社區藥局之經營管理: 專業面、商業面、競合面的觀點

Operation model of the community pharmacy: analysis from the approach of professionalism, commercialism, and co-copetition.

陳佩琪(Pei-Chi CHEN)

指導教授 ： 鄭慧文

臺北醫學大學/藥學院/藥學系(碩博士班)/碩士(2013年)

https://doi.org/10.6831/TMU.2013.00058

摘要

在台灣及先進國家,社區藥師及社區藥局日益受到重視的趨勢是不可抵擋的。 相較於其他醫療機構,社區藥局更加貼近民眾日常生活,為基層醫療不可或缺的 重要組成。社區藥師身為醫療團隊的成員,可藉由社區藥局提供醫療保健相關服 務,從「專業藥事服務功能」的出發,延伸出降低用藥疏失、提供安全有效商品、 配合政策提供慢性病照護等多元化服務。
由於社區藥局業務範圍涵蓋藥品及非藥品的販賣銷售服務,對民眾生命安全 影響甚鉅,故屬於法規高度管制的特殊產業。醫院藥局評鑑制度近年來也導入至 社區藥局,藉由評鑑相對地提高了社區藥局的經營門檻。社區藥局除了要因應醫 藥衛生法規的管制,還面臨了市場開放的跨界競爭。連鎖經營體系(藥妝及藥商) 的加入,大企業、製造商、供應商等跨足連鎖藥局的經營,使得社區藥局產業成 了競爭激烈的紅海市場。置身於商業戰場的社區藥師,除了要俱備藥學專業,在 日常運作上還必須考量財務風險及管理挑戰。因此經營管理社區藥局如何在「藥 學專業」及「商業操作」兩者之間取得共識,是值得討論的議題。
本研究核心為「社區藥師經營管理社區藥局時,如何在求得專業與商業雙贏 的可能性」,以台北市全民健保特約藥局(社區藥局)的經營管理實況為研究基礎 點,深度訪談產業鏈組成份子以進行利害關係人分析(stakeholders analysis),並 對社區藥局進行實地個案觀察以近距離記錄社區藥師的實際工作,以瞭解社區藥 的經營管理現況及未來發展趨勢,並對照文獻以理解台灣與先進國家的經營差異。 本研究屬性為質化研究之「探索性研究」,從三個面向對社區藥局分析有關的影響: (1)專業面:藥事照護、教育訓練、醫療團隊;(2)商業面:產業定位、市場開放、財務支持;(3)競合面:政府政策、專業形象之建構、文化與社會規範。 分析顯示,一般民眾及醫療專業人員對於社區藥局所能提供的專業藥事照護 有所期望,然而社區藥局產業整體競爭如此激烈,忽略了本質上的藥學專業,一 味地撥弄商業操作,導致社區藥師面臨了「形象商業化」和「功能模糊化」的窘 境,連帶使得各界對社區藥師的觀感不佳,也忽略了社區藥局在基層醫療網所能
發揮的醫療保健功能。
有鑑於此,本研究對社區藥局的經營管理提出建議如下:
一、專業面:社區藥師需強化藥事照護服務功能,並加強與醫療團隊的溝通及合
作,以建構社區藥師專業形象。
二、商業面:社區藥局需導入及應用資訊科技,以輔助藥師專業服務及藥局商業
操作能夠順利進行。
三、競合面:社區藥師需強化藥學專業養成的藥學倫理觀,而主管機關之政策法令務求落實、並加強取締不合格的藥局,方能建立公平競爭的營業環境。

關鍵字

社區藥局 ； 藥事照護 ； 藥事服務 ； 利害關係人分析 ； 連鎖經營

並列摘要

The community pharmacists and community pharmacies are playing an increasing important role in Taiwan and other developed countries. Compared to other branches of the pharmacy profession, community pharmacies are an important part of primary care that provides the basic daily needs to the people in the local area. The service involves a registered pharmacist to provide the professional service for the community, such as minimizing medication error, offering safe and effective products, providing care to patients with chronic disease accordingly to the government regulations etc.
One of the main functions that community pharmacies provide is to sale pharmaceutical and non‐pharmaceutical products. It has great implications on the safety of the general public. Hence community pharmacies are a specialized industry closely regulated by the law. Hospital pharmacy accreditation system has been introduced to community pharmacies in recent years. It has raised the standards of operating community pharmacies. Not only do community pharmacies have to comply to the newly implemented pharmaceutical and health regulations, they also have to face the competitions from other industries in the open market. With chain stores (cosmeceutical shops and drugstores) entering the market, and enterprises and manufacturers stepping into management of chain pharmacy business, the industry has become a highly competitive red ocean market. Standing on the business battlefield, community pharmacists not only have to be equipped with pharmaceutical profession but also have to handle financial risks and management challenges on daily basis. Hence how to acquire a balance point between pharmaceutical profession and business operation in running and managing community pharmacies is an interesting topic worth further investigation.
This study focuses on the possibility of community pharmacists excelling in both the professionalism and business in operating community pharmacies. It is based on the actual business management of the community pharmacies in Taipei City. By in‐depth interview with stakeholders and participant observation case studies, this study closely records and analyzes the information, investigates the current operation management and future development trends of community pharmacies, and compares the differences in business operation between Taiwan and other developed countries by literature review. This is a qualitative exploratory research which investigates three areas that have influences on community pharmacies:
(1) Professionalism: pharmacy care, educational training, medical team;(2) Business: industry positioning, open markets, financial support;
(3) Co‐opetition: government policy, creating a professional image, social and cultural norms.
According to the analysis, medical professionals and the general public have high expectations for the professional pharmacy care provided by the community pharmacies, yet the essential pharmacy profession has been neglected and business operation has become the main focus due to the competitions in the community pharmacy industry. This has led community pharmacists to the predicaments of “publicity and commercialization” and “indistinguishable functionality” and the bad reputation towards community pharmacists from the public. The medical and health function supposedly provided by the community pharmacies in the primary care network has also been neglected. Hence, this study provides the following suggestions to the operation and the management of community pharmacies:
I. Professionalism: community pharmacists need to enhance pharmacy care services and reinforce communication and collaboration with the medical team to create the professional image of community pharmacists.
II. Business: community pharmacies need to introduce and apply information technologies to assist professional pharmacy services and pharmacy business operations.
III. Co‐opetition: community pharmacists need to reinforce codes of ethics in pharmacy. To ensure fair competition in the business environment, governmental regulations need be enforced and pharmacies that do not meet the standards should be penalized.

並列關鍵字

Community Pharmacy ； Pharmaceutical Care ； Pharmaceutical Service ； Stakeholders Analysis ； Chain Store

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