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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