Turf war: have the debate, but keep it constructive


doctor shaking hands

It’s important to discuss where the limits of pharmacy’s role lie – but the current “turf war” approach isn’t supported by the profession

This month, PSA national president Dr Shane Jackson wrote an opinion piece in GP magazine Medical Observer, calling for an end to the “turf wars” and hoping for a more constructive discussion about scope of practice.

Dr Jackson’s call to action followed a barrage of criticism by GP groups regarding pharmacist vaccination, the codeine upschedule and Amcal’s now-defunct pharmacy pathology service.

It appears that the average pharmacist agrees with Dr Jackson. AJP asked in our latest poll what readers thought about the “turf war” and the response was clear: it’s not helpful.

The top response, getting 40% of the vote (137 readers) was that the discussion was important, but “could be handled more constructively”.

The next most popular response, with 33% of the vote – readers were able to tick as many responses as they felt applied to their opinion – was that pharmacist groups are right: pharmacists can and should do more.

Another 26% said that the turf war does not reflect their good relationship with local GPs.

Twenty-two per cent said that the “turf war” is out of control and not conducive to providing good health care; 11% said GP groups are right, and that pharmacists are taking on roles they shouldn’t; and 15% said that “nobody cares here on the ground”.

Dr Jackson told the AJP this week that the most important consideration in the debate is the wellbeing of patients.

“We must talk about collaborative roles, and the roles of health professionals in general—whether that’s doctors, nurses or pharmacists—regularly, because health care is evolving,” he says.

“Because of that evolution, the roles and activities will often change.

“So if you don’t talk about those things, and don’t acknowledge that change, then health care won’t evolve, and you won’t deliver the best services you can, whether you’re a pharmacist or another health care professional.

“These discussions are often about referral, or handover, or transitions of care where one health professional perhaps takes over more than another does.

“But the key point is that you’ve got to have the discussion in a constructive way. If it’s not constructive and focused on what we all need to be focused on – which is delivery of services to the patient – then it’s just a destructive debate.”

Dr Jackson says that the days of health professionals practising in silos are over.

“It’s absolutely over, and the only way to solve the issues we have now – for example, medication management issues – is simply to collaborate and work together.”

He says that he’s heartened by the strong response to the poll indicating that GP-pharmacist relations are actually quite positive at a grassroots level, saying this backs up his stance in the Medical Observer article.

“What’s happening on the ground is that people are focused on achieving the best for the person that they’re caring for,” he says.

“You need to work with local providers to be able to do that, and any difficulties or disagreements you might have, you put aside – if they exist.”

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