MEDICUS May 2022

The bottom line Why are pharmacists so interested in vaccines? The Pharmacy Guild says it is because they are interested in public health. Another is that some pharmacies aim to get people through the door by any means, and then sell them overpriced goods, groceries, cards, toys and healthcare products. Another business model is to get people in, and then upsell non-evidence-based, hocus pocus ‘treatments’ that do nothing other than line the pocket of the pharmacy owners. A 2014 Choice magazine investigation titled Dubious pharmacy products concluded (on the findings of a mystery shopper study) that some pharmacies were selling ‘health’ products which simply didn’t work. 4 An Australian study in 2019 showed that 31.4 per cent of pharmacies over treated or overmedicated customers. 5 In 2018, complementary medicines formed a $4.9 billion industry in Australia, 41 per cent of which were sold through pharmacies. Although indications for vitamin and mineral supplements do occasionally arise, the vast majority of such complementary medicine is just colouring people's urine. These complementary medicines, backed by little or no evidence, had grown by $2 billion in five years. 6 Getting people through the door is becoming more and more important to allow upselling for some pharmacy groups, with the advent of e-pharmacies and Amazon Pharmacy. Some may suggest it is more convenient for clients. But if that is the case, then let’s deregulate pharmacies as recommended by numerous inquiries and reviews. Let’s have them in supermarkets. That way, we can all put in our prescription, and then shop in an environment of cheap, rather than overpriced products. Heck, let’s have them in doctors’ offices for true integrated healthcare! AHPRA 8 has suspended doctors for recommending alternative, unproven medical treatments, and the Medical Board of Australia 8 has previously cracked down on unproven complementary and quack treatments. Bizarrely, some pharmacists see such treatments as good business and even more bizarrely, offer it in a regulated and thereby protected, non-competitive environment. The WA pitch So, where to now for the Pharmacy Guild in WA? Some insight may be gained from the 2019 comments of Chris Owen, then Vice President of the Queensland Pharmacy Guild and now president, when he said according to The Courier Mail : “There will be no difference between a pharmacist and a doctor”. Queensland is usually the proving ground for pharmacy professional creep (I mean ‘professional services’) as there is only one house of Parliament. Accordingly, the incumbent government can pass legislation without alteration or restraint. What better place for a powerful lobby group to instigate change and then roll it out to the other states and territories? Next, the Pharmacy Guild in WA will want to diagnose, prescribe and dispense, as has been trialled in Queensland recently, with no outcome measures. In response to the “sham trial”, the RACGP in Queensland 9 has expressed grave concerns regarding misdiagnosis, use of Bactrim in undiagnosed pregnancy, and cases of cancer being missed. It is firmly the AMA (WA)’s position that pharmacists should only be diagnosing and prescribing when they have obtained their medical degree, now and in the future. ■ References available upon request. F or almost two years now, Queensland has run the Urinary Tract Infection Pharmacy Pilot, allowing pharmacists across the State to prescribe antibiotics to women with a suspected UTI. Stamping it a “success”, the Qld Government has announced an expanded trial will kick off in North Queensland (including remote Aboriginal communities) from next month, giving pharmacists the green light to treat 23 serious conditions. In the absence of any publicly available data, AMA Queensland turned to doctors across the State to report on their experiences with patients treated under the UTI pilot. The survey ran for 10 days, generated more than 1,300 responses and revealed some truly alarming results: ƒ 240 patient complications were reported. One in five GPs and one in eight of all doctors who responded reported seeing at least one patient complication. ƒ Most commonly, complications included sexually transmitted infections (STIs), but also cancerous conditions and pregnancies. ƒ Patients were sold antibiotics that were not only inappropriate, but dangerous. ƒ At least six pregnant women were sold antibiotics unsafe in the first trimester, and one woman had a potentially life-threatening ectopic pregnancy. “Our survey report is a compelling read for anyone who cares about the health of Queenslanders,” wrote AMA Qld President Professor Chris Perry in his foreword. With the WA Government extending the clinical reach of pharmacists in our State, I’d dare say it’s one to add to your reading list! qld.ama.com.au/Stop-NQ-Pharmacy-Trial M AY 2 0 2 2 M E D I C U S 3 Janine Martin Editor, Medicus Pilot off course! F R O M T H E E D I T O R