‘Chemist shop model’ criticised


pharmacist pharmacy

A prominent GP has suggested that pharmacy owners are acting less like health care providers and more like commercially driven retailers

Edwin Kruys, immediate past RACGP vice president and RACGP Queensland chair, has penned a piece in his Doctor’s Bag blog in which he asks, “Is community pharmacy on a road to nowhere?”

“Community pharmacy owners want to be taken seriously as healthcare providers yet, at the same time, they continue to behave like a commercial interest group,” writes Dr Kruys, in looking at the Government’s response to the King Review.

He writes that in order to be taken seriously, community pharmacy needs to “change tack”.

Dr Kruys singled out the King Review’s recommendation that homeopathy not be permitted to be sold in pharmacies, and that complementary medicines with a limited evidence base be separated in-store from the S2 and S3 area.

“Political donations and backdoor lobbying are still the norm in this industry,” he wrote.

He cited comments from the Guild’s president, George Tambassis, in which Mr Tambassis said the organisation looks forward to continuing to work with the Government; and from the Guild’s executive director, David Quilty, in which Mr Quilty said that the community pharmacy sector works well, so why “tinker unnecessarily with it?”

“The question is, does the chemist shop model work ‘very well’, or is it relying on lotions and potions, anti-competitive regulation and protection, lobbying and political donations to stay afloat?” wrote Dr Kruys.

He said that he agreed with a recent Australian Financial Review opinion piece by the Grattan Institute’s Stephen Duckett, in which Mr Duckett claimed the Government “totally squibbed” the King Review and slammed its “do-nothing response”.

This opinion piece was rebutted in a letter to the AFR editor by David Quilty, who said that its claims “could not be further from the truth”.

However Dr Kruys said regarding Mr Duckett’s comments regarding “the power of sectoral interest groups,” he could not agree more.

“I’m looking forward to the day the community pharmacy sector shakes its retail sales focus – but I’m not holding my breath,” he wrote.

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17 Comments

  1. Greg Kyle
    22/05/2018

    If pharmacy owners continue to want to live in the past and not embrace change, they will reap those rewards. Pharmacy needs a good dose of revolutionary change – the evolutionary change has left us paralysed “at the crossroads” for the past 25 years!!

  2. Bei
    22/05/2018

    Perhaps if the government doesn’t keep cutting pbs funds and pharmacists wages and leave us a chance to survive, we will be able to focus, even more than now, on the health professional side of the job!!

  3. Nicholas Logan
    22/05/2018

    I have always wondered what Dr Kruys’ pharmacy-bashing motivation is. Is it to take focus off GPs/MBS? If a return to the health centre style pharmacy is desired then the federal government needs to professionally remunerate dispensing and services. At the moment the discount model, which thrives on margin from non-health sales and promotes dispensing as bait, seems to be winning. The result is terrible minimum wages and pot shots from doctor’s groups that are hard to defend. It also doesn’t help that organisations have the financial clout to make a joke of the location rules.

    • PharmOwner
      22/05/2018

      Ending the optional $1.00 co-payment discount would be a good start. If government wants to save patients a dollar, they should fund it, not pharmacies. Mandating compulsory script pricing across the board so that there is no variation among pharmacies would be another policy to consider. This way patients would know there is no need to “shop around” for the lowest possible script price.

  4. pagophilus
    22/05/2018

    Pharmacists need to decide whether they’re health professionals or health related goods sellers. When you walk into a GP clinic, physiotherapy centre etc you don’t see a shop full of stuff to buy and you aren’t offered upsells to buy things you don’t need in order for them to make more money and/or to keep the clinic afloat.

    • PharmOwner
      22/05/2018

      GPs and physiotherapists also have enough self-respect to not promote themselves as “Australia’s Cheapest Profession” ie they don’t discount and cut each other’s throats

  5. truman
    22/05/2018

    yes, you are right. so pbs cuts, too many chemist warehouse, too many competitions, less profits, pharmacy is done.

  6. MICHAEL O'DONNELL
    22/05/2018

    Hope the good doctor doesn’t suggest his patients chase low prices on their prescriptions..

  7. RAJ DUDHANI
    22/05/2018

    This is absolutely true and well established fact
    As intellictual community we all have to think, why are we discussing this today
    What the pharmacist needs? Simple answer is a stable income protection.
    Drs need not worry about this coz their income is protected and linked to their services and paid by tax payers
    Pharmacy owner has lots on plate to deal with apart from duty as health professional.
    Let us formulate a Model where the pharmacist is reimbursed directly by Medicare and see the effects
    Remove pharmacist from retail shop keeper role and pay for his or her individual services offered
    Community will gain more in health services with no added cost to the medical system

  8. Anthony Tassone
    22/05/2018

    Given these views from Dr. Kruys, I can only assume he will be supportive of pharmacies and pharmacists receiving appropriate recognition and remuneration for delivery of health services within our scope, for example, MBS funding for delivery of vaccinations?

    Or will he resort to previous arguments that he and his colleagues have shown that pharmacists should not have an expanded role due to their ‘lack of expertise’, or the risk of ‘fragmentation of care’ and that the ‘chemist shop isn’t an appropriate environment’ for such services to occur.

