- Email: [email protected]
OEO Program in New Jersey*
OED
HEALTHRIGHT
OEO program • New Jersey* In
by Anthony F. Capriotti
wish to share with you our experience on the OEO neighborhood health center scene in Mel1cer County, New Jersey. I -am not going to battle OEO concepts nor la m I going to present a neat, clear-cut formula for guaranteeing a vendor program for pharmacy in the neighborhood health centers throughout the country. I am going to-
I
• Relate factually the events in Mercer County, with the hope of providing some vital insights-relative to the establishment of health centers in other parts of the country-with the purpose of upgrading pharmaceutical services for centercity poor. • Appeal to this organization to quickly act in the dissemination of knowledge to community pharmacists in high priority situations such as the OEO neighborhood health centers. Every pharmacist should take -an interest in this key area, even before the situation arises. We in Mercer County have been wrestling with the creation of a neighborhood health center for over a year. We have come to realize that OEO does have justification in the promotion of neighborhood health centers and OEO has learned that community pharmacy's involvement in its program has merit and will contribute significantly to a vastly improved health program. I practice pharma'c y in the heart of one of ,t he poorest neighborhoods of Mercer County. I was personally alarmed when first alerted to the onsite pharmacy in a proposed health center for Trenton. Since March 1967, I have been close to this challenge and shall re-
• Presented before APhA's Academy of General Practice of Pharmacy in Miami Beach, May 6.
main so until there is clearly pointed out a definite reason for my exclusion in the delivery of pharmaceutical services in my neighborhood. If you have any doubts that -a concentrated, localized, major attack on poverty is not needed, let me assure you th'a t in my community it is the most urgent need. Administering to the dirty ills of society-such as drug addiction, drug abuse, prostitution, venereal disease, tuberculosis, high infant-mOl1tality rate, bad housing and all the many crushing socio-medical and economic ills-has been our constant daily challenge and commitment. That is why I am for OEO or any other agency that will help the disadvantaged. Out in suburbia you might never know the streets of our decaying cities. I do not care who funds a program to help the center-city, be it OEO or HEW, but help we must get. The first neighborhood health center proposal was hastily drafted and submitted by United Progress Inc. (UPI), the community action group in Trenton, in March 1967. The OEO did not approve the proposal because there was no operating agency, no site piCked out and it did not provide a realistic 'b udget. I point this out to illustrate the lack of preparation and the total exdusion of major health provider groups in its development. Since there was no medical school or other sponsoring agency in Trenton, the medical society was briefly told of its contents. They, in turn, called the dentists and the pharmacists beoause they needed help in opposing it. After many meetings, the three health society groups could not arrive at any agreement with UPI in formulating a realistic proposal for a center. It was ,t hen that Trenton Mayor Armenti wisely established a task force to resolve the issue. The first
meeting took place July 12, 1967, at City Hall. The group consisted of the medical society, the dental society, representatives of the three major hospitals,the visiting nurses, the pharmaceutical society, civic groups, industry, labor, business 'a nd representatives of the poor themselves. The mayor appointed Russell Brown, a highly respected industrialist well-versed in hospital activities, to chair the committee. It was the first time that such a group was formed to discuss and plan for the future health needs of the poor in Tr'e nton and it ,also was the first time that pharmacy was represented on any policy-making committee dealing with health needs of the city. Allied with the physicians, our representative drew adverse publicity when he objected to centrolized medical and pharmaceutical practice within the center. When he was hospitalized, I was assigned to replace him because of my personal involvement in the target area. Since I agreed that a crash program was needed to help the poor, at my first task force meeting I stressed that we needed a health center and, for the first time, deviated from the adamant stand that the physicians had taken, stating that our society would cooperate with the task force to find a solution using innovation, fair play and providing rthe intended recipient with a program which would preserve and insure his dignity. I also urged them to keep the neighborhood intact, stressing that pharmacy had remained in the poverty areas and that pharmacists were generally approachable. This was our first step in breaking down the barriers of suspicion that the poor of the community had towards the solidified medical groups. After that first meeting, I made it a point to discuss our ,s tand personally with the six representatives of the Vol. NS8, No. 10, October 1968
541
tronage and friendship. We want you and we need you and believe that you need us.
