As the negotiations for the 7th Community Pharmacy Agreement begin, the entirely expected articles and comments have begun. The turf wars have erupted again in the political spheres and increasing strident comment becomes the norm. The significant thing about all this politicking is that it is mostly about keeping the status quo and resisting change. Surely it is time for all sides to see that answers lie with moving forward, not slamming doors. Perhaps approaching the discussion with the patient in mind might change the dynamics.
Here’s the question I want to pose. What is it that we Pharmacists on the ground really want? I’m pretty sure we don’t want to do what a Doctor does, otherwise we would have become Doctors. We talk about our scope of practice then really don’t define what we think that is, or if we do, it’s different depending on who you are talking to and what their agenda is. We make ourselves easy targets for criticism when we don’t have clearly defined clinical standards which leads to an inconsistencies in clinical practice.
We have QCPP standards that define standards across the business, but where are the QCPP style standards that identify minimum standards of clinical care? Where are the standards that identify what a Pharmacy Assistant can and could do? Competency Standards do exist but unlike QCPP, they are not audited. There must be an industry wide standard. Those Pharmacies that do not obtain these standards can continue to be Commodity Pharmacy and those that meet the standards can be called Community Pharmacy.
Here’s my two bobs worth. Using where we are now as a baseline, when I have the appropriate training and the qualification to prove it, I want to be able to administer Immunisations, UTI medications and things like the best wound care. I want to be sure that what I do is the best it can be. I need the training and I need the resources that maintains the standard. I believe that this standard should be a minimum requirement, perhaps even a notation on my registration, guaranteeing quality practice and allowing for paid services. Obtaining these qualifications should be accessible to all Pharmacists both geographically and economically.
That’s all well and good, but none of that is at the core of what I believe our role, and the best use of our skills is. As well as being the most accessible health professional, we are the ultimate collaborators. We triage people and refer when appropriate. We inform patients and provide them with pathways to wellness. What I really want are the tools to do this job properly in the interests of the patient. When I refer a patient to their Doctor, I want to be able to ensure that referral gets to that Doctor, and that they are obliged to act upon it, even if that is to reject it. I should not have to fight my way past the receptionist to get my message across. I want to know that the message has been received by a secure messaging system. I want to be able to liaise with other allied health care professionals in the same way. Far from taking patients away from GPs, I want to make sure they get to the GP. I see our role as much more about screening, reporting and disease state management. If that means we monitor home test devices and report to the relevant medical professional, great. If I perform a blood test, spirometry, oximetry etc that has clinically significant results, I want the relevant medical professionals to know. We want to be able to be the best that we can be, which of course means that we must be remunerated, otherwise it can’t happen.
In summary, I see our role as the triage person. We screen people for medical concerns and refer to the correct professional. We monitor their conditions and report to the relevant medical professional. On occasion, we may even make a clinical decision that is within our knowledge and skill base. I want to see us as an important part of the collaborative health care team.
Trust me, I do not want to be a Doctor.
Comments