Home' Australian Pharmacist : Australian Pharmacist March 2014 Contents Australian Pharmacist March 2014 I ©Pharmaceutical Society of Australia Ltd. 13
AMA believes that doctors should be
supervising vaccinations in the interests
of patient health, it is a view at odds with
practice in other comparable countries.
If the campaign is part of a turf war, then
the AMA, it seems, has got lost on the
way to what should be a more important
goal in advancing patient care. That is
the development of more sophisticated
practice which enables GPs to exploit
the full potential of their training and
expertise in the treatment of patients
with complex and chronic illnesses.
When you consider the current roles
of GPs, nurses, pharmacists and allied
health practitioners, you can imagine
each of these practitioner groups could
be more effectively deployed for the
overall good of patient care if each was
able to maximise that group's expertise
in concert with the other practitioners.
As the Grattan Institute's Professor Stephen
Duckett wrote recently in the Australian
Financial Review: 'Now we need to change
the way almost every health professional
works, change referral patterns and
information, provide support to people
with chronic conditions to help them
manage the problems they live with
24/7, and eliminate waste in the system.
Policy also needs to focus on prevention
and go beyond traditional health services,
and make healthy choices easy choices.'
The current system means too many GPs
are processing their patients smartly
through the Medicare turnstile to
generate a reasonable income from the
meagre bulk billing rate.
Such revolving-door medicine hardly
represents a worthwhile payoff for the
long years of training and expertise
of the GP, let alone the right return on
investment in Medicare by the taxpayer.
The time has long past for the Medicare
payment system to be restructured so
that there is a greater incentive for the
GP to spend time dealing with the many
complexities of diagnosing and treating
non-communicable diseases such
That way the doctor could better serve
patients, rather than clinging to
The outcry the Australian Medical Association unleashed against a pilot
scheme in Queensland for pharmacists to administer flu vaccinations
highlights the unresolved turf issues that bedevil practitioner roles in
If we accept that what is best for the
health system is whatever works
best and most cost-effectively for
the patient/consumer, then it seems
consumers would be best served
having an accessible, appropriately
administered vaccination service in
places like pharmacies.
That should not challenge the GP's role
as the central practitioner in primary
care. What the vaccination issue has
highlighted however is the need for
a more searching look at the GP's
involvement in routine, straightforward
services, like immunisation.
Vaccinations are routinely performed
in this country and in comparable
countries overseas by nurses without
the direct supervision of a doctor.
Employer-organised influenza shots
are just one example: many thousands
of employees are immunised by
appropriately trained nurses, far from
supervision of doctors.
Pharmacists are well-placed to provide
this service in every neighbourhood,
for the old and young who require
vaccinations. In the normal course of
events, most people are likely to visit
their pharmacy more often than their GP.
International research quoted by the
Pharmaceutical Society shows that
providing immunisations in pharmacies
picks up people who normally wouldn't
However from the consumer's point of
view there are aspects that need to be
dealt with to ensure the pharmacist's
immunisation services are in order.
The first is appropriate training for
pharmacy staff undertaking the
procedure. There should be an
appropriate private space for the
immunisation including chair or couch.
Governance safeguards and rigorous
recordkeeping are also in order to reduce
the risk of mistakes or overservicing.
Such measures would in no small part
aid the advance of the pharmacist
into a wider role that should improve
consumers' access to worthwhile
healthcare. In passing, I believe that
pharmacists would burnish their clinical
credibility if they did away with the
shelves of complementary medicines
that have little evidence-based efficacy.
That could provide the space to
administer the vaccinations.
The pharmacists could be expected to
seek to have the $25--$30 cost of the
vaccine and administration rebated
by Medicare, adding to the appeal of a
pharmacy jab for many consumers.
Such competitive considerations
may lie behind the AMA's fuss. If the
Put the patient first
BY MARK METHERELL, COMMUNICATIONS DIRECTOR,
CONSUMERS HEALTH FORUM OF AUSTRALIA
BE OUR GUEST
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