GP re­jects strat­egy

Seymour Telegraph - - NEWS - By Cathy Walker

The Vic­to­rian Gov­ern­ment last week asked for ex­pres­sions of in­ter­est from phar­ma­cists and GPs to par­tic­i­pate in the new Phar­ma­cist Chronic Dis­ease Man­age­ment pi­lot pro­gram, but one Seymour GP has al­ready branded it a risky strat­egy.

The pi­lot pro­gram will see phar­ma­cists and GPs work closely to­gether to help pa­tients man­age their chronic ill­nesses and med­i­ca­tion.

But many GPs, who are funded by the Fed­eral Gov­ern­ment, are un­likely to be happy with a pro­gram that po­ten­tially takes pay­ing pa­tients away from them in a sim­i­lar man­ner to flu vac­ci­na­tion schemes, where nurses ad­min­is­ter in­jec­tions off­site and ob­vi­ate the need for a doc­tor’s ap­point­ment.

Through the chronic dis­ease pi­lot, el­i­gi­ble pa­tients will be able to visit their lo­cal phar­ma­cist to mon­i­tor chronic con­di­tions and man­age med­i­ca­tions un­der the di­rec­tion of their GP’s care plan.

Seymour Med­i­cal Clinic’s Dr Rob Peter­son re­sponded to the pi­lot pro­gram plan with dis­quiet.

‘‘Chronic dis­ease needs to be man­aged by GPs who can make ap­pro­pri­ate med­i­ca­tion and treat­ment changes af­ter tak­ing ac­count of the full pa­tient his­tory, in­clud­ing pathol­ogy re­sults, spe­cial­ist re­ports and in­di­vid­ual re­sponses,’’ Dr Peter­son said.

‘‘In­volv­ing phar­ma­cists in med­i­cal man­age­ment adds an­other layer of ser­vices that will cre­ate con­fu­sion and in­crease risk to the pa­tient.’’

Dr Rosey Panelli, the gen­eral prac­tice man­age­ment con­sul­tant at Seymour Med­i­cal Clinic and a re­searcher work­ing in the area of chronic dis­ease, was more out­spo­ken.

‘‘This pro­posal is yet an­other strat­egy that could un­der­mine Aus­tralian health care rather than im­prove it,’’ Dr Panelli said.

‘‘To build healthy com­mu­ni­ties we need to pro­mote con­ti­nu­ity of care. Pa­tients de­serve the op­por­tu­nity to build long-term and trust­ing re­la­tion­ships with a GP and a med­i­cal clinic.’’

Act­ing Health Min­is­ter Jenny Mikakos said more than 87 per cent of Vic­to­ri­ans live within 2.5 km of a phar­macy, and the pi­lot pro­gram would give peo­ple with chronic dis­eases a con­ve­nient op­tion to ac­cess the care and treat­ment they need.

‘‘By us­ing the skills of our highly trained phar­ma­cists to de­liver pri­mary care we’re help­ing take pres­sure off our hos­pi­tals and bet­ter meet the chal­lenges of ris­ing rates of chronic dis­ease,’’ Ms Mikakos said.

Ms Mikakos said more than half of all vis­its to GPs now in­volve the man­age­ment of at least one chronic con­di­tion.

Many of these vis­its con­cern re­new­ing pre­scrip­tions or mak­ing dose ad­just­ments, rather than di­ag­nos­ing new con­di­tions.

She said by ex­pand­ing the role of phar­ma­cists in col­lab­o­ra­tion with GPs, fam­i­lies would have a new con­ve­nient op­tion to ac­cess the health­care they need, when they need it and close to home.

Dr Panelli said it was time Aus­tralian health pol­icy mak­ers stopped throw­ing out ran­dom sug­ges­tions about how to im­prove the health care sys­tem with one hand while tak­ing away re­sources and re­spect from gen­eral prac­tice with the other.

‘‘We live in an era when many changes in so­ci­ety and in the de­liv­ery of med­i­cal ser­vices threaten to break down what was once a strong and val­ued pri­mary care sys­tem,’’ Dr Panelli said.

‘‘Poli­cies that pro­mote frag­men­ta­tion of care are in­ef­fec­tive and dan­ger­ous.

‘‘Phar­ma­cists and GPs have a long his­tory of work­ing to­gether to as­sist their pa­tients. How­ever, tak­ing med­i­cal ser­vices out of the clinic where pa­tient have their his­tory of care, and putting them into a re­tail set­ting, is not a pos­i­tive step for pa­tients and it will cre­ate con­fu­sion in a sys­tem which is be­com­ing in­creas­ingly com­plex.

‘‘Aus­tralian gen­eral prac­tice has good foun­da­tions. We need to value and sup­port the work that is done there. We need to en­cour­age and pro­tect it be­fore it has been weak­ened be­yond re­cov­ery.’’

The 18-month pi­lot pro­gram will be im­ple­mented in one metropoli­tan and two ru­ral lo­ca­tions. El­i­gi­ble lo­ca­tions have been iden­ti­fied as ar­eas with an in­creased preva­lence of chronic dis­ease that would most ben­e­fit from the ini­tia­tive.

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