AMA rejects calls for pharmacists to play greater role in health care system

Despite a shortage of GPs in regional Australia and some patients being left out of pocket after doctor visits, the Australian Medical Association (AMA) has rejected calls from the Pharmacy Guild of Australia for pharmacists to play a greater role in the country’s healthcare system, claiming they don’t have the same experience as general practitioners to administer travel vaccinations, prescribe certain medications or offer treatments for health issues such as urinary tract infections.

It comes after the Pharmacy Guild of Australia released its Community Pharmacies: Part of the Solution policy earlier this week, saying that community pharmacists could play a greater role in the nation’s healthcare system and help improve accessibility and affordability for Australian families by using their training to the full.

The National President of the Guild, George Tambassi, said the health care system isn’t adapting to Australia’s ageing and growing population, with many people struggling with longer waits to visit their GP and greater out-of-pocket expenses.

“We found allowing pharmacists to perform to their full scope in the health system – including treating common ailments, dispensing medication for stable and ongoing medical conditions, and administering vaccines, could relieve pressure on GPs and Emergency Departments, freeing them up to spend more time with their patients,” Tambassi said in a statement, claiming that as many as half a million Aussies have avoided a visit to the doctor in recent times because the costs were simply too high.

The policy paper said pharmacists are in a position to relieve stresses and strains on the health system if they were able to fulfil the scope of their practice – something the AMA strongly disagrees with. AMA President Tony Bartone said in a statement that pharmacists should spend up to 15 years studying for a medical degree if they wanted to be doctors and that the public receive a higher level of care when health professionals work as a team within their scope of practice.

“Patient care suffers, and health and lives are put at risk, when there is fragmentation of health care and the loss of continuity of quality health care,” Bartone said. “GPs study and train for more than a decade to provide quality holistic care for individuals and families through all stages of life.”

Tambassis said pharmacists currently undergo five years of training before they’re registered and that they are required to undertake continuous professional development each year, explaining that a policy change would allow pharmacists to use their training in full – just as they are in other countries such as Canada and the UK.

“According to the policy paper pharmacists would only treat to the extent of their training and are quick to refer patients to their GP or an ED when their health issue was beyond this training or patients needed reassurance,” Tambassis said.

Still, the AMA isn’t on board with the idea, with Bartone explaining that half a decade of study isn’t sufficient to practice as a doctor and that there are complex and special skills that come with being a GP. He also argued that pharmacists don’t know the medical histories of patients and that trusted doctor-patient relationship is at the core of safe, high-quality health and medical care.

“Undermining or diluting this relationship, as the Pharmacy Guild is proposing, is irresponsible and dangerous,” Bartone said. “The Guild should be focused on the interests of its members and individual pharmacists, not looking to make profits from usurping the roles of other health professions.”

Speaking on ABC Radio Melbourne with Jacinta Parsons and Sami Shah on Friday, he added that travel vaccination is “a very complex field”, despite chemists being able to administer the flu jab, while a tweet from the AMA read: “It would be irresponsible and dangerous to have pharmacists move way beyond their scope of practice to perform specialised roles currently undertaken by GPs.”

President of the Pharmacy Guild of Australia (Victoria) Anthony Tassone later tweeted: “It’s not a matter for @ama_media to dictate to an independently regulated profession including pharmacists what our scope of practice is. That’s a matter for the Pharmacy Board under the @AHPRA scheme.”

It’s not a matter for @ama_media to dictate to an independently regulated profession including pharmacists what our scope of practice is.
That’s a matter for the Pharmacy Board under the @AHPRA scheme https://t.co/PcPIsN7HDI

— Anthony Tassone (@A_Tass1) August 16, 2019

It’s also caused debate from patients within the community. One person on Twitter said: “Whilst pharmacist are not trained to take over roles of doctors it is also clear that doctors must pull their socks up with their less than ideal overprescribing habits.”

Another comment read: “After reading the article, I don’t see the problem. Travel vaccines, birth control, utis…not exactly things I’d demand they have an additional 4 years on top of their degrees to prescribe to me. Just seems like you don’t want to lose the money, or did I miss something?”

Another said: “Everybody’s health depends on a trusting and cooperative relationship between doctors and pharmacists. Without judging the proposals, there is a significant risk that this relationship will break down if the conflict is not quickly resolved. Patients will be the losers.”