Health Orchestra needs fine-tuning

GPs play a central role in the Health Care System akin to a conductor in an orchestra. While major differences between how GPs communicate with patients are rare, the same could not always be said for some other members of the broader “Health Care Team”. You would never hear a GP sending a patient with a suspicious lesion to a dermatologist, for instance, telling them to “get this removed”. In all likelihood, you would tell the patient to find out what the specialist thinks about it. However I sometimes face challenging situations with patients after their contact some allied health colleagues. In my experience the majority of these problems relate to pharmacists and nurses. For an example of this disconnect, take the report on differences between what the pharmacists and doctors advise people, regarding the use of cortisone creams (“Steroid phobia undermining child eczema care” , Australian Doctor.com.au 24 March 2015) . Also I regularly speak with patients on antihypertensives who have been refused “cold & flu” tablets by pharmacists. While I acknowledge some cold & flu tablets are not advisable in people with severe hypertension, surely pharmacists should be aware that GPs would have considered that fact. At worst pharmacists should use their discretion to suggest the type without pseudoephedrine rather than sending patients back to GPs alarmed and confused. These are only examples of an apparent huge disconnect between the principles that I learnt in medical school and those taught in pharmacy and nursing schools these days. Apart from the huge time wasted undoing the misconceptions and occasionally wrong advice implanted in people’s minds (perhaps inadvertently often these encounters lead to confusion and hostility towards doctors. The latter certainly occurs when the “recommendations “of these colleagues are not dutifully obliged. And of course the time clarify the confusion could be spent more appropriately. While it is hard to re-educate a whole generation of nurses and pharmacists quickly, perhaps it is time to think of some degree of consultation and coordination among the relevant schools, regarding the way the basic information is taught to the next generation of our colleagues. In other words and to keep with the orchestra analogy we all need to be reading from the same (musical) notes to avoid discordance.

Dr Tony Marshal

Australian Doctor; 15/05/2015 1) http://www.australiandoctor.com.au/news/latest-news/pharmacists-undermining-child-eczema-care- dermato

GPs play a central role in the Health Care System akin to a conductor in an orchestra. While major differences between how GPs communicate with patients are rare, the same could not always be said for some other members of the broader “Health Care Team”.
You would never hear a GP sending a patient with a suspicious lesion to a dermatologist, for instance, telling them to “get this removed”. In all likelihood, you would tell the patient to find out what the specialist thinks about it.
However I sometimes face challenging situations with patients after their contact some allied health colleagues. In my experience the majority of these problems relate to pharmacists and nurses.

For an example of this disconnect, take the report on differences between what the pharmacists and doctors advise people, regarding the use of cortisone creams (“Steroid phobia undermining child eczema care” , Australian Doctor.com.au 24 March 2015) .
Also I regularly speak with patients on antihypertensives who have been refused “cold & flu” tablets by pharmacists. While I acknowledge some cold & flu tablets are not advisable in people with severe hypertension, surely pharmacists should be aware that GPs would have considered that fact. At worst pharmacists should use their discretion to suggest the type without pseudoephedrine rather than sending patients back to GPs alarmed
and confused.
These are only examples of an apparent huge disconnect between the principles that I learnt in medical school and those taught in pharmacy and nursing schools these days.
Apart from the huge time wasted undoing the misconceptions and occasionally wrong advice implanted in people’s minds (perhaps inadvertently often these encounters lead to confusion and hostility towards doctors.
The latter certainly occurs when the “recommendations “of these colleagues are not dutifully obliged.
And of course the time clarify the confusion could be spent more appropriately.
While it is hard to re-educate a whole generation of nurses and pharmacists quickly, perhaps it is time to think of some degree of consultation and coordination among the relevant schools, regarding the way the basic information is taught to the next generation of our colleagues.
In other words and to keep with the orchestra analogy we all need to be reading from the same (musical) notes to avoid discordance.

Dr Tony Marshal

Australian Doctor; 15/05/2015

1) http://www.australiandoctor.com.au/news/latest-news/pharmacists-undermining-child-eczema-care-
dermato