12 July 2018

It is time to leave the Machiavellian era of healthcare behind?

General practice Government Pharmacy

Community pharmacy groups are lobbying for pharmacy prescribing, a topic that has been on the wish list for a long time.

Medical groups are concerned about patient safety and fragmentation and are pushing back. Is this Australian conflict model what we want or is there a better way forward?

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.

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.

Pushback

Not surprisingly, medical groups are upset and believe the proposal is not helpful and not in the best interest of patients.

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.

As a result there will likely be pushback from medical groups. It is to be expected that when the debate heats up some unpleasant words will be said in the media before the Health Minister of the day makes a decision based on evidence, opinion or political expedience.

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.

A better way

This series of events has become a familiar scenario in Australian healthcare. What’s missing is of course a joint strategy or a solution that would benefit both parties as well as our patients (a win-win-win solution).

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.

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.

This is of course easier said than done. It is, however, time to leave the Machiavellian era of Australian healthcare behind. Who’s going to take the first step?

Something to say?

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13 Comments on "It is time to leave the Machiavellian era of healthcare behind?"

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Ahad KHAN
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4 months 1 day ago
The Pharmacist should stick with being Pharmacists & not Doctors. If Pharmacists want to function as Doctors, then they should do a MBBS Course, qualifying them to become a DIAGNOSTICIAN – and you need to be a DIAGNOSTICIAN before you can take on the Role of a MEDICATION PRESCRIBER.. The RACGP is silently & shamelessly encouraging Non-MBBS Allied Health Professionals to step into the shoes of a GP. Whilst MBBSs are made by the RACGP to jump over Hurdles after Hurdles before they can function as GPs., the RACGP & its representative Voices, like that of Dr. Kruys shamelessly allow… Read more »
Anonymous
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Anonymous
4 months 2 days ago

There’s a model which does not need the pharmacist’s input.
Replace them with dispensing machines and warehousing informed in real-time by eRx

Ahad KHAN
Guest
4 months 2 days ago
I thought a Prescription should only be given, once we have made a DIAGNOSIS. As I see it, to become a DIAGNOSTICIAN, one needs to do at least a basic MBBS Course. There is a saying : Half a Physician is a Danger to the Community ‘ . I have immense Respect for Nurses & for Pharmacists, so long as they work within their Qualifications. But these AHPs stepping into the shoes of GPs —— ?????? It is sad to note the RACGP support Pharmacists to function a ‘Pretend GPs ‘. On the one hand, MBBSs are made to go… Read more »
GEORGE QUITTNER
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GEORGE QUITTNER
4 months 3 days ago
SAME OLD PLACES SAME OLD FACES Hi Peter and Lou! I think we basically just talk to each other. I say : Put us in the boxing ring with the pharmacists…..Waddya say Lou? Seriously but.. EVERYBODY IS A DOCTOR. The pharmacists are just following a community trend. Our vocation. Our profession. Our calling is now open hunting season. The temptation to give medical advice seems irresistible to anyone with the most tenuous link to being a therapeutic agent. The very title DOCTOR (courtesy or otherwise) has been appropriated by any number of people who have no resemblance to what is… Read more »
Leong Ng
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Leong Ng
3 months 26 days ago

Sorry Dr Quittner, we are not the real doctors but Honorary ones. The real doctors are those traditionally with PhDs, DSc, D Litt, DD but how would you compare and MBBS with the new DBA? D

Leong Ng
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Leong Ng
3 months 26 days ago

Yes! A new discovery due to frustration with AD and MO! Same people in the crowd.

Leong Nf
Guest
Leong Nf
3 months 26 days ago
If a patient has, for exampled wrongly Googled some therapy and decided that she must have it, her first port of call is not her ‘usual’ GP but one where she can lie and probably say “I cant get in till 2 week’s time. I need it now” The young GP, wanting to please, will prescribe what she wants. This is the reality today and yesterday. So, it begs the question: “Do we need top heavy regulation on the prescription of standard drugs?” The answer may be yes or no and is naturally open to debate. “When there is a… Read more »
John J Gyorki
Guest
4 months 3 days ago

This is all garbage and not worth commenting on.. Medical school, junior and senior training, sacrificed time and lifelong experience of/for the profession versus untrained and incompetent ambitions of a group of merchants qualified to sell drugs. C’mon.

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