MAS – the pharmacists’ reply

A RECENT MJA InSight opinion piece by Dr Evan Ackermann attempts to highlight perceived issues with the role of pharmacists in the health industry.

While it is disappointing that this article was heavily focused on negative attitudes and unsubstantiated claims of improper dealings by pharmacists, the larger issue at hand is that the article failed to address a more relevant issue: the perception by a small but vocal minority of GPs that pharmacists have a conflict of interest in the supply of medication.

The Minor Ailments Scheme (MAS) is a proposed funding model that would recognise the role that pharmacists in community settings have provided on a daily basis since the inception of pharmacy degrees.

• Related: MJA InSight – Evan Ackermann: MAS a push for drug sales

Pharmacists consult with patients regarding their health conditions as part of their everyday role in providing health care services to the community. This is not new, and while some pharmacists may operate in their own version of “6-minute medicine”, this does not represent the majority of my colleagues.

While some commentators regard pharmacists as little more than shopkeepers who sell any trendy, unproven product that enters the market, this misconception fails to recognise that advice provided by pharmacists focuses on the best outcome for the patient. Achieving this regularly means that the patient is advised to use something different to what they requested. A significant proportion of this advice includes no sale – the patient may already have the product they need at home, their ailment may require no treatment, or they may require a referral to another health professional.

Dr Ackermann’s article fails to recognise these two key points: That pharmacists already provide minor ailment services (funded only via the sale of relevant medications or health aids), and that pharmacists (in applying their clinical expertise) often forego the sale of these products to patients if it is not in the patient’s best interest.

By not being aware of these two factors of everyday pharmacy practice, Dr Ackermann has mistaken this program as a way to generate sales of products. This is a shame, since what this kind of program is designed to do is de-link pharmacy remuneration from the sale of products. It is about recognising the clinical expertise pharmacists provide to patients presenting with health concerns or seeking health advice, whether that advice results in a referral, a reassurance, or a recommendation for a certain treatment.

Dr Ackermann missed a perfect opportunity to engage with community pharmacists for his article – instead of talking about pharmacists, he could have talked TO them. Instead of implying that there is no integrity in pharmacy, he could have observed for himself the reason that pharmacists are continually regarded by the community as one of the most trusted professions in the country. Instead of claiming that pharmacists put profits before consumer benefit, he could have recognised the professionalism and expertise that The Consumer Health Forum recognised when surveying patients about expanding the professional services provided by pharmacists.

Dr Ackermann would like to have it both ways – pharmacists should not benefit from the sale of products within their business; nor should they benefit from remunerated services that utilise their expertise and clinical training.

The majority of GPs that I know personally don’t feel that way, nor, I suspect, do a majority of GPs.

Thankfully, most GPs and pharmacists in Australia are more concerned with collaboration, interprofessional cooperation, and putting the patient at the centre of care in a way that meaningfully and effectively improves outcomes.

Jarrod McMaugh is a community pharmacist, based in Melbourne, with a strong interest in clinical services offered through community pharmacy. He is also an asthma specialist pharmacist with spirometry training.