The RACGP president says it is ‘frustrating’ to see governments ploughing ahead with reforms against medical advice.
RACGP president Dr Michael Wright says there’s a “disturbing pattern” of state and territory health departments bringing doctors into expert advisory groups for initiatives like pharmacist-led prescribing, only to seemingly ignore their advice.
It comes after one rural generalist told media that he had quit an advisory group after feeling unheard.
On Friday last week, rural generalist Dr David Leaf called into a segment on ABC radio and told presenter Thomas Oriti that he had been on the expert advisory group for NSW pharmacist-led prescribing but had resigned “in disgust” about one month ago.
“In the meetings, the pharmacists completely over-represented the type of training that they have, and over-represented also the kinds of follow-ups that they could reasonably achieve, as well as considering all the different diagnoses that occur,” the Barangaroo-based doctor said.
Dr Leaf went on to say that he felt the University of Newcastle-run pharmacist UTI and oral contraceptive prescribing trials – off the back of which further trials have been announced – had reached “unreasonable” conclusions.
“We represented this to the chief medical officer in writing and in meetings, and it was clear they simply weren’t interested in the experts gathered there from various specialty colleges,” he said.
When questioned as to why the government would ignore the concerns of doctors, Dr Leaf said that the Pharmacy Guild of Australia was very powerful.
“It felt like the assembled experts in this meeting were there to be ticked off as ‘attended’,” he said.
“But when you form an expert advisory group, you listen to the experts and you incorporate them into your recommendations. That was not happening.”
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Dr Wright called Dr Leaf’s words “powerful” and said the pharmacist-led prescribing rollout in NSW had been particularly frustrating.
“Over the last month we’ve seen a number of calls to slow this down, that there isn’t evidence to do it,” he told The Medical Republic.
“So for the government to keep bulldozing through, in spite of the evidence, is bad enough.
“But then actually hearing that they’re ignoring any evidence that there might be, or ignoring any concerns that there might be, just reinforces that.”
The RACGP president said there were still unanswered questions about pharmacist prescribing, even as the federal government gears up for a nationally subsidised trial of prescribing for the oral contraceptive pill.
“That’s a perfect example of where we don’t have the evidence, and we need proper evidence to understand the risks and safety behind this,” Dr Wright said.
“With pharmacy prescribing, a consultation is never just a pill or never just a script, so we really need to look at what the impact of this is on health outcomes.
“Are people getting the care they need? Is it cost-effective? Are people delaying care and then increasing costs elsewhere in the health system?
“But we need proper evidence to do that, and we need to make sure that the states are actually gathering that evidence and not ignoring it.”