    This blog states a convenient and repeated argument that is actually not open to any alternative or innovation from the baseline model if it means a role expansion.

    I’m looking forward to the day medical groups support the evidence based and patient centric decisions to expand the role of pharmacist’s practice, though I won’t be holding my breath.

    Anthony Tassone
    President, Pharmacy Guild of Australia (Victoria Branch)

  9. B Lee
    22/05/2018

    I really cannot see what is wrong with Dr Kruy’s view on the pharmacy profession.

    I studied Pharmacy because it is health care sector and can help people in community level. Even small smile and advice can sometimes change a patient’s life and that was my motivation to choose this path.

    Now I worked at discount chains and on the first day working there ever since, I regretted my decision to pursue in Pharmacy career. They don’t care what patients feel, all the owners want is to up sell and get them more money.

    It is understandable, as inevitably it is a business, but discount chains basically shifted my profession towards commercial driven “health care” where “service” is only carried out when there is profit promised and if not, not even care about it.

    And looks like even pharmacy organisations such as Guild don’t care about it as they think pharmacists are getting paid too much for our job workload.

    I really can not see any difference between a pharmacy and a supermarket other than pharmacy can dispense and sell medications

  10. PharmOwner
    22/05/2018

    Apart from unsubstantiated and inflammatory claims such as “Political donations and backdoor lobbying are still the norm in this industry,” Dr Kruys (for once) has made a valid point about the ethics of owners – particularly those who sell homeopathy. There is absolutely no room in any self-respecting real pharmacy for homeopathic junk. Period.

  11. Niels Bowen
    22/05/2018

    I have never read an article by a Pharmacist telling Doctors how they should run their practices. Why because we really have no idea.I have also never met a doctor who had the faintest idea on how a pharmacy functions. Dr Kruys clearly has no idea either. So who really cares what his opinion is?

  12. Robert Broadbent
    23/05/2018

    Going to be a hard habit to break – been around since 2600 BCE, before gynecologists, surgeons and I suspect many other health professionals. But then, maybe it’s time for a change. – Also interesting that Wikipedia notes that “The modern pharmacist (also colloquially referred to as chemist in British English)…….” Maybe too we should start to use the pharmacist more in our interaction with the media, and other folks – viz ” Pharmacist Warehouse” 🙂

  13. Peter Ghobros
    27/05/2018

    As a Pharmacist providing an important professional service (DAA) to my community where I practice, I can argue Dr Kruys’ article and flip it over to the other side based on what happened with me yesterday.
    GP sent us a referral letter for a new patient to start on a DAA, however, no scripts were sent. Phoned GP to request scripts. Due to a number of scripts needed, GP refused to give scripts and requested me to tell the patient to make another appointment to get the scripts. I told GP, you have already seen them! GP said yes, I spent 45 min with them but only claimed half an hour of MBS and still insist to see patient again to provide scripts. That’s what i call abuse of the MBS and loophole in the system. Yet, medical groups/organisations put their nose in the pharmacy industry and claim pharmacies for seeking commercial interest!
    I have to admit that not all GPs are behaving in a such way, same like pharmacies not all are seeking commercial interest.
    Both GPs and Pharmacies should work in collaboration for the best interest of the consumer and put political debates aside.

    • PharmOwner
      27/05/2018

      Not to mention the GPs who see a patient every 3 minutes. Not much patient care there for all the MBS fees claimed.

  14. bakassi
    04/06/2018

    Its sad that the Pharmacists Board in Australia does not find anything wrong with the current model. Worse still, that this is coming from a general practitioner. I’m foreigner, a pharmacist- practising in my home country in Africa and presently enrolled in a postgraduate program in Australia. There are some existing issues which i think must be looked into for pharmacist to be taken seriously as health professional in Australia. These are:
    Firstly, no seat in the pharmacy and for the pharmacist. I can’t imagine standing up for hours without a seat. Do other health professionals stand? Do other healthcare workers act as the cashier or receptionist or call operator? Secondly, pharmacists are usually unavailable to suggest and advise on non-prescription drugs. From numerous experiences, the pharmacist is too busy to offer advice on pharmacy-only medicine (surprisingly, i read the pharmacy body is agitating for pharmacy prescribing). Thirdly, the most disgusting of all- pharmacy setting appears more like a showroom/ supermarket. Selling all sorts. Fourth, pharmacy advertising slogans suggest nothing clinical. Most are centred around offering cheap medicine and filling prescription fast. I was hoping to learn or see something new here, to take back home. But I was greatly dissapointed and amazed! In my country, the pharmacist wage is good, next in line to the doctor’s. Pharmacist are highly respected as many are relied upon to provide primary health care. This is because there is no effective national health insurance. Most people prefer to visit the pharmacy first, as it is much cheaper since most payment is out-of-pocket. Again, Pfizer, GSK, Novartis, Astra Zeneca, Roche and many other multinationals employ ONLY pharmacist as medical representatives. This position comes with benefits such as a car, driver and bounty allowances. Lastly, apart from clinical pharmacy and pharmacology; we still incorporate pharmacognosy, pharmaceutical chemistry and pharmaceutical microbiology into our training. Thus expanding pharmacist job opportunities. In my view ,Australia Pharmacy Board or the PSA needs to be proactive to address these challenges.

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