The hybrid health matrix

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EDs, GPs and community pharmacies need to overcome barriers to working together, writes Angel Gonzalez

There is no question that community pharmacies could play a more valuable role in health care, by providing a wide range of services in a timely, cost-effective manner.

However, to reach their full capabilities, community pharmacies have to overcome several barriers.

These barriers come in the form of regulations that serve to limit the scope of services that pharmacies can provide, reducing the capacity for expansion beyond that of merely dispensing pills.

The unjustified reason for this hurdle is the concern for patient safety, imposed by political pressure from physicians’ guilds.

Pharmacists are highly trained health professionals, knowledgeable about a range of medical conditions and capable of delivering advise, diagnostic, and treatment services. Customers have more contact with pharmacists than any other health-care provider and they highly value and appreciate their pharmacists’ advice.

The Roy Morgan Image of Professions Survey 2016 found that Australian pharmacists ranked second amongst all professionals as ‘an honest and ethical profession’ behind nurses, as equal to doctors, and ahead of dentists, judges, teachers, police members’, accountants, lawyers, and public servants. Consumers confidence represents a significant advantage.

Another barrier to expansion of services offered is organisational. Australian health care providers are reimbursed based on the number of the visits rather than on the outcomes.

Physicians and hospitals do not receive incentives to collaborate with pharmacists to address issues such as patient chronic compliance with their therapies.

Community pharmacies need to move toward more integration with the healthcare system, rather than functioning in parallel with it.

The integration could develop a hybrid health matrix, with community pharmacies serving as accessible retail hubs for the health care organisations, performing triage functions, offering primary care to customers with minor ailments and referring where necessary to general practitioners, specialists, or Emergency Departments.

This creates a win, win, win situation for everybody: the consumer (time and financial savings) : physicians (generation of foot traffic via referrals from community pharmacies): and community pharmacies (gaining increased patronage from Emergency Departments) and GP’s directing their patients with common, uncomplicated conditions to the pharmacy for quick, high quality, cost-effective attention.

Positioned as ‘Retail Health Centres,’ community pharmacies would focus on healthy customers and chronic patients, providing a range of health services, including counselling, tracking risk factors, smoking cessation programs, vaccinations (the full range), nutrition and weight management, among others.

A partnership with consumer product companies and the pharmaceutical industry will be essential to deliver a powerful value proposition for customers.

The ultimate outcome would be for the community pharmacy to become more integrated into a consumer centric model, in which patients would be guided toward the most appropriate specialist (whether it be the Emergency Department, GP or community pharmacy)  according to the specific characteristics of their health problems.


Dr. Angel Gonzalez is a Senior Associate with XPotential™ and Director of SymptoMapp. A qualified medical practitioner and anaesthetist in his home country, he is the owner of his own medical consulting business in Latin America. Angel’s deep medical knowledge, commitment to improving consumer health literacy and creativity provides unique insight into opportunities to improve healthcare in Australia.

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  1. Kevin Hayward

    One of the areas primary care pharmacy could seek to develop, without the need for government funding or regulation is community services. I have just been looking at the diploma in community services, a qualification greatly in demand by care providers in Australia. Curiously many experienced community pharmacists have the skills described in the qualification. Many Community pharmacies are already delivering a cohort of the services. It does not take a rocket scientist to work out that community pharmacies could contract with care providers formally to deliver community care services. A new paradigm, a new funding stream, and no PBS to worry about!

  2. Correne

    Totally agree Kevin, as a pharmacist with over 30 years community and owner experience we have to get over a couple of bumps in the road…Our mindset that our professional services are not receptive for renumeration by the consumer or that we would not be able to put a case to Medicare for primary health care services. We have got approval numbers just need to put the case to include PBS codes for services in the Yellow Book. Sometimes simplicity is a possible solution

    • Kevin Hayward

      Hi Correne, interestingly you appear to be the only person who has grasped the possibilities here. As pharmacy has ceased to define itself as a dispensing chemist and moved into healthcare, why are we not contracting with other community care providers like Vinnies etc. We might even get paid for our home deliveries and care of the elderly for a change!

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