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Dispensing doctors
Tremendous clinical governance issues
From Mr A. B. Sutherland, MRPharmS
What an interesting edition last week’s Pharmaceutical Journal was (23 April). There was a substantial piece on the contract-enforced “peace” between
our rural
colleagues and dispensing doctors, and substantial relief and
support for Ghislaine
Brant from her colleagues. I am sure the letters
published reflect only a small amount of the thanks that we all feel
that the Statutory Committee did not pursue what amounted to a witch
hunt.
However, did anyone notice the irony? Post Shipman, we are now reviewing
our already rigid Controlled Drugs legislation, and pushing further the
role of the pharmacist as the “checks and balances” system
for everything from prescribing to monitoring of chronic therapy to being
encouraged to inform the authorities of any “dodgy” looking
prescriptions or prescribing trends. If I reported every such prescription
to the authorities I should soon become a pariah among my colleagues
and peers.
But surely we are overlooking what could be a significant problem. Where
are the checks and balances in a dispensing practice? Who checks one
GP’s prescribing? The staff employed to dispense the products certainly
are not in a place to make a clinical judgement on interactions or the
like. Would the odd ampoule of 30mg diamorphine be noticed over the course
of many months at a dispensing doctors’ practice? Is there another
Shipman out there using the cover of rural GP practice to perpetuate
his own nefarious activites?
Perhaps in the light of all that has happened since 1998, the Royal Pharmaceutical
Society should not be focusing on the business-related problems of dispensing
doctors, but on the tremendous clinical governance issues that such a
closed shop throws in our faces.
Adam Sutherland
London |
The
Pharmaceutical Journal