Pharmacy under fire

Critics ramp up attacks over pharmacy vitamin sales, but profession fights back

Pharmacy’s income sources need to overhauled to reduce the reliance on complementary medicine sales, doctor’s groups have argued.

As revealed by AJP last week the AMA submission to the Review of Pharmacy Remuneration and Regulation gave support to the deregulation of pharmacy ownership and location rules.

The submission also called for alternate funding model to “focus on professional, evidence-based interactions with patients”.

“Pharmacists’ expertise and training are under-utilised in a commercial pharmacy environment where they are distracted by retail imperatives, including the sale of complementary medicines that have no basis in evidence,” the AMA submission states. “It would be difficult for anyone to argue that there is no inherent conflict of interest in this situation.”

The comments have been picked up by mainstream media sources, with The Weekend Australian covering the submission in an article entitled “Vitamin sales ‘put chemists in conflict’”.

The AMA position has attracted the ire of many in pharmacy, with a number of the profession’s leaders taking to social media and the AJP website to express their disappointment with their submission, and with The Australian’s article.

The doctors’ group submission listed a wide range of services which it believed were beyond pharmacists’ core scope of practice, including “prescribing Schedule 4 medicines; early detection and intervention for mental illness; advice on nutrition, weight loss, smoking cessation, pregnancy and baby care; chronic disease management, e.g. asthma and diabetes”.

In response to the AMA submission and comments, PSA Chief Executive Officer Dr Lance Emerson said:

“PSA strongly supports pharmacists’ delivery of evidence-based services within pharmacists’ scope of practice that meet consumer health needs. Advice to consumers on a range of conditions, including smoking cessation and some other services mentioned in the AMA submission are well within the current scope of practice for pharmacists, and covered within the Competency Standards required of all registered pharmacists. Such services make good use of the available health workforce and should be supported as important public health initiatives.

“Regarding General Practice pharmacists, PSA broadly supports AMAs proposed model, however as previously stated, PSA firmly believes that the pharmacist hourly rate modelled in AMA’s submission is too low, and there is still much discussion to be had on the best model for payment.”

Commenting on AJP, Anthony Tassone, president of the Pharmacy Guild of Australia (Victoria) said: “the AMA position on acceptance of co-location of pharmacies in supermarkets and deregulation of pharmacy ownership to allow supermarket control is out of step with consumer views”.

“This was evidenced by a consumer survey conducted by the ‘Institute for Choice’ (a research institute from the University of South Australia) that was part of the Pharmacy Guild’s submission to the Competition Policy Review (aka Harper Review) which found of those surveyed that the majority of consumers supported health professionals/practitioners owning their own practice (rather than corporate or other ownership).

Based on conversations that I have had with senior elected officials of the AMA, they privately do not support corporate ownership of medical centres. One has to wonder why they feel the need to wade into the pharmacy ownership debate. Yes, a pharmacist can own a medical centre and a Doctor cannot own a pharmacy.

Consultant pharmacist Karalyn Huxhagen said: “The AMA’s statement is not how we practise in the 21st century in Australian pharmacy. The collaborative modelling of the GP payment system pushes the GP to use every partner that they can. Only problem for pharmacy is that we missed being made a part of the payment system when EPC, Collaborates, health care planning etc were designed”.

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  1. Tony Lee

    Unfortunately the AMA has always held a negative view of Pharmacy, probably as they see it as a competitor for areas of practice they have monopolized for many years unreasonably . I believe they also fear that the knowledge and training pharmacists acquire to-day infringes on their ‘I am better than thee’ syndrome.

  2. Jan Jackson

    This infuriates me. Totally agree with Tony Lee. What happened to Hippocrates “First do no harm”? Doctors have no understanding of this oath that they take. It is the consumer’s choice as to their chosen method for better health, it’s called “informed consent”. Doctors are fearful of pharmacists as they continue to educate themselves on nutrition, naturopathy, herbal medicines and vitamin and mineral deficiencies – their symptoms and testing. Doctors believe that this is their domain but in reality they have no education or training on any of these and have no intention of educating themselves on these matters. They would rather just scoff and intimidate pharmacists who have chosen to not only continue their education and “get with the rest of the world” but move forward in human science and the latest scientific discoveries. It is a shame that some doctors cannot see how much pharmacists save their as*** on a daily basis by stopping them from killing their patients with wrong meds being prescribed amongst other things. Doctors really need to take their heads out of their as***.

  3. Professor David Jackson

    Certainly, the medical profession will watch its own turf. But on the other hand, they have a point with some of their comments. For example, the ad lib sale of vitamins (of all sorts and mixtures) to one and all (and for that matter, all that natural therapy stuff!!). And as we all know, MOST require NO vitamin supplementation whatsoever. And where they do need a supplement, such as vitamin D and related, such a need should be backed up by evidence.

  4. Tim Hewitt

    There are plenty of Doctors out there ‘prescribing’ multi vitamins and the like to their patients, among other ‘treatments’ and ‘therapies’ with evidence of efficacy that I am unaware of. My argument to the King review re vitamins is that at least if purchased from a pharmacy, the ‘consumer’ has the opportunity to gain guidance from a qualified practitioner (that’s the pharmacist) , and then they can make their own mind up. I frequently advise patients that the vitamins etc they are interested in have no scientific evidence for efficacy, and armed with this knowledge, they decide to purchase anyway.. (i try not to take it personally..) that’s the human condition / faith based medicine/ culture/ call it what you like, versus ‘science’ in the real world..

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