In an article in the current issue of the International Pharmacy Journal, Dr Milton writes that most doctors would see it as legitimate and proper that the role of pharmacists should evolve with the changes in patient self perception, but he adds:

'There are, however, clearly very sharp differences of opinion as to whether pharmacists should diagnose and prescribe remedies for ailments that traditionally have been taken care of by doctors. As much as the medical profession welcomes patient participation and empowerment, it still sees the medical profession as the only profession with the knowledge and training necessary to diagnose, and differentiate between different diagnoses and prescribe the appropriate treatment.'

Dr Milton's article comes as the WMA has decided to prepare a report on the relative roles and responsibilities of the medical and pharmaceutical professions. Following a recent meeting between representatives from the WMA and the International Pharmaceutical Federation, the WMA has decided to draw up a document for consideration at its next Council meeting in Hamburg, Germany, in November.

Dr Milton said: ' Although there are very sincere differences between us on self medication, we feel that it is important to continue the dialogue with the pharmacists'.

In his article Dr Milton says of the two professions: 'To some extent we are like Siamese twins, bound together and close enough that what the one learns will very soon be the knowledge also of the other. None of us can work in an optimal fashion without actively co-operating with the other.'

He says both sides agreed that patients would have to be active participants in all decisions concerning prevention, diagnosis or treatment and he adds: 'The empowerment of the patients is a positive development that changes both the role of the doctor and pharmacists to that of an adviser, a counsellor, that guides the patient with reliable information and always keeps in mind that the final decision, in most cases, rests with the patients'.