Cheap Healthcare or Great Healthcare – your choice

Yesterday an opinion piece in our local Newspaper stated in big bold letters

Why do ACT women still need to see a GP to get the pill?

The article was the latest volley in the relentless war that the Pharmacy Guild of Australia is waging to attempt broadening of the scope of what Pharmacists should offer their “clients”

The author claims:

Nationally, we are expecting to see a shortfall in the number of GPs, whilst hospitals are struggling to cope with population growth. We need to be doing as much as possible to support doctors in treating patients who need their skills and expertise, so they aren’t spending their time doing work which could easily be done by a community pharmacist”


This triggered a brilliant response by one of our local ACT GPs

– time will tell if the Canberra Times will publish Dr Gosling’s response:

Dear editor,
I write in reference to the Op-Ed piece in today’s Canberra Times. I am a GP and would appreciate an Op-Ed right of reply:

The advent of the combined oral contraceptive pill was a boon to women all over the world: fertility control and menstrual regulation in the form of a daily tablet. Absolutely this is something to which women should have ready access. And they do: one visit to a GP and they have a year’s worth of prescription.
Provided it’s the most appropriate choice for them, at this stage in their life. Provided they’re remembering to take it. Provided they haven’t started smoking, gained a lot of weight, started suffering from migraines, or are only using it because of coercion from a partner who refuses to use a condom. Provided there’s no family history of a clotting disorder.

What do I talk about when a see a woman about contraception? I ask whether she’s having sex, and who with. If she’s forgetting to take the pill. If there is consent. Whether she needs STI screening. Whether she has genetic or lifestyle predisposition to having a fatal blood clot or a disabling stroke. Whether she has plans to start a family. Whether her cervical screening is up to date. Whether an alternative contraceptive would be safer or more effective.

Are we as women likely to have these tricky conversations with the pharmacist? Or will it just be assumed (it is, after all, ‘convenient’ to assume) that women who are ‘stable’ on the pill are sexually active cishetero women with one consensual male partner? And if we’re not all monogamous in our activities, who will arrange the STI screening? If we are, who will perform the overdue cervical screening test? Who will provide the advice on family planning? And who ultimately takes responsibility if things go pear shaped?

Some will call this a turf war between GPs and pharmacists. It’s not about that: it’s care vs convenience, and true reproductive liberation requires more than a quick fix script. It means placing value on the health of a whole person. GPs might be busy, but whole-person care is our raison d’être. We’re not too busy for that. Pressuring women to see a pharmacist because it’s quicker and cheaper sends the patronising and familiar message that we are worth less.

Why do ACT women still need to see a GP to get the pill?
Because our reproductive health is too important to be fragmented in the name of convenience and government cost-cutting.

Dr Penny Gosling

For now we are only seeing copies of this succinct and insightful response on Social Media

(Thank you to Dr Wendy Burton for the cover image that featured on her brilliant GPs can website )

Edit 30/12/19:

Tho the Canberra Times’credit Dr Gosling’s response was published

This entry was posted in GP, Medical, Medical ethics and tagged , , , . Bookmark the permalink.

3 Responses to Cheap Healthcare or Great Healthcare – your choice

  1. Max Kamien says:

    Any editor who fails to publish Dr Gosling’s letter should be sacked.
    On a different tack, did you see the article that you inspired on Mrs P in a recent Medical Observer?

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