Payment for short consults?

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There is a “very, very big gap in the payment model” for professional pharmacy services, says Trent Twomey

Mr Twomey, Pharmacy Guild Queensland branch president, was speaking at a State of the Industry Question and Answer session with former Guild national president Kos Sclavos and CP2025 senior advisor Marsha Gomez.

“If you go to a doctor, they have short consults, you know, the seven and a half minute thing that you pay $18 for, and they’ve got medium consults and large consults,” Mr Twomey said this week.

“We have HMRs, that’s a long consult. We have MedsChecks, Diabetes MedsChecks, Chronic Pain MedsChecks… which is a medium consult.

“But the vast majority of interactions we have with our patients… are short consults on the back counter.

“And a lot of those don’t result in the sale of a product. It’s advice. So a big gap, in my mind, in the remuneration structure is there is not a paid model for the short consults which form the vast majority of what it is that we do.

“Where I’d like to end up, then, once we have this suite of things, is: it’s not just ‘have I hit my MedsChecks target, have I hit my DAA targets?’

“It’s just basically, ‘I don’t need to worry about caps, and targets, I just serve the person that comes in and I need to make sure I claim for it’.

“In an ideal world there would be no caps, it would just be based on patients’ needs that walk into the pharmacy.”

He said that pharmacy was currently “a while off that” but “it will evolve”.

Mr Sclavos warned that GP stakeholder groups would not like such changes, but they were absolutely worth pursuing in the interest of public health.

“No advancement as pharmacy has ever occurred because another profession has gladly said, ‘Oh, okay, let the pharmacists do that’,” he said.

Queensland Guild president Trent Twomey addresses delegates at PA2018.
Queensland Guild president Trent Twomey addresses delegates at PA2018.

“With flu vaccine we had a war going on.

“Here we are four and a half years [after the initial Queensland flu vaccine trial] with vaccination all round Australia.”

He said that pharmacy leadership “takes bullets sometimes” because advancements in pharmacy are a battle.

“You don’t win these things by playing nice. But it’s all based on evidence.”

Mr Twomey said that at the grassroots level, GPs were very happy to work with pharmacists and see pharmacists doing more.

Specialists will have to allow GPs to do more, while GPs will have to allow pharmacists to do more, he said.

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  1. Jo Sorensen

    Payment for any consult time is warranted. For a number of years now we have established a credible, respected and professional sleep apnoea service. Our overnight sleep tests and their follow up process were charged to the customer at a fee comensurate with the time and professionalism required and the costof hiring the necessary testing equipment. However that is all gone now due to another “colleague ” in our town advertising free tests when they have only been providing this service a few months in order to gain market share. We continue to do it to ourselves.

    • Paul Sapardanis

      Free bp tests free delivery free glucose testing free DAA’S etc. How can an independent body place a value on our services we provide when we don’t ourselves

      • Apotheke

        If as a profession we keep on offering our skills and expertise for “FREE” that is exactly the value the patients, doctors and the government will place on our clinical skills and input into patient care a big fat ZERO. Time to establish our own recommended fee scale just like the AMA has set out for GPs based on their modelling of practice costs. Over to you Pharmacy Guild that is a job for your economic modelling branch. A fee scale is well overdue and please do not tell me there are legal impediments to a “recommended set of fees”.

  2. JimT

    In the “good old days” there was enough margin in what we sold/dispensed that covered these consults that didn’t result in a sale to cover it. Now everything is basically pay for service model and payments are based on the steps we do then it is a logical step that we have a fee for consult structure as described in the above article

  3. Johnny Teo

    “It’s just basically, ‘I don’t need to worry about caps, and targets, I just serve the person that comes in and I need to make sure I claim for it’.

    Yup that’s going to get abused badly. I mean I’ve already witnessed a ton of pharmacists making stuff up or really bad ones such as ‘patient needs probiotics with their antibiotics’ with regards to clinical interventions just to boost numbers. Surely, we can be better than this. How many of us have witnessed theoretical medication issues that don’t impact the patient in hmrs- I’m not saying that they’re all rubbish but it’s quite sad, just to meet quotas.

    We need to go back to our roots. Compounding or working in gp clinics where we can put our expertise to good use

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