Sick note spat is back


pharmacist double checking prescription

Representatives of the AMA have again attacked pharmacy over sick notes, after a Herald Sun reporter obtained one in less than two minutes

Doctors and the mainstream media have waded in for another round of the absence-from-work certificate debate, which has reared its head a number of times during 2018.

This time, the Australian Medical Association’s Victorian president, Julian Rait, has told the Herald Sun that “wandering into a pharmacy and being issued a certificate without history or examination is very concerning”.

Reporter Tamsin Rose also spoke to AMA treasurer and Brunswick GP Dr Michael Levick, who said that pharmacists were not qualified to make such diagnoses and could potentially not notice serious health problems.

“They are very well trained in medication management, but they are not well trained in medical management,” he said.

“Encouraging people with medical problems to see non-medically trained people is not good.”

A Herald Sun reporter attended a MyChemist pharmacy in Melbourne and was given a two-day absence from work certificate in less than two minutes, Ms Rose reports.

“The intern pharmacist asked five questions about the reporter’s physical symptoms and performed no physical assessment,” she writes.

“The pharmacist spent more than a third of the consultation time spruiking pharmacy products for sale.”

A carer’s leave certificate was obtained in a similar manner from a Chemist Warehouse, she writes.

Pharmacy Guild Victorian Branch president Anthony Tassone told Ms Rose that doctors’ “perceived fears of fragmentation of care do not ­excuse delays in care or potential lack of access to care”.

He later told the AJP that as pharmacists are authorised to provide absence-from-work certificates under the Fair Work Act 2009 as proof of a legitimate reason for absence from work, the phenomenon was hardly “breaking news” or a new development.

Some pharmacies have been offering the service for almost a decade, he pointed out.

“The AMA continually raises ‘concerns’ whenever another autonomous health profession seeks to practice to their full scope,” Mr Tassone told the AJP.

“Pharmacists are regulated by a national registration board and are accountable for their practice.

“Pharmacists as autonomous health professionals that are regulated by our own registration board do not need our scope of practice dictated or determined by another health profession. Policy makers, regulators and the public will determine the roles of pharmacists.

“Pharmacists, or any other health profession certainly do not do this towards doctors.

“Absence from Work Certificates are issued at the pharmacists’ discretion at pharmacies which offer this service. Pharmacists can only issue certificates for conditions that are within their scope of practice; such as minor ailments.

“If a patient’s illness or injury is outside a pharmacist’s ability to assess, they will refer them to a doctor or other relevant healthcare professional.”

He said that it makes sense for pharmacists to practice to their full scope of ability, as this takes pressure off an otherwise stretched healthcare system, and offers patients choice with another contact point into the primary healthcare system.

“Along with the Pharmaceutical Society of Australia, the Pharmacy Guild have developed comprehensive guidelines for pharmacists in issuing absence-from-work certificates to help align with obligations under the Fair Work Act and pharmacist professional practice and competency standards,” Mr Tassone said.

Updated guidelines were released in October.

“The Guild supports pharmacists practising to their full scope of practice, and issuing of absence of work certificates for illnesses or ailments that are within a pharmacist’s scope of training and expertise can provide benefits for the community and broader economy and health system.”

In March, News Corp media reported that Innex Willox, chief executive of the Australian Industry Group, felt “some bosses would be sceptical of notes obtained from a chain store pharmacy”.

Chemist Warehouse’s $20 sick notes came under particular fire.

Soon afterwards, the PSA issued guidance on the matter.

In July, AMA president Dr Tony Bartone also criticised pharmacy sick notes after a sign advertising the service at a Torquay, Victoria pharmacy advertised it and went viral.

In September, the MBS Review specifically cited the provision of absence-from-work certificates and other administrative tasks as areas of concern where doctors believe their time could be better spent.

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