Writing a script is rarely just a five-minute job, it requires established relationships and a knowledge of patient history, writes Dr Ramya Raman.
From the outside, a repeat prescription can look like a five-minute administrative task: patient comes in, a few clicks, a signature, job done.
Inside the consulting room, it’s something else entirely. Safe prescribing draws on years of training, a deep knowledge of a person’s history and risks and, most importantly, the trust and rapport built over time with their GP and family.
That diagnostic triad represents the quiet engine room of our health system.
Western Australia is moving to test how far the definition of that engine room can be stretched. Under the Enhanced Access Community Pharmacy Pilot, pharmacists will be trained to identify and treat more than 17 conditions, including asthma, ear infections, acne, shingles, reflux, hormonal contraception and weight management.
The intent is understandable: make care faster and closer to home. But the question isn’t who is ‘allowed’ to treat what, but instead what model actually delivers safer care, fewer adverse events and genuine system relief?
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Continuity of care is the lever most likely to achieve those goals. The OECD’s Patient-Reported Indicator Survey (PaRIS) survey, Australia’s first national, patient-reported snapshot of chronic-condition care, shows how strongly outcomes track with therapeutic relationships.
Some 94% of Australians with chronic conditions reported positive experiences at their GP practice, above the OECD average. Among people who had the same GP for three to five years, 97% rated their care positively, compared with 79% among those without a regular GP.
Better coordination and trust followed the same pattern – the longer and steadier the therapeutic relationship, the better the experience and outcomes. In policy terms, this is not soft evidence.
General practice remains the most cost-effective way to uphold the health system, not because it is cheaper in isolation, but because it prevents expensive problems downstream.
The OECD’s analysis of PaRIS data is blunt – doing more for people with chronic conditions “does not necessarily mean spending more”.
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The features that matter are person-centred, coordinated primary care delivered by a workforce patients know and trust. That is precisely what high-functioning general practice offers when it is supported well.
This is where WA has a choice. We can extend roles in ways that fragment care, have multiple entry points, variable records, and no guaranteed feedback to the usual GP.
Or we can aim for continuity, strive for same-day communication with the patient’s nominated GP and upload to My Health Record, establish clear escalation thresholds, and mandate time-limited prescribing linked to follow-up.
It also means measuring the right things; not just service counts and satisfaction, but adverse events, antibiotic stewardship, confirmed follow-up with the usual GP, and changes in ED presentations for those specific conditions, reported independently and transparently.
RELATED: Pharmacist and GP roles ‘are not interchangeable’
It also means investing in access inside general practice funding for same-day or next-day acute appointments and after-hours cooperatives, so patients don’t have to choose between timeliness and continuity.
Pharmacists, nurses, allied health professionals and GPs already work side-by-side every day. The task ahead is not to pit us against each other, it’s to knit our contributions together around a patient’s medical care.
The five-minute script is rarely just a script, it’s the product of a relationship that prevents harm, reduces duplication and quietly keeps hospital doors a little less busy.
ED: Dr Raman is the RACGP Vice President and WA Chair.
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