From Mr M. Daly, MRPharmS, and others
We were most alarmed to read on the General Pharmaceutical Council’s website the recent decision
of the Disciplinary Committee involving a pharmacist [Asif Gharfoor, registration number 5058709] who conducted a physical examination of a patient and was found guilty of misconduct. The committee concluded: “A pharmacist is not competent to undertake a physical examination which includes the touching of a patient’s body as part of a diagnostic procedure.”
We were astonished that, in the 21st century, our regulatory body should feel it appropriate to make such a statement. We are involved in preparing the next generation of pharmacists to take on the clinical challenges awaiting them and strongly believe that this is a retrograde step and one that hinders professional development. In many schools of pharmacy undergraduate students are now instructed in basic physical examination to aid the diagnosis of conditions which may present in a community pharmacy. This is based on sound evidence from the medical literature that shows physical examination increases the probability of a correct differential diagnosis.1
In addition, pharmacists undergoing training to become independent prescribers are required by the GPhC to demonstrate competence in a variety of clinical skills, including the physical examination of a range of body systems. This is clearly impossible if pharmacists are not to be allowed to touch their patients to examine them, This in turn will remove the ability of pharmacist prescribers to establish a diagnosis, and thus severely restrict their ability to provide safe care for their patients. Can we now expect the GPhC to revise their learning outcomes for independent prescriber training to exclude these aspects of the role?
We agree that pharmacists, like all other healthcare professionals, would do well to consider the need for a chaperone to be present when undertaking physical examinations. However, it seems preposterous to us that people acting on behalf of our regulatory authority can make such a sweeping statement.
We hope that other pharmacists, and the Royal Pharmaceutical Society as our professional body, will agree that, when appropriate to establish a differential diagnosis, physical examination may be not only desirable but even essential for optimal patient care, and that they will join us in protesting in the strongest terms against this ruling.
Primary Care Teacher Practitioner
Community Teacher Practitioner
Hospital Teacher Practitioner
Senior Lecturer in Pharmacy Practice
Principal Lecturer in Pharmacy Practice
University of Wolverhampton
1 Roshan M, Rao AP. A study on relative contributions of the history, physical examination and investigations in making medical diagnosis. Journal of the Association of Physicians of India 2000;48:771–5.