A pathway to the GP: The pharmaceutical 'consultation' as a first port of call in primary health care

Objectives. This study explored advice-giving behaviour of staff in community pharmacies in order to generate fresh insights into the nature, sequence and process of pharmacy consultations for minor ailment advice. Method. An ethnographic-style research strategy was used, combining staff and patient interviews, with non-participant observation of medicines and health-related interactions between pharmacy users and staff. One full week was spent in each of ten pharmacies. Results. The study highlighted that patients use pharmacies for treatment of minor ailments, sometimes before going to the GP, and sometimes in preference to the GP. By matching remedies to conditions, community pharmacy staff play a major role in keeping minor ailments out of general practice, but act as an agent of referral in cases which merit a GP consultation. Conclusion. It is in the interests of GPs to 'exploit' the advisory role of the pharmacist. A two-way referral system would allow doctors to build on the professional skills of the pharmacist as an over-the-counter expert, while ensuring that pharmacists have a channel through which to filter patients with potentially serious illnesses.