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Members’ Forum

The suggestion made by Dr Brian Morton, Chair of the AMA Council of General Practice, that consideration be given to employing pharmacists within general practices (see Time for a new take on where pharmacists work? http://ausmed.ama.com.au/time-new-take-where-pharmacists-work) has drawn considerable interest. Doctors who have already gone this path say it has been a success and, unsurprisingly, pharmacists themselves say they are keen. A call by GP leaders for chronic care to be spared from any budget cuts (Shield chronic care from Budget knife: united GP call http://ausmed.ama.com.au/shield-chronic-care-budget-knife-united-gp-ca) stirred debate about the usefulness of care plans, while reports of a Medicare crackdown on public hospital billing (see http://ausmed.ama.com.au/medicare-crackdown-public-hospital-billing) had some questioning billing arrangements that left doctors vulnerable.

25 Mar 2013

The suggestion made by Dr Brian Morton, Chair of the AMA Council of General Practice, that consideration be given to employing pharmacists within general practices (see Time for a new take on where pharmacists work? http://ausmed.ama.com.au/time-new-take-where-pharmacists-work) has drawn considerable interest. Doctors who have already gone this path say it has been a success and, unsurprisingly, pharmacists themselves say they are keen. A call by GP leaders for chronic care to be spared from any budget cuts (Shield chronic care from Budget knife: united GP call http://ausmed.ama.com.au/shield-chronic-care-budget-knife-united-gp-ca) stirred debate about the usefulness of care plans, while reports of a Medicare crackdown on public hospital billing (see http://ausmed.ama.com.au/medicare-crackdown-public-hospital-billing) had some questioning billing arrangements that left doctors vulnerable.

GP clinic pharmacists

I couldn't agree more with the following comment: “We shouldn’t waste their skills and expertise. Maybe it is time to look more closely at employing pharmacists in general practice.” Four years ago the doctors at Camp Hill General Practice, decided to improve its quality use of medicines by engaging the services of a non -dispensing pharmacist. The pharmacist works as part of a multidisciplinary team. He assists with the provision of Home Medicine Reviews (HMRs), up -to -date medication information, and quality prescribing activities that enhance the skills of all clinicians. Our practice has greatly benefited from this workforce innovation. Ian Williams - General Practitioner

As a pharmacist, I can confidently say that pharmacists do have a lot to offer, and would bring a useful skill set to general practice. Also, many pharmacists would be very interested in being employed in this setting. My background is hospital pharmacy, where pharmacists work on the ward as a valued team member, with a focus on medication safety and education. Anonymous

 

Chronic care

High Medicare rebates for care plans compared with rebates for consultations are distorting the medical care landscape. For many practices, the income from care plans forms an important part of their business model. Government is increasingly promoting activities, which provide measurable outcomes, which of itself is not an unreasonable aim. But, in essence, this results in box-ticking behaviour and not necessarily an improvement in patient care. Promotion of high quality medical practice should be the ultimate aim, with the acknowledged difficulty being how to assess quality. There is no substitute for time spent with the patient, by an ethical, well-trained medical practitioner, but there has been very little support for this in Medicare rebates over the years. Anonymous

I agree major changes need to happen to care plans. I spend quite a bit of time (an average of 20 to 30 minutes) writing up the plan, writing it all again for the team care arrangement, and get paid an amount which seems totally out of step with other rebates. They are cumbersome, unclear and mostly sit in the notes and never referred to again till the next time. They are about the only thing I make any money on as I have long complex consults and bulk bill a lot and I still want to get rid of them. The system is open to major rorting. Anonymous

Medicare crackdown

It is fair enough that doctors are advised to “keep adequate ... medical records", but what about cases where tests/services are ordered under a doctor's provider number when the request did not come from that doctor, and quite possibly the doctor is unaware that the service is being requested? I have worked at several hospitals where all tests and services are billed under the provider number of the consultant officially responsible for the patient. More often than not, the ordering of the test or service is a decision made by the registrar or resident. The junior doctors do have their own provider numbers, but despite this, and regardless of the doctor's name, signature and provider number written on the order form, the order gets recorded under the provider number of the consultant. Is this practice even legal? How is the consultant supposed to defend himself, years down the track, for ordering investigations "inappropriately" if he never even knew they were being ordered? Anonymous

 

 

 

 

 


Published: 25 Mar 2013