Too much risk: Non-collaborative prescribing schemes threaten patient safety
The Australian Medical Association has warned against the continued use of non-collaborative prescribing models, saying policy should be directed at encouraging proven models based on collaboration between doctors and other health professionals that prioritise safety and quality.
In a submission to a consultation on proposed changes to the National Prescribing Competencies Framework, the AMA expressed serious concerns about the proliferation of prescribing models where no doctor was involved.
With no medical doctor involved, these prescribing models increased the risk of dangerous events occurring, AMA President Dr Danielle McMullen said.
“Fragmentation is the enemy of patient safety, and it is time that we end these dangerous experiments and focus on models that are proven to deliver high quality patient outcomes,” she said.
“We have concerns that the revised prescribing framework does not sufficiently emphasise collaborative prescribing models, where non-medical prescribers operate in a medically-led team.
“Our position is 100 per cent clear: non-medical prescribers must work in close collaboration with medical practitioners to ensure safe, effective, and evidence-based care.
“Today’s patients increasingly have one or more complex chronic conditions. Only medical doctors, who have a minimum of 10 years of training, can safely diagnose and prescribe medicines without oversight.”
Dr McMullen said the AMA was concerned the proposed revisions move away from best practice models of prescribing, and simply encourage more prescribing by other health practitioners with no clinical leadership from a medical practitioner.
“Prescribing models that don’t involve a patient’s doctor are a thin end of the wedge which could potentially result in serious harms to patients,” Dr McMullen said.
“Doctors value the contribution of other health professionals, and we want to work with them to improve access to care and deliver the best possible outcomes for patients. But there is no substitute for care from your doctor and their team. Short-sighted solutions like pharmacist prescribing are taking Australia down the same path that other countries have followed, with their health systems delivering inferior health outcomes compared to Australia.”
Dr McMullen said independent pharmacy prescribing also ignored concerns on separating prescribing and dispensing of medicines – regarding risk management and potential financial conflicts of interest. In the case of antibiotic prescribing, expanded non-medical prescribing could lead to an increase in anti-microbial resistance and the emergence of more superbugs.
“Appropriate regulations, clinical governance guidelines, protocols, monitoring, and evaluation of frameworks will need to be implemented to ensure these models are safe and effective.”