Anthony F. Capriotti is a community pharmacist in Trenton, New Jersey. He graduated from the Philadelphia College of Pharmacy and Science in 1950. Capriotti is a past president of the Society of .Mercer County Pharmacists, chairman of the county committee on 0 EO and chairman of the New Jersey state committee on OEO and government drug programs.
poor. They stated that they didn't w ant the world but they were just tired of clink-type operations and saw in the neighborhood health center a place they could call their own that would give them a chance to better themselves. When asked whether they would prefer a choice of pharmacy, the answer was yes. Only a few of the 1517 .p harmacists in the area seemed to neglect their needs. We agreed that there were some personality problems, but at least we had remained to provide medication and counseling, and they ha,d exposure to a professional of the health team. Whenever our classification with the physicians came up, I stressed our unique and singular difference. The task force opened up new lines of communication, a stumbling block in the past. The over-riding problem for our OEO 'c ommittee was the lack of information on OEO, its objectives, its methods a nd its guidelines in the establishment of health centers. My goal w as to press for a neighborhood health center but with pharmaceutical services provided through the target ar,e a's community pharmacists. When the OEO consultant arrived at a task force meeting, we showed him a bulletin in which Joseph T. English, MD, OEO assistant director for health affairs, was quoted as stating that "under certain situations a community pharmacist would be able to participate in a vendor program." The consultant said he would speak with the community aotion health program peopl:e in Washington and let us know what might be possible. His letter arrived two days later and basically said that if we would draft a pharmacy proposal with such considerations as prompt service, accessibility, continuity of prescription care, generic pres.c ribing and low cost, we could then proceed to resolve the pharmacy issue. 542
Our committee met with Morris Blatman who discussed a modified vendor program in Philadelphia. The following two days, we quickly drafted a proposal covering all points enumerated by the consultant, and more. We added such innovations as consultation areas in pharmacies, participation of pharmacists in periodic reviews, daily reports It o the center and utilizing the community pharmacist as an arm of the center and his phar1m acy as a satellite of the center. They were made aware of some major concessions they would make and of the upgrading of their pharmaceutical services. The proposal was unanimously approved at a special meeting of the society and target area pharmacists. Then, the New Jersey Pharmaceutical Association went to work apprising senators and all of our congressional delegates of the OEO plan, :a nd letters and copies of our proposal went out to all county leaders in New Jersey. Meanwhile, I continued our appeal to the representatives of the poor stressing our continued involvement and the fervent hope of remaining with them. We sought out and favorably impressed many leaders of neighborhood civic groups, patrons and clergy. We talked to the policymakers of UPI and to the intended recipients of the neighborhood health center £acilities. The comments of these poor people ,a resi'gnincant as related to their needs. In one conversation one person told meYou say you want to help us. Then don't stereotype us. Don't talk down to us. Try to overlook some of our crudeness. Reach out and try to understand us. Serve us with some measure of dignity and then, to show that you really care, hire us. Let us ring the register, provide us with meaningful jobs, trust us and we shall certainly reward you with pa-
Journal of the AMERICAN PHARMACEUTICAL ASSOCIATION
