Home' Australian Pharmacist : Australian Pharmacist October 2012 Contents Australian Pharmacist October 2012 I ©Pharmaceutical Society of Australia Ltd. 771
Sticking to the script
By Dr Steve Hambleton, National President of the Australian
BE OUR GUEST
The professional relationship between
doctors and pharmacists is an important
part of health care.
It is based on cooperation, insight,
understanding, trust, a unique matching
of skills and experience, and a shared
desire to deliver the best possible
outcomes for patients. And, some would
say, an uncanny ability to decipher
handwriting. Your emerging professional
colleagues don't know what they missed.
The relationship works best when doctors
prescribe and pharmacists dispense.
Any blurring of the roles can diminish
performance and lead to fragmentation
We know our roles. We should stick to
For the most part, the relationship
at the grassroots level and at the
professional organisation level is cordial
and productive. It is only when political
and professional disputes over 'turf' and
ownership arise that things get testy.
The 'continued dispensing' process is one
The AMA is opposing the growing trend
to grant prescribing rights to more
non-medical health professionals, outside
of a medically delegated environment.
In the interests of patient safety,
any prescribing by non-medical
practitioners should only be carried out
within strict co-management regimes.
Unfortunately, under 'continued
dispensing' legislation passed by Federal
Parliament, pharmacists will be able
to dispense medicines under the PBS
without a prescription and without
reference to the patient's treating doctor,
on the basis of a previous prescription.
This represents a signi cant change in the
professional role of pharmacists within a
health care team.
Medical practitioners place a high value
on the professional role of pharmacists
and work with them to improve the
medication management of patients
and their clinical outcomes. However,
'continued dispensing' will allow
pharmacists to operate autonomously.
Initially pharmacists will only be
able to dispense 'eligible' medicines:
the contraceptive pill and lipid
However, we can expect strong lobbying
by the pharmacy sector to expand that
list over time.
Draft guidelines for continued dispensing
prepared by the Pharmaceutical
Society of Australia (PSA) state that,
after dispensing an eligible medicine,
'... pharmacists must provide written
communication to ... the most recent
prescriber advising of the supply of the
medicine to the consumer.'
However, unless a pharmacist checks
with the treating doctor, he or she has
no way of knowing whether the patient's
medical practitioner intended to continue
the medication, to adjust it, or to cease
It is a concern that a professional
organisation such as the PSA has seen
t to turn back the tide of collaborative
care by guiding the pharmacist to inform
the relevant medical practitioner after
This arrangement will compromise
doctors' care of their patients.
Who will be responsible if something
goes wrong after the pharmacist has
given the patient more medication
without review by the patient's
The guidelines state that the pharmacist
must provide written advice to the
patient's doctor within 24 hours of the
supply of the medicine, together with
information covering: the patient's name
and address; date medicine dispensed;
medicine details such as the strength,
form and instructions provided for use;
and reason for continued dispensing.
The information must also include a
declaration co-signed by the consumer
indicating their understanding of, and
consent to, the supply.
The AMA does not consider this system
to be in the best interests of patients.
We will continue to raise the matter with
Another issue the AMA raises constantly
with governments is the matter of
As you know, under current
arrangements, pharmacists can own a
medical practice but doctors cannot own
I believe it is possible to develop a safe
model of doctors owning and operating
a pharmacy within general practice that
maintains the separation of prescribing
It is a natural development of the
relationship that currently exists between
community GPs and community
pharmacists that would produce greater
convenience for patients.
Such a model would also create a new
and rewarding career path for young
pharmacists. They could manage or work
in a GP pharmacy without the nancial
burden of ownership in the early years of
GP-owned pharmacies would provide
new ways to provide coordinated
services for aged care and would build
greater e ciencies with hospitals,
especially with discharge summaries and
I think this concept is worth
serious discussion between the
professions. It would strengthen the
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