Pharmacy accused of ‘cookbook or recipe medicine’

A GP and pharmacist has accused pharmacy of using the Queensland UTI trial and vaccinations as “new ways to get traffic into their retail outlets”

The Australian Medical Association’s Queensland branch says that the Urinary Tract Infection Pharmacy Pilot – Queensland (UTIPP-Q) trial will cost Queenslanders more than a bulk-billed GP consultation.

Wide Bay GP Dr Nick Yim, who worked as a pharmacist for four years before practising medicine, has said in a statement for the AMA that this “role substitution” allows health practitioners to work beyond their scope of training and is dangerous to patient care.

“The pharmacist will not have access to the patient’s medical history to correlate symptoms, will not send urine samples for testing and cannot examine the patient for symptoms of pelvic and bladder cancer which may be similar to infection,” Dr Yim said.

“I’m not exactly sure what the patient is paying for but it’s a prescription for disaster for patient care.”

Dr Yim said that while pharmacists play a vital and valuable role in the health care system, they are not trained to be doctors.

“As a pharmacist, I probably felt I could diagnose a UTI easily due to the simplicity of the condition, but I realise now—having worked as a GP—that I didn’t have the knowledge or training to ensure the symptoms were not masking something more serious which, left untreated, could become a major health issue,” he said.

“Pharmacists are the experts when it comes to the safe use of medicines, but diagnosing patients is not something they get trained to do and that’s why doctors are opposed to the trial.

“You do not want cookbook or recipe medicine. Each patient is different.”

The pharmacy trial went live in June with the release of the Drug Therapy Protocol for participating pharmacists.

Dr Yim’s comments were only the latest in a series of criticism of the trial by GP stakeholders; last month AMA Queensland president Dr Chris Perry said that “Queenslanders are being sold this new style of patient care under the guise of choice and convenience, but it’s simply a bargain basement version of health care,” and called on GPs to fill out a survey on the future of medicine.

At the time, Pharmacy Guild Queensland president Trent Twomey said that such statements were “unfounded” and “anti-patient”.

He said that rather than risking patient health, the UTIPP-Q “is yet another example of safe and effective innovation in the primary healthcare model”.

He pointed out that internationally pharmacists have had the ability to prescribe antibiotics for UTIs for a number of years.

The trial launched at around the same time as the State Government expanded the number of vaccinations that Queensland pharmacists can provide from three to nine—the same number offered by GPs.

Dr Yim also criticised this expansion of vaccination services.

“GPs are able to provide many of these vaccinations free of charge for patients that meet certain criteria, and provide complete care for the patient without conflict of interest,” Dr Yim said.

“I know from first-hand experience that pharmacists are always needing to look for new ways to get traffic into their retail outlets and expanding their scope of training through the UTI trial and vaccinations helps them achieve this.

“Pharmacists are also trained in companion selling—recommending customers purchase other products from the shelves apart from their prescriptions.

“There are shelves of perfumes, cosmetics and non-evidenced products.”

Dr Yim said the UTI trial constituted poor patient care and that “allowing more antibiotics to circulate in the community flew in the face of national and global efforts to combat antimicrobial resistance”.

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