“The time for criticism is over”

Calls for collaboration and support following GP criticism over secret shopper results

A recent study published in the International Journal of Clinical Pharmacy utilised mystery shoppers to assess whether they would be appropriately referred by a pharmacist or pharmacy staff member to a medical practitioner based on the presenting symptoms (all of the mystery shopper scenarios required referral).

A significant difference was found between visits where a pharmacist was involved and where a non-pharmacist staff member handled the interaction alone.

Interaction with a pharmacist, either directly or after first speaking to a non-pharmacist staff member, resulted in referral in 80% of interactions.

However, mystery shoppers who only dealt with a non-pharmacy staff member (i.e. a pharmacy assistant) were referred to a medical professional in less than a quarter (24%) of the occasions.

The finding led the authors, from the University of Sydney, to call for improved training of non-pharmacy staff.

However an Australian Doctor article covering the study did not clearly differentiate between the level of referral when a pharmacist was involved in the mystery shopper interaction, or when the customer only spoke with non-pharmacy staff.

Australian Doctor readers were quick to respond, with one saying the results were “the very reason that pharmacists should never be ordering pathology and treating diseases, as they are not trained to make clinical decisions on asthma and diarrhoea etc., and cannot therefore recognise “red flags”, nor be expected to do so.”

“This is whats happens when Govt promotes pseudo doctors to save money. In the end its costing more, leave aside the disability patients develops. Its the pharmacy guild who have bought their way in at peoples health cost. i have never seen such a bureaucracy anywhere where non-doctors are made doctors at the cost of peoples health,” said another.

The PSA has responded to comments and the article with a call for collaboration between GPs and pharmacists, saying that “the time for criticism is over”.

“What we need to be doing is working together to support evidence-based practices that improve the quality of care consumers receive,” says PSA National President Dr Shane Jackson.

He acknowledged that the report documented some behaviours that fall short of the standards expected of the pharmacy profession, and said that there is a need for support to enable pharmacists to have the majority of these consultations, and better training for pharmacy staff as a whole.

“While the majority do this well, PSA is working hard to support the profession through a range of resources to improve these practices, and has urged the government to allocate funding to develop quality indicators for pharmacist practice,” says Dr Jackson.

“We should also note, however, that this kind of challenge is not limited to pharmacists. Just this week we had reports of inappropriate antibiotic prescribing by GPs – at up to nine times the recommended rates – contributing to the problem of antimicrobial resistance and even deaths.

“The response from the GP groups was to encourage better education and protocols. Pharmacists are supportive of this and expect the same in response from our GP colleagues where the need for improvement is identified.”

Dr Jackson says there could be many positive outcomes for Australia by optimising the role of pharmacists, especially within collaborative healthcare frameworks.

“Internationally, we see GPs and pharmacists working together to build shared protocols and improved communication pathways, with evidence this improves outcomes for consumers, particularly those with chronic disease,” he says.

“With all the reform happening in primary care at the moment, let’s not miss the opportunity to realise these benefits in Australia.

“At PSA, our door continues to be open to RACGP and other GP groups to develop collaborative protocols that avoid the type of problems highlighted today, and deliver cost-effective health outcomes to consumers.”

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