A lot of what he said is true. I have followed some of these points and I can say that I have been compensated both financially and spiritually. I have five Negroes working for me. Over the years I have found that their work is as satisfactory as any. I cannot stress too strongly that if we are to participate in any approach to the solution of poverty in our midst we must hire the poor and take a greater interest in our poor patrons. September was spent circulating our proposal throughout pharmacy circles and submitting additions and corrections to improve patient oare and preslc ription continuity. Our committee met again with the OEO consultant and he basically approved our program. We also were successful in obtaining financial appropdaitions from the Society of Mercer County Pharmacists for use in public relationS' work. We kept in touch with the physicians and the dentists, strengthening our ties with the representatives of each group. The three hospitals as a consortium had agreed to be the sponsoring agency. The physicians, meanwhile, had formulated several proposals which had met with little support because they continued to utilize office visits and not the centralized concept of medical care. Pharmacy was included in these plans and we had no objection since they concurred with our proposal. In early October, representatives of the three 'Societies went to Washington to speak with English about the medical proposal. The visit proved that decen tralized practice was not possible within the scope of the neighborhood health center and the physicians returned to Trenton to attempt another proposal. While in Washington with this group, I briefly discussed the pharmacy proposal with English and I left a .copy of it with him. In fairness to the physicians, let me point out that all meetings were open to the pharmacists. We were a part of .their plan. However, the physicians now revamped their plan. They finally agreed to work in the center. As a part of that plan, they propos·e d that the pharmacy also be in the center. Though we approved most of their plan for better health care, we could not possibly remain within that corporation if one of the conditions was an on-site pharmacy. We must necessarily supply the pharmacy package independently. This move on our part cooled relations he tween the two professions. This was unfortunate but our survival was at stake. In October, a delegation from our
society visited Mayor Armenti of Trenton and left him a copy of our proposal. We stressed the importance of pharmacy as a focal point of the community a nd how really important a pharmacy is, especially to the poor. , In our proposal, we were confident that it was an opportunity to upgrade service and a chance to make centercity attractive again. He baoked us 100 percent and pledged his support. In November, the OEO consultant met individually with various groups , of the task force. He approved the pharmacy proposal which now had grown to eight pages. We had made steady progress and, in his approval, he mentioned that the neighborhood poor would decide if this is what they wanted. It was on November 15, 1967, that the long-awaited action on our proposal by ,t he task force camethe .p roposal was unanimously approved. It was now obvious that the task force had aided our ,c ause. The members of the task force exchanged ideas, argued, discussed mutual problems, forwarded each other persuasive and educational material, and established friendships and lines ofcommunieation with other members of the community and the health team. For me it was an experience in public relations and community aotion which I will never forget. For the community it amounted to an experience upon which would be built a foundation for promoting large-scale, coordinated community health planning. Throughout all of our task foroe deliberations, pharmacy received very little pubHcity in the local press. This was done purposely to avoid unnecessary antagonism from any group. These signifioant points of our innovative proposal helped to prove pharnnacy was I1eady to act positively-
I
• Provision of consultation areas. • Utilization of 'the neighborhood health center as a depot for stocking generic drugs. • The daily reports to the center by the pharmacy director and reviewing patient record cards with the purpose of improving patient care and private consultation with the center physicians from time to time. • Consultation with the pharmacy director and community pharmacists as an integral part of patient care. • Monthly seminars for participating pharmacists of the neighborhood health center program with the pharmacy director and the medical staff at the center.
