Doctor groups slam plans to give pharmacist diagnosis and prescribing roles


By Michael Woodhead

14 Feb 2022

Medical groups have expressed alarm at a scheme to extend the scope of practice of retail pharmacists to allow them to manage chronic diseases such as diabetes and heart failure.

The Royal Australian College of General Practitioners (RACGP) has warned that a pilot “Scope of Practice” trial planned to run in North Queensland in June poses a serious risk to patient safety.

“The trial would allow pharmacists to diagnose and treat patients when they don’t have the necessary training or experience – they are completely unqualified to do this, it’s playing with fire and putting patients at serious risk,” said RACGP Queensland Chair Dr Bruce Willett.

“A specialist GP undertakes a minimum of 10-years training, including medical school as well as vocational training to diagnose and recommend treatment to patients unsupervised. But this trial would see pharmacists diagnosing, treating and prescribing to patients for complex medical conditions unsupervised, after just a three-week course.

Dr Willett noted that the pilot scheme is proposed to take place in North Queensland, where there is a high proportion of Aboriginal and Torres Strait Islander people, many whom have complex health needs and multiple chronic conditions.

“This makes it even worse – substandard care from a pharmacist, instead of a properly qualified doctor, puts their health at significant risk.”

“The pilot is in direct opposition to current clinical arrangements across Australia and prescribing arrangements agreed to by national health regulatory bodies. It would require a pharmacist, who doesn’t have the required training or skills, to make complex diagnostic decisions and manage complex chronic illnesses, such as diabetes and chronic obstructive pulmonary disease,” he said.

The AMA has also slammed the trial, saying it will lead to significant misdiagnosis of potentially serious conditions while fragmenting care and undermining efforts to control antibiotic prescribing.

The AMA said it is seeking urgent clarification from the Therapeutic Goods Administration over proposals that pharmacist would be allowed to independently prescribe S4 medications such as oral contraceptives, a move that appears to be illegal under the Therapeutic Goods Act.

“It’s second-rate medicine for people in north Queensland. It’s just dangerous,” said AMA Queensland president Dr Chris Perry.

The Queensland government says the scheme is designed to address gaps in healthcare services in regional areas where there are no doctors available

But the Rural Doctors Association of Australia described the scheme as cheap band-aid solution and warned that pharmacist prescribing would only worsen rural medical workforce shortages by making rural regions unattractive for doctors.

“This pilot is not aimed at increasing rural access to primary care services, just a desire to increase profit for pharmacies based in cities and large regional centres,” they said in a joint statement issued with the RACGP.

“There are also serious conflicts of interests involved, with pharmacists encouraged to not only diagnose conditions, but also sell patients medications based on this diagnosis.”

The scheme is being promoted by the Pharmacy Guild, whose president Trent Twomey is a pharmacist in north Queensland and a former LNP campaign director.

The RACGP said the Pharmacy Guild was undermining the fundamental principle of separation of prescribing and dispensing.

“This no longer seems important when the profits of retail pharmacy are at stake,” said RACGP President Dr Karen Price.

“The RACGP has deep concerns about moves by the retail pharmacy sector to push through policy changes that put financial gains ahead of patient care and safety. We will fight this every step of the way.”

Both the AMA and RACGP have withdrawn from the advisory committee in protest.

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