Pharmacists have fought for a greater role in providing health care, but as Deakin University’s Michael Vagg explains, that can create a conflict of interest.
Pharmacy picture from Shutterstock
Pharmacists are consistently held up as among the most respected and trusted of professionals. They fulfil an important role within the health professions of being the gatekeepers of medication dispensing and the link between the community and their medication use. For more than one hundred years, there has been a very clear and ethical distinction between doctors (who prescribe medications) and pharmacists (who sell them). That way, the argument goes, doctors have no direct financial interest in drugs they prescribe, and pharmacists have no direct financial interest in recommending any of the drugs on their shelves directly to patients. So far, so good.
There has been a bit of role creep over the years, with calls from some doctors to be allowed to sell their own concoctions directly to their patients, as well as a much more concerted push by pharmacists to play a bigger role in health care, including providing immunisations and health checks direct to consumers. Naturally this is of concern to GPs as such proposals have the potential to fragment primary care even further. Not to mention taking the critical role of diagnosis and putting it into the hands of those who are underqualified, underinsured and undersupported to handle it.
What concerns me particularly is not so much that these health checks will take work away from GPs. If anything I suspect they will increase GPs workloads, sorting out the advice already given to patients by wannabe GP enthusiasts like pharmacists and their associated naturopaths. This month's Skeptic magazine from Australian Skeptics highlights the problem quite well.
I think it's time for pharmacists to decide if they want to keep the trust placed in them by the community to give sound advice. If they want to remain a trusted source of advice they need to lift their game and get all the ear candles, homeopathy, magnets, herbs and supplements out of their shops, along with the iridologists and other fairground 'health professionals'. In short, they need to start acting like they deserve the trust and respect that is accorded them. We have heard nothing of the training and CPD requirements for pharmacists who want to diagnose and treat patients, let alone how they will be insured. I would want to see all this detail before I let my croupy baby or breathless grandmother within a bull's roar of a pharmacist's diagnostic skills.
The protectionism involved in the business of running pharmacies is breathtaking. Like dentists, only pharmacists are legally allowed to profit from running pharmacies, and they have defended this with all the bitterness and vitriol you might expect from a group who know they are onto a good thing. Health Minister Peter Dutton seems all for the pharmacists' ambitions and has been on the media trail vowing not to wind back their protected status.
So it seems the pharmacists will have all they want. I wonder if they deserve it? I hope they take the opportunity to lift their game as a profession and use their protected status to raise standards, not profits. A good place to start would be to stop advertising and selling shonky devices and products that would be considered fraudulent in any other context. Too hard? Then get out of the expanded responsibility game for good.
Michael Vagg is Clinical Senior Lecturer at Deakin University School of Medicine & Pain Specialist at Barwon Health. He does not work for, consult to, own shares in or receive funding from any company or organisation that would benefit from this article, and has no relevant affiliations.