Pharmacists in Ontario could be given new powers to assess patients and prescribe medication for a number of common ailments, including coughs, sore throats, pink eye and urinary tract infections.
Premier Doug Ford’s first budget, introduced last Thursday, included measures to expand the scope of practice for several health care providers – which it calls a “basic change” to save patients’ time and money.
Instead of referring a patient to a physician, pharmacists would be given the ability to perform on-site assessments and prescribe medications, while also administering flu shots to children above the age of two.
The move is being hailed by the Ontario Pharmacists Association, which has been advocating for the change for over a decade. The association says that as it stands now, patients who arrive during evenings and weekends often have to be sent to a family doctor, walk-in clinic or emergency room for a simple prescription.
“They come back four, five, eight hours later, depending on where they’ve gone, and they come back holding that same prescription for the very product I would have given them, had I had the opportunity to prescribe it,” says Allan Malek, Executive Vice-President and Chief Pharmacy Officer for the Ontario Pharmacists Association.
Health Minister Christine Elliott says the government is hoping that by allowing pharmacists to use the full extent of their medical expertise they’ll be able to divert patients away from overloaded emergency rooms and allow doctors to focus on patients with more complex needs.
“We have lots of qualified people here and lots of people need help,” Elliott told CTV News Toronto. “We want to provide better options for people to receive timely access to care from qualified professionals.”
Elliott says her ministry will be working with the College of Pharmacists to determine the appropriate list of minor ailments that can come under a pharmacist’s jurisdiction.
Licensed pharmacists in New Brunswick, who were given the ability to diagnose in 2008, are restricted to a list of 32 ailments and have to undergo mandatory training on the processes and standards before offering the service.
Paul Blanchard, Executive Director of the New Brunswick Pharmacists Association, says the province hasn’t experienced “any issues” with the policy and patients are always referred to doctors in more complex cases.
“The pharmacist will follow up within three days to make sure that their issues are resolved,” Blanchard told CTV News. “If they haven’t, then they’ll encourage the patient to see further treatment.”
The province is also looking to expand the scope of nurse practitioners, dental specialists and optometrists, allowing them to order MRI and CT scans without a doctor’s appointment.
The Ontario Medical Association (OMA) is calling for strict regulation to ensure there is collaboration with doctors, patient treatment information is shared with a family doctor and that patient safety is upheld.
The OMA says in a statement it’s also looking for assurances “no health care provider is unreasonably burdened with complications arising from expanded scopes of practice” from pharmacists assessments.
Malek says pharmacists are covered by professional liability and their assessment of a patient’s symptoms isn’t a departure from how a doctor would approach the same situation.
“Based on the symptoms and how they’re presenting and based on the assessments and ruling out more serious conditions – the pharmacist would then prescribe,” Malek says. “No different than the way a physician would.”
While pharmacists would be paid for each assessment they conduct, Elliott says patients would not have to pay out of pocket and pharmacists would bill OHIP instead.
The government doesn’t have a timeline for when the change would become official.