Collaboration, not competition
BY DR RICHARD KIDD, CHAIR, AMA COUNCIL OF GENERAL PRACTICE
Team work in providing comprehensive and quality patient care is not a new concept. Within the medical profession, we recognise our professional limitations and operate only within our scope of practice. When needed, we seek the opinion, or skills and expertise of other colleagues.
With an aging population and the rising incidence of chronic disease adding to the complexity of patient care, there is an enhanced focus on the role and importance of well-coordinated multidisciplinary health care teams. However, it is critical that these teams work effectively. Mutual respect for the skills and expertise of team members is fundamental, with each making their contribution within their scope of practice to meet the health care needs of the patient.
We all know the dangers to our patients of poorly coordinated, fragmented care. We also know that best practice care starts with the right assessment and diagnosis by a medical practitioner and, in the case of general practice, a longitudinal relationship with the patient. Despite this, we see ceaseless ambition of some pharmacist groups for prescribing rights and a greater role in the provision of health services, such as preventative health, disease screening and detection and chronic disease management.
For a GP, the community pharmacist, who is responsible for the dispensing and supply of medications, provides an important and complementary role in the delivery of quality patient care. Pharmacists are vital to the safe provision and use of medicines. They provide assurance that correct dosages are dispensed and that patients understand when and how to take their medications.
The AMA places a high value on the professional role of pharmacists working with medical practitioners and patients to: ensure medication adherence; improve medication management; and provide education about patient safety.
The AMA fully supports pharmacists undertaking roles within their scope of practices to support patient health care. But the community needs a clear understanding of how the core education and training differentiates medical practitioner and pharmacist scopes of practice.
Taking comprehensive histories, undertaking examinations, determining appropriate diagnostic investigations, making a diagnosis, and managing and treating a patient are the domain of the medical profession because that is what we, not pharmacists, are trained to do.
Certainly, the AMA recognises the benefits of integrating non-dispensing pharmacists into general practice to provide enhanced patient care. That is why we worked with the Pharmaceutical Society of Australia in developing such a plan that now, through the incoming Workforce Incentive Program, will see GPs and pharmacists supported to work even more collaboratively in the best interest of patients. With medical oversight, the current role of pharmacists may well expand to support a greater role in the provision of more holistic patient care. Patient wellbeing, after all, is a fundamental tenet of both our professions’ codes of ethics.
What we don’t want to see is patient care further fragmented, services duplicated, and access to the right care delayed. This simply causes undue costs to the health system and poor health outcomes for patients. What GPs and pharmacists should do is continue to work together respectfully, acknowledging the different skills and expertise we bring to the team for the patient. Our patients deserve collaboration, not competition, and policy makers must continue to avoid simplistic ideas that are driven by commercial needs and not good patient care.