Australian Doctor Australian Doctor 7th July 2017

7 JULY 2017 AUSTRALIA’S LEADING INDEPENDENT MEDICAL PUBLICATION I www.australiandoctor.com.au INTERVENTION HOW TO TREAT Dr Emil Djakic on his time in the NT Opinion, page 32 Myocarditis Earn CPD points online Pharmacy path push But GPs may have to deal with the fallout It would be appropriate for GPs to follow-up and manage the patient — irrespective of whether a pharmacist had ordered the test, said Dr Sara Bird. a “comprehensive general health screening”. The most expensive test will include HbA1c, total cholesterol, HDL, LDL, triglycerides, FBC, iron studies, LFT and a kidney function test (urea electrolytes and creatinine). The AMA dubbed it “opportun- istic, wasteful and bordering on irresponsible”, with patients facing unnecessary costs. But Amcal senior pharmacist James Nevile said pharmacists were screening patients before ordering tests to make sure the tests are appropriate. “The pharmacist may say ‘see your GP’. Some patients will do that, but some may prefer to do it there themselves,” he said. Mr Nevile said patients were accessing inappropriate, expensive tests online, such as PSA testing, and it was better for pharmacists to offer pre-paid pathology rather than online vendors providing them. If the results required urgent EXCLUSIVE A doctor’s nightmare attention, the pathologist would either contact the patient or the patient’s regular GP, he added. His comments raised concern among GPs, particularly over their legal obligations if abruptly brought into the care loop. GP obligations would depend on the specific circumstances, said Dr Sara Bird, a medicolegal adviser at MDA National. The tests offered could throw up a variety of results requiring urgent attention, such as hepatitis, acute renal failure, severe anaemia, neutropaenia or throm- bocytopaenia, she said. In many situations, it would be appropriate for GPs to follow-up and manage the patient — irre- spective of whether a pharmacist had ordered the test, she said. cont’d page 4 ANTONY SCHOLEFIELD PHARMACIES are charging patients up to $220 for pathology screening tests for kidney, thyroid and liver function under a new push into preventive healthcare. The scheme, which is backed by the Royal College of Patholo- gists of Australasia (RCPA) but has angered GPs, is the result of a deal between the Amcal pharmacy chain and pathology giant Sonic Healthcare. Amcal announced last week that patients were buying the tests in “bundles” so they could be screened for diabetes, heart health, fatigue and general health. Because no Medicare rebates can be claimed, prices range from $25 for a simple HbA1c test performed in the pharmacy to $219.50 for “I THINK this will escalate at some stage and he may come up with a gun or knife and try to kill me,” says Dr Munjed Al Muderis. He shifts in the chair, hands clasped in front of him. His face hardens. “But I am prepared for that and I don’t have any fear.” Dr Al Muderis is talking about Gerardo Mazzella, a former patient he will never refer to by name during his interview with Australian Doctor. See News Review, page 11, for full story AD_ F CB_ i 1 0 _ h r - 1 2 0 1 6 - 1 0 - 2 0 T1 1 : 4 6 : 2 8 + 1 1 : 0 0 PHN = Postherpetic Neuralgia Hypothetical patient profile. May not be representative of every patient’s experience of shingles. NOW AVAILABLE FREE ON THE NATIONAL IMMUNISATION PROGRAM FOR 70-79 YEAR OLDS¹ HELP PROTECT YOUR 70-79 YEAR OLD PATIENTS FROM SHINGLES AND PHN² AVAILABLE FOR 70 YEAR OLDS, WITH A 5-YEAR CATCH UP PROGRAM FOR 71–79 YEAR OLDS 1 Print Post Approved PP100007880 AD_FCB_i2.indd 1 Before prescribing, please review the PBS and Product Information available in the Primary Advertisment in this publication. References: 1. Department of Health. Australian Government Department of Health. National Immunisation Program Schedule. Available at: http://www.immunise.health.gov.au. 2. ZOSTAVAX® approved Product Information, April 2016. Seqirus (Australia) Pty Ltd ABN: 66 120 398 067 63 Poplar Road, Parkville VIC 3052 www.seqirus.com.au; distributor for Merck, Sharp and Dohme (Australia) Pty Ltd. CSL Medical Information: 1800 642 865. ®ZOSTAVAX is a registered trademark of Merck & Co. Inc Whitehouse Station, NJ, USA. Seqirus TM is a trademark of Seqirus UK Limited or its affiliates. Date of preparation October 2016. SEQ/ZOST/0816/0148b. 02071SEQ/AD/FCB. 20/10/2016 10:05 AM