Doctors raise the stakes in turf war with pharmacists
Doctors have upped the stakes in their turf war with pharmacists, hitting back at a threatened intrusion into their domain with a proposal to allow GPs to own chemists.
A coalition of general practitioners will lobby Health Minister Greg Hunt for the change, which doctors say would help give Australians access to cheaper medicines through increased competition – especially in regional areas.
But the Guild, representing thousands of small community pharmacy owners, will argue that doctors should not be allowed to own chemist shops as it would create an incentive for them to prescribe medicines even when they may not be needed.
Royal Australian College of GPs president Harry Nespolon rejected this suggestion, saying doctors were subject to strict oversight by the Medical Board of Australia and Australian Health Practitioner Regulation Agency.
“Most doctors are more interested in getting people off drugs than on them,” he said.
Currently, only a fully qualified pharmacist may own a chemist shop.
“I can own a bank, but I can’t own a pharmacy,” Dr Nespolon said.
He said numerous inquiries had concluded that the current pharmacy rules were anti-competitive and should be overhauled, a position backed by former competition tsar Graeme Samuel – who wants the market to be deregulated.
Mr Hunt is negotiating a new Community Pharmacy Agreement to govern the sector from mid-2020 and has promised to finalise the deal by December.
Pharmacists are pushing the government for changes to the Medicare system to allow Australians to claim rebates for vaccinations and medical consultations at their local chemist.
But Australian Medical Association president Tony Bartone said the guild’s push to be allowed to take on more GP-like tasks “must be stopped”, accusing the peak body of relentless “attempts to bully governments” in pursuit of ever-higher profits.
“Pharmacists are highly valued members of the health workforce … but they do not have the skills, expertise, or many years of highly-specialised training to perform the work of GPs,” he said.
Dr Bartone said if GPs could own pharmacies, they could bring down drug costs through both increased competition and better collaboration to ensure that patients were prescribed “more appropriate, better targeted medication”.
“We’ve seen what Chemist Warehouse has done to the landscape and anything that increases competition is a good thing,” he said.
He said GPs working more closely with pharmacists within medical practices had been shown to result in “a reduction in duplication of medications” and more efficient drug trialling, and that the model worked well overseas.
Australian College of Rural and Remote Medicine president Ewen McPhee said pharmacists working collaboratively with general practitioners was “the best and safest model of care”.
“Most doctors have a positive and productive relationship with their local pharmacist, and we respect each other’s areas of expertise,” Dr McPhee said.
“Pharmacists can offer a lot when it comes to the management of chronic and complex disease, and in the area of medication safety.
“A collaborative model where each member is working to their appropriate scope of practice, rather than a fragmentation of care, is the way to achieve the best patient outcomes.”
Dr Bartone is chair of United General Practice Australia, which is made up of the AMA, the Rural Doctors Association of Australia, the Australian College of Rural and Remote Medicine, General Practice Supervisors Australia and the General Practice Registrars Australia.
The RACGP, which represents 40,000 general practitioners, is not a member, but supports the campaign.