Why the backflip?

Jarrod McMaugh shares his concerns about Sonic’s withdrawal from Sigma’s in-pharmacy pathology screening program

The news is extremely disappointing, and I feel it amounts to suppression of competition within the health sector.

Competition is healthy in all areas of society, including the health sector. While the primary purpose of Amcal and Sonic’s agreement was to make these types of services available to more people who choose to self-direct their health care, it can’t be denied that this service created a small level of competition between Amcal pharmacies and other providers of pathology requests (including GPs, specialists, naturopaths, or even self-selection online without any healthcare practitioner).

Competition isn’t a dirty word, and the fact remains that pharmacists are capable of writing referrals to all health professionals (including pathologists)—the difference is that pharmacist referrals lead to services from other health professionals that are ineligible for Medicare rebates. This isn’t a new development, and remains unchanged by the reversal by Sonic in its agreement with Sigma.

It must be asked, what led to Sonic’s sudden reversal? Dr Michael Harrison, President of the Royal College of Pathologists of Australasia (RCPA) had gone on record saying that Sonic and RCPA were very happy with the arrangement, and that complaints from GPs amounted to no more than  “the usual ongoing ‘trench warfare’ between GPs and pharmacists”.

Yet suddenly there is a backflip and it is no longer a service that will be offered due to “many GPs express(ing) concerns about the initiative”.

The troubling question is whether any medical lobby groups directly applied pressure to Sonic in order to have the service shut down—for instance, implying or threatening to have members of one of these organisations boycott Sonic. If this is the case, I believe it would be a gross abuse of market power. For this reason, I will be contacting ACCC and asking them to investigate further.

Of greatest concern is the wider implications of such a move. What would have happened if a medical lobby group had pressured vaccine suppliers when QUT initiated pilots for pharmacist-provided vaccinations? What could happen in the future for any number of health services provided by pharmacists? Is this the way that pharmacists will be “kept to their knitting”?

I will be pushing for this to be investigated fully, and would be more than happy for any other concerned pharmacists, GPs or other health professionals to get in contact with me about this issue —especially if anyone has any communication that would confirm my concerns.

Jarrod McMaugh is a community pharmacy practitioner with Capital Chemist in the northern suburbs of Melbourne, and Vice President of the PSA Victoria Branch.

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  1. Philip Smith

    No proof, but smells fishy.

    Someone will have a smoking gun somewhere in the medical profession and one would argue they are required to report it under their code of ethics.

    3.1 Professional conduct
    3.1.10 Report suspected unethical or unprofessional conduct by a colleague to the appropriate
    3.1.11 Report any form of bullying or harassment of, or by, students, colleagues or other health care professionals.

    But we have seen how the AMA president follows these code of ethics.

  2. Bruce Willett

    Agreed, there is certainly a need for increased competition in pharmacy in Australia, it is one to the most protected industries on the planet. It would be great to see an opening up of pharmacy licences, too long have the guild indulge in the practice of “eating their young” by lobbying for restrictions on pharmacy which drives up costs and prevents young pharmacists from operating their own pharmacies. It is time for a review of this restrictive anti-competitive practice.
    It has long been the belief in this country that there is an important function serve by separating the clinician and the dispenser. It has served as a checking and safety mechanism, but more importantly it means there is no pecuniary interest for the prescriber to prescribe. The push by pharmacies to a clinical management would seem to indicate that many no longer feel either of these protections is important. It naturally follows the increase competition means that the dispensing could (and I would argue should) be moved back to the medical practitioner who is in a better position to understand the whole of the patient’s needs and circumstance and can provide the service at a reduced cost. Ideally incorporating some of the new pharmacy gradates into the practice, who are able to own shares General Practices but who have Pharmacies held out of their reach.

    • Jarrod McMaugh

      You know if your only argument against this kind of issue is “yeah but you guys are shit too” then you don’t have much of an argument

      • Bruce Willett

        I think you have missed the point, I certainly don’t think “you guys are shit”, the opposite is true, and I don’t think that language is helpful. The point is it is better to co-operate than compete. However it is difficult for the most controlled industry in the country, one that uses that control for established Guild members to take advance of new pharmacy grads, to then complain about anti competitive behavior. If you want competition you must surely support freeing up of dispensing licences. (anything less is just hypocritical).
        Why not just work together instead of this antagonistic approach.

        • Jarrod McMaugh

          Bruce the issue I raised here is one of a potential breach of competition laws, which may affect the registration of individual doctors who were involved.

          What you speak of (location rules) is a government policy designed to ensure that pharmacies are evenly distributed in the county – a policy that is in fact successful.

          What you speak of (pharmacy ownership) is a government policy to prevent medications being commoditized either by non HCPs who do not respect the nature of medicine as not being standard items of commerce, or by prescribers who would be in a position to create supply and demand.

          Removing the first would be a detriment to the public as some brands would utilise market power to squeeze out competitions.

          Removing the second would see large numbers purchased by a small number of large businesses who have the finances to do so quickly (one supermarket chain supposedly has an in-principle agreement to buy a pharmacy chain overnight if this policy is relaxed)

          In either case, removing one or both would in no way advantage young pharmacists who wish to become owners. The only way to do this would be to further restrict the rules, not remove them.

          In any event, none of this is on topic, since none of it is about the apparent abuse of market power to exert “commercial pressure” on a company to cease providing a service to another company in competition with the current status quo in pathology requests.

          So I again say, if your only argument is to ignore the points I raised, and instead extol the vices of the phaacy industry, then you aren’t adding anything to the discussion, and your points come down to nothing more than trying to justify illegal behaviour because you don’t like the law.

          • bernardlou1

            Love your structured, professional reply Jarrod. Well said.

        • bernardlou1

          Freeing up dispensary,
          PBS approval is PBS approval. It allows the supply of PBS listed meds a listed price to the consumer and it should be the same. Not higher or lower!!!
          How can you compete on a listed price!! Discount the listed price??
          Warehouse style pharmacies are the only one that try to run their dispensaries at a break even point to attract customers to their front of store offering!!!
          Freeing up approval number
          Will notngife those pharmacies any advantage and they will become like any other business.

    • Xpharmacist

      Bruce, you have identified some of the glaring inequities that plague retail pharmacy in Australia and I endorse everything you said above, including your brilliant idea of allowing pharmacists to work in GP “dispensaries” that they are able to have a portion of ownership in.

      • bernardlou1

        Dear X Pharmacist, you are free to go and set up pharmacies anywhere you wish!!! The only difference is you may not obtain a PBS approval to do so.
        Did you know that hospital pharmacies do not councel their patients, cause they don’t have time!! It’s a tax payers dunded model.
        Did you know that warehouse style pharmacies donor counsel their patients either!!! This model is partly funded by the tax payers. Did you know the only proven model that councel its patients and provide advice, support and ongoing care is the traditional community pharmacy model???

    • bernardlou1

      The average age is guild member is 45!!! If this is old then I’m not sure how would you classify young!!

  3. Andrew

    As long as location laws exist pharmacists have no place commenting on “competition”.

    • bernardlou1

      The king review proves you incorrect. According to the kind review there is 200% variation in prices!!!!
      If this isn’t competition then what is. There are 5600 pharmacies approximately in this country and they are all owned by different entities!!!
      Again if this isn’t competition then what is???
      Unlike supermarkets ownership by listed companies or the warehouse style store owned by three people.

      Please provide evidence for your comment.

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