Docs accuse pharmacists of ‘bargain basement’ health care

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Doctors say they are “outraged” by the commencement of the Queensland UTI prescribing trial, but the Pharmacy Guild has hit back, saying medicos are using “old scare campaigns”

The Urinary Tract Infection Pharmacy Pilot – Queensland (UTIPP-Q) trial went live a week ago, with the release of the Drug Therapy Protocol for participating pharmacists.

The trial has been implemented as part of the Queensland Government’s response to the inquiry into the establishment of a pharmacy council and transfer of pharmacy ownership in Queensland.

The Australian Medical Association (Queensland) has said in a statement that it has “issued a call to arms for doctors to unite against the increasing introduction of role substitutions that allow other health practitioners to deliver services traditionally provided by qualified doctors”.

AMA Queensland president Dr Chris Perry said that such “role substitutions” deliver patients with “inferior care under the guise of convenience”.

“AMA Queensland has consistently and regularly voiced its concerns and fears for patient safety regarding task substitutions, however, our voice has for some reason fallen on deaf ears,” he said.

“Queensland is the only state or territory in the country to allow a trial where pharmacists can diagnose urinary tract infections instead of GPs, and sell antibiotics over the counter without conducting any tests to be sure there is an infection, and at a time when the country is facing a serious problem of antibiotic resistance because of over-prescribing.”

He also attacked midwife-led childbirth and public patients having “referrals to specialists being diverted instead to other health practitioners” as sub-standard cost-cutting measures.

“Queenslanders are being sold this new style of patient care under the guise of choice and convenience, but it’s simply a bargain basement version of health care,” he said.

He called on all doctors to “unite to put patient care above political point-scoring and cost-cutting”.

“Enough is enough. We believe there are serious risks in providing this kind of inferior patient care,” he said, asking doctors to complete a survey about the current state of the health system.

“Apart from the inherent risks in having health practitioners without training providing services of qualified doctors, there’s a genuine danger of a two-tiered health system forming – one that is run on the cheap by clinicians operating outside their scope of practice, and another one that provides quality care for those who are able and willing to pay for it,” he said.

Pharmacy Guild Queensland branch president Trent Twomey said that the statements were “unfounded” and “unsupportive of a modern and efficient healthcare system, that’s supportive of advancements for women’s health”.

“The old scare campaigns voiced by some doctors are anti-patient and do reputational damage to their own profession,” he said.

“It’s disappointing that some doctors still maintain an ‘us’ versus ‘them’ mentality based on their hip-pocket.

“Patients should be the centre of our health system, but unfortunately some doctors believe they are the centre of the health system. The on-going attack on fellow primary healthcare professionals, health and allied health practitioners is frankly ridiculous.

“Queensland should be at the forefront of the best primary healthcare practices. The Urinary Tract Infection Pharmacy Pilot – Queensland (UTIPP-Q) is yet another example of safe and effective innovation in the primary healthcare model.

“We make no apology for putting patient-centred primary healthcare first.

“Although the pilot is new for Queensland, other OECD countries, including New Zealand and the United Kingdom, have had pharmacists prescribing treatment for Urinary Tract Infections for many years.”

He urged the AMA Queensland to stop such “scare campaigns” and instead work with pharmacists.

“This pilot puts the patient in the centre of care and doesn’t remove access to general practice,” he said.

“In fact, by following clinical guidelines community pharmacists will be in an ideal position to refer necessary patients to their general practitioner when treatment may have otherwise been delayed.

“In a time when some general practices have moved to a full telehealth model and are focusing on their long term chronically ill patients, it is no wonder that Consumer Health Queensland is also backing this common sense move to improve support primary healthcare delivery.

“The pilot supports patient referrals to GPs, if needed, to ensure continuity of care, where a complex Urinary Tract Infection is identified.

“The pilot is focussed on non-complicated Urinary Tract Infections and as such, the appropriate clinical protocols form part of the training and pilot protocols. Service provision is well within the scope of practice for community pharmacists.

“Community pharmacists want to work with you as primary healthcare professionals,” he said to doctors.

“Over the next two years we’ll see the pilot’s successful results do the talking.”

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