Why substituting one profession for another won’t fix our health system, but it just might break it

Increasingly, families are being told that instead of seeing a GP, they can visit their local pharmacist. Some even describe this as “GP-level care.”

It’s an appealing idea on the surface: quick, local, and affordable. But it glosses over a much harder truth: asking one already stretched profession to step in for another doesn’t serve patients, pharmacists, or GPs. 

Both general practice and pharmacy are under immense pressure. 

Workforce shortages, rising demand, and increasingly complex health needs are straining every part of the system. But the answer isn’t to blur professional boundaries.

Healthcare works best when each profession is supported to deliver the work for which they are trained, not when one part is asked to fill gaps created elsewhere.

GPs and pharmacists are trained for different, equally important roles. 

GPs spend over a decade learning to diagnose illness, navigate uncertainty, rule out serious conditions, and carry responsibility for coordination, follow-up, referring and long-term care. Their work is as much about what might be happening as it is about what is.

Pharmacists bring essential medicines expertise—how medicines work, interact, and how to use them safely and effectively. 

Trouble arises when pharmacists are positioned as direct substitutes for GP care. It creates confusion and false expectations. 

In moments like the sick child scenario, what level of assessment is actually occurring? Who holds responsibility if symptoms get worse? Who follows up? What happens if something serious is missed?

When people hear “GP level care,” they reasonably assume a comprehensive assessment, access to medical history, and continuity if things don’t improve. That’s not how pharmacy settings run. Without shared records or clear handover, healthcare becomes fragmented and risks increase. 

Tasmanian families shouldn’t have to guess what kind of care they’re walking into. Clear, well-defined roles allow people to make confident, informed decisions at stressful times. 

A strong health system is built on collaboration between health care professionals, not substitution.

If Tasmania wants a system that is safe and sustainable, the solution is not one that stretches untrained alternatives to cover gaps in a highly specialised area. 

We need to invest in our future workforce, respect the expertise of each profession, and build systems that allow them to work together for the benefit of all Tasmanians.

Supporters of expanded pharmacy roles often argue that poorer access to GPs justifies substitution. But access and safety are not interchangeable. 

A shortage in one part of the system doesn’t mean we should stretch another profession to absorb the other's responsibilities. 

This doesn’t fix the root causes of general practice access, of chronic underfunding of Medicare, escalating administrative burden and difficulty of attracting and keeping GPs. 

It also ignores the fact that the pharmacy workforce is similarly under strain, and they need to be supported to do their core work that is essential for our community. Asking them to fill gaps elsewhere pulls them away from this vital medicines-focused role and exposes them to clinical risk without the systems and supports that exist within general practice. 

Politically, it’s easier to offer a faster, cheaper alternative than to invest in long-term solutions. But doing so risks normalising a disconnected system. We know fragmentation equals worse health outcomes regardless of any other factor. 

Mistakes that come about from the fragmentation of care aren’t always obvious at the time. Missed cancers, autoimmune diseases, or chronic diseases often reveal themselves months or years later. Healthcare policy must be judged not by the smooth cases, but by the consequences of the one serious case that slips through. 

If access is the problem, the answer isn’t to shift responsibility from one profession to another. The real solution is a coordinated, team-based model of care with general practice at the epicentre.

That means investing in primary care capacity while ensuring pharmacists also have the support, they need to contribute their medicines expertise within a connected team. It means shared information, clear referral pathways and care that is designed from the outset to be collaborative rather than substitutive, not some dangerous turf war.

If we keep chipping away at general practice, keep offering band-aid solutions, what we actually risk is a slow, quiet unravelling of a service that underpins the entire health system, a “death by a thousand cuts”. It’s not about losing small tasks; it’s about hollowing out the stability, continuity and diagnostic capacity that only a fully functioning general practice workforce can provide.

When a presentation inevitably exceeds the scope of any alternative model, patients will turn back to their GP not only to seek solutions but to uncover the root causes of their issues. Without careful system design, this creates duplication, delays, and a growing burden concentrated on a shrinking workforce.

If general practice were to become unavailable, that’s when access to healthcare services will become a dangerous problem. Patients would struggle to receive essential evaluations, preventive care, and chronic condition management, leading to greater reliance on emergency services. 

This shift would increase the burden on hospitals, potentially causing longer wait times and worse health outcomes for those needing routine care. 

We can avoid this. 

A team-based system allows each profession to work to its strengths. When these roles complement each other, care becomes safer, clearer and more consistent for patients.

Tasmania needs a health system built on trust and teamwork. That requires long-term investment, clarity of roles and models that support collaboration instead of episodic, disconnected care. It means designing care around safety and continuity, not convenience alone.

Families deserve clarity. Clinicians and pharmacists deserve support to do the job they are trained to do, and Tasmanians deserve a system that delivers the right care from the right professional at the right time. 

The answer isn’t substitution. It’s collaboration.>>>ENDS

Drs Meg Creely Vice President & Fiona Beer