Docs call for pharmacists in GP surgeries


The AMA Queensland has waded into the pharmacist prescribing debate, with its president warning that patients could die

AMA Queensland State President Dr Dilip Dhupelia has told pharmacists to go back to their studies if they want to widen their scope of practise to include some prescribing rights.

They do not have the high-level medical training or expertise to “replace GPs,” he says.

His comments were regarding a Queensland Parliamentary Inquiry which is examining issues around pharmacist prescribing and the establishment of a Pharmacy Council. Ownership legislation is also being examined. There has been no suggestion from proponents that pharmacists should replace doctors.

“If pharmacists want to diagnose and treat patients, and be allowed to control and manage patient medication, they should devote the many years needed to be a skilled and qualified doctor,” Dr Dhupelia says.

“There’s an inarguable reason GPs spend so much time training and in ongoing professional development and their expertise can’t be duplicated without those qualifications.”

He called for the Queensland state government to reject the pharmacist prescribing proposal, and instead queried the integrity of the retail pharmacy sector.

Doctors fear that if pharmacists had a wider scope of practise, some pharmacists would “upsell” to patients by recommending and selling products they did not need, Dr Dhupelia says.

“Rather than declaring an open slather free-for-all on our health, the state government should encourage pharmacists to integrate into GP practices,” he says.

“It’s much better for patients where pharmacists and GPs work together under one roof, and only provide the services they are actually qualified to give.”

He said the Government would have to take full responsibility for any negative outcomes from pharmacist prescribing, including suggested activities such as supplying contraceptive pills and certain medicines for cardiovascular or respiratory disease without a repeat prescription.

“This is the thin edge of the wedge,” Dr Dhupelia said. “The pharmacy lobby is riding roughshod over the best interests of our patients. Prioritising convenience over health outcomes and letting pharmacists do what they want puts Queenslanders’ health at risk,” he said. 

“Research shows that people who regularly visit their GP are healthier and live longer.

“Taking shortcuts can lead to chronic and fatal health problems being missed until it’s too late.

“Our members can provide numerous instances of where a repeat prescription encounter became a life-saving opportunity.

“For example, a patient went in for a repeat prescription and the GP found a malignant melanoma while taking her blood pressure.

“And, at a time when four people die every day from drug misuse, it is ludicrous to even consider making it easier for people to get drugs by fronting up to a pharmacy without a prescription from a doctor.”

The comments follow a slew of criticisms of the community pharmacy sector, widening of pharmacist scope of practise and services offered in pharmacy.

Dr Evan Ackermann, a Queensland GP and chair of the RACGP’s national standing committee on quality, wrote in Medical Observer that pharmacist prescribing was a “Pandora’s Box” and that there would be “regulatory incompetence on a grand scale” were it permitted.

And RACGP Victoria chair Dr Cameron Loy recently spoke to Fairfax Media to accuse pharmacies offering health checks of being “motivated by money”.

Pharmacy leaders including PSA national president Dr Shane Jackson, acting national president of the Guild Anthony Tassone and NSW Guild president David Heffernan have all expressed frustration and disappointment over these comments.

Mr Tassone and Dr Edwin Kruys, immediate past RACGP Vice President and RACGP Queensland Chair, have recently called on pharmacists and GPs to improve collaboration.

Meanwhile Pharmacy Guild Queensland vice president Kos Sclavos has told the Courier Mail that the Guild does not support the AMAQ’s claims.

“Medication continuance is available now but in a limited capacity,” he said.

The Courier Mail also spoke to Queensland Health Minister Steven Miles, who said safety is the state government’s top priority.

“At the last election, the Palaszczuk Government made a commitment to ask the relevant parliamentary committee to investigate the establishment of a Pharmacy Council,” he said.

“The inquiry will consider how a Pharmacy Council would operate in Queensland and look at how pharmacists and pharmacy assistants operate in other states and whether there are other services they could safely provide.”

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5 Comments

  1. chris
    21/07/2018

    Advertising only works on two principles, sex and fear and my oh my hasn’t the banana bender resorted to fear in about the most extravagant manner. I haven’t laughed so much since Clive Palmer announced he was running again. They sure as hell breed ’em different up there. If I were to make a statement that could cause a lot of controversy, I could look at the road trauma data including deaths on roads and make a point that some people have died on the way to seeing their doctor and would have been better of staying at home ringing their pharmacy for advice. See how silly it all gets when money is at steak folks. Well done !

  2. Daniel Hackett
    22/07/2018

    High level medical training being a euphemism for asking the drug rep what’s new? I think a pharmacist can do that. The image of two bald men fighting over a comb springs to mind.

  3. Toby
    22/07/2018

    Here are the opinions of some doctors, as published in ‘Australian Doctor’, about the role of pharmacy and pharmacists…

    Dr robert richardson 26 seconds ago
    The diagnostician and treating person must always be separate from the dispenser or its alternative junk medicine

    Reply
    Dr Solly Zilman 7 minutes 38 seconds ago
    If the dispensers gain prescribing rights, then symmetry dictates that the prescribers gain dispensing rights. There can be no reasonable argument to suggest otherwise. I’m sure many of my patients will appreciate avoiding the inconvenience of attending the local gift shop to have an all-obscuring sticker applied to the box whilst the label-licker seeks a medical history in the privacy of the perfume section.

    Reply
    Dr Alfred Chung 1 hour 1 minute ago
    Agreed. A great tongue in cheek response to the pharmacists prescribing. Bring back the Doctor dispensing practice and we can all make more money. The big pharma can once again bring us expensive gifts and sponsor our holidays so that we will prescribe and preferentially dispense their ware and doctors can once again be respected by all by driving expensive cars and throw extravagant parties in our mansions. We may even have one or two doctors running for the parliament! Pharmacists would then go to medical school if they want to be doctors to make more profit and social order will once again be restored. Doctors would love the opportunity to have the right to prescribing and dispensing medications they can profit from disregarding whether patients require them or not. Perhaps the pharmacists are doing us all a favour by their application for the right to prescribe and dispense. There was initially a logic behind separating prescribing and dispensing responsibilities, what was it again?

    Reply
    Dr Peter Bradley 26 minutes 40 seconds ago
    Indeed Alfred. I am reminded of my early days in GP, back when I owned the whole thing. There was a pharmacist next door. Cunningly planned by the developer who built the complex for sure. Patients would walk out my door, and into his. He was reimbursed for any shortfall in the drug costs, when a eligible patient presented, I was not reimbursed (and we still aren’t) for the shortfall when I bulk-billed the same patient. He drove a Mercedes and owned a lakeside holiday cottage, I just had a large overdraft. Somewhere along the line, thing have gone skewiff, for sure.

  4. chris
    22/07/2018

    The meat in the sandwich can be a nice steak and well done as well. Twas a purpose spelling.

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