A war of words

A community pharmacist has responded to a column that referred to the profession as ‘usurpers’ who only have ‘dispensing degrees’

An outraged community pharmacist has responded to a recently penned column by AMA vice president Dr Chris Zappala.

In his article, published by the AMA’s Australian Medicine, the thoracic specialist from Queensland slammed community pharmacist professional services.

He wrote: “Retail pharmacy owners i.e. the Guild (who need to be differentiated from the more numerous pharmacists working collaboratively in hospitals, general practice and elsewhere) want two main things:

  1. To dispense/prescribe more of anything they can possibly get their hands on.
  2. To offer medical advice as a ‘professional service’ to patients as a substitute for general practitioners (or anyone else really) with MBS funding to do so.

“I suspect the sole reason retail pharmacy owners desire this is to increase foot traffic in their pharmacies, so more supplements, foot massagers, perfume and over-the-counter drugs can be sold,” said Dr Zappala.

“Usurpers often abandon activities truly in scope that they have been appropriately trained for, as they make a blatant grab for extended scope.”

He referred to asthma management in pharmacy, saying pharmacists were not qualified to practise in this area.

“Treating asthma is clearly not in the scope of practice for a pharmacist with a dispensing degree,” he said.

“Any attempted assessment regarding disease severity in this context is fraught and leads patients into further harm. How could anyone safely treat an asthmatic without listening to their chest?”

Caroline Diamantis, who works full-time in community pharmacy but also holds a position as vice president of the Pharmacy Guild NSW branch, told AJP that Dr Zappala’s comments are “disappointing on so many levels”.

“We hold a five-year Bachelor of Pharmacy minimum—a four-year degree plus one year of internship.

“We do not hold a ‘dispensing degree’ – what is that anyway?” asked Ms Diamantis, who received her pharmacy degree from the University of Sydney.

“Community pharmacists call themselves clinical pharmacists, and do not appreciate the nickname ‘retail pharmacy owners’,” she continued.

“No one uses it except the AMA. This is once again an attempt to discredit our clinical capacity.”

“Pharmacists have comprehensive clinical training on diagnosis and treatment across a broad spectrum of diseases, as well as the thorough knowledge of how medications when correctly used will improve disease states,” she said.

“It is poor form to continually belittle our capacity.”

In response to Dr Zappala’s comment about community pharmacist products, Ms Diamantis said that “while some models of community pharmacy have chosen to expand their offer to include various retail items (some of the larger banners come to mind), it is important to note that not all community pharmacies stock the ranges of perfumes, foot massagers or other paraphernalia constantly being referred to.

“Nevertheless this in no way compromises the extremely strict and comprehensive legislation and practice guidelines that pharmacist clinicians are bound by.”

Dr Zappala said pharmacists embedded within a general practice team would be an “invaluable resource”, however he suggested community pharmacists could be done away with altogether.

“Let’s promote online options for patients (e.g. UberPharmacy) or dispensing in GP practices,” he said.

“If patients and the government want convenience, there are many ways to achieve this that streamlines and shortens the medication supply chain from wholesaler to patients, and saves patients from having to trudge to their pharmacy every month for medications, all without compromising the quality of community care that remains the sole purview of the general practitioner and his/her integrated team.”

Ms Diamantis said she is shocked by Dr Zappala’s suggestion of leaving out community pharmacists altogether.

“The arrogance of diminishing our role to ‘irrelevant’ simply demonstrates the total misunderstanding of the vital role pharmacists play and the sheer lack of vision this doctor has,” she told AJP.

“How sad that he may never enjoy the professional satisfaction and rewards of genuinely putting his patients first and collaborating with any allied health professional who wishes to contribute to patients’ best medical health outcomes.”

Read the full Australian Medicine article here

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