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Is the animosity between pharmacists and GPs overblown?

"We have absolutely no issue with patients attending the pharmacy for their minor illness or blood pressure check, say"

The turf war between the two professions is not as bad as it's made out to be, says Dr Messenger

All the talk about turf wars between pharmacists and GPs is quite funny really. It’s referred to so often that it’s assumed to be true. But I’m not sure if it is – funny or true, I mean.

Admittedly, I come at this from the point of view of a non-dispensing doctor, so I can’t comment on that particular territorial spat. It may, I guess, be a real source of strife, albeit only affecting the minority of GPs that actually dispense.

And, yes, last year there was an unseemly row about the first national pharmacy flu campaign affecting GPs’ own flu offering. That was hardly surprising – on the one hand, pharmacists were only pursuing a legitimate slice of the flu action, while on the other, we GPs were understandably cheesed off by competition appearing so late in the day that we risked being stuck with surplus stock.

The real culprit – and, therefore, enemy  was, of course, the government, because it was the politicians who belatedly came up with the idea. But if my local experience is anything to go by, GPs and pharmacists on each side of the divide were too entrenched to realise that  ‘healthy competition’ had escalated into messages and counter-messages between pharmacies and GPs that were more lengthy and heated than those generated by, say, a manufacturing shortage of Manevac.

But that’s a really rare example, given that it involved two groups of frontline professionals in an unseemly fight over the same pot of money. Most of the time, it’s not like that at all – not least because the majority of GP income is based on patient numbers, rather than activity. Unlike pharmacists, GPs are paid whether or not patients attend.

So if it sometimes feels like, to cope with stress and workload, GPs are perfectly happy to keep patients at bay, that’s probably because we are. Which means we have absolutely no issue with patients attending the pharmacy for their minor illness or blood pressure check. You’re welcome to the work, so it’s a turf giveaway rather than war.

When we do get aerated, it’s really not about being territorial – it’s simply exasperation that effort is being duplicated and NHS funds wasted. Take the new medicine service or medicines use reviews, for example. These cost us nothing in terms of finance and very little in terms of territory. But they do make us wonder about the logic of replicating a service that any self-respecting GP builds into his consultations whenever a prescription is issued.

In other words, if there is a conflict to be resolved, it’s about defining, exactly, who is doing what, so that services aren’t duplicated or omitted, and resources aren’t frittered away. And that requires not war-war, but jaw-jaw. So let’s stop pseudo-squaring up over turf and instead get round a table.


Olukunmi Popoola, Community pharmacist

When would community pharmacy get paid like GPs - whether patients come or not?

Kevin Western, Community pharmacist

I can see that it is perfectly possible for local relationships to be good though that is an uphill struggle from a Pharmacist perspective. |The real problem comes with national and local GP representatives who steadfastly refuse to countenance Pharmacist participation in the NHS via commissioned services despite GPs being overworked underpaid and underresourced :-) 

This hypocrisy is so blatant that it is THE major barrier to good Pharmacist/GP relations

edited because I'd forgotten how to type....

Din Patel, Manager

Doctors = highly educated. typical 3A grades at  level.
Pharmacists = low paid and poorly educated, typical low grades at A level and inferior to doctors, yet will not admit it.

Kevin Western, Community pharmacist

are you saying that is GPs perception of pharmacists or yours?

Graham Phillips, Superintendent Pharmacist

Remarkably similar to some of the points I made in the GP press:

Z ZZzzzz, Information Technology

GPs affected by any loss of income from flu vaccination for not jabbing enough folk last year get it back this year.  No increase in fee payment for pharmacy, increase in fee payment for GPs due to loss of income from last year.  If pharmacies this year or next decided to give up flu vaccination and all that extra income went GPs way, do you think the GPs would take a reduction in fee payment the following year due to receiving excess income.  It would never happen.  And you wonder why there is animosity between some sections in pharmacy (those that truly understand what is going on, and has been going on for years) and some sections in GPland.  Please take off those rose-tinted specs.

Leon The Apothecary, Student

I like to think that I maintain a healthy open line of communications with GPs, we're all part of the same chain essentially, and as the saying goes, we're only as strong as the weakest link.

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