I would not want to mislead you into thinking that Mercer County~s program is without flaws. Through the alienation of the medical society and its insistence on one-third representation on the governing board, and
because of a running battle between the neighborhood councils of the poor and medical society on the ·m ethod of selecting the medioal director, we were unable to secure a position on the governing board. We, therefore, have no ties to the operating agency except through the strength of our proposal and the neighborhood people. Then on April 3, 1968, came our greatest setback. Hours before the UPI board would vote giving final approval of their complete neighborhood health center proposal, a staff writer phoned explaining that the pharmacy proposal had been drastically modified contrary to the recommendations of the task force. I called the OEO consultant and he, too, stated that some on-site pharmacy dispensing had to be included. It completely surpris·e d me. That ,evening, over our objections, the UPI board, in their understandable oompulsion to secure a neighborhood health center for Trenton, approved the entire proposal. The next day was spent calling key members of the now disbanded task force-the chairman, secretary, medical society representatives, hospitals and the poor themselves. They all backed the task f.orce action. When the UPI saw the massive resistance to any major change, it reinstated pharmacy's original proposal. However, there are still discrepancies in areas of budget and personnel. This proves that an absolutely continuing relationship must be maintained from the initial planning stage for a health center with a community action group to the ultimate end when a neighborhood health center is functioning. Even then, we must constantly maintain liaison with its governing hoard-possibly this oan be done only IOn a contractual basis. I don't know. However, it is certain that ,t he community action groups are of vital concern to us, ,a nd we mustin ,e very county in the ,o ountry-estabHsh a De gular liaison rela ti{)nship whether a problem exists at the moment or not. The liaison represent ative should be capable of give and take, without predisposition for or against any person or set of individuals or facts. Whatever happens in the political arena, we are optimistic of pharmacy's role in the cities. If it is necessary, we must seek alternatives to OEO funding, utilizing private, industrial, community and other gOViernment agenWe must think in cies' funds. terms of future total health care and what part pharmacy will play. My conviction is that nowhere can the pharmaceutical services be better delivered than within the free enterprise system. •
COMPENDIUM OF PHARMACEUTICALS AND SPECIALTIES
This 1,000 page reference book, published b y the C anadian Pharmaceutical Association, briefly and factually describes pharmaceutical products in oomprehensive monographs - dosage format, indications, administration, contraindications, side actions, precautions, supply. Monographs are in alphabetical sequence. Cross-indexing in coloured pages includes: Therapeutic Index and Prescriber's Guide, Manufacturers' Index, Nonproprietary Names Index, and Trade Names Index. Also provided a re 'conversion tables, children's dosages, and abbreviations and information concerning Canada's drug legislation. Price per copy $12.50 Payment in full must accompany each order.
Canadian Pharmaceutical Association, 175 College Street, Toronto 28, Ontario, Canada. We
enclose herewi,t h payment of for copies of Compendium of Pharmaceuticals and Specialties, Fourth Edition. Please rush to:
$
(Print name and address)
Vol. NS8, No. 10, October 1968
543
HEALTHRIGHT
OEO program • New Jersey* In
by Anthony F. Capriotti
wish to share with you our experience on the OEO neighborhood health center scene in Mel1cer County, New Jersey. I -am not going to battle OEO concepts nor la m I going to present a neat, clear-cut formula for guaranteeing a vendor program for pharmacy in the neighborhood health centers throughout the country. I am going to-
I
• Relate factually the events in Mercer County, with the hope of providing some vital insights-relative to the establishment of health centers in other parts of the country-with the purpose of upgrading pharmaceutical services for centercity poor. • Appeal to this organization to quickly act in the dissemination of knowledge to community pharmacists in high priority situations such as the OEO neighborhood health centers. Every pharmacist should take -an interest in this key area, even before the situation arises. We in Mercer County have been wrestling with the creation of a neighborhood health center for over a year. We have come to realize that OEO does have justification in the promotion of neighborhood health centers and OEO has learned that community pharmacy's involvement in its program has merit and will contribute significantly to a vastly improved health program. I practice pharma'c y in the heart of one of ,t he poorest neighborhoods of Mercer County. I was personally alarmed when first alerted to the onsite pharmacy in a proposed health center for Trenton. Since March 1967, I have been close to this challenge and shall re-
• Presented before APhA's Academy of General Practice of Pharmacy in Miami Beach, May 6.
