Recently, the GP publication Pulse decided to publish a piece that once again showed that there is a portion of GPs who still don’t understand what pharmacists do – or even what we did for those years at university. And no, it wasn’t shop-keeping.
So, I’m going to say something that some GPs may find both incredulous and bordering heretical: I know more about medication than you do.
This shouldn’t be controversial to say but to some GPs, this concept is incompatible with their belief that they are the great gatekeepers of healthcare; that they are unquestionable and never wrong. But surely this should be fairly basic? I study all facets of medication in great depth across a masters in pharmacy but will learn the basics of diagnosing and treating minor ailments. Doctors will learn all facets of diagnosing disease and will learn the basics of pharmacology. But just as my module on cardiology doesn’t qualify me as a cardiothoracic surgeon, a doctor’s pharmacology module doesn’t equate to an MPharm.
Sadly, like some patients, some GPs still think our role is just putting labels on boxes, but this is about as accurate as saying that they ‘just sign bits of paper’. We’re checking that what’s on the prescription is safe and that you are not about to cause harm. Do we have the glamorous job? No, but it’s still one that needs to be done.
GPs can be a fickle bunch. They can complain about being overworked with patients who they don’t want to see, with their ‘trivial ailments’, but then complain about pharmacy – a profession that is actively trying to take over these consultations. A recent Pharmaceutical Services Negotiating Committee audit suggests that, without pharmacy, there would be an estimated 57,000 extra A&E and 491,600 extra GP appointment requests.
When you realise that these figures are per week, you would have thought GPs would be wanting us to do more to free them up for the stuff they deem worthy of their time.
The Pulse article implies that even if patients have self-limiting conditions, no symptom relief should be given in most cases – which any pharmacist should know is not true.
In Scotland, we are making great steps to take over more minor ailment treatment with Pharmacy First; we have a national patient group direction for treating urinary tract infections, impetigo, minor skin infections and shingles, as well as a basic formulary for common minor conditions. We’re also moving towards there being an independent prescriber in each pharmacy. So as much as GPs may disapprove, pharmacists are going to contribute to patient care more and more.
I commend Royal Pharmaceutical Society English Board chair Thorrun Govind’s call for a roundtable talk on how the professions of primary care can collaborate to improve patient care. But first, the side with members acting in bad faith need to address their own attitudes. How can talks take place if one side wants to see the end of the other? Do we need to get our representative body to educate GPs or do GP bodies need to be the ones to bring their members lost to egotism to the table?
Tom Wilde is a community pharmacist in Scotland