Backlash after CWH ‘undermines’ local GPs

A Tasmanian doctor’s surgery has decided to step back from working with local Chemist Warehouses after the discount giant began marketing its partnership with a national telehealth service

Dr Donald Rose, a partner at the Summerdale Medical Centre in Launceston, said that when the COVID-19 pandemic hit, the practice needed to find a workaround to get its own telehealth scripts to pharmacies, trying to reduce the amount of foot traffic it received.

Summerdale faxed and emailed scripts to the patients’ preferred pharmacies, as well as mailing them, but “there was often a delay in getting the hard copies – they were getting lost in the mail, or they weren’t arriving,” Dr Rose told the AJP.

“So we started to deliver. A receptionist spent a couple of hours a day delivering all the prescriptions. It was the only way to solve it, and it worked very, very well. The pharmacies were getting a prescription within a day of us writing it.”

But patients who used one of the five local Chemist Warehouse pharmacies to have these scripts filled began to offer the GP surgery feedback, he said.

“The response from Chemist Warehouse was to use an opportunity to market telehealth to our patients.”

As promoted in mainstream media and on its website, Chemist Warehouse has partnered with the telehealth service Instant Consult.

Dr Rose said that when patients went to the Chemist Warehouse pharmacies to get their medicines dispensed, they were given flyers promoting the telehealth service.

“That wasn’t the response we would have liked,” said Dr Rose.

“It was ludicrous. One of our receptionists, wearing her uniform, dropped prescriptions to the Chemist Warehouse and they gave her a flyer!

“The way we look at it, they rely on us – we’re spoon-feeding them our prescriptions to solve the problem, to try and get the prescriptions to them – we thought we were doing a service, as part of the cooperative way we like to work.”

Summerdale began to communicate to patients that it would take a step backwards from the way it had been working with the local Chemist Warehouses during the pandemic.

However Dr Rose said this move was not a boycott.

“It has been brought to our attention that the Chemist Warehouse franchise has partnered with a national telehealth service and is actively marketing the service to residents of the City of Launceston, and of more concern to patients that attend our practice by handing them a flyer for this service when dispensing prescriptions we have prescribed,” the GP surgery wrote on Facebook.

“This type of practice undermines our work as local general practitioners as well as risking the patients care as this service cannot arrange face to face consultations.

“Due to Chemist Warehouse’s actions by undermining local general practices through this partnership, we have made the decision, along with many other local GPs, to no longer support their business model.

“This means we are unable to provide faxing, posting or delivery of prescriptions to Chemist Warehouse. We will still do the prescription but it will need to be collected from our surgery. This also pertains to Webster packs.

“We will continue to fax, post and deliver prescriptions to all other pharmacies in the northern region. We ask our patients to consider supporting local businesses. Your local GP is a local business.”

Dr Rose stressed that the doctors’ concerns lie with Chemist Warehouse at a corporate level, and with the non-local telehealth service model, rather than the two franchisees who operate the five local Chemist Warehouse outlets.

These franchisees have agreed to take down posters and stop handing out flyers promoting telehealth, he said, though the discount giant’s mass media marketing continues, which means that the surgery will continue its stance on not supporting Chemist Warehouse outlets.

“The corporate office somewhere didn’t appreciate the damage it would do, to try and market telehealth in opposition to local GPs,” he said.

“They [The local Chemist Warehouse pharmacists] were just doing what they had to do as part of the franchisee agreement they probably had.

“They’re just the meat in the sandwich, and we don’t want to target them.”

He also said that GPs in general, as well as those at the Summerdale Medical Centre, have strong concerns about the telehealth model.

He said that “pop-up” telehealth services, or those which always operate this way – rather than doctors working under the traditional model who have had to scramble to adapt due to the COVID-19 pandemic – cannot replace a relationship with a usual GP and these consultations often result in patients being sent to emergency departments because the telehealth GP cannot help them.

He said it was disappointing that some GPs chose to work in these “kitchen-based” pop-ups, which do not have overheads like rent or wages for support staff.

However he said health authorities cannot address the problem because telehealth consultations are needed in the current environment to protect GPs – particularly vulnerable GPs, such as those who are older, pregnant or who have underlying conditions – from potentially contracting COVID-19.

“You have to have these rules written as they are to protect older doctors – but they’re not for corporates to make money from providing easy things like repeat scripts,” he said.

“It’s disappointing that doctors work for them and they can’t hope to provide a quality service.

“Patients trust their pharmacists – and if a pharmacist endorses telehealth, the patient thinks it must be all right.”

He said that promoting an interstate telehealth GP service as equivalent to having a local GP is “a complete wrong message”.

“We all want telehealth to continue, but it needs to be fine-tuned.”

The national president of the Royal Australian College of General Practitioners, Dr Harry Nespolon, tweeted his support for the Summerdale Medical Centre.

“Telehealth corporate pop ups are bad news for patient care and pharmacies should not promote consults with interstate doctors over local GPs,” he wrote.

A spokesperson for the Pharmacy Guild said: “The facilitation of telehealth has served patients well during the COVID-19 emergency, but the fact remains that the best form of care is face-to-face contact with a health professional”.

“It is not in patients’ interests to promote telehealth as the norm where contact with a local doctor or pharmacist is available.”

In the meantime, Dr Rose said that he has been told more GPs are now considering pulling back from a closer relationship with pharmacies which actively promote interstate telehealth services.

He said that trust between GPs and pharmacies was vital, particularly during the peak of the COVID-19 pandemic, and again should a second wave of infection occur.

“If we didn’t work together, the whole thing wouldn’t work,” he said, saying that the Summerdale Medical Centre has an excellent relationship with local pharmacies, and that he appreciates that pharmacists were as much “under the pump” as GPs.

“We were faxing prescriptions to pharmacies, and they don’t get paid [at the time] until they get a hard copy. That requires enormous trust, and it’s why we started to deliver.”

But marketing a telehealth service meant that “the relationship of helping each other was broken”.

Chemist Warehouse has declined to comment.

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