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Pharmacy steps outside the comfort zone

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Without question, the profession of pharmacy is continuing to evolve. Not only has scope of practice changed throughout Canada, there is a shift in the delivery and expectation of pharmacist care from both patients and payers. 

 

By Mike Boivin BSc.Phm.

 

 

Without question, the profession of pharmacy is continuing to evolve. Not only has scope of practice changed throughout Canada, there is a shift in the delivery and expectation of pharmacist care from both patients and payers.

We interviewed seven pharmacist thought leaders from across the country to share their views on the profession’s current state of affairs and what the future may hold. They shared their candid thoughts on the different opportunities and challenges. Although each provided a unique perspective of the profession, there were several key underlying themes.

Change has only just begun

 

Mike Sullivan, President & Co-Founder Cubic Health: We have and will continue to see an increase in commoditization of dispensing services in Canada. Payers want to control the utilization of healthcare resources and no longer accept being at the mercy of healthcare professionals dictating the cost of products/services.

Rose Dipchand, Manager of Professional Affairs for Pharmasave Atlantic: The profession has to continue to explore and create the changing face and language of pharmacy. There has been a dynamic change in the delivery of pharmacy services, and we are and will continue to be in a state of constant evolution. There is no magic formula for determining the profession’s future roadmap. Most of what we do involves a patient conversation. By prioritizing what we can do for our patients, we will continue to be able to see opportunities and continue to carve out our role in the healthcare system.

 

There is value in what we do

 

Mike Sullivan: Payers are expecting measurable outcomes from all of their providers. Pharmacists need to measure what they are doing and show where they can have the greatest impact from both a financial and patient health perspective.

Sherilyn Houle, Assistant Professor (School of Pharmacy), University of Waterloo: Pharmacists must not get caught up in the number of interventions provided to a patient. More important is the value of these interventions in improving the health of the patient. Improving and measuring changes in outcomes has to be a priority for our profession moving forward.

 

Services around dispensing will continue to occur

 

Aaron Sihota, pharmacist, BC Pharmacy Association: Dispensing is currently a fundamental component of pharmacy. We derive the majority of our profitability from it. Currently all of our clinical services are centred on our dispensing workflow. As we continue to move forward (and look at reconfiguring our workflow), we will have to look at delivering new services less around dispensing and more around how we can have the most impact for our patients.

Rose Dipchand: Pharmacists shouldn’t downplay the fundamental role we have in educating and managing patients’ drug therapy during the process of dispensing. Our role in assessing the appropriateness of drug therapy and working with patients to help them manage their medications and conditions is key, not the technical aspect of putting the pills in the bottle.

 

We are redefining our role

 

Rita Winn, COO General Manager, Lovell drugs: Other healthcare professionals don’t know what pharmacists do; it is our responsibility to demonstrate what we can do for our patients. We need to actively promote what we can do; there is a massive untapped opportunity to demonstrate our value to patients, payers and other healthcare professionals.

Heather Foley, Clinical Pharmacist – Case Manager at Chatham Kent Family Health Team (who works in a collaborative model with physicians and other healthcare professionals): Our profession has to focus on what we can do well. As a pharmacist, I am accountable and responsible for the drug management of our patients. By focusing on managing pharmacotherapy, patients and other healthcare professionals on the team can clearly see my role and the value I bring. But without working together as a team, we will never be able to firmly establish our role in the healthcare system and ultimately continue to run in to an increasing number of barriers.

Suzanne Han, Manager, Pharmacy Managed Care at London Drugs: Pharmacists need to identify gaps in the care of our patients. In our province, there is a shortage of physician care in many areas. I feel there is an opportunity for pharmacists to help manage the needs of our patients by fully utilizing their scope to address this gap. Although we have a wide number of tools in our expanded service toolbox, many pharmacists are hesitant to fully integrate them in our practice. I think we are at a crucial time to define our role and demonstrate that if we fully utilize our scope and work collaboratively with other healthcare professionals, we can prove to everyone the significant impact we can bring to the healthcare system.

 

Specialization will continue to occur

 

Suzanne Han: There is a demand for a wide number of health services that are outside of the traditional pharmacy role. We have successfully integrated travel medicine into our pharmacies and will continue to look for new opportunities to address the needs of our patients.

Rita Winn: We are seeing an increasing role for appointment-based pharmacy where we proactively look for concerns and address them. This is a fundamental shift since as a profession we tend to be reactionary; we tend to wait for a problem to occur before we do something about it.

Confidence and accountability must carry on

 

Sherilyn Houle: Many pharmacists have told us they feel powerless and have no control over their day-to-day tasks. Although most have the skillset, many are not confident to fully implement their entire scope of practice.

Suzanne Han: Pharmacists have to think differently than before. Making clinical decisions is not always black and white, and we have to make the best possible decisions with the information we have.

Rose Dipchand: We have to do what is right for the patient based on the information we have and not focus on what we are missing. By being transparent with our patients and letting them know the reasons why we are doing (or not doing) something, or why we are recommending a particular pharmacy service will to help to build their trust. It is our responsibility to have these conversations with patients.

Everything starts with a patient conversation

 

Rose Dipchand: I have seen pharmacists continually beat themselves up because they feel like they only make “small interventions”. Not everything we do has to be earth-shattering. Helping patients take their medication or stay adherent through a simple conversation could have a massive impact on their long-term health.

Heather Foley: Every pharmacy service involves a conversation to assess a patient’s needs and then the desire to develop the long-term relationship to improve the patient’s health.