Over the past 27 years, Tracey Phillips, owner of Westport Village Pharmacy in Westport, Ont., has approached her roles in the pharmacy world with enthusiasm and positivity.
By Tom Smiley, BScPhm, PharmD
Photo by Jessica Deeks
That is the attitude that has helped Tracey build a thriving injection service business at her independent pharmacy in a province where influenza vaccine has been the only injection allowed to be administered by a pharmacist other than through direct order or medical directive.
For Tracey, building the uptake of injection services in collaboration with her pharmacy team has always been about taking advantage of existing opportunities. Building relationships with local physicians and trust among patients, as well as demonstrating and creating awareness of the value of accessibility and convenience of injection services, has been key to growing the business. Helping physicians understand that she is fully qualified to administer most injections through either direct order or medical directive has also been a critical component of Tracey’s success.
How did Tracey’s injection service business evolve? ”I was new to the community and approached physicians and patients one by one as opportunities arose,” she says. “The first injections were authorized by direct order, which means that a physician prescribes an injection medication for a patient and provides authorization for a specific pharmacist to administer it. The patient must have been assessed by the authorizer.”
This differs from a medical directive, she explains, in that the latter provides a specific pharmacist with authorization to administer a specific injection under particular circumstances for any of that physician’s patients who meet the specific criteria. In this case the authorizer does not have to provide authorization to administer the medication or vaccine each time, however the medication/vaccine must still be prescribed by the physician. (See http://www.ocpinfo.com/regulations-standards/policies-guidelines/medical-directives/)
Many Canadian provinces currently allow pharmacists to administer vaccines and medicines other than influenza vaccine, but this does not include the authority to prescribe a particular injection.
Word of Westport Village’s injection services soon spread by word of mouth as a result of advocacy at the pharmacy and the pharmacy team’s professional and efficient approach. “Physicians soon began referring patients to the pharmacy to receive many different types of injections,” says Tracey, who is always on the lookout for other vaccines to administer. “I assess patients to determine if they may need particular vaccines like pneumococcal vaccine or are interested in receiving vaccines such as herpes zoster.”
Tracey cites many business benefits evolving from the successful injection services. First and foremost is the building of the business. Offering a “hands-on” professional service has provided clients with a fresh view of the role of the pharmacist. This has helped with promotion of additional professional services such as medication reviews. Tracey points to the fact that start-up costs are low, and overhead to provide the service is minimal. Therefore, money received through injection services largely goes to the bottom line.
The good news is that Tracey’s story could be duplicated by any pharmacists with the self-confidence to promote themselves to local physicians and patients. Moving beyond providing flu vaccine injections to other vaccines and medicines is a logical progression in the provision of patient-centred care.