The Royal College of General Practitioners ( RACGP), the AMA and grass-root general practitioners have all responded with concern and media warnings after the Amcal Pharmacy chain announced a new service, offering packages of screening pathology blood tests, with prices ranging from $25  to $220 for a "comprehensive general health screen". These tests are sold directly to the customer by the Pharmacist ,and will not have a Medicare rebate attached. All the groups support  pharmacists being  pharmacists, but they are not doctors and the 6 hours training required before selling pathology blood  tests directly to a patient is clearly inadequate.

Unnecessary tests are a waste of patient's money and can cause unnecessary worry, confusion and even more unnecessary costs for patients. The tests may also provide a conflict of interest for the chemist, who could use the test to sell various products such as vitamin D , when it is not recommended. Questions have also been raised  about tests requiring urgent medical attention and the borderline, not normal test results requiring further investigation, particularly how that will be arranged and coordinated.

If a pharmacist determines that a customer has risk factors that require further investigation, the customer is best advised to see their GP to undertake an examination, review a person's past medical history and extended history on occasions and determine the appropriate diagnostic tests required. These tests will be determined as clinically justified and will attract a Medicare rebate, so the patient will avoid paying the full cost. The National Prescribing Service and RACGP and many other organisations have formal screening guidelines used by GPs that apply to individuals depending upon their family, personal and other risk factors. Health checks, screening activities and diagnostic tests should be conducted if they are clinically indicated, evidence-based, and cost-effective. The best example of how complicated screening tests can be is the PSA ( prostate cancer screening blood test) International Committees continue to debate the use of this screening test due to the high number of side-effects and the severity of permanent side-effects from following up an abnormal test, whether to have this one screening test and the appropriate age and how often and what to do with borderline increases in the levels demonstrates with just one of the tests available, how convoluted and difficult the decision can be for the patient and the doctor.

The acting president of the RACGP, Dr Edwyn Krys issued a media release stating, " while we welcome and encourage other healthcare providers to contribute to patient care, your GP Clinic is the most appropriate place to order a pathology test, not a pharmacy. GP's are in the best position to recommend pathology tests based on your personal medical history, symptoms and a physical examination."

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