Sam Turner is an advanced practice prescribing pharmacist from Brisbane. Now, he’s at the helm of a historic pilot program that has the potential to completely change what role community pharmacies play in Australia. The Pharmacy Guild of Australia has put forward a radical proposal. If passed, up to 80% of community pharmacists would receive the power to assess, diagnose and treat a range of health conditions – meaning patients won’t have to see their general practitioners (GPs) first. This ambitious strategy is aimed at reducing the growing burden on the health care system, particularly emergency departments. Simultaneously, it aims to improve patients’ access to urgent/acute care.
The Pharmacy Guild’s initiative is designed to transform Australia’s 6,000 community pharmacies into primary healthcare hubs by 2035. If it works, this plan could prevent up to 6.5 million GP appointments each year. Furthermore, it could save up to 52,000 hours of time in emergency departments. The intent is not to displace GPs. Instead, it wants to stop them from having their time wasted on simple cases, says Trent Twomey, the national president of the Pharmacy Guild of Australia.
Expanding Pharmacists’ Roles
Turner emphasizes the role that trained pharmacists in Queensland can play in managing chronic conditions. These can be simple UTIs, ear infections, acne, psoriasis and school sores. He recently graduated from James Cook University’s postgraduate pharmacy prescribing course. Now, he’s sounding the alarm that the integrity of timely treatment for acute conditions is at risk.
“With those acute conditions — whether it’s shingles, school sores or even mild to moderate eczema or psoriasis — a lot of patients come in and they need treatment straight away,” – Sam Turner.
Turner argues that because these are such common ailments, pharmacists are perfectly positioned to offer immediate diagnoses and treatments for them. He thinks this new approach will help take some pressure off GPs and hospitals. At the same time, it will better ensure that patients receive quality care in a timely fashion.
Concerns from the Medical Community
While the plan attracts broad support from numerous stakeholders in the pharmacy space, the move has alarmed other healthcare providers. Dr. Michael Clements, the rural chair of the Royal Australian College of General Practitioners, questions whether pharmacists will have adequate access to patients’ medical histories. He provides examples of misdiagnosis that have happened in pharmacies, demonstrating the need for a full picture of the patient to make sound judgments.
“When you teach people a small number of diseases and you give them a toolkit that only treats a small number of things, patients are at risk,” – Dr. Clements.
Dr. Clements can’t forget one patient she treated who was now using a steroid cream for his shingles. This case serves as a cautionary tale against the improper or insufficient training in diagnosing multilocular conditions. He warns against the unintended consequences of expanding the scope of practice for pharmacists without guaranteeing they have access to vital patient medical history.
Support for a Collaborative Approach
Despite these concerns, supporters of the plan say increasing pharmacists’ responsibilities would improve healthcare access, quality and efficiency. For TDA’s executive director Trent Twomey, the point of the initiative is to supplement current healthcare providers—not supplant them. He argues that 75% of Australians live within two-and-a-half kilometers of a pharmacy. This short distance allows many people to easily get the low-level medical care they need when they need it.
“It doesn’t replace other healthcare providers, it just provides citizens with greater choice,” – Professor Twomey.
Twomey reiterates that the plan is a set of common-sense, bipartisan reforms aimed at making it easier to access safe, affordable healthcare. He believes that this collaboration among healthcare providers can alleviate pressure on public hospitals and GP clinics across the country.
“Unfortunately there is enough sickness to go around. If we are able to achieve all our ambitions in this plan… it frees up our precious GPs to deal with those more complicated cases,” – Professor Twomey.
