Hands off prescribing
In response to a growing trend to grant prescribing rights to more non-medical health professionals, the AMA has adopted a formal position rejecting all forms of non-medical practitioner prescribing, with the exception of dentists. At its March meeting in Canberra, the AMA Federal Council unanimously carried the following motion:
In response to a growing trend to grant prescribing rights to more non-medical health professionals, the AMA has adopted a formal position rejecting all forms of non-medical practitioner prescribing, with the exception of dentists.
At its March meeting in Canberra, the AMA Federal Council unanimously carried the following motion:
That Federal Council rejects all forms of non-medical practitioner (exclusive of dentists) prescribing outside of a consistent and sustainable medically delegated environment in the interests of patient safety.
The motion comes at a time when there is a concerted push by governments to expand the range of healthcare practitioners who can prescribe medicines.
We believe there is a very real risk to patient safety when expanding the roles of health practitioners beyond roles for which they are properly trained.
The risk of adverse events increases when more than one medication is taken, or used, at one time.
Only medical practitioners are trained to take a comprehensive history, examine the whole person when making a diagnosis, and initiate investigation, management and treatment.
Only medical practitioners are trained to know the full range of clinically appropriate treatments for given conditions.
In the interests of patient safety, any prescribing by non-medical practitioners should only be carried out within strict co-management regimes, with the relevant medical professional groups working with the relevant non-medical groups.
It is the AMA’s view that there must be consistent and sustainable medically delegated environments that ensure:
- practitioners are prescribing within their scope of practice;
- practitioners are competent in using their knowledge and making judgements about when not to prescribe;
- patients are referred to another health professional when the patient’s clinical condition is outside the scope of practice of the treating practitioner; and
- patients are referred to a medical practitioner if they fail to improve within a specified period of time.
It is important that prescribers fully understand the interactions between various medications.
Medical practitioners have extensive training in medication management and medical practitioners know and recognise the risks of adverse events from taking medications - and they know how to respond to those events.
It is a responsibility we take very seriously, and it is a responsibility that should not be handed over unsupervised to other health professionals who do not have the same levels of training and experience.
Health Workforce Australia is currently considering the safest approach to non-medical prescribing, the quality use of medicines, and the most effective use of healthcare services.
In the interests of patient safety, governments should not take any further action to expand health practitioner prescribing rights until this important work is completed.
I add that the AMA supports prescribing by dentists. Dentists are trained to prescribe medicines for dental conditions, and they prescribe within their scope of practice.
The AMA will speak out and oppose moves to grant prescribing rights to non-medical health professionals in situations outside those covered by our guidelines.
Published: 02 Apr 2012