“It was the best of times, it was the worst of times.” Charles Dickens may have written that line back in 1859, but its relevance to pharmacy in this day and age still holds true.
By Dayle Acorn
In the midst of a long-anticipated boom of opportunity for pharmacists finally coming to fruition with expanded services there is a disconcerting pessimism about the future of the profession.
According to the 2016 Trends & Insights survey of community pharmacists, only 37% of respondents are optimistic about their personal future compared to 54% in 2014. Furthermore, only 26% feel things are better for them as pharmacists compared to 10 years ago. This pessimism is attributed to challenges around job insecurity, family-unfriendly working hours, a corporate focus on dispensing volumes and professional service quotas – plus a general feeling of loss of control over their professional practice. When asked about the greatest challenges facing pharmacy owners and managers, public drug plan reform and barriers to providing expanded services topped the list.
Yet on a positive note, 69% of those pharmacists surveyed said they had taken steps to expand their roles in order to improve patient care. Three out of five said they provide expanded services beyond traditional counselling in their day-to-day practice. We don’t have to look further than the recipients of the Canadian Foundation for Pharmacy’s various grants and awards to see the impact pharmacists can have on patients in the community. Dr. Barbara Farrell, one of the 2016 Innovation Fund Grant winners, is looking at how to mobilize community pharmacists in deprescribing. Another, Dr. Line Guenette, is developing evidence-based electronic tools to help community pharmacists detect and improve medication non-adherence.
Perhaps those feeling less optimistic about the future role of pharmacists should take a better look at the prospects already available for them. At CFP’s latest Pharmacy Forum, Lisa Dolovich, pharmacist and co-lead of the Ontario Pharmacy Evidence Network (OPEN), spoke about a wealth of missed opportunities in pharmacy services for immunizations, MedsCheck medication reviews and interventions available under the Pharmaceutical Opinion Program. The research shows 30% of those patients not vaccinated in pharmacies, for example, didn’t even know the service was available.
At the Forum, Green Shield Canada’s Pharmacy Strategy Leader Ned Pojskic also emphasized the underutilization of pharmacy services as a resource for managing chronic disease. He warned audience members that payers, in their quest to keep drug plan costs sustainable, will eventually focus on other strategies if the uptake on current services isn’t there. GSC has taken a proactive approach to getting pharmacists working with at-risk patients through its Pharmacist Health Coaching Cardiovascular program, which is now a standard benefit in most GSC benefit plans. But while the insurer is happy with the number of pharmacists who have taken the training, the uptake on the service itself could be a whole lot better.
In this time of great change and cultural shift in the profession, the one certainty is that pharmacists can and do have a positive impact on patients. Part of the challenge is for pharmacists and their owners coming together, in an attempt to remove some of the barriers preventing this advance. Rather than crack under the pressure now, let’s focus on that and remember why we fought so hard to get to this point.
Dayle Acorn is Executive Director of the Canadian Foundation for Pharmacy (www.cfpnet.ca), a registered charity dedicated to supporting innovation and leadership to advance the profession of pharmacy.