Editor, – It was with interest that I read the editorial 'Nurse prescribing: adding value to the consumer experience' (Aust Prescr 2007;30:2–3). As Australia finds itself in the midst of a health workforce crisis, there is pressure to allow health professionals other than doctors to prescribe.
The strength of medical practitioner training means doctors are the health professionals most qualified to understand the risks and benefits inherent in prescribing, and to make a complete diagnosis. Patients have confidence in a doctor's ability and knowledge. We should not substitute doctors with lesser-trained health professionals simply to ease an acute political problem with little acknowledgement of the effect it will have on fragmentation of care, patient outcomes and the quality of prescribing. Where there is no other choice, an alternative must be sought in the best interests of patient care, but such a compromise should not become the standard.
Non-medical practitioners are able to prescribe from a broad range of S3 medications. The remaining S4 prescription-only medicines should remain as that – doctor prescription-only medications.
The prime consideration should be the safety of patients. The benefit of a degree in medical training as opposed to a short course in prescribing should be paramount to any discussion around prescribing and the quality use of medicines.
The Productivity Commission proposals have the potential to realign healthcare delivery. However, in the words of Martin Van Der Weyden, the Editor of the Medical Journal of Australia, 'It should not be the slippery slope to doctor pretenders'.1
John Gullotta
Associate Professor
Chair, Therapeutics Committee
Australian Medical Association
Canberra
