Pharmacist prescribing: a threat to medical dominance?

Has non-medical prescribing presented a threat to the professional dominance of medicine? So far, it seems not, according to the conclusions of this article describing interviews with 23 pharmacist supplementary prescribers, conducted early on during the implementation of supplementary prescribing for this group.

There was an interesting range of views over whether prescription writing itself is important to a sense of professional self-worth and the status associated with prescribing, or whether the decision-making processes that precede prescription writing are what are important. Some prescribing pharmacists appeared uncomfortable with the prescribing autonomy offered by supplementary prescribing.

There was also a range of views on which activities constitute prescribing, both in hospitals and in the community, for example dose adjustment. Prescribing can be seen as “a complex series of processes with distinct tasks and decision points” and pharmacists were involved in some of these activities under the former legislative regime: this has helped make the changes in the workplace acceptable. The emphasis on competence limits and safe practice, and on a team approach to managing patients, has also helped with legitimacy.

Medicine has, however, developed what the authors describe as an ‘overseer’ role over the prescribing process, controls the knowledge base for prescribing practice, and has retained its high status: it would seem debatable whether new prescribers have threatened medicine’s professional dominance.

Weiss MC and Sutton J. The changing nature of prescribing: pharmacists as prescribers and challenges to medical dominance. Sociology of Health & Illness 2009; 31(3): 406-421.