‘Playground nonsense’?

RACGP hits back at NSW Guild column

President of the Royal Australian College of General Practitioners (RACGP) Harry Nespolon has responded to a column written by Pharmacy Guild NSW president David Heffernan late last week.

The column drew the ire of doctors after Mr Heffernan referred to “corporate GP practices, business models that appear to encourage five-minute medicine – turnstile operations which encourage patients to come in for short visits and often”.

He suggested pharmacists could take on the full minor ailment space, adding that more funding for GPs would be “a disaster for an already struggling MBS budget”.

David Heffernan. Image: Twitter
David Heffernan calls for legislation to allow pharmacists to take on the full minor ailments space.

“Increased funding to GPs will only incentivise five-minute medicine and blow out an already out of control GP and hospital spend,” said Mr Heffernan.

After a few days of silence from doctors’ groups, Dr Nespolon this week published his response entitled: ‘Do they teach perfume dispensing in pharmacy school?’

In his column Dr Nespolon labels Mr Heffernan’s comments “extraordinary” and “baseless”, arguing that the Pharmacy Guild’s only initiatives are “how to increase profit by upselling non-evidence-based products”.

“The evidence is clear: the more time a GP spends with their patient, the better the outcome,” says Dr Nespolon. “I have never seen research showing a similar conclusion for patients who see pharmacists for their minor ailments.

“Five-minute medicine? Turnstile operations? Where did they come from? Is the Guild feeling pressure from its own members, the large pharmacy chains or from the public?” he asks.

“The closest thing I see to a turnstile in healthcare is at the cash registers of the pharmacy.”

The RACGP president said GPs will continue to advocate for patients to receive appropriate rebates to ensure they can see their doctor for longer, more comprehensive visits. Image: RACGP/newsGP
The RACGP president said GPs will continue to advocate for patients to receive appropriate rebates to ensure they can see their doctor for longer, more comprehensive visits. Image: RACGP/newsGP

So far comments on the article have mostly called for an end to the ‘turf war’ and sniping.

“Now children please stop fighting,” said one pharmacist commenter on the newsGP website.

“This is playground nonsense,” said another commenter.

“Let them say what they like. When we start little comments about perfumes and things aren’t we just becoming as pathetic as they are. We all have degrees in our respective fields. We need them as much as they need us.

“Let them push their probiotics and multivitamins at the end of the day we live in a capitalist society. The end goal for privately owned anything… even general practices is PROFIT.”

“I find this response inflammatory and counterproductive,” added a different newsGP commenter. “Sometimes no response at all is a safer strategy when representing an organisation rather than allowing previous negative personal experiences override the gravitas of one’s position.”

“The experiences and understanding of the different roles of allied health and those of a GP are poles apart, but are indeed complementary, and it is destructive to turn the situation into turf warfare. We need to work together,” said a doctor.

However one said: “Good on you Harry for speaking out the truth about the greediness of the Pharmacy Guild and its members whose main interest is to protect its monopoly on pharmacy ownership.”

AJP readers have added to the conversation:

“SIGH this power struggle between pharmacists and doctors is actually so detrimental to healthcare, there is absolute arrogance from both sides, doctors do not value pharmacists, we pharmacists just think it’s all a money grab from doctors, I would love for healthcare to be what its supposed to be, respect between both professions, it’s all about the dollar and its honestly ripping healthcare apart for the needy so sad,” said Matthew.

“Mr Heffernan’s comments are intemperate, ill-advised, politically immature, offensive, indelicate, undiplomatic, uncivil and rude. They contribute nothing but envy and bile to the relationship. When you want people to trust and respect you the first action is not to spit in their face,” said John Wilks.

Gavin Mingay agreed with Mr Heffernan that pharmacists need more scope: “We need pharmacist prescribing for urgent cases such as fluclox for skin infections, prednisone urgent chest issues, steroid preventers for asthma, shingles meds… The late night pharmacies really suffer because the home doctor service struggle to find doctors to work, so we are constantly being asked to look after patients, but we are unable to. Trouble is, we need to be careful as certain pharmacy groups will rort the system as usual…”

“A few years ago there was a Hobart General Practice, operating several clinics across the city that was running TV adverts highlighting that they could help people with (from memory) ailments such as inset bites, sunburn, hay fever, summer colds! Not a great use of a doctors time and MBS funds!” said Angus Thompson.

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  1. Debbie Rigby

    It **is** “playground nonsense” and needs to stop.
    Have a read from one GP https://doctorsbag.net/2019/02/14/who-is-the-real-winner-in-the-latest-stoush-between-pharmacists-and-doctors/

    • Jarrod McMaugh

      It’s great that Dr Kruys is starting to change his attitude to pharmacists, and advocacy via media, but he may wish to start by addressing the significant contribution he has made to the problem he now wants addressed

      See again from his website https://doctorsbag.net/?s=Pharmacist

      Significant unfounded criticism of pharmacists, most when we was a representative or vice president of RACGP.

      There is a place for responding to criticism – in fact I think Dr Nespolon was quite restrained. What needs to stop is the “opening salvos”… But a greater issue is the underlying cultural issues that breed resentment & disdain for each other’s professions.

  2. Anne Todd

    Actually I would expect far better of children in a playground. I expect the leadership of all professional bodies to stay above such petty squabbles. Name calling does in lower the gravitas of the position as noted by my office buddy on the RACGP website and quoted here.

    And by the way as we discussed the commentary it turned out one out of two pharmacists and the one GP in the room had done “post graduate” perfume courses, in my case 3 days with Michael Edwards in the 1990s, and in his a workshop in the south of France on holiday. Not sure what that means other than we both understand terms like Chypre and have a working knowledge of potential causes and treatment of allergic rhinitis.

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