GP-pharmacist relationships improving


handshake

But one third of pharmacists still believe GPs think their primary job is just to supply medications, according to new report

More pharmacists are reporting a positive working relationship with their main prescribing GP, according to the 2018 UTS Pharmacy Barometer released on Tuesday.

The number of pharmacists reporting a “very good” relationship with their local GP has almost doubled in the past few years – from 30% in 2016 to 57% in 2018.

A further 34% said they had a “good” relationship with their local GP.

The report surveyed 361 pharmacists with the sample being representative of the Australian community pharmacy sector.

Of these, 301 (83%) were owners, owner-managers, pharmacists-in-charge or pharmacy managers, with the remaining 17% being employee pharmacists.

No pharmacists reported having a “poor” or “very poor” relationship with their local GP, while 8% reported having a “neutral” relationship.

“By and large pharmacists are getting on well with their local GP,” commented PSA director and past president Warwick Plunkett.

However the frequency of communication between pharmacists and GPs was low.

On average, pharmacies reported dispensing 1,067 PBS items per week and contacting the local GP approximately 11.7 times per week.

UTS Adjunct Professor John Montgomery said, “The number of GP contacts per week as a proportion of the items dispensed seems low at about 1%.”

“With such positive relationships, how do we increase the interaction between pharmacist and GP?” questioned Professor Kylie Williams, Head of Pharmacy at UTS.

Most pharmacists identified that their opinion and expertise as a pharmacist was well respected by GPs.

An overwhelming 84% of pharmacists highlighted that GPs made changes to their prescribing as a result of the interaction they had with a pharmacist (64% agreeing and 20% strongly agreeing).

There was strong agreement from pharmacists that GPs accept their role as a medication expert (55% agree, 17.5% strongly agree) and accept their clinical recommendations (60% agree, 17% strongly agree).

“This represents a good basis for further collaboration,” said Adjunct Professor Montgomery.

A significant one third of pharmacists believe GPs think their primary job is just to supply medications, while 36% disagreed with this statement, 4% strongly disagreed, and nearly a third were neutral.

Meanwhile 38% of pharmacists agreed or strongly agreed that GPs appear to be increasingly involving pharmacists in the decision-making process about the medications they prescribe.

A further 30% remained neutral on the topic.

“There are pharmacists who feel that GPs are really not looking to them for clinical recommendations, rather just to supply the medicines,” said Professor Williams.

However overall, “there is a general belief by pharmacists that GPs collaborate well with them and accept their clinical decisions,” said Mr Plunkett.

Previous Under fire
Next Green light for GSK/Pfizer acquisition

NOTICE: It can sometimes take awhile for comment submissions to go through, please be patient.

3 Comments

  1. Thorough credit needs to be given to SHPA for developing the clinical pharmacy program in our hospitals. All the young medicos that are churning through the system are introduced to clinical pharmacy early in their careers and are introduced to pharmacists as an invaluable resource for medication information and as fellow health professional colleagues. Medical interns and HMO’s especially rely on the expertise of their ward pharmacist.

    We should see positive things with this doctor-pharmacist collaboration for the whole of pharmacy as this generation of medicos graduate into fully-fledged consultants. What will hold us back, is the constant conflict between our respective professional groups.

    • Ron Batagol
      09/05/2019

      Yes, I agree with you, Alexander. I was part of the group of pharmacists who spearheaded the establishment of SHPA’s ‘Guidelines for Clinical Pharmacy Practice’ in 1978.
      And as I am still working within the system, it’s been great to see the evolution and growth of clinical pharmacy in the hospital practice area, leading to the high level of collaborative work between the professions.

      With respect to the apparent conflict between our respective groups within the area of community care, I would suggest that there is a basic, unacknowledged and, I suspect, unintended, misunderstanding by some medical groups and individuals about the concept and operation being proposed for pharmacist prescribing, as highlighted by the article discussing a range of differential diagnostic aligorithms that may arise from a presentation of “U.T.I symptoms”.

      Having worked and liaised with a wide range of medical practitioners over many years, including advising on the potential risk/benefits of therapeutic options in pregnancy and breastfeeding, I have the greatest admiration for the differential diagnostic skills and expertise of doctors in their diverse areas of clinical practice.

      I don’t believe any pharmacists or pharmacy spokespersons is in any way suggesting that pharmacist prescribers would aim to become “alternative differential diagnosticians,” so as to supplant or compromise this critical role performed by medical practitioners!

      Clearly, the aim of moving towards pharmacist prescribing, including appropriate validated credentialing, as evidenced by the Health Professions Prescribing Pathway (HPPP) Project, the June 2018 Pharmacist Prescribing Forum, including the Background paper by Nissen et.al., and the NPS Prescribing Competencies Framework, is to facilitate guidelines for a structured outcome in the move towards pharmacy prescribing, according to either agreed protocols, within an agreed collaborative framework, or in clearly defined roles of independent prescribing.

      At the end of the day, such a program for developing the scope of pharmacy professional services in this way, can only enhance the level of triaging and referral expertise that pharmacists have successfully carried out for many years, as well as enabling them greater collaborative role in better managing patient care within the community.

      • Hi Ron, thank you for your detailed response and especially thank you for your innovation in establishing clinical pharmacy in Australia. Something I am now very passionate about.

        Our difference in views comes down to perspective, and I would argue I am approaching this from a more objective point of view.

        Regardless of intention, autonomous prescribing for UTI will require a pharmacist (a lesser trained diagnostician) to make a diagnosis and treat with a prescription. The opportunity cost here, is for the patient to have foregone seeing the GP (a highly trained diagnostician) for a diagnosis and treatment. From my perspective, this is both wasteful and unnecessary.

        I believe “an agreed collaborative framework” and “clearly defined roles of independent prescribing” are two very different propositions. The former, I can appreciate and if facilitated properly in conjunction with our medical colleagues, will be beneficial for our patients and healthcare system overall. I stress the requirement to collaborate with our medical colleagues, something which I believe has not been done due to their very public outcry.

        In regards to your last paragraph, I appreciate the major role that pharmacists play in triage and referral but to argue that somehow pharmacist prescribing will enhance this role is completely moot.

        I want to stress that I am not against pharmacist prescribing. If and when we do prescribe, it should be within the realms of our skills and expertise. If there is any requirement to diagnose a potentially threatening ailment, this is beyond what we have trained for. There is also a perfectly able medical colleague that could do that for you.

        It’s simple. If your mother had a suspected UTI, would you send them to the local pharmacist or to the local GP?

        And why should any patient be treated any differently?

Leave a reply