It was probably inevitable that Australia's chemists would seek to rectify a profit drop now that the Pharmaceutical Benefits Scheme ( PBS ) is being amended to stop their industry pocketing the price difference between patented and generic drugs because of an anomaly in the previous Community Pharmacy Agreement with the Federal government.
It is now being suggested that the vast pharmacy network become a sort of filter between the overworked emergency room in hospitals and the network of general practitioners who either bulk bill or charge a standard fee for consultations. Chemists feel that their pool of medical knowledge qualifies them to do more than just stick labels on drugs prescribed by doctors. They want to be licensed to charge a fee for giving advice and doing tests that are within the range of the qualifications for which they have studied to obtain their license.
This suggestion would require a law change, but they are proposing that chemists be allowed to provide vaccinations, conduct tests for blood pressure and diabetes, prepare weight management programmes, give contraception advice to women and manage anti smoking medication.
No doubt this will be vigorously opposed by the medical profession on the grounds that chemists will lack the expertise to diagnose serious health risks and there is the danger that it could morph into another tier of medicine - not quite to the level of a registered GP, but somewhere in the area of a "Village Shaman " - wise in the ways of medicine, but with limitations !
It is also a grab for a fee for what the chemist shops now dispense freely - good advice. When we have a cold or a minor ailment we usually ask the friendly local chemist to suggest a stock remedy.
It is doubtful that many women customers would appreciate being given advice on the various brands of contraceptives available within earshot of other customers and hence it is likely that chemist shops would quickly develop private "consultation " areas. It is not hard to imagine this trend developing into a state of the art medical facility - with the requirement that patients "book "for an appointment.
It is a bold step that could quickly develop beyond expectations. It would actually put chemists into competition with general practitioners in the " reputation " stakes. A friendly, personable chemist known to give good advice could seem a more reasonable choice, particularly so if the proposed $15 co-payment for a consultation ever becomes reality.
There is logic in both sides of this argument. The pharmacy industry employs 22,000 registered chemists in Australia and it's network of pharmacies operates on a seven day basis - and over a wide range of hours. The sticking point would seem to be control of what can be charged when a person asks a question - and that question becomes a " consultation " ? Most GP's do minor surgery in their rooms - and once again the area of jurisdiction arises. Faced with a cut that requires local anaesthetic and stitching - should this also enter the realm of the chemist ? Creating a legal dividing line could become a nightmare !
Wise heads in government will approach this suggestion with caution. We certainly have a need to reign in the costs of our health system and yet the provision of medical services is under pressure. Emergency rooms are struggling to meet demand and many rural areas are failing to attract even a single GP to take up residence. The pharmacy industry certainly could plug a gap, but at the cost of lowering standards. We would not want to see medicine revert to third world standards and health care become the province of "witch doctors "!
It would also be a retrograde step if asking a simple question at the local chemist shop - attracted a demand for a fee !
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