AJP takes a look back at this week’s best reader comments
Our interview with Saxby Pharmacy’s and Friends of Science in Medicine’s Ian Carr, “Naturopathy: if it wasn’t so serious it would be funny,” caused quite a reaction, with responses split between supporting Carr’s criticism of naturopathy in pharmacy and disagreeing intensely.
“Absolutely agree—it frustrates me no end as an academic that teaches a course in interpreting evidence, and who writes an evidence-based textbook, to see all this teaching ignored once out in profession for the sake of profit. I would be a happy pharmacist if I never see another basket of ear candles sitting on the front bench of a pharmacy again!” said reader David Newby
Frank van der Kooy queried claims that naturopathy is embraced by other countries: “For example in the Netherlands there is not even a single department at any University that support or perform research on CM, not even the ‘phytochemistry’ of herbs.
“That some pharmacies have fallen for the ‘all natural, all holistic’ propaganda has indeed happened, but the scientific community over there is frowning upon this and is actively trying to reverse this dangerous trend.
“As with many other things in life it is all about money and it has very little to do with improving healthcare and it has got absolutely nothing to do with a scientific evidence base,” van der Kooy wrote.
“The pharmacy makes a bit of extra money, the naturopath makes a lot of money because they now suddenly have a huge market. Being allowed in a pharmacy gives them legitimacy and to some degree credibility—after all the public thinks that everything in a pharmacy is evidence based (and that the pharmacist really cares about your health) and thus naturopathy suddenly becomes ‘evidence based’.
“It is a sad state of affairs when the pharmacy industry openly support naturopathy and the like.”
But Katherine Maslen, who says she is a properly trained and evidence-based clinical practitioner, said that “anyone that says that naturopathy is not evidence based is either ignorant or has not taken the time to read any research.
“These days, naturopaths are Bachelor qualified (4 years full time study) and all of their assessment is evidence based. Sure, they use empirical knowledge as well, but this is combined with a strong evidence base and every day there are dozens of studies being published on herbal medicines and nutrition.”
“A naturopath is a pharmacy is ideal – we complement each other perfectly,” she wrote.
Our article covering Pulse editor Nigel Praities’ column asking, “Do we really need pharmacies?” and the Guild’s Tim Logan’s response attracted several comments, including from Pharmacy Guild Victorian Branch president Anthony Tassone.
“Rather than viewing the issue or debate from a ‘turf’ or ‘territory’ perspective, it’s essential that we consider it from a consumer or patient need perspective,” Tassone wrote.
“There is a clear safety imperative with the separation of prescribing and supply.
“Furthermore, advocating for an expanded role for pharmacists is done in the context that pharmacists are underutilised in a health system that is under pressure. There is a consumer benefit.
“Are consumers experiencing a lack of accessibility to receiving prescriptions being dispensed from a pharmacy? The evidence doesn’t suggest that with 87% of the Australian population living within 2.5km of a community pharmacy.
“Is there evidence that patients are having delayed wait times to have an appointment with a GP? There is evidence to suggest that this is the case with some evidence suggesting that 23% of Australians in capital cities and 42% in other areas wait at least three days for a GP appointment.
“Hypothetically speaking, if GP’s were to take on a dispensing role would these wait times increase? Would an accessibility problem be made worse?
“Suggestions by some doctors groups of ‘if you pharmacists take on a greater role, then maybe we should take up dispensing and some of your role’ should ensure the patient is placed at the forefront of our considerations; their safety and whether it addresses a clear need.
“On their previous arguments—it doesn’t appear as they’ve been able to make a strong case.”
But contributor William pointed out that in country areas, doctors once dispensed and “it was very sensible in isolated areas”.
“When there was a need for the apothecary to compound substances there was a real need of specialised knowledge and the operation took a lot more than sticking a label on products and collecting the money.
“Very few pharmacist would actually know how to make compound mixtures these days as we area all at the end of our career.
“Something needs to be done to decrease the total costs to the community of healthcare.”
And reader Nuggettyone compared the Australian system to that of Singapore, where “doctors all dispense”.
“I think Australia’s system of separating dispensing from prescribing is far superior to Singapore’s. It doesn’t just help with the detection of adverse interactions, medications checking, and an additional pair of eyes with better pharmacological knowledge. It is a system with innate checks and balances that protects the sick from opportunism.
“In Singapore, it’s pretty much a fact of life that your GP bills can vary wildly – it simply depends on how much the GP feels like ‘padding’ with additional vitamins, unneeded medications, etc etc.”
And in reaction to our story on automation, in which we spoke to pharmacist and PharmHack founder Sabrine Elkhodr about whether pharmacists will lose jobs to robots, reader The Truth had this to say:
“There WILL be a time for automation in pharmacy, but I would wait before buying in as the current tech is expensive and far from foolproof.
“Technology is advancing at a rapid rate. It’s a bit like purchasing the latest sports car with all the bells and whistles.
“Sure they go quick but they don’t mean you get to your destination any faster. If your fancy machine breaks down on the way then you look like a fool sitting on the side of the road. They also come with heavy service costs and once out of warranty repair is also expensive.
“However they do make you appear successful…”