Are doctors being replaced?

Patients no longer have to wait a week to book an appointment with their physician to get prescribed their medications – pharmacists now have the authority to do this and other medical duties, such as treat minor infections and administer flu shots.

“It is a positive step,” said Kit Poon, an Edmonton community pharmacist. “For too long, pharmacists have been delegated to a dispensary only – it has been a big waste of a healthcare provider.”These new laws allow pharmacists to see the patient sooner than a doctor would when an emergency happens.

Photo courtesy of University of Alberta, College of Pharmacy

With all the schooling pharmacists go through, the majority of their skills are not put to good use, Poon said.

Ravina Sanghera, University of Alberta pharmacy law and ethics professor, said “After doing an assessment, the same theme kept popping up – some health care professionals are not being utilized to their full potential; pharmacists are definitely one of them.

“There are 4,300 licensed chemists in Alberta that are ready and able to help patients close to their homes,” she said.

Helping patients

A lot of medication errors are also noticed and prevented with this new system, said Poon.

“For example: if a patient has a history of misusing medication, I, the pharmacist, see that first-hand when they come in for their refills,” he said, “Then I identify whether or not I can deal with it on my own, or if I need a physician.”

“I’m preventing a future problem, rather than treating a current problem.”

With new rules, comes new training, but more compensation.

Educating pharmacists

“The education is always self-identified,” Poon explained, “The professionals need to keep track of their own training and what is outdated.”

“No special education is necessary, but there is always updated training that is needed. It is based on your ability to care for a patient and to document those instances of care,” he added.

Sanghera said, “Pharmacists are being paid more, because they are doing more work – their skills are aligned and recognized with what they are giving to their patients.” 

Pharmacists and doctors

This does not mean the use of a doctor is not needed; if anything, it is helping them by leaving time open for more serious cases, added Sanghera.

Under new Alberta Health regulations that went into effect in July, pharmacists are able to do the following without a doctor’s involvement:

• Renew prescriptions
• Administer injections and vaccines
• Change prescriptions based on the individual patient needs
• Refer drug therapy programs (where appropriate)
• Order and assess lab tests

“We’re not trying to do something someone else is doing, but to do what pharmacists were trained to do,” said Jeff Whissell, director of pharmacy practice at the Alberta Pharmacists’ Association.

Poon added, “It allows us to address the timely care of most patients – there is a shortage in physician resources, so it is really hard to get concerns looked at within the day of when it happens.”

In any change in health care, there will always be disagreements, Whissell said.

“Physicians and pharmacists have always had an on-going battle – it is natural, just as long as those discussions have a positive goal in mind,” he said.

All health care professionals should talk to each other, and when there is concern, they need to work together in the best interest of the patient, Sanghera noted.

The future of health care

“Ultimately, the ideal future for Alberta health care involves each profession concentrating on their own specialty, to seamlessly integrate with each other to solve a patient’s problem, rather than fighting each other to be the hero,” Poon said.

“When a patient comes out of an office, instead of the physician doing it all, they diagnose the problem, and the pharmacist decides how to proceed with treatment and the on-going follow-up,” he said, “But doctors won’t let go of the treatment-responsibility aspect of their jobs.”

With this new system in place, and plans for more steps in the future, the relationship between a patient and their pharmacist will only get stronger, Poon suggested.

“We already see the patient more than any other health care professional, so it only makes sense why we are the most trusted profession,” he said.

ltrischuk@cjournal.ca