main so until there is clearly pointed out a definite reason for my exclusion in the delivery of pharmaceutical services in my neighborhood. If you have any doubts that -a concentrated, localized, major attack on poverty is not needed, let me assure you th'a t in my community it is the most urgent need. Administering to the dirty ills of society-such as drug addiction, drug abuse, prostitution, venereal disease, tuberculosis, high infant-mOl1tality rate, bad housing and all the many crushing socio-medical and economic ills-has been our constant daily challenge and commitment. That is why I am for OEO or any other agency that will help the disadvantaged. Out in suburbia you might never know the streets of our decaying cities. I do not care who funds a program to help the center-city, be it OEO or HEW, but help we must get. The first neighborhood health center proposal was hastily drafted and submitted by United Progress Inc. (UPI), the community action group in Trenton, in March 1967. The OEO did not approve the proposal because there was no operating agency, no site piCked out and it did not provide a realistic 'b udget. I point this out to illustrate the lack of preparation and the total exdusion of major health provider groups in its development. Since there was no medical school or other sponsoring agency in Trenton, the medical society was briefly told of its contents. They, in turn, called the dentists and the pharmacists beoause they needed help in opposing it. After many meetings, the three health society groups could not arrive at any agreement with UPI in formulating a realistic proposal for a center. It was ,t hen that Trenton Mayor Armenti wisely established a task force to resolve the issue. The first
meeting took place July 12, 1967, at City Hall. The group consisted of the medical society, the dental society, representatives of the three major hospitals,the visiting nurses, the pharmaceutical society, civic groups, industry, labor, business 'a nd representatives of the poor themselves. The mayor appointed Russell Brown, a highly respected industrialist well-versed in hospital activities, to chair the committee. It was the first time that such a group was formed to discuss and plan for the future health needs of the poor in Tr'e nton and it ,also was the first time that pharmacy was represented on any policy-making committee dealing with health needs of the city. Allied with the physicians, our representative drew adverse publicity when he objected to centrolized medical and pharmaceutical practice within the center. When he was hospitalized, I was assigned to replace him because of my personal involvement in the target area. Since I agreed that a crash program was needed to help the poor, at my first task force meeting I stressed that we needed a health center and, for the first time, deviated from the adamant stand that the physicians had taken, stating that our society would cooperate with the task force to find a solution using innovation, fair play and providing rthe intended recipient with a program which would preserve and insure his dignity. I also urged them to keep the neighborhood intact, stressing that pharmacy had remained in the poverty areas and that pharmacists were generally approachable. This was our first step in breaking down the barriers of suspicion that the poor of the community had towards the solidified medical groups. After that first meeting, I made it a point to discuss our ,s tand personally with the six representatives of the Vol. NS8, No. 10, October 1968
541
tronage and friendship. We want you and we need you and believe that you need us.
Anthony F. Capriotti is a community pharmacist in Trenton, New Jersey. He graduated from the Philadelphia College of Pharmacy and Science in 1950. Capriotti is a past president of the Society of .Mercer County Pharmacists, chairman of the county committee on 0 EO and chairman of the New Jersey state committee on OEO and government drug programs.
poor. They stated that they didn't w ant the world but they were just tired of clink-type operations and saw in the neighborhood health center a place they could call their own that would give them a chance to better themselves. When asked whether they would prefer a choice of pharmacy, the answer was yes. Only a few of the 1517 .p harmacists in the area seemed to neglect their needs. We agreed that there were some personality problems, but at least we had remained to provide medication and counseling, and they ha,d exposure to a professional of the health team. Whenever our classification with the physicians came up, I stressed our unique and singular difference. The task force opened up new lines of communication, a stumbling block in the past. The over-riding problem for our OEO 'c ommittee was the lack of information on OEO, its objectives, its methods a nd its guidelines in the establishment of health centers. My goal w as to press for a neighborhood health center but with pharmaceutical services provided through the target ar,e a's community pharmacists. When the OEO consultant arrived at a task force meeting, we showed him a bulletin in which Joseph T. English, MD, OEO assistant director for health affairs, was quoted as stating that "under certain situations a community pharmacist would be able to participate in a vendor program." The consultant said he would speak with the community aotion health program peopl:e in Washington and let us know what might be possible. His letter arrived two days later and basically said that if we would draft a pharmacy proposal with such considerations as prompt service, accessibility, continuity of prescription care, generic pres.c ribing and low cost, we could then proceed to resolve the pharmacy issue. 542
