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Dispensing advice on the phoney pharmacist war

25 May 2016

With the war of words heating up between GPs and pharmacists over dispensing doctors and the new Minor Ailments Scheme, Dr Ruairi Hanley believes pharmacists deserve the respect not antagonism of medics

Over the past few months, it appears some colleagues have decided to declare a ‘cyber war’ on Irish pharmacists. An unofficial online campaign has been waged, in the course of which those responsible for dispensing medications have been routinely belittled.

The trigger for this growing tide of negativity seems to be the suggestion that pharmacists should have an increased role in patient care. In the eyes of some members of my specialty, this is an outrageous incursion on their turf, one that cannot be countenanced under any circumstances.

Interestingly, hospital consultants, who are rarely burdened by unspoken feelings of professional insecurity, are largely unfazed by these developments.

Some people have hinted that because pharmacies are commercial entities they somehow belong to a lower ethical order than general practitioners. It has also been suggested that patient welfare (the trump card produced in almost any argument against change in our health system) would be compromised by letting pharmacists provide more services.

Strangely, those making such dire predictions have provided very little objective evidence in support of their position. Similar prophecies of doom were uttered when pharmacists were allowed to administer the flu vaccine, but this proved to be very wide of the mark indeed.

Commercial interests
For the record, this latest rise of anti-pharmacy sentiment has nothing whatsoever to do with money. Perish the thought, dear readers! GPs have no interest in such matters. Indeed, so long as we have a few spare shillings to spend on halo polish then we are content with our lives.

And lest anyone is confused, general practices are apparently not small businesses with ‘commercial interests’ like pharmacists. They actually are charitable endeavours employed by the Legion of Mary.

Furthermore, while pharmacies are regularly criticised for making money selling such dubious products as vitamin pills and probiotics, we GPs never get paid for anything that is not directly connected with evidence based medicine. We thus may rest assured that no colleague ever received thousands of euro annually for providing medico-legal reports in support of dubious whiplash claims.

Similarly, no Irish GP ever gave a heart-sink patient a glorified placebo just to get them out the door. And no primary care doctor has ever charged anyone for providing a letter in support of a social welfare payment of questionable merit.

We also should recognise that Irish GPs have long been believers in fairness and a level playing field for all colleagues. Our specialty therefore did not preside for four decades over a shameful system whereby young, fully trained doctors were denied the right to treat public patients, but first-degree relatives of GPs were able to gain access to a GMS contract via a rigged interview with their father holding a veto over the appointment. (Oh wait a minute! That is exactly what happened!)

Ah, but you see, none of this stuff counts as ‘commercial’ activity. It is much more noble and principled than that because we doctors are the ones doing it. I am more than happy to clear that up.


Pic: Getty Images

Drug errors
Now we have addressed these issues, I believe it is time for a few kind words about pharmacists. Those GPs who struggle with such an idea should ask themselves a simple question. Have you ever made a prescribing error that was spotted by an eagle-eyed pharmacist? An error that might have had severe consequences had it not been identified by the person dispensing the drug?

I know I have. Perhaps the rest of you are perfect, have never made a mistake and thus don’t feel you owe pharmacists an occasional kind word of gratitude. Or maybe you just don’t want to say “thank you” publicly, as I have?

In conclusion, I believe pharmacists deserve our respect and not our antagonism. As a profession, we cannot whinge incessantly about being overwhelmed with minor illnesses while simultaneously going ballistic at any suggestion that others might be capable of dealing with such problems.

However, pharmacists must also realise that any expansion of their role carries with it a significant increase in responsibility. Taking the extra money and passing the buck to the doctor when things go wrong is not an acceptable approach.

Finally, on a personal note, I would like to say this. Throughout my career I have encountered nothing but kindness and support from those who work in pharmacies across the land. I wish I could say the same about all of my medical colleagues. In truth, no pharmacist ever went behind my back and tried to damage my career or reputation.

I have no quarrel with a group of fundamentally decent people trying to earn a living. Those of my colleagues who appear intent on creating one may rest assured of one thing. You do not act in my name.

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Click here to view the full article which appeared in Irish Medical Times: Opinion

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