine in this context. The need for management as health technologies in a more rational way, sooner or later cares about the ideas made, providing new perspectives for pharmaceutical ideas in this one.
Administration, even the issue of specialization will pose challenges to these care-providing structures: it is the Health System Center itself (ACSS) that, in the interpretation made of the legal framework of the Pharmaceutical Residency, opens the possibility of granting training suitability to establishments in the sector private and social. Will they be to someone probably the opportunity to implement Residency, giving a unique way of origin of the internship; and Career, with the recognized ones, investing in its resources?
5 We live in the times of this change in the provision of care, in which citizens must be, effectively, the center, with respect for their autonomy and individuality. As a change in the regulation of the liberal professions, namely with regard to public professional associations, challenges arise that need to be addressed. For the pharmaceutical profession, it’s time for choices. It is no longer possible to escape the need for professional knowledge projects that raise this multi-secular level in Portugal. There is certainly no need for compromises, but the essentials cannot be called into question. Will the public authorities have the courage to decide to bet on pharmacists, for the benefit of the health system? And will pharmacists have the courage to decide for themselves, for the benefit of the citizens?