Click on the Newsletter Reader's Forum link to access a forum from which you can express your comment or viewpoint on this article.
The author values your input, so please take the time to register your details, and participate in the only free debate on the future of Australian pharmacy.
Registration is free, and required once only, for permanent access.
You do not need to register if you only wish to view comments.

Perhaps.
Last week, at a QUM meeting held in one of the local divisions of general practice, I chanced on an interesting piece of information.
In Western Australia only 25% of consultant pharmacists have indicated a willingness to take part in DMMR!
"Why is this so?" Professor Julius Sumner Miller would have asked in amazement. Have not pharmacists been crying out for greater involvement in total patient care and the chance to prove their ability to improve outcomes?
Consultant pharmacists have been bemoaning the fact that DVA veterans have not been referred to them for medication reviews and complaining that doctors are refusing to make use of their expertise.
Why is it that now, when doctors are keen to refer, consultant pharmacists have gone missing?
I have pondered this question over the past few days and have decided that there are two possible reasons.
One, the consultants are already too busy to take on extra workload and two, the cause may lie in the one major difference between the two schemes, namely who gets paid for the service.
In the DVA case the consultant pharmacist is directly remunerated but in the new DMMR it is the patient's nominated pharmacy, even if the person actually carrying out the medication review has no ties with that pharmacy.
I have long thought that this could be a stumbling block to a rapid uptake of the opportunity.
One experienced consultant pharmacist friend of mine calculated that, even if the full $140 fee came to the consultant, he would only be receiving about $35-40 per hour for a properly carried out DMMR.
"Remember", he said "it will be the patients with complex and difficult medication profiles who are initially referred and these will take some time to deal with."
If the community pharmacist demands his "cut" of the fee it will become even less attractive, so my friend understands the reluctance of accredited people to make themselves available.
Is this another case of pharmacy allowing the wrong group to negotiate with government on its behalf?
The Pharmacy Guild of Australia (PGA) has taken it upon itself to develop this programme with the Commonwealth and has, naturally, ensured that its own constituency (pharmacy proprietors) are well placed to benefit.
Given that the Guild represents a mere 26% of the pharmacy profession in Australia, and only about 45% of pharmacy owners, is it the best organisation to negotiate and sign agreements with third parties?
The Computachem Newsletter has, over the past few editions, seen a number of contributors arguing that pharmacy must unite to form a more coherent, stronger, body to better protect the profession's position in the health care team.
PGA claims, with some justification, that it has fought to ensure pharmacy's right to have some control of its destiny but the narrow emphasis of the organisation has led to some interesting agreements.
(I have yet to find someone who can explain to my satisfaction how limiting, or even reducing, pharmacy numbers will contain PBS drugs costs. To my simple mind, the cost of five pharmacies each dispensing 200 scripts a day would be no different if the number is reduced to four pharmacies, each dispensing 250 scripts per day - 1000 items per day is still 1000 items per day!).
A strong pharmacy profession would have fought the gradual reduction in PBS mark up and how we, as a group, managed to get lumbered with IME I'll never know.
As I indicated in the title of this offering, DMMR may be the chance of a lifetime for pharmacists in the community to prove their professionalism but, and this is a big but, the reluctance of accredited persons to offer their services is of concern. Doctors are excluded from carrying out their own review under this programme and can only access payment by referring patients to pharmacists for their input. There is, thus, an incentive for doctors to bring our profession "into the fold" but are we ready, or able, to prove our effectiveness?
I hope so.
More members of the profession must become accredited to carry out reviews so that we, as a group, can become major players in this new area relating to the quality use of medicine.
AACP and SHPA must streamline the accreditation process to make it less of an ordeal for already busy pharmacists.
Only by ensuring that we have a sufficient number of consultant pharmacists ready to grasp the opportunity to get off the dispensing treadmill will we be able to grasp this chance of a lifetime.

I would like to wish my fellow columnists and all readers of the newsletter the compliments of the season, with the hope that we will meet again in 2002. Ken Stafford

Ends

Previous Article

Next Article

Back to Article Index
Article Archive 2000
Article Archive 2001
Home