Our committee met with Morris Blatman who discussed a modified vendor program in Philadelphia. The following two days, we quickly drafted a proposal covering all points enumerated by the consultant, and more. We added such innovations as consultation areas in pharmacies, participation of pharmacists in periodic reviews, daily reports It o the center and utilizing the community pharmacist as an arm of the center and his phar1m acy as a satellite of the center. They were made aware of some major concessions they would make and of the upgrading of their pharmaceutical services. The proposal was unanimously approved at a special meeting of the society and target area pharmacists. Then, the New Jersey Pharmaceutical Association went to work apprising senators and all of our congressional delegates of the OEO plan, :a nd letters and copies of our proposal went out to all county leaders in New Jersey. Meanwhile, I continued our appeal to the representatives of the poor stressing our continued involvement and the fervent hope of remaining with them. We sought out and favorably impressed many leaders of neighborhood civic groups, patrons and clergy. We talked to the policymakers of UPI and to the intended recipients of the neighborhood health center £acilities. The comments of these poor people ,a resi'gnincant as related to their needs. In one conversation one person told meYou say you want to help us. Then don't stereotype us. Don't talk down to us. Try to overlook some of our crudeness. Reach out and try to understand us. Serve us with some measure of dignity and then, to show that you really care, hire us. Let us ring the register, provide us with meaningful jobs, trust us and we shall certainly reward you with pa-
Journal of the AMERICAN PHARMACEUTICAL ASSOCIATION
A lot of what he said is true. I have followed some of these points and I can say that I have been compensated both financially and spiritually. I have five Negroes working for me. Over the years I have found that their work is as satisfactory as any. I cannot stress too strongly that if we are to participate in any approach to the solution of poverty in our midst we must hire the poor and take a greater interest in our poor patrons. September was spent circulating our proposal throughout pharmacy circles and submitting additions and corrections to improve patient oare and preslc ription continuity. Our committee met again with the OEO consultant and he basically approved our program. We also were successful in obtaining financial appropdaitions from the Society of Mercer County Pharmacists for use in public relationS' work. We kept in touch with the physicians and the dentists, strengthening our ties with the representatives of each group. The three hospitals as a consortium had agreed to be the sponsoring agency. The physicians, meanwhile, had formulated several proposals which had met with little support because they continued to utilize office visits and not the centralized concept of medical care. Pharmacy was included in these plans and we had no objection since they concurred with our proposal. In early October, representatives of the three 'Societies went to Washington to speak with English about the medical proposal. The visit proved that decen tralized practice was not possible within the scope of the neighborhood health center and the physicians returned to Trenton to attempt another proposal. While in Washington with this group, I briefly discussed the pharmacy proposal with English and I left a .copy of it with him. In fairness to the physicians, let me point out that all meetings were open to the pharmacists. We were a part of .their plan. However, the physicians now revamped their plan. They finally agreed to work in the center. As a part of that plan, they propos·e d that the pharmacy also be in the center. Though we approved most of their plan for better health care, we could not possibly remain within that corporation if one of the conditions was an on-site pharmacy. We must necessarily supply the pharmacy package independently. This move on our part cooled relations he tween the two professions. This was unfortunate but our survival was at stake. In October, a delegation from our
society visited Mayor Armenti of Trenton and left him a copy of our proposal. We stressed the importance of pharmacy as a focal point of the community a nd how really important a pharmacy is, especially to the poor. , In our proposal, we were confident that it was an opportunity to upgrade service and a chance to make centercity attractive again. He baoked us 100 percent and pledged his support. In November, the OEO consultant met individually with various groups , of the task force. He approved the pharmacy proposal which now had grown to eight pages. We had made steady progress and, in his approval, he mentioned that the neighborhood poor would decide if this is what they wanted. It was on November 15, 1967, that the long-awaited action on our proposal by ,t he task force camethe .p roposal was unanimously approved. It was now obvious that the task force had aided our ,c ause. The members of the task force exchanged ideas, argued, discussed mutual problems, forwarded each other persuasive and educational material, and established friendships and lines ofcommunieation with other members of the community and the health team. For me it was an experience in public relations and community aotion which I will never forget. For the community it amounted to an experience upon which would be built a foundation for promoting large-scale, coordinated community health planning. Throughout all of our task foroe deliberations, pharmacy received very little pubHcity in the local press. This was done purposely to avoid unnecessary antagonism from any group. These signifioant points of our innovative proposal helped to prove pharnnacy was I1eady to act positively-
I
• Provision of consultation areas. • Utilization of 'the neighborhood health center as a depot for stocking generic drugs. • The daily reports to the center by the pharmacy director and reviewing patient record cards with the purpose of improving patient care and private consultation with the center physicians from time to time. • Consultation with the pharmacy director and community pharmacists as an integral part of patient care. • Monthly seminars for participating pharmacists of the neighborhood health center program with the pharmacy director and the medical staff at the center.
