Across Canada pharmacists are enjoying an expanded scope of practice – and patients are reaping the benefits. For many pharmacists, contemporary practice now includes prescribing for minor ailments and renewing physician scripts.
By donalee Moulton
Photography by Kevin Hogarth
“Pharmacists are filling a gap for our patients. We are conveniently available and accessible,” says Rod Amaya, an associate owner of a Shoppers Drug Mart in Saskatoon.
In Saskatchewan, as in most other provinces, pharmacists can refill medication for patients who cannot get in to see their doctor, for doctors away from the office who leave instructions, and in emergency situations such as patients on vacation who forgot their medication. As well, in cases where patients have a less serious medical condition such as a cold sore or seasonal allergies, many pharmacists can now prescribe medication rather than recommending a milder, non-prescription option.
Prescribing and refilling medication benefits individual patients and the healthcare system itself. “It gives us the opportunity to connect with our patients, and the reward is both professional satisfaction and business profitability,” says Amaya. “In the past, pharmacy owners/managers subsidized professional services from dispensing revenues and generic subsidies. Now, we can plan labour hours to provide professional services paid for by the revenues created by those services.”
Business growth must be managed, and it must be incorporated into daily operations. Above all, training is essential. At Amaya’s pharmacy, all staff are trained to identify customers who might benefit from the prescription service and refer them to the pharmacist. For example, if a customer asks a clerk where to find Abreva, the employee will direct them to the pharmacist, who can then speak with the customer about prescription as well as OTC options for cold sores.
“We involve everyone in the store,” notes Amaya. “They understand what to do if a customer asks about a minor ailment and why it is important to direct them to the pharmacy.”
In addition, training includes a more in-depth focus on specific minor ailments. In Saskatchewan, pharmacists can prescribe for 17 conditions, including oral thrush, ring worm, and muscle strains and sprains. Every seven days, Amaya promotes a “Minor Ailment of the Week” with staff. “It’s a closer look at a minor ailment and how we can help patients,” he says. “It’s also a great way to train new staff and refresh staff who have been with us for some time.”
The weekly focus is often tied to a likely increase in requests for medication. For example, allergic rhinitis most frequently occurs in the spring, so it is the focus of training at this time. Other conditions, such as acne and diaper rash, occur year-round, so they can be scheduled for weekly discussion at any time.
For patients, the training benefits them in two ways. It helps staff to identify what a patient needs and offer support that goes beyond simply pointing them to a particular aisle. “It’s about customer service,” says Amaya. “We want patients to come to us with their questions.”
Answering questions is about more than providing information, he adds. “It’s about having a conversation with the patient. It provides us with a one-on-one opportunity to connect with patients.”
In most provinces, the pharmacist’s expanded scope of practice has been reported on in local media, and provincial associations have undertaken awareness campaigns. However, most patients continue to learn about the services pharmacists can offer at the store level, says Amaya. He notes that education has been effective. “Now people come to us and ask for these services directly.”
Pharmacists should prepare for the additional time it takes to provide these services. It will be time well spent, says Amaya. “You may need to adjust your workflow and time management, but you will find a process that works for you. The more of these services you provide, the easier it gets.”
The time to start is now. “Patients will come to expect these services from pharmacists,” stresses Amaya. “It’s about optimal care. The patient gets important information so they can make the best choice for them.”