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Outsider: Time to stop joking around

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Outsider: Time to stop joking around

Have you heard the one about the pharmacist who was worked to the bone delivering free services? Outsider has – and he thinks it’s no laughing matter

A pharmacist, a doctor, and a duck walk into a bar. The doctor says: “I’ll have a beer.” The pharmacist says: “I’ll have a glass of wine.” The duck says: “Just put it on my bill!”

The bartender looks at the duck and says: “You’ve got some nerve walking in here with those two. The last time they prescribed me something, I was out cold for a week!”

After last month’s foray into artificial intelligence (AI) and large language models (LLM) I found I just couldn’t stop myself, which is how I’ve ended up down a rabbit hole of trying to get a LLM to make me English, Irish and Scots jokes about pharmacy.  

It wasn’t very successful. When I bemoaned the lack of verbatim record keeping for pharmacist-patient interventions previously, nothing compares to the scarcity of high quality – or just vaguely humorous – jokes about pharmacy and pharmacists.

In fact, the opening gambit above only came out as good as it did because I modified the prompt and put a duck in there. It was this tweak that finally resulted in some form of a joke, even though the only bit that works is the bit about the duck and its bill.

The pharmacist-doctor thing is mere side-dressing and could be swapped out for any profession, even that of being an Englishman.

Why, then am I back with AI, two months in a row, you ask? I didn’t mean to be. Certainly, I’d love to devote words and inches to remarkable new developments in the contractual negotiations, or some positive news about making political headway in a challenging time but… well, there is nothing to say that has not already been said.

Yes, a new report, albeit it from a blast from the past – Lord Darzi – has come out and described how pharmacy could really save the NHS again.  

At least I think that’s what the headline on Community Pharmacy England’s website said. Across the 163 pages of the report, pharmacy features in four paragraphs, or just under a page.

Taking up space on that singular page is a graph claiming to show 1,200 pharmacies have closed since 2017, featuring a line starting at 11,949 and ending at 11,414. We can’t even get accurate press about or own demise correct.

Why did the pharmacist break up with the thermometer? Because they were tired of dealing with someone who always had to be right and was way too temperamental!

That’s a terrible joke there from the AI, which would be a bit too close to the bone if it was phrased the other way around. For pharmacists are inculcated into following rules and process.

They are stymied by historic precedents and a culture that reveres conservatism paired with a tried and trusted business model of marginal gains built on volume and market share. That traditional outlook doesn’t serve well when margin is hard to find and volume is curtailed at source.

But look around and you will find examples of innovators who are breaking fee of the constraints of the past. Offering bespoke services to their communities, such as a tailored weight loss support, with modern technology the integrates with peoples’ actual lifestyles.

And charging for it at a price that reflects their expertise. Overcoming that hurdle of fear that no-one will pay with a confidence that they will; and knowing they lose nothing if they don’t because the alternative is giving it away for free.

It’s clear that there is a place where community pharmacies can thrive and be successful. There are plenty of pharmacies that are doing that right now.

They are succeeding in affluent areas and they are succeeding in areas of inequality. There is no doubt that the market is significantly different than 20 years ago, but there is still a place for community pharmacy.

Why did the pharmacist go broke?

Because he kept giving away free advice and couldn’t figure out how to charge for it!

If this was ever to become a series of AI articles, or just AI generated jokes, then this ended it. For where can you go from here?

After all, AI is just a probability engine and the funniest thing about pharmacy is that it doesn’t know how to monetise itself. How to value itself. How to even recognise it has value.

That an algorithm can give such stark relief to the fundamental flaw in our current service model is neither shocking nor surprising.

It’s the only answer it can give, because it is trained on existing knowledge, and the sector has been saying the same thing out loud for decades. 

Therefore, when you train the AI on the existing knowledge (the internet), the knowledge says one thing: Charge for your services.

Outsider is a community pharmacy commentator

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