..Information to Pharmacists
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    Your Monthly E-Magazine
    APRIL, 2003

    Published by Computachem Services

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    NSW Australia

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    HEATHER PYM

    Division of General Practice Perspective
    Looking at Roles or Looking for a Role?

    The Division Six Month report was tabled this week and as I read it I was struck by the activities highlighted as areas of ongoing concern with appropriate programs dedicated to furthering better health outcomes in the community.
    What really is interesting reading are the health programs with strong support both in funding and human resource dedicated to immunisation, diabetes, asthma, and smoking cessation. There are others also that address gambling and other addictions. And then there are the QUM programs of medication review and evidence based drug information.
    General Practice in the community is supported well for providing health resources in what most would acknowledge as the traditional role of the medical profession. New incentives are offered to GPs to encourage a pro-active preventive role in community health initiatives.
    Why then are pharmacists attempting to set up diabetes programs, immunisation programs and asthma programs in their pharmacies when down the road or next door a health professional covers these health issues in a comprehensive manner supported well by the local Division?
    When did the roles become merged if they ever did or is Pharmacy still looking for an identity in the community as evolutionary trends project pharmacists away from the skills of compounding and dispensing?
    Are pharmacists really interested in immunising the community? Do they realise the implications of maintaining a room for the administration and observation of patients and do they really have the expertise to deal with anaphylaxis and urgent reactions? And the knowledge of concomitant disease states that would preclude a vaccine? And the question must be asked also - why would the profession want to go down this path when there is an acknowledged shortage of pharmacists to do what they ordinarily do now.
    And the same could be asked for diabetes and asthma management and smoking cessation programs.
    The medication review program is an area where the expertise of general practitioners and pharmacists is used jointly for better health outcomes for the patients. There is no doubt that working together in this area produces result that neither professional could achieve on their own. I have seen examples of this and the MBS item 900 acknowledges this joint service. Gradually pharmacists and doctors are working together - each with their unique expertise. There appears to be a good acceptance of this program and recognition for what it can achieve.
    I doubt if the other programs suggested by the pharmacy profession would receive the same acceptance from the medical profession and with this doubt I am wondering where funding would come to launch and support it.
    I suggest that pharmacists stick to the delivery of drugs to the community in the most optimal way. Counsel people with diabetes about use of their medications and blood glucose measuring equipment and the people with asthma about the correct use of their inhalation devices and supply their vaccines with advice on storage and transport to the clinic. This is the expected role of the pharmacist but ongoing management of the health condition is the role of the general practitioner. Working together as is beginning to happen with medication management reviews will enhance and define our respective roles.
    Competing for services that we really cannot deliver as well will not only jeopardise our patient's health but also the relationships both professions need to strengthen in order to achieve best health outcomes in the community.
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