Does anyone have HMR pharmacists’ back?

Failure to lift the cap on HMRs makes no sense, writes Karalyn Huxhagen

The recent discussion about the new Community Pharmacy Agreement rules has fuelled my ire.

When I spoke with the Pharmacy Guild of Australia about my frustration in relation to the lack of increase to the caps on Home Medicines Reviews, I was directed to this section of the 6CPA agreement which spells out that the funding is only for community pharmacies and independent accredited pharmacists are not mentioned in this agreement as being a partner for funding.

My reply was, and still is, that the next section talks about improving access to consumers in rural and remote areas.

I work closely with all of the community pharmacies who practice in these areas. We have mutual respect, good dialogue and I am providing a much-needed service.

They identify at-risk clients, organise referrals, provide dispensing histories and background information. After I perform the medication review I visit with the pharmacist and have a chat before writing my report to the doctor.

These community pharmacists are at the centre of the health and wellbeing of these clients, especially in towns relying on locum services and Royal Flying Doctor Service.

The cap restricts how many patients I can see each month, causes me increased expense as I have to travel large distances to see 20 people and then return the following month to see 20 more, and the list goes on.

The payment of $125 for one round trip to see these 20 people does not cover the fuel costs, let alone wear and tear on my vehicle or accommodation.

At a recent Guild roadshow meeting, an owner pharmacist rose from her seat to complain that I was taking business away from her pharmacy, which also performs HMRs. The Guild representative stated quite clearly that he was working towards removing people like me from the payment system. Great!

The hysterics of the night got better but the real issue is that I am not performing HMRs anywhere near this person’s catchment. On any given day I have between 50-60 HMRs sitting on my desk for rural and remote locations.

I am now taking calls from GPs asking me to support them with HMRs as the pool of HMR pharmacists has decreased in my catchment areas. My hard work has paid off as I am now recognised for the talent that I have and the efforts I make to see clients.

I have not targeted the local area that I live in, as there were other HMR pharmacists performing this role. Three of these pharmacists have now left the HMR business model as it costs you money to be a HMR pharmacist, rather than supporting your existence as a pharmacist. 

I niched my efforts elsewhere and grew my business with the help of the rural community pharmacies and rural GPs who appreciate and value my work. If this owner is not gaining many referrals, than she needs to look at her business practice and stop throwing barbs at others in the profession.

I am told that I have to wait for the evolution of the pharmacist in general practice model if I want to see a genuine return on investment for what I do.

I have already waited for two years for realism. I have put in a submission to the King Review which the Guild now damns as a piece of wild speculation. I have participated in more research programs and interviews than I can list here, and still I am in a silo of ‘who has my back’ in this fight for a right to practice and be appropriately remunerated.

Karalyn Huxhagen is a community pharmacist and was 2010 Pharmaceutical Society of Australia Pharmacist of the Year. She has been named winner of the 2015 PSA Award for Quality Use of Medicines in Pain Management and is group facilitator of the Mackay Pain Support Group.

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