AMA acting ‘cheap’ over Qld pharmacy trial


Dr Bav Manoharan makes a motion at the AMA's 2019 AGM. Image AMA Media via Twitter.
Dr Bav Manoharan makes a motion at the AMA's 2019 AGM. Image AMA Media via Twitter.

The Australian Medical Association has passed an urgency motion that the organisation should call for the Queensland pharmacy prescribing trial to be stopped immediately

At the AMA’s Annual General Meeting, held during its national conference in Brisbane, Dr Bav Manoharan, director at the AMA and its Queensland branch, moved “That Federal Council and AMA Federal President call for an urgent and immediate end to the trial of prescribing of antibiotics, paediatric vaccinations and oral contraceptives by community pharmacists in Queensland and Nationally, and to call for the Queensland Health Minister to adhere to national processes as occurring under the direction of COAG”.

The motion was seconded by Dr Nick Yim and passed.

Since it was announced, the Queensland trial has attracted significant criticism from doctors, particularly at the leadership level of the AMA and the Royal Australian College of General Practitioners.

Pharmacy Guild of Australia Queensland branch president Trent Twomey expressed disappointment in the motion.

“I think this just shows the true colours of the AMA has being nothing more, and nothing less, than a cheap lobby group rather than a professional body,” he told the AJP.

“I’d like to ask the AMA lobby to park their biases, park their self-interest and work with the Guild and both sides of politics – because this has bipartisan support, and the pharmacy workforce is ready to do our part.”

He said that in his experience, doctors at the grass-roots level and patients alike were supportive of the trial and its aims.

“My own personal interaction with the local GPs I work with is nothing but positive,” he said. “I just find these comments so short-sighted and childish, and I would ask that the AMA leadership put patients, rather than profits, first.

“I think that all GPs and community pharmacists know that when GPs think of pharmacists, they think of their local pharmacy; while we think of our local GP. So they need to take a step back from politics and go back to first principles.”

He said that as a community pharmacist and a Guild representative he has had only positive support from patients and politicians.

“They acknowledge that the highly skilled and highly trained pharmacist workforce can do more, and should do more, to keep Queenslanders healthier and out of hospitals.”

This has been particularly important in the light of this year’s early and severe flu season, which to date has seen 58,974 laboratory confirmed notifications of influenza across Australia for 2019 as at the start of 27 May, and 11,799 in Queensland alone.

“Over a million Australians have received a flu vaccine from a community pharmacy this year, so that is nothing short of policy success – and we congratulate both the State and the Federal Government on their work in this area.”

All health professionals – GPs, pharmacists, nurses, Aboriginal and Torres Strait Island health workers – should be supported to work to their full scope of practice, Mr Twomey said.

He was not the only pharmacist to take issue with the motion.

A second motion made at the AGM concerned the HMR cap.

The motion, “That the AMA advocates for the removal of the limit of 20 Medication Management Reviews per month credentialled pharmacists are able to perform in Modified Monash Model 4-7 to improve patient care and reduce adverse medication events,” was also carried.

 

‘A prescription for trouble’

Meanwhile, Dr Yim – who qualified and worked as a community pharmacist before becoming a GP – has also penned a piece in MJA InSight condemning the pharmacy prescribing trial.

He said that his training and experience let him consider that there may be an alternative diagnosis to a simple UTI when a patient presents with such symptoms.

“A pharmacist, who is not trained as a GP, may feel they can perform this same consultation easily due to the simplicity of the condition, but they don’t have the knowledge, training or background to ensure it is not something more serious which, if left untreated, could become a major health issue,” Dr Yim wrote.

“In my view, allowing pharmacists to prescribe puts convenience ahead of patient safety.

“There are too many unseen risks and potentially higher costs.”

He called on the Government to increase funding to general practice instead of pharmacy, including for non-dispensing pharmacists in GP surgeries.

Dr Yim also warned that his experience in pharmacy had included training in companion selling – including “the odd fragrance or two during the festive season!”

But he also said that pharmacy was underfunded, with pharmacists not paid for their clinical expertise; this “has affected the bottom line of pharmacy owners”.

“The way to improve the business of pharmacists is not to increase their scope of practice without also requiring they undergo the appropriate training,” he wrote.

“Health is not about convenience; it cannot be operated like a fast food chain. It is about the delivery of safe and quality health care. Increasing the scope of practice of pharmacists is a gamble that we can’t afford.

“Queenslanders deserve safe, quality and accessible health care, but altering the scope of practice of pharmacists is not the way to deliver it.

“We need an appropriately funded health system, not shortcuts and further fragmentation of care.”

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