Pharmacists’ expanded scope of practice could change Canada’s healthcare model.

December 9, 2015 Steven Laird

We’ve all experienced it: that middle-of-the night visit to the emergency room, sitting on a hard plastic chair for hours, anxiously waiting to see a medical professional. Call your family doctor instead, and you might get an appointment…three weeks from now.

As Canadians, we’re very fortunate to live in a country with public healthcare, supplemented by employer-sponsored health benefits. We can see a family doctor without paying out of pocket for the visit. We can stay in the hospital without racking up thousands of dollars of debt.

But access to care remains an ongoing concern. In 2013, Canada ranked last among 11 OECD countries in terms of how quickly people are able to see their regular family physicians, CBC news reports.

Pharmacists have been lobbying to change this, arguing an expanded scope of practice can help fill the gaps in the Canadian healthcare system. And the scope of services available is broader than you might think.

Per the 2014-15 Ontario Pharmacists Association (OPA) membership survey, the top 10 professional services offered by Ontario pharmacists are as follows:

  1. Pharmaceutical opinions (85%);
  2. MedsCheck (84%);
  3. Prescription renewals (81%);
  4. Adaptations (73%);
  5. Diabetes management (69%);
  6. Flu shots (65%);
  7. Smoking cessation (61%);
  8. Cardiovascular health (54%);
  9. Asthma management (42%); and
  10. Trial prescriptions (40%).

Pharmacists have the advantage of having direct, front-line contact with patients, and their actions can have a significant impact. For example, the 2015 Pharmacist Interventions in Diabetes report (developed in partnership between Great-West Life and Shoppers Drug Mart) notes about half of all diabetic patients who had a follow-up appointment with a pharmacist had a clinically significant reduction in their blood sugar levels. Recognizing a broader need, the OPA is currently in the process of rolling out a more comprehensive program for diabetes management.

Of course, implementation is never simple, particularly since health care in Canada is managed at the provincial level. The scope of additional services pharmacists can provide varies from province to province—and how they are compensated for those services remains a sticking point.

But purely from a service delivery standpoint, it makes sense to me. Why should I have to wait three weeks to get an appointment with my family doctor to get the flu shot, when I can just stop by the pharmacy on my way home? If pharmacists can pick up the slack and take some of the pressure off busy physicians, why wouldn’t we explore this model?

And if I can avoid that hard plastic chair in the ER waiting room—even just once—so much the better.

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