TORONTO - Ontario patients could soon get drug prescriptions from their local pharmacist as the governing Liberals look to join other provinces and expand the prescribing powers of pharmacists, nurses and other non-physicians.
Despite concern from the country's doctors, Health Minister George Smitherman is asking for advice on who should be allowed to prescribe drugs and whether nurse practitioners -- who have some prescribing power -- should be able to write prescriptions for a wider array of medication.
"You are seeing more and more the capability of the pharmacists being unlocked to serve patients,'' Smitherman said.
"I think it's an appropriate thing to take a look at. Obviously it's got to be done with . . . an abundance of caution on behalf of patients but also recognizing that, for patients, it can be a matter of extraordinary convenience.''
The Ministry of Health is quietly commissioning a study which would examine whether those who have prescription authority now -- like midwives, optometrists and nurse practitioners -- should be able to prescribe more classes of drugs.
The study would also look at the role of pharmacists and whether they could ease pressure on the health-care system by writing prescriptions.
Ontario's interest comes after Alberta expanded the role of its pharmacists last year, allowing them to prescribe some drugs, give drug refills and inject vaccinations.
New Brunswick is moving forward with legislation that allows pharmacists to refill prescriptions without a doctor's consent, alter the prescription if necessary and write prescriptions for minor conditions. Manitoba is also moving toward a system which would give pharmacists to not only the authority to prescribe drugs but also order and interpret tests.
While doctors argue patients could be put at risk because pharmacists aren't trained to diagnose and prescribe medication, Smitherman said Ontario's pharmacists are well-qualified.
"Pharmacists go to school for just about as long as doctor does so if we can deploy them more effectively as a front-line health-care provider, that could be advantageous to patients,'' he said.
Having prescribing pharmacists would help take the pressure off clogged emergency rooms and doctors' offices, argues the Canadian Pharmacists Association.
Executive Director Jeff Poston said pharmacists could help patients manage chronic illnesses which, in turn, would save them trips to the hospital. With the increasing scarcity of doctors, Poston said people in remote, rural areas also have more access to pharmacies than a doctor's office.
Other provinces and countries around the world are increasing the authority of pharmacists so it's likely Ontario will follow suit, Poston said.
"There is a definite trend,'' he said. "We're going to begin to see some real benefits for patients emerging from pharmacists and other health-care professionals having some increased authority to prescribe drugs.''
Pharmacists already diagnose and recommend medication for ailments like coughs, colds and diarrhea, he added.
But Brian Day, head of the Canadian Medical Association, said today's pharmacy training doesn't prepare graduates for the responsibility of patient examination and diagnosis.
A patient complaining of stomach pain could be given over-the-counter medication when they are actually suffering from a burst appendix, he said.
"My father was a pharmacist and he had a great knowledge of drugs but he was never trained in diagnosis,'' said Day, adding prescribing pharmacists isn't the solution to the doctor shortage either.
"To say this is an answer to the doctor shortage is ludicrous. The answer to a shortage of doctors is to produce more doctors.''
