By the way... Put pharmacists in every GP surgery
THE recent suggestion that pharmacists should work in GP practices is to be welcomed: I hope that most doctors will co-operate with the plans as experience shows that a close working relationship between pharmacist and GP reduces the workload on the doctors and improves patient safety.
We piloted this idea in my practice six years ago, and it worked so well that after the first 12 months we committed to the arrangement long term.
We’d started the scheme partly out of convenience for our patients, but also recognising that we doctors would benefit from easily available expert guidance and information. One thing we hadn’t anticipated was that many patients opted to consult the pharmacist rather than a GP, usually to gain help with minor symptoms or common ailments, sensing that they were getting skilled and experienced advice without having to trouble their usual GP.
Some patients would opt to speak first to the practice nurse, and on occasions she would pass them straight across to the pharmacist — or both would advise in tandem.
In our experience, the knowledge of a pharmacist about medicines, their sideeffects, interactions and other details has often come to the rescue of a GP who, inadvertently, and despite computer generated warnings, issued a prescription unwisely, failing to take into account some specific contraindication.
For instance, giving an anti-inflammatory drug to a patient with acute gout who’s also taking an anticoagulant, a combination that can raise the risk of intestinal bleeding. But we found it essential that the pharmacist has an assistant, often a junior pharmacist in training. This is because it proved impossible on many occasions for the pharmacist to provide a good service to those waiting for prescriptions to be dispensed as well as being available at a moment’s notice for urgent consultations. Providing a discreet, confidential consulting room goes without saying.
Pharmacists have a long, scientific and detailed training: they are a resource to be used wisely, particularly at this time of great stress in primary care, when many GPs over 50 are planning to retire early, disillusioned by the ever increasing pressure of red tape, inspections and a mounting workload — and when fewer medical graduates are opting for general practice as the prospects are less and less enticing. I say bring them on!