Patient safety before pharmacy profits: AMA NT reject autonomous pharmacy prescribing
The Australian Medical Association Northern Territory (AMA NT) is calling on the Chief Minister to abandon the proposed trial of autonomous pharmacist prescribing, warning that the model is driven by retail business interests rather than evidence-based patient care and will leave Territorians worse off.
AMA NT President Dr John Zorbas warned that the trial, heavily lobbied for by the Pharmacy Guild, would fundamentally compromise the integrity of the Northern Territory’s primary health system and put vulnerable Territorians at risk.
"Let us be clear about what is being proposed: this is an initiative pushed by an industrial organisation representing retail pharmacy owners, not a clinical body representing pharmacists," Dr Zorbas.
"Healthcare decisions must be driven by clinical need, not retail foot traffic. Removing the critical separation between the person diagnosing a condition and the business profiting from selling the medication creates an unacceptable financial conflict of interest."
The AMA NT says the proposed trial threatens patient safety in three ways: diagnostic blind spots; conflict of interest and fragmented care and hospital pressures.
Dr Zorbas said while pharmacists are highly valued medication experts, they do not have the 10+ years of training required for medical diagnostics.
“Treating an isolated symptom without the facilities or training for a comprehensive physical examination is dangerous,” he said. “Offering a quick fix over the counter for a suspected urinary tract infection, for instance, risks missing complex underlying conditions, including sexually transmitted infections or systemic illnesses.”
“There is also a huge conflict of interest. The fundamental principle of safe prescribing relies on independent medical judgement. Allowing retail businesses to both authorise and sell scheduled medications removes the necessary checks and balances that keep patients safe.”
Dr Zorbas said bypassing general practitioners would also fragment vital, longitudinal care in the Territory where doctors and patients frequently manage complex, long-term conditions.
“Bypassing GPs will only fragment much needed ongoing care. Furthermore, unregulated prescribing in retail settings significantly increases the risk of over-prescribing antibiotics, accelerating antimicrobial resistance and ultimately putting immense downstream pressure on our public hospitals.”
Dr Zorbas said the trial would achieve the exact opposite effect of what the government is trying to achieve.
“Territorians deserve a doctor when they need one, not the cheapest substitute model available to the government of the day,” he said. “We strongly support the integration of non-dispensing pharmacists into broader primary care teams, provided they operate under a safe, medically governed framework.
"We are not opposed to optimising our allied health workforce, in fact we champion it, having called for improved conditions for pharmacists in the NT not less than six months ago. The AMA NT supports models such as nurse practitioner prescribing because it is done collaboratively, with a medical practitioner leading the team. It is a model of delegation, rather than substitution.
"We want pharmacists working alongside GPs in our clinics, operating under shared care plans with rigorous medical oversight. This collaborative model protects the separation of prescribing and dispensing, ensures a proper medical diagnosis, and strengthens the clinical team. Most importantly, it is the safest model for patients and the cheapest model for government in the long term.
“We call on the NT Chief Minister and Cabinet to listen to their clinical workforce, rather than retail lobbyists, and reject this unsafe trial in favour of genuine, team-based primary care. The best care for Territorians comes from investments in clinicians on the frontline of the Territory, not retail lobby groups based outside of the NT.”
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