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This week the new Medical Benefits Schedule (MBS) item number for GPs to refer consenting patients for a DMMR was initiated.
In our Division this has been hailed by the unexpected delivery of many, many boxes of DMMR literature for GPs and pads of referral forms.
I expect it has to start somewhere but so far it has annoyed the staff, frustrated the delivery man who no doubt thought we were expecting this haulage and filled the small storage area we have.
We have yet to develop a plan to 'get this out'.
I have been reading with interest the comments from pharmacists on Auspharm email on the subject. Again a mixed bag of positive and negative, enthusiasm and reluctance.
It is the same with the GPs.
Whenever I am in a surgery waiting to visit the GP I am aware of the busy coming and going of patients, couriers, staff, phone calls etc etc - much like my days in the pharmacy. It is so busy these days and time is so precious. GPs are rushed off their feet and I doubt very much if out there in GP land they are even aware of the new MBS item and the opportunity they have to collaborate with their local, and probably not so local pharmacists on medication management for their patients.
As it has been said in many forums lately the GPs do really believe that they already review their patient's medication each time they are seen!
I was privileged to be a member of the 'Model Pharmacy Project' conducted by the University of South Australia under the leadership of Associate Professor Andrew Gilbert some years ago. Three of the 'models' explored domiciliary medication reviews and the results were impressive.
The benefit pharmacists, working closely with consumers (mostly in the consumer's home), could bring to the health outcomes was significant and could not be disregarded by any of the health professionals involved in that patient's care.
I believe that the GPs working in the stressful environment they are in, have not had the opportunity for exposure to these findings or the expertise pharmacists can bring to the health care team.
An ADR is managed by prescribing another drug, non-compliance in their patient is a worry and a nuisance.
Are the reasons ever uncovered or investigated or the patient given the lengthy education required to help them comprehend the therapy?
There is simply not the time or understanding.
DMMR will be a challenge to both GPs and pharmacists.
This week it has started, however slowly and obscurely,but I believe it has the potential to change the 'culture' - a long hard road, time consuming, painful and uncomfortable. It probably will not bring in the income we are all used to from 'supply' but there are no guarantees this will stay the same and in this 'information' age surely the intelligent way for our profession to head is to optimise the opportunities and market our unique knowledge base in a practical and publicly useful way?
And a way that will be remunerated!
Perhaps down the track this will be the only way pharmacists can earn a living.
It is worth giving it everything we've got now to get this off the ground and into the public weil.

Editor's Note:
Heather has expressed a wish to share the poem below with readers.
It was sent to her by an American colleague.

MESSAGE FOR BIN-LADEN

Osama Bin-Laden, your time is short;
We'd rather you die than come to court.

Why are you hiding if it was in God's name?
You're just a punk with a turban, a pathetic shame.

I have a question about your theory and laws-
How come you never "die for the cause"?

Because you're a coward who counts on others.
Here in America, we stand by our brothers.

As usual, you failed in your mission;
If you expected chaos, you can keep on wishin'.

Americans are now focused and stronger than ever
Your death will become our next endeavor.

What you tried to kill doesn't live in our walls,
It's not in the buildings or the shopping malls.

If all our structures came crashing down,
It would still be there, safe and sound.

Because pride and courage can't be destroyed
Even though lost lives leave a deep void.

We'll band together and fill the holes,
We'll bury our dead and bless their souls

But then, our energy will focus on you
And you'll feel the wrath of the red, white and blue.

So slither and hide like a snake in the grass
Because America's coming to KICK YOUR ASS

Ends
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