Another round of turf wars erupt

It has been a bit quiet on the health IT front recently but things were enlivened somewhat this week with another eruption of the ongoing turf war between doctors and pharmacists. No sooner had a brief announcement of a partnership between health insurer Bupa and the newly merged TerryWhite Chemmart been released than the AMA decided to arc up, thundering about how it threatened the very foundations of general practice.

It's doubtful that there's really much cause for concern over a vague agreement on reducing some costs for medications and supplies for Bupa health fund members, combined with a bit of encouragement to take part in in-pharmacy health screening programs pharmacies and the promise of a dinky new health app, but the AMA let fly nonetheless.

Consumers have been wasting their money buying useless supplements and unguents from pharmacies for years and that's not going to change much, galling as it must be to GPs who have to listen to patients whinge about their Medicare rebate. While we welcomed the president of the Pharmaceutical Society of Australia's decision to urge banner groups against stocking homeopathic products in their stores back in January, pharmacies are increasingly offering extra health programs and services that were previously the exclusive domain of general practice.

Newer, cheaper technology is going to drive this more often, Apple's ECG app being a case in point. The annual Australian Pharmacy Professional conference is being held on the Gold Coast at the moment and you can bet that remuneration of community pharmacy services, driven by new technologies, is a hot topic of conversation.

Also this week there was yet another call from a state coroner for the fast-tracking of real-time prescription monitoring, this time in NSW. The call came as Victoria launched a new awareness program for its SafeScript system, which is due to roll out to the rest of the state next month following a pilot by GPs and pharmacists in western Victoria. We'll watch this with interest because while technology can of course facilitate prescription monitoring programs, their success is much more about adequately funding drug treatment services than some shiny new bit of tech.

A case in point is the NSW deputy coroner's report, which detailed an inquiry into six people who had accidentally overdosed on a mixture of opioids, including fentanyl. Of the three people who died with fentanyl in their system, only one had been prescribed it and there is no evidence of the others being doctor shoppers.

That said, and as we've written numerous times, the states and territories have dragged their feet on the roll-out of RTPM. Greg Hunt promised action on it last year but not much has happened, so whoever the new health minister is come the federal election in May, the states need a rocket put up them. Mr Hunt, however, appears bereft of any actual health policy ideas and has been spending the last year announcing every single new listing on the PBS as if he had personally paid for it.

In NSW, where an election is two weeks away, healthcare is again top of mind. There have been some murmurings up in Queensland recently about the alleged danger to patient safety that is its integrated electronic medical record so it's a surprise that there hasn't been a squeak about it further south, considering NSW has rolled out an EMR from the same vendor. Instead, the headlines in NSW have been about turf wars within the medical profession itself, along with some shocking cases of burnout experienced by junior doctors.

The NSW government is discovering that despite the many billions it has spent on hospital infrastructure over the last eight years – and it has been an extraordinary program of works – it all amounts to nothing if you can't staff those hospitals adequately and doctors and nurses either leave the profession or take more drastic measures over burnout and bullying.

Speaking of which, if you are looking for some weekend reading we recommend you take a look at this article from US publication MedCity News, in which a reporter took up a challenge by Epic founder Judy Faulkner to investigate the link between EMR satisfaction and doctor burnout and see what they find. We also recommend that if you have access to Twitter, you take a look at this thread from lawyer Elizabeth McLaughlin on the utter disaster that is the US health system for patients. The US Democratic party may actually make Medicare for All a policy leading into the 2020 presidential election, and you can see why.

There is also news on a story we have been watching with interest concerning moves by a consortium of some of America's largest companies in Amazon, Berkshire Hathaway and JP Morgan Chase, headed by surgeon and writer Atul Gawande, to do something about healthcare there. This week, we were shattered that the consortium had decided against calling itself Berkmorgazon, instead choosing something naff like Haven. Berkmorgazon sounds nothing if not disruptive.

Back home, and in our poll last week we asked if you thought Australia and New Zealand should set up a healthcare data breach Wall of Shame like the one in the US. Some of you thought it was a good idea, with 60 per cent saying yes and 40 per saying no.

This week, we ask: do you think health apps and cheap devices will increase demand for unnecessary health services?

Sign up to our weekend edition or Pulse+IT Chat to vote, or leave your thoughts below.


0 # Oliver Frank 2019-03-10 09:05
Elizabeth mcLaughlin's sad and shocking story says more about the lack of family doctors (GPs as we call them) or people's choice not to have a usual GP or general practice than about anything else. One person relied quite rightly asking whether the child even needed any antibiotic. Except in very rare cases, antibiotics are not needed or useful as 'preventatives' as Elizabeth McLaughlin apparently believes. In fact, with the increasing understanding of the long lasting adverse effects of antibiotics, one could almost start calling dosing one's child with an unnecessary antibiotic an unintended while well-meant form of child abuse.

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