The mindset shift that’s key to prescribing success

Pharmacist prescribing is emerging as a powerful extension of primary care in Australia – one that has the potential to improve access, enhance patient outcomes and reshape the profession. 

For patients, it means timely, evidence-based treatment without the long waits often associated with GP appointments. For pharmacists, it represents an opportunity to practise to  full scope, strengthen professional relationships and deliver care with immediacy and depth.

But becoming a prescriber is not just a new credential – it’s a mindset shift, demanding confidence, competence and a willingness to explore every aspect of a patient’s life to inform safe and effective decisions.

Kate Gunthorpe MPS, a Queensland-based pharmacist prescriber who recently presented at PSA25 and received special commendation in the PSA Symbion Early Career Pharmacist of the Year award category, explained to Australian Pharmacist what budding pharmacist prescribers should expect.

Pharmacist prescribing to become standard practice

According to Ms Gunthorpe, it is no longer a question of if, but when, pharmacist prescribing will become a normal part of primary care in Australia – as it already is in other countries. 

‘Our scope will continue to expand. It’s not about replacing anyone, it’s about using every healthcare professional’s skills to their fullest,’ she said. ‘Pharmacist prescribing will also bring more students into the profession, and improve job satisfaction and retention.’

For Ms Gunthorpe, becoming a prescriber was a quest to close the gap between what patients needed and what she could offer. 

‘I was often the first health professional someone would see, but without the ability to diagnose and treat within my scope, I sometimes felt like I was sending them away with half the solution,’ she said. ‘Prescribing gives me the ability to act in that moment, keep care local, and make a real difference straight away.’

Patients can often wait weeks to see a GP – or avoid care altogether because it feels too hard. Pharmacist prescribing gives them another safe, qualified option, and helps to  ease pressure on other parts of the health system.

‘I’ve seen people walk in with something that’s been bothering them for months, and walk out with a treatment plan in under half an hour,’ Ms Gunthorpe said. ‘For some, it’s the difference between getting treated and just living with the problem.’

From a patient perspective, the feedback on the service has been overwhelmingly positive. 

‘People are often surprised that pharmacists can now prescribe, but once they experience it, they appreciate the convenience and thoroughness,’ she said. ‘Many have told me they wish this had been available years ago and I’ve already had several patients come back for other prescribing services because they trust the process.’

Evolving your practice mindset

Becoming a pharmacist prescriber is not a box-ticking exercise – it’s a mindset shift.

Pharmacists are already great at taking medication histories. Asking, ‘Do you have any allergies? Have you had this before? What medications are you taking? Have you had any adverse effects?’ is par for the course.

But effectively growing into full scope requires pharmacists to push the envelope further. Take acne management for example.

As part of standard pharmacist care, acne consultations are mainly about over-the-counter options and suggesting a GP review for more severe cases. 

‘Now, [as a pharmacist prescriber], I take a full patient history – incorporating their biopsychosocial factors – to assess the severity and check for underlying causes,’ she said. ‘I can [also] initiate prescription-only treatments when appropriate. It means I can manage the condition from start to finish, rather than just being a stepping stone.’

Sometimes it can be a matter of life or death. Ms Gunthorpe recalled a case where a patient presented with nausea and vomiting. After reviewing his symptoms and social history, a diagnosis of viral or bacterial gastroenteritis didn’t quite fit. So, she probed further:

Q: ‘What do you do for work?’
A: ‘I’m an electrician.’
Q: ‘So did you work today?’
A: ‘Yeah.’
Q: ‘How was work? Anything a bit unusual happen today? Did you bump your head or anything like that?’
A: ‘I stood up in a room today and hit the back of my head so hard I’ve had a raging headache ever since and I feel dizzy.’ 

Following this interaction, Ms Gunthorpe sent the patient to the emergency department straight away. 

‘If I had just provided him with some ondansetron, he could have not woken up that night,’ she said.  ‘So think about how that impacted his treatment plan, just because I asked him what his occupation is.’

Encouraging patients to open up

It’s not always easy getting the right information out of patients – particularly in a pharmacy environment. So Ms Gunthorpe takes a structured approach to these interactions.

‘I say, “I’m going to ask you a few questions about your life and your lifestyle, just to let me get to know you a little bit more so we can create a unique and shared management plan for you”,’ she said. 

This helps patients understand that she’s not just prying – and that each question has a purpose.

‘Then they are more than willing,’ she said. ‘Nothing actually surprises me now about what patients say to me – whether it’s injecting heroin or the sexual activity they get up to on the weekend.’

Post-consultation, documentation is an equally important part of the process.

‘Everything you asked, the answers to these questions and what the patient tells you has to be documented,’ Ms Gunthorpe said. ‘If it’s not documented, then it didn’t happen. That’s just a flat out rule.’ 

In other words, you will not be covered medicolegally if you provide advice and there is no paper trail.

‘I encourage you to start documenting – even if it doesn’t feel like it’s too important,’ she said. ‘That’s something we as a whole industry need to start doing better.’ 

Redesigning workflows and upskilling staff

While embracing a prescribing mindset is crucial, so is maintaining the dispensary – allowing for uninterrupted patient consultations. 

‘We need to ensure our dispensary keeps running while we are off the floor,’ Ms Gunthorpe said. ‘I’ve never worried that someone will burst into the room [when I’m seeing a] GP  mid-consult – so we need to create that same protected environment in pharmacy.’

Upskilling pharmacy assistants and dispensary technicians has been key to making this possible. Staff now take patient details before the consultation, manage the consult rooms, and triage patients when Ms Gunthorpe is unavailable – a role they have embraced with enthusiasm.

‘When I’m not there, they need to make appointments, explain our services, and direct patients to me when I am in consults,’ she said. ‘It’s been really satisfying for them to step into expanded roles.’

Reframing relationships with general practice

Pharmacist prescribing is not intended to replace GPs, but to create more accessible, collaborative and timely care – relying on strong relationships, shared responsibility and open communication.

‘Think of prescribing as stepping into a shared space, not taking over someone else’s. Let’s do it together, with confidence, compassion, and clinical excellence,’ Ms Gunthorpe said.

In some cases referral to a GP is necessary, particularly when additional diagnostics are required. This can cause frustration if patients pay for a consultation but leave without medicines. So strengthening GP-pharmacist relationships is essential to making the model work.

‘We want this to be a shared space where we both feel safe and respected when referring either way,’ she said. ‘If a GP is booked out for 2 weeks and a child has otitis media, we want the receptionist to be able to say, “Kate down the road has consults available this afternoon”. That’s the collaboration we’re aiming for.’

Queensland Government funding for pharmacists to undertake prescribing training remains open. For more information and to check eligibility visit Pharmacist Prescribing Scope of Practice Training Program.