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‘After all we did through COVID-19, why don’t some GPs get it?’

Tom Wilde: "There is a portion of GPs who still don’t understand what pharmacists do"

A recent hit-piece by a GP showed some doctors need a real attitude adjustment when it comes to pharmacy if we are ever going to work well together, says pharmacist Tom Wilde.

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

6 Comments

Nilesh Tailor, Community pharmacist

I agree with Tom Wilde's comments.The issue in hand is that at present after the change to ccg Drs have a much better upperhand .We are being told to do more clinical services yet the problem is there is no collaboration. As an example our local pcn lead recently has proposed a nhs chargable service for bp monitoring yet gps still will send patients to get them done thru pharmacies.

Its crazy they are the only healthcare sector sheltering from patients,wait till the flu campaign starts and suddenly their doors will be open!

At present even simple things like bloods need to be done at hospital!The situation needs to be addressed problem is our psnc are too weak!

Getting Shorter, Community pharmacist

I saw the article. I was tempted to pick it apart and refute it point-by-point, but it would have been... pointless. And remember that columnists are often choosen and encouraged to be controversial ;)

The one thing that I really did take away from their artcile was the closing statement that a complete re-design of primary care would see GPs remain and pharmacists vanish... don't be so sure, matey - there are many countries with no GP system at all (just over the water in France, for example); and you've just spent a year showing that we don't need GPs at the heart of our communities at all. But then a strong offence is the best form of defence!

 

 

Also, I'm guessing the author is hoping we've all forgotten about Dr David Roberts of the DDA, who was the last person who argued strongly about the pointlessness of pharmacists.

Uma Patel, Community pharmacist

The GP's have a monopoly. The only solution is to make it easier to open new surgeries

Sildenafil Sunrise, Community pharmacist

The bigot GP that wrote the article is a fossil, stuck in the old way of thinking of us VS them. Move out of the way fossil, the NHS is moving on without you and your outdated respect for other professions.

Kevin Western, Community pharmacist

And the way they signed and sent out every script request going, so they could run away and hide, with no clinical thought at all, completely abandoning any right to be thought of as responsible for patients medication , is another factor.
Generalisations are always dangerous but as a profession, they are arrogant, isolated, greedy and think the NHS belongs to them. If the patients play nice, they may allow them in occasionally but anyone else can go whistle.
I apologise in advance to the more modern thinking members of the profession!

Peter John Walker, Manager

I could not agree ore with what Tom Wilde’s comments. I believe that there needs to be a serious relook at the GP contract. The way they have isolated themselves during the Pandemic has shown them up generally. They have routinely referred their patients to out patients or telephone 101. Pharmacy has reacted magnificently. The voice of the GPs has continuously claimed how over worked GPs are without any real evidence. The Department if Health need to be made much more aware of the game they play at tax payers expense.

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