Welcome to your November issue of Irish Pharmacist, which we hope will inform and entertain you as the days grow ever shorter.
In his column this month, Ultan Molloy draws attention to the renewed resistance from some elements of the medical profession to the continued expansion of the role of pharmacists.
If you thought we had moved beyond that stage, the IMO Submission to the Expert Taskforce to Support the Expansion of the Role of the Pharmacy will make for irritating reading. “The IMO fears that pharmacy prescribing will increase medicalisation of self-limiting illness and lead to fragmentation of care with worse outcomes, especially in instances of delayed or incorrect initial diagnosis by community pharmacy” is one of the quotes from the Submission. I’ll spare your blood pressure from too many of these excerpts. Some would call these comments ‘frank’; others consider them to be inflammatory.
But if you think all this friction began when pharmacists started to expand their scope of practice in recent years, you’d be mistaken — this ‘turf war’ has been bubbling under for a very long time.
Until 1240AD, pharmacy and medicine were pretty much considered the same discipline and coexisted happily under one umbrella. At this time in Northern Italy and Sicily, Emperor Frederick II ascended to the throne of the Holy Roman Empire and decreed that pharmacists and physicians had different responsibilities, and should be governed by different regulations.
However, pharmacists were considered subordinate to doctors and had to work under a physician’s authority. As with the doctors, the best pharmacists — or those with the right connections — worked for members of the royal family or prominent citizens. This, along with compiling encyclopedias of drugs, took up all a top pharmacist’s time back then.
In Britain, doctors were often sent to pharmacies to inspect them — only drugs that were favoured by the king could be dispensed, with no option for the pharmacist to tweak the remedies to improve them.
Not only were these early pharmacists looked down upon by physicians, there was also growing resistance to this professionalisation by farmers, who believed that the cure to all ailments lay somewhere in their crops.
The recent resistance to the expansion of pharmacists’ roles is nothing new, and in fact has ancient roots. But the public would be best served by these two neighbours in healthcare working together to improve outcomes. Granted, the most vocal opponents in the medical profession are few, but not few enough.
Meanwhile, our clinical content, written by pharmacists for pharmacists, covers topics such as digestive issues, including the role of the gut microbiota. Two separate features on women’s health and vaginal health look at a number of aspect of this area of care, while there is also an overview of coughs and colds as we approach the season of sniffles.
All told, we hope this issue gives you a little food for thought and a few nuggets of clinical information you can take with you.
