Community pharmacist prescribing ‘indefensible,’ says doc

man holding 'no' sign

Only two in three Australians trying to access a GP for urgent medical care are seen that day, a leading GP writes in criticising the Queensland pharmacy trial

Dr Richard Kidd, chair AMA Council of General Practice, has written in AusMed that the trial “potentially undermines patient safety and quality prescribing” and “flies in the face of the framework” agreed to by AHPRA and the Coalition of Australian Governments to maintain a nationally consistent, transparent process for non-medical health professionals to prescribe, or expand their prescribing.

He argues for the separation of prescribing and dispensing in the name of safety.

Pharmacists are “an important safety mechanism to ensure that patients do not receive an inappropriate medication or dosage, and that patients understand how to safely and effectively use the medication,” Dr Kidd writes.

“Cloud that view and patient safety will undoubtedly be compromised, and compromised for a false premise, that of enhanced access to care. Quality of care will have been sacrificed to meet a constructed convenience.”

Dr Kidd writes that the Pharmacy Guild “wilfully promotes the idea that accessing general practice is difficult or costly”.

He cites ABS data which he says counteracts this argument.

“Of those who saw a GP for urgent medical care, two thirds were seen by a GP that day and within four hours.

“Less than two in ten reported waiting longer than ‘they felt’ acceptable for an appointment. Only four per cent of patients who saw a GP in the last 12 months delayed or did not see a GP due to cost.”

“For the AMA, it is indefensible that the patient protections currently in place are trying to be circumvented by those with a pecuniary interest in both prescribing and dispensing.

“Given that pharmacies receive a dispensing fee from Government for each PBS medication they dispense, it is easy to see they would have a conflict of interest if pharmacist staff could also prescribe such medications.”

The AMA will “strongly” oppose any model of pharmacist prescribing which will involve any connection to a retail pharmacy, he says.

A spokesperson for the Guild told the AJP that: “We certainly do not accept Dr Kidd’s doctor-centric view of the world, and fortunately legislators in comparable countries – and increasingly in Australia – are seeing the wisdom and common sense of making better, broader use of pharmacists’ skills and training.

“Dr Kidd can deny the GP shortage until the cows come home, but real patients know full well that getting in to see a GP in a timely fashion is increasingly difficult to achieve in some parts of Australia.”

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