'another option': pharmacists say ability to prescribe medicine for minor ailments makes sense for patients, health system
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ottawa pharmacist scott watson is used to being asked for advice by customers about their minor ailments. being able to prescribe medicine for some of those ailments, he said, is a natural extension of what many pharmacists already do.
as of the beginning of this year, pharmacists in ontario have been able to prescribe medicine for 13 minor ailments, including dermatitis, conjunctivitis, cold sores and uncomplicated urinary tract infections, among others, something already done in most provinces.
watson, who owns two independent compounding pharmacies in ottawa, said pharmacists in his stores were still working out how the ability to prescribe will fit in with the way they did their work.
“it is going to take us a little bit of time to get comfortable with this.”
but he believes the change is good for individuals and the health system.
“for the people of ontario, it is another option. some people don’t have a family doctor and are going to the hospital emergency department. if there are things that we can do to help relieve that whole health-care crunch, i think it is a great step in the right direction.”
watson, who studied pharmacy in alberta, says he has colleagues there who are “almost like family doctors now.”
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alberta was the first province in canada to allow pharmacists to write prescriptions, beginning in 2007. only british columbia does not allow the practice.
research suggests the practice makes financial sense. a university of waterloo study found that allowing pharmacists in ontario to prescribe for minor ailments would save the province upwards of $42 million a year.
beyond that, pharmacists and others say the expansion is crucial at a time when the health system is overburdened and a significant percentage of people in the province do not have family doctors. and it makes sense.
some critics are not so sure.
among criticism of the expansion are that the move will present a conflict of interest for pharmacists who both prescribe and sell medicine, that they will miss more serious diagnoses and that it will contribute to the overprescribing of antibiotics, increasing the risk of antibiotic resistance.
toronto emergency physician dr. raghu venugopal shares some of those concerns.
he is particularly concerned that more complex illnesses might go untreated or mistreated. pink eye, he noted, can indicate more serious illnesses than conjunctivitis that need to be treated by a specialist. that includes acute glaucoma.
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symptoms that are similar to urinary tract infections can also result from other issues that require other treatments than antibiotics, he said.
“we don’t dispense drugs without examining a patient.”
venugopal says the policy change allows pharmacists to confirm a patient’s self-diagnosis and rule out red flags. he agrees with the policy for some of the ailments, but not all of them.
“it goes too far for clinicians who have seen and been humbled by delayed and missed diagnoses.”
he also says the kinds of patients that can now be prescribed medicine by pharmacists are not the ones clogging up emergency departments and the expansion of powers to pharmacists won’t address the serious problems in the health system.
“it is not utis and pink eyes that clog up emergency rooms. it is frail elderly patients who are so sick they can’t go anywhere else.”
pharmacist scott watson, owner of watson’s pharmacy and compounding centre, prepares a prescription on saturday.
ashley fraser
/
postmedia
jen belcher, vice-president of strategic initiatives and member relations for the ontario pharmacists association, said the changes are supported by most people, but added “there has been some pushback, fear-mongering and gate-keeping that this is a conflict of interest, that its unsafe and it is the privatization of health care.”
she said pharmacists were bound by a code of ethics to put patients first and that the assessment was what was being funded by the province as part of the new policy and patients could take prescriptions anywhere. she also noted it had been practised in most provinces for years, even decades, and that identifying red flags was built into the process.
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“it is not an us versus them,” said justin bates, chief executive officer of the ontario pharmacists association. he said the new policy should add capacity to the health system and enhance collaboration.
in ontario, pharmacists have been able to prescribe paxlovid, an anti-viral to treat covid-19, since december. prescriptions have increased since then for the treatment that many argued was difficult to access in time to be useful.
watson said pharmacists had been cautious about prescribing paxlovid at his stores and had referred customers to assessment centres when they had any doubts.
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