GP script restrictions questioned

RESTRICTIONS preventing GPs from dispensing medications have been questioned by a Curtin University study showing Australian doctors who dispense PBS medications issue fewer prescriptions than non-dispensing doctors.

The finding of the study – published in the MJA this week – compared PBS claims data of 72 dispensing GPs against data from 1080 of their non-dispensing colleagues.

The authors said the results were at odds with international research suggesting dispensing doctors prescribe more, rely less on generic medicines and use antibiotics less judiciously.

There are 80 Australian sites  where GPs have licences  to dispense their own prescriptions, where populations are too small to support pharmacies.

“Interviews with 22 of the dispensing doctors showed the lower prescribing rates were due to perceived expectations from the profession about prescribing norms” and a desire to cut down on paperwork, the study found.

University of WA professor of general practice Alistair Vickery agreed the best model was for a GP and pharmacist to work closely together but said the study gave credence to his belief that there was room for more flexibility in the system.

“What you’re saying [by not allowing GPs to dispense] is doctors are not ethical enough and responsible enough to do so, and I think that’s a misconception.”

Pharmacy Guild of Australia acting president Tim Logan said while it made sense for some rural doctors to dispense their own prescriptions, as a general rule health practitioners “shouldn’t be able to write the cheque and then cash it”.
MJA 2011; 195:172-75