Pretending pharmacists are medical doctors

Credit:Illustration: Andrew Dyson

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Pretending pharmacists are medical doctors

Re Victoria’s 12-month pilot allowing pharmacists to reissue pill prescriptions, prescribe antibiotics for urinary tract infections and treat some skin conditions, from the middle of next year (The Age, 29/11). As a GP for 47 years and former university clinical tutor for 12 years for medical students (including some pharmacists), I believe the move to pretend pharmacists are medical doctors is dangerously delusional.

I have the utmost respect for pharmacists’ expertise in their field, but their training does not produce clinicians capable of clinically evaluating symptoms in broad context, including dermatological ones. Almost any symptom may mean minor or serious disease (eg headache, nausea, diarrhoea, chest pain and even symptoms mimicking “simple” urinary infection).

Proper clinical assessment requires the breadth and years of medical clinical training. The idea that apparently “simple” symptoms can be hived off to be treated by pharmacists in recipe-book fashion reveals ignorance of the complexity involved in proper medical consultation, and of the importance of GPs’ holistic continuity and co-ordination of care.

There will be an increased risk of mis-diagnosis, delayed diagnosis, incorrect treatment, antibiotic overuse and resistance in the community, over-prescribing and conflict of interest. Also, the fragmentation not only of patient care but also of GPs’ records of patients, with the resultant gaps, will increase the risk of errors.
Dr Joe Di Stefano, Geelong

Doctors are promoting unnecessary fear

For the past 15 years, the opportunities to advance the prescribing and referral capabilities of pharmacists, nurses and allied health practitioners has been blocked. The health and wellbeing of all Australians is the heart and soul of all health professional practice. It is time for the Australian Medical Association and other “blocking” professional groups to move into the 21st century and embrace change in health care. All state and federal government should support this. The proactive implementation of extended scopes of practice for other health professionals will enhance primary health care and enable GPs to use their skills and expertise on more complex cases. Promoting unnecessary fear is not a way forward.
Tess Wylie, Aspendale

Importance of GPs who know patients’ history

Is this declaration by Daniel Andrews an attempt to dumb down the practice of medicine? Other questions I puzzle over if this wretched declaration goes ahead: Will the pharmacists test the person’s urine to assist with the diagnosis? Will they be aware that the symptoms may have another cause? Will they know if the person has any allergies? Will they know which antibiotic is most suitable? Will this well-paid service provide the best care available? My pharmacist is caring and efficient. My GP is caring and efficient as well, and knows my history and treats my symptoms accordingly.
Wendy McClelland, Castlemaine


Hip-pocket opposition

Daniel Andrews’ promise to grant pharmacists the power to treat certain medical issues is a step in the right direction. Pharmacists are qualified to make decisions in these areas, despite the scare campaign being run by the self-serving Australian Medical Association.

This long overdue initiative will be well-received by those who cannot easily make an appointment with their GP or who have to wait endlessly to see one in a bulk-billing clinic. GPs will lose some business, with fewer paying customers coming through their doors. However, the public will be the winner.
Michael Gamble, Belmont

Who is being protected?

So the Bruce Lehrmann rape trial will be abandoned to “protect” the mental health of the complainant, Brittany Higgins (The Age, 2/12), which is understandably fragile after she underwent days of grilling in court. If legal changes in making it easier for witnesses in sexual assault cases are the result of this abandoned trial, well and good. As the law, and legal processes now stand, it makes one wonder just who the law is meant to “protect”.
Cheryl Day, Beaumaris

Case should go ahead

Why did the ACT Director of Public Prosecutions drop a case on the basis of a complainant’s state of mind? Trauma would be commonplace in victims but it does not mean you should drop the case. It is utterly irresponsible to have this as reasoning for not going further with the proceedings and nonsensical to hold a press conference to do so.
William Cook, Ascot Vale

Sending wrong message

And people wonder why women of all ages do not want to report sexual assaults. On the strength of watching just this highly publicised case, what message is being broadcast to our younger women about their rights, safety and ability to get any justice for a sexual assault? Why would you risk that second assault on your wellbeing, the doubling-down of objectification and targeting? Australia: where men are men, sheep are everywhere and women are silenced.
Lisa Dooley, South Melbourne

A minister without value

David Crowe’s informative and damning article – “Minister’s mates got inside running” (The Age, 2/12) – concludes that taxpayers have been left with a lemon. Very true, and a lemon with a name: Stuart Robert.
Richard Hughes, Woodend

It’s better not to ask

As Tim Soutphommasane argues (Comment, 1/12), it should be OK to ask where someone is from. However, in my experience, it is a loaded question that more and more people find objectionable.
At a semantic level, it can be confusing. If asking where someone is from is a really question about origins, are we ultimately asking about birthplace, nationality or cultural heritage?

Add to this the political sensitivities of cultural attachment in an era dominated by identity politics where the question might be seen as a micro aggression – irrespective of the manner of delivery. For the most part, a bit more forbearance is warranted.
Kirk Weeden, Frankston

Inappropriate questions

Finland punches well above its weight. So when its Prime Minister Sanna Marin appeared on 7.30 (ABC TV, 1/12), I expected an informative interview with her.

