Impact of non-medical prescribing

The last research roundup provided you with an overview of some papers covering the areas of prescribing errors and of electronic prescribing (Robertson, 2021). The studies looked at prescribing error rates between doctors in pharmacists in one trust and then at errors using an electronic prescribing system for discharge prescriptions and the impact of electronic prescribing on prescribing opioids and the issue of overprescribing.

This month we look at the impact of non-medical prescribing in some clearly defined settings. The first article looks at the subject of perceived medical dominance and how the introduction of non-medical prescribing may have impacted on this dominant stance. The second looks at the impact of paramedic prescribing in emergency, urgent and critical care. Finally, we will review the impact of optometrist prescribing in primary care settings.

This article published in the Journal of Research in Social and Administrative Pharmacy seeks to contribute to the ongoing dialogue in the professional arena of the dominance of the medical professional since the inception of non-medical prescribing (Weiss, 2021). The author focuses on the fact that prescribing allows the clinician to exercise their clinical autonomy stating that the right to prescribe gives them control over the object of their work, that being the prescription, through their ability to independently make decisions on care involving medications. The issue of whether or not non-medical prescribers pose a threat to the medical dominance of doctors is discussed. The profession discussed in this paper are pharmacists; the rationale for choosing them is that the author feels they are a profession that poses a competing claim to dominance due to the long association with medicines and supply. The issues of jurisdiction and professional ideology are also covered. The article gives a background to the inception and development of pharmacist prescribing and the legislative changes required before exploring the profession of pharmacy in general. The dominance of the medical profession and the perceived threat to this is then discussed and the author identifies strategies supporting this dominance such as the legitimising and overseeing of supplementary prescribing, deference to doctors by other professions, and diagnostic skills and responsibilities.