A frequent critic of the pharmacy sector has spoken out to urge GPs and pharmacists to work together
In his Doctor’s Bag blog, immediate past RACGP Vice President and RACGP Queensland Chair Edwin Kruys, has expressed concern that “the relationship between pharmacists and doctors remains sour at the expense of patient care”.
He explains the conflict between pharmacists and GPs at the stakeholder level, outlining the pharmacy sector’s hopes to widen pharmacists’ scope of practice.
“Some pharmacists want to be able to write prescriptions as they believe it is in the scope of practice of a pharmacist and more convenient for patients,” he writes.
“Examples from abroad are used as an argument why Australia must follow suit. A ‘collaborative prescribing pilot’ is underway and the pharmacy sector is looking forward to the soon-to-be released results.
“Pharmacists expect that their proposal will be cost-saving as people will not need to see the family doctor for prescriptions.”
PSA president Dr Shane Jackson has recently told the AJP that prescribing rights for pharmacists are imminent.
A Queensland inquiry is looking into the issue as well as others affecting the sector.
Medical groups, on the other hand, are “upset” and don’t believe this proposal is either helpful or in the interest of the public, Dr Kruys says.
“Doctors are concerned that soon the head doesn’t know what the tail is doing or, in other words, that more prescribers will lead to more fragmentation and adverse health outcomes.
“Concerns have been raised that warning signs or significant (mental) health conditions will be missed and screening opportunities lost. Some have also argued that pharmacists prescribing and selling medications at the same time creates commercial conflicts of interest.”
He predicts that the debate will “heat up” and “unpleasant words” will be exchanged in the media before any decision on the proposal is made by the relevant Health Minister.
“Then there will be a loser (usually not the Health Minister) and a winner, and the relationship between pharmacists and doctors remains sour at the expense of patient care,” Dr Kruys writes.
Falling short of actually criticising pharmacist prescribing himself, Dr Kruys says that what is missing in the debate over pharmacy’s scope of practice is any word of a “joint strategy or a solution that would benefit both parties as well as our patients”.
“Community pharmacists play an essential role within primary care teams. The pharmacy sector is under pressure and is attempting to implement strategies to remain viable into the future, such as introducing services currently provided by doctors, nurses and others,” he writes.
“An obvious way forward would be for pharmacists and doctors to explore models that are not competitive but complement each other. This is a joint process that requires broad support from both parties.
“We desperately need genuine collaborative models of care, such as pharmacists working in general practice, but there may be other models too.”
Dr Kruys finishes by saying that it’s “time to leave the Miachiavellian era of Australian healthcare behind” and asks, “Who’s going to take the first step?”