Doctors raise concerns with Ford plan to allow pharmacists to prescribe medications
Published Thursday, April 18, 2019 6:23PM EDT
Last Updated Tuesday, April 23, 2019 4:59PM EDT
Frontline physicians are raising ethical and safety concerns about Ontario Premier Doug Ford’s plans to give pharmacists the power to prescribe some medications.
The Ford government unveiled plans in last Thursday’s budget to expand the scope of pharmacists, giving them the ability to perform assessments, diagnose ailments and prescribe medication.
The scope would be restricted to a small number of minor ailments such as pink eye, coughs, sore throats and urinary tract infections.
However, the president of Concerned Ontario Doctors questions whether pharmacists have the education, training and experience required to adequately assess a patient.
“Years of grueling university and on-call training that doctors receive is crucial to equip family doctors with the clinical knowledge of when to not prescribe medications, of when not to order investigations and when not to intervene,” says Dr. Kulvinder Gill.
“(Pharmacists) are not trained to diagnose, they are not trained to treat medical conditions, and they are not trained in any physical examination skills.”
Health Minister Christine Elliott acknowledges that pharmacists who want to partake in minor ailment assessments would need “additional training” – similar to mandated training programs in other provinces that have widened scopes of practice.
While officials with the ministry of health have kicked off conversations with the Ontario Pharmacists Association to discuss the expanded powers, Elliott says decisions on which conditions can be treated by a pharmacist and training programs won’t be made until the regulatory body weighs in.
“It does take a long period of time, sometimes up to a year for this (change) to happen,” Elliott told reporters on Thursday. “We are hopeful we can work with the college (of pharmacists) to move that forward.”
Ontario pharmacists have been advocating for the change for over a decade, even proactively preparing students for the possibility of one day being able to prescribe.
At the University of Toronto, students graduate with a Doctor of Pharmacy, which includes lessons on diagnostics and treatment of minor conditions.
“They teach our students; what are common ailments, how do they occur, what’s the path of physiology behind them, what are the treatment options and then they have simulations of how to do that in the program,” says Kishor Wasan, the incoming Dean of the Leslie Dan Faculty of Pharmacy, adding the program is similar to other university courses across the country.
The Ontario Pharmacist Association stresses that pharmacists abide by strict code of conduct guidelines and are only looking to take on “self-limiting conditions.”
“We’re not trying to be a doctor on all things that physicians normally do,” says Allan Malek, Executive Vice-President and Chief Pharmacy Officer for the Ontario Pharmacists Association. “We’re not trying to take on a diagnostic role in diabetes or hypertension. We’re talking about common, very minor conditions that are self-limiting.”
Malek adds that if pharmacists are uncomfortable with the condition or if the symptoms are more complex, pharmacists would be forced to refer or else face disciplinary action.
“We’re not going to do something if we’re not comfortable doing it. Because we know what’s at risk.”
Correction: An earlier version of this story said that the Ontario College of Pharmacists stressed that pharmacists abide by a strict code of conduct guidelines. The article should have referred to the Ontario Pharmacist Association.