Tensions are rising between doctors and pharmacists in Western Australia, with one GP calling the idea of pharmacist prescribing a “dog’s breakfast”
Following last week’s release of Western Australia’s review into the pharmacy sector – which made a number of recommendations, including that pharmacists be recognised as underutilised and not currently able to practise to full scope – doctors have become vocal in attacking the review.
Last week, the Australian Medical Association’s newly elected state president, Dr Andrew Miller, referred to pharmacists on 6PR as “basically Dr Google with a shop”.
Now, doctors are continuing to accuse the pharmacy sector – particularly the Pharmacy Guild – of placing business interests over patient health.
Dr Harry Nespolon, national president of the RACGP, told newsGP that “pharmacists, as a profession, are being judged by the public activities of the Pharmacy Guild”.
“These include practising beyond scope, rejecting any changes that may benefit patients and compliance, [and] promoting a business model that seeks to up sell patients to name a few,” he told newsGP’s Doug Hendrie.
“It becomes clearer every day to the public that pharmacists are using their sheltered position to generate sales, not take care of patients.
“If the PSA and the government do not change this reality, whatever value pharmacists may have will be lost.”
Dr Nespolon said he was not “anti-pharmacist” but that pharmacists should stick to what he called their scope of practice, and “get the government to fund that”.
Meanwhile Chair of the RACGP Board, Associate Professor Charlotte Hespe, told newsGP that prescribing fit in general practice, not pharmacy.
The AMA Western Australia’s immediate past president, Dr Omar Khorshid, told 6PR’s Karl O’Callaghan on the weekend that GPs are highly trained and skilled and need to have experience outside general practice before they are permitted to take on a GP role.
“The idea that you can kind of do the same just by plonking some other type of health practitioner in that role – what that says is that we don’t really care about the quality,” he told Mr O’Callaghan.
“The whole model of pharmacy, it’s a retail model. They have to sell you something, otherwise they’re providing you a service for free.
“I can tell you, pharmacists don’t do anything for free. Pharmacy owners, anyway. So they’ve got to make money out of you, and that means they’ve got to sell you something.
“When you go to the doctor, you pay for the professional service. You pay for their time, or the Government does… and they don’t have to sell you anything. In fact they’re not allowed to, which is actually one of the strengths, I think of the Australian model.
“There’s no conflict of interest there. There’s no drive to get you to buy an antibiotic, and we know that we give people too many drugs already.
“If you go to a pharmacy, they’ve actually got to sell you something. You go to the GP, they’re going to provide you with a professional service to the best of their ability which may or may not include drugs.”
And the Kalgoorlie Miner also covered the issue, speaking to Tower Medical Centre’s Dr Mal Hodsdon, who said pharmacists lacked the required resources and qualifications to provide the services recommended in the review.
“They are not doctors obviously, and they would be taking on a great responsibility if they start diagnosing and treating,” Dr Hodsdon said.
“It would just become a dog’s breakfast if patients go into the chemist on the expectation they are going to get a thorough history and examination done.”
Last week, the Pharmacy Guild’s WA branch director Matt Tweedie told the AJP that the Guild was disappointed in the doctors’ response, and that he extended an invitation to the AMA to discuss ways to move forward collaboratively with pharmacist stakeholders.
“We should be making better use of a trained workforce that sees one million Western Australians every week,” he said. “If we don’t, we’re failing the community, in my view.”
Doctors also expressed opposition to the WA review’s findings – and pharmacists concern at the doctors’ reactions – on social media.
Pharmacists are Medicines experts. Not trained to same level as GPs. Pill repeat = BP check, history eg. any new contraindications, STI prevention, Folate, missed pill protocol, ask why not using LARC instead. Anything less lazy policy, not good enough #womenshealth care @AMA_WA https://t.co/7zdjtZgnB2
— Michael Gannon (@drmichaelgannon) July 4, 2019
Pharmacists submitted report to govt suggesting big increase scope of practice. No GP collab was sought. We happy to discuss all but were not asked. No surprise AMA now think they not interested in GPs views but we will discuss & point out obvious problems. Oz is not USA. https://t.co/vPewxFMqdn
— AMA (WA) President (@AMA_WAPresident) July 6, 2019
This vitriol is horrendous – pharmacists are happy to work as part of teams with team players. Total lack of understanding of expertise is where this criticism fails. https://t.co/ryNA7Vst5D
— Shane Jackson (@ShaneJacks) July 5, 2019
It's really sickening how often the AMA takes shots at other professions for political points. Patient care is core and no profession is above. Lots of overseas modelling showing collaborative care is key. Stop looking after your patch and start looking out for patients.
— Blue Frogs (@fofafumalaka) July 5, 2019