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are really grateful that the pharmacy is operational.
Shutting the pharmacy so the pharmacist can have a
small break takes away a vital service in these small
No shortage of HMR requests
There is plenty of potential HMR work in western
Queensland. However, the 20-a -month cap limits
how many HMRs she can do.
In a submission responding to the Review of
Pharmacy Remuneration and Regulation Discussion
Paper, Karalyn highlighted that at times she drove
1,800 kilometres in a round trip to see patients.
She said: ‘The government pays me $125 per round
trip to see these patients and no accommodation
allowance. This is not $125 per patient. It is $125 per
trip and I must be sent the referrals direct from the
GP. If the community pharmacy sends me the HMR referrals I cannot claim the
‘ To drive that distance over several days and pay for accommodation makes the
service totally unviable. The HMR cap needs to be expanded for these locations
as there is very little economic sense sending a pharmacist these distances and
restricting how many patients they can see.’
To illustrate her point she cited three requests received for rural and remote
The first, west of Mackay, was for 200 patients with travel time 5–7 hours one
way. Most of the patients were waiting for placement in one of the few aged care
facilities in the area.
‘ The expectation is that they will never achieve placements,’ she said.
The second, west of Rockhampton, was for 60 patients with travel time of seven
hours one way. The third, west of Toowoomba, was for 300 patients with travel
time of 12 hours one way.
In each case no accommodation was provided and the maximum travel
allowance available was $125.
‘All of these areas have asked their local pharmacies if they can provide the
services and they cannot. All of these locations have health and hospital service
accommodation for visiting medical officers, pay their GPs to fly in and out and
have support services such as diabetes educators funded by CheckUp.’ (See:
All of the patients had been investigated and deemed to be at risk due to
multiple prescribers, poor health literacy, predominantly Indigenous heritage,
lack of recurring health services with the loss of Royal Flying Doctor Service and
other programs, and inability to access regional hospital and health services due
to a lack of money and ability to travel.
‘I can only visit 20 patients per month so you can see I would have plenty of
work for several years. How do I triage who to see first? Why would I travel these
distances and pay for accommodation and travel and receive a measly $125?
While the current model is barely adequate in the regional locations, it is not
feasible when you have to travel distances that require overnight stays,’ Karalyn
said in her submission.
I enjoy being able to help people. My first choice of occupation was
nursing but I was not physically strong enough so I went to university
and became a pharmacist. I enjoy interacting with patients, their
families and carers. I particularly like being the ‘Ms Fixit’ who joins the
dots and helps them navigate their health pathway. I work closely with
the practice nurses and managers and have gained the respect of the
GPs. Their respect and confidence inspires me to keep doing what I do.
Never stop pushing
the boundaries. Make
sure your voice is the
loudest in the room.
Know your place but
push for inclusion and
The greatest challenge is the poor
remuneration for working outside of a
community/hospital practice setting.
Another is the lack of understanding
of my worth and place in practice by
fellow allied health colleagues.
Hopefully people like me
will be independently
funded for the roles we
perform. I hope the Review
of Pharmacy Regulation
and Remuneration looks
at dividing out the areas
such as ownership from
practice so we can start to
be recognised within the
health arena as needing
to be supported and
funded in the same way as
clinical consultant nurse
My main goal is to achieve a worthwhile remuneration
for what I do and the long distances I travel. The second
goal is to work on my succession plan to hand over my
remote Home Medicines Review work to someone who
loves central Queensland as much as I do.
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