Surely this was an opportunity to learn more about Finland’s world-leading education system, progressive social policies or high technology industries. Instead the ABC chose to insult their viewers, let alone Marin and the people of Finland, by spending most of the time discussing her age, gender and a video of her dancing.

Why on earth did our national broadcaster decide that this line of questioning was appropriate for a visiting world leader?
Andrea Bunting, Brunswick

Well done, Ms Alcorn

Re “Alcorn steps down as editor” (The Age, 2/12). Thanks and best wishes to Gay Alcorn for leading The Age through an unprecedented period of history, striving to maintain the masthead’s independence in reporting, while coming across as connected with, and caring about, the manifold pandemic afflictions of its readers.
Ruth Farr, Blackburn South

The US, land of the gun

No, Grace Tame, lawful violence is generally not police brutality (Comment, 1/12) despite what many activists and anarchists would have us believe.

The use of force, all the way up to “justifiable homicide”, often involves police defending themselves and others from violent criminals, and citizens doing likewise during events such as home invasions (or even thwarting mass shooting events, as occurred in Indiana in July).

It is worth remembering, too, that currently one particular demographic represents the fastest growing cohort of first-time firearms owners in the United States, and also commits the fewest firearm-related crimes: women.
Andrew Christie, Point Cook

Surely photos will do

Why are we paying for oil paintings of former prime ministers – “A rare brush with unity as Abbott joins portrait gallery” (The Age, 1/12)? During a recent tour of New Zealand’s parliament house in Wellington, I learned that NZ remembers its former prime ministers with a gallery of photos. Good enough.
Margarete Lee, Blackburn

Plea to act on housing

Migrants growing up in the post-World War II years had an ability to see a future if they worked hard and saved. They could find a place to rent and a means to pay for it. Today many are faced with little hope.

The federal government must get rid of negative gearing for a start. Then it, and the state government, must do more about ‴⁣⁣ousing” than put an “h” in front of it. Look overseas at what can be done.

When I grew up, no one slept in Swanston Street and accommodation existed for hapless people. Politicians desperately want to be elected. Do something brave and bold.
Peter Berenyi, Howes Creek

A fairer negative gearing

The Reserve Bank will likely increase interest rates next week, causing more heartache for those who are mortgage-stressed. This means families going without basic necessities to keep a roof over their heads.

The only equitable solution is to give struggling homeowners the same tax breaks given to negatively geared investors. All mortgage and other home expenses above a market rent for the property should be deductible against income. Yes, this will be a hit to the budget but I would rather see my taxes money go towards a genuine home owner than someone on their fifth investment property.
Barry Lizmore, Ocean Grove

Aiming for equality

A racist is someone of a dominant and colonist race decrying the opportunity to lift a deliberately maligned, decimated and humiliated original people from their position of inequality. It is absurd and insulting for your correspondent to claim that the proposal for the Voice is “blatantly racist” (Letters, 1/12).
Chris Pettifer, Hughesdale

What was that you said?

For a world-class facility, Melbourne Airport suffers from a common but easily fixable flaw: a public address system of D-grade level.

As a musician with many years of providing a reasonable listening experience to an audience, I cannot understand why the system is tolerated by airport management. Plenty of volume yes, but announcements come through with an accompanying echo that make words barely distinguishable and lost in a cavernous wash.

Management, get in a recognised sound engineer to tune your public address equipment so we can understand all of what is being announced rather than picking up on some key words and trying to guess the rest. Some training in microphone technique for the people who have to make announcements would also help.
Paul Burchill, Carlton North


Credit:Illustration: Matt Golding


Scott Morrison doesn’t seek forgiveness. Instead he delivers a sermon filled with messianic hubris from the pulpit.
Danny Hampel, Caulfield North

I wonder what the Liberal Party might look like if Bridget Arthur became its leader.
Berys Dixon, Moonee Ponds

Did Scott ask Jenny what she thought about him secretly taking over the role of ministers?
Royden James, Tatura

We’ve seen it all now: a conga line of hypocrites shaking Morrison’s hand.
Mary Mandanici, West Preston

And we thought Whitlam was an arrogant PM until Morrison came along. His reply to parliament showed a new level of mouthing off.
Robert Saunders, Box Hill North

If anyone in the LNP saw NSW Treasurer Matt Kean on Q+A (ABC TV, 1/12), they’d be trying to get him to Canberra and into a leadership position.
Michael Brinkman, Ventnor

I’ve asked Santa for a train for Christmas. I hope I don’t get a bus replacement service instead.
Paul Custance, Highett


For the Socceroos, things may be about to get Messi.
James Inglis, Coburg

When I was a member of a football team, my position was left-right-out.
Steve Barrett, Glenbrook

The Test cricket crowds seem “sparse” (Sport, 2/12). Do Perth people prefer watching it on free-to-air television rather than seeing world-class cricket in person?
Peter Fagg, Blackburn


It appears the Taronga Zoo lions had been planning their escape for some time. Nobody saw that coming.
David Cayzer, Clifton Hill

Perhaps instead of printing “smoking kills” on each cigarette, put the words “I am an idiot”.
Vicki Jordan, Lower Plenty

The phone signal drops out on the train (30/11) and people look around. Amazing.
Peter Baddeley, Portland

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