I would not want to mislead you into thinking that Mercer County~s program is without flaws. Through the alienation of the medical society and its insistence on one-third representation on the governing board, and
because of a running battle between the neighborhood councils of the poor and medical society on the ·m ethod of selecting the medioal director, we were unable to secure a position on the governing board. We, therefore, have no ties to the operating agency except through the strength of our proposal and the neighborhood people. Then on April 3, 1968, came our greatest setback. Hours before the UPI board would vote giving final approval of their complete neighborhood health center proposal, a staff writer phoned explaining that the pharmacy proposal had been drastically modified contrary to the recommendations of the task force. I called the OEO consultant and he, too, stated that some on-site pharmacy dispensing had to be included. It completely surpris·e d me. That ,evening, over our objections, the UPI board, in their understandable oompulsion to secure a neighborhood health center for Trenton, approved the entire proposal. The next day was spent calling key members of the now disbanded task force-the chairman, secretary, medical society representatives, hospitals and the poor themselves. They all backed the task f.orce action. When the UPI saw the massive resistance to any major change, it reinstated pharmacy's original proposal. However, there are still discrepancies in areas of budget and personnel. This proves that an absolutely continuing relationship must be maintained from the initial planning stage for a health center with a community action group to the ultimate end when a neighborhood health center is functioning. Even then, we must constantly maintain liaison with its governing hoard-possibly this oan be done only IOn a contractual basis. I don't know. However, it is certain that ,t he community action groups are of vital concern to us, ,a nd we mustin ,e very county in the ,o ountry-estabHsh a De gular liaison rela ti{)nship whether a problem exists at the moment or not. The liaison represent ative should be capable of give and take, without predisposition for or against any person or set of individuals or facts. Whatever happens in the political arena, we are optimistic of pharmacy's role in the cities. If it is necessary, we must seek alternatives to OEO funding, utilizing private, industrial, community and other gOViernment agenWe must think in cies' funds. terms of future total health care and what part pharmacy will play. My conviction is that nowhere can the pharmaceutical services be better delivered than within the free enterprise system. •
COMPENDIUM OF PHARMACEUTICALS AND SPECIALTIES
This 1,000 page reference book, published b y the C anadian Pharmaceutical Association, briefly and factually describes pharmaceutical products in oomprehensive monographs - dosage format, indications, administration, contraindications, side actions, precautions, supply. Monographs are in alphabetical sequence. Cross-indexing in coloured pages includes: Therapeutic Index and Prescriber's Guide, Manufacturers' Index, Nonproprietary Names Index, and Trade Names Index. Also provided a re 'conversion tables, children's dosages, and abbreviations and information concerning Canada's drug legislation. Price per copy $12.50 Payment in full must accompany each order.
Canadian Pharmaceutical Association, 175 College Street, Toronto 28, Ontario, Canada. We
enclose herewi,t h payment of for copies of Compendium of Pharmaceuticals and Specialties, Fourth Edition. Please rush to:
$
(Print name and address)
Vol. NS8, No. 10, October 1968
543