Turf War

The Pharmacy Guild of Australia released its policy paper Community Pharmacies: Part of the Solution in mid-August, which argued pharmacists could play a greater role in the healthcare system.

The Guild’s vice-president Anthony Tassone has indicated pharmacists should be allowed to give travel vaccinations, prescribe the contraceptive pill and treat conditions such as erectile dysfunction and urinary tract infections.

Opposition has been swift, with AMA President, Dr Tony Bartone pointedly telling chemists that if they want to be doctors they should “go to medical school”.

The media love a doctors versus pharmacists story. However, when doctors publicly reject pharmacists’ attempts to extend their scope of practice, we’re often accused of ‘protecting our turf’. But it’s really about protecting patients.

Ideally, vaccinations should be provided by a doctor, because it’s about more than just administering a needle injection. It’s an opportunity for patients to have a vital consultation with their GP.

GPs are best placed to manage patients. Doctors are trained to take a comprehensive patient history, conduct an examination, make a diagnosis, start an investigation, manage the patient’s condition(s), and provide treatment.

Medical practitioners have a depth of knowledge that includes the most clinically appropriate treatments for a condition – we also know when not to prescribe and the impact of treatments on other co-existing, yet unrelated conditions.

Pharmacists have not completed years of medical school and do not have the subsequent specialist training and clinical experience required to support pharmacist prescribing.

We also strongly believe there should be a separation between prescribing and dispensing. There is a conflict of interest where a pharmacist stands to commercially benefit from prescribing medicines.

Pharmacists have an important role to play in supporting patients and are trained to advise and dispense medicines.

Despite the us vs them turf war rhetoric, there is ample opportunity to have a more cohesive, integrated relationship.

We need to look for new solutions to improve patient care and there could be real benefit in providing team-based care through inclusion of clinical pharmacists in general practice. A non-dispensing pharmacist who delivers clinical and education services to patients within the general practice setting could ensure compliance, improve patient awareness, support the coordination of care, and emphasise a team-based approach.

This approach would see pharmacists and doctors working to the full extent of their scope of practice in an integrated team environment, for the ultimate benefit of patients.

Fragmented care or integrated care – it’s clear to me what the best choice for the Australian health system would be.