ANNAPOLIS COUNTY, NS - The Pharmacy Association of Nova Scotia wants the provincial government to see pharmacies as a part of the solution when it comes to issues relating to doctor shortages.
"Pharmacists in Nova Scotia are ready, willing and able to help alleviate some of the healthcare stresses that exist in this province due to the physician shortage," said Rose Dipchand, chairperson of the Board of the Pharmacy Association of Nova Scotia (PANS), in a recent media release.
"We are this province's most accessible health care provider, and we can help."
PANS wants to see government savings from the new generic drug price framework recently announced by the pan-Canadian Pharmaceutical Alliance to be put into frontline pharmacy services.
“By investing in pharmacy services, such as minor ailments assessments and prescribing, vaccinations, prescription renewals and chronic disease management services, the government can make immediate improvements to healthcare access across this province,” reads a prepared statement circulated by PANS Jan. 29.
"Studies show that when pharmacists provide services, such as chronic disease management, they can significantly improve patient health while decreasing costs to the healthcare system. Investing in pharmacy means pharmacies will be able to provide these much-needed services."
PANS points to the publicly-funded flu shot as a prime example of how pharmacies can shoulder some of the strain within an over-burdened care delivery system.
‘Opportunity to utilize pharmacy’
Local pharmacist Kirk Lycett, owner of Pharmasave in Bridgetown, has noticed a significant increase in patients seeking services in light of physician retirements. He sees the overall impact on his pharmacy as twofold.
“It does provide us with a fee for service, which further includes the pharmacist in the total healthcare picture, (and) it increases the demand on our time, which is in high demand already. It puts a little more strain on staffing, especially during the busy times of the month,” said Lycett.
He believes the associations representing various health professionals must come together to discuss how to best work together to help patients and doctors alike.
“I see there are opportunities to utilize pharmacy, nurse practitioners, nurses and other care professionals more to take some of the pressure off the doctors,” said Lycett.
“There’s potentially a lot of patients that are going to be without physicians and the current number of physicians in our area will, in no way, be able to absorb that number of patients.”
He said pharmacists are readily available during flexible hours, and they frequently console customers stressed about the lack of family physicians available to prescribe or authorize refills.
“We hear it, but unfortunately until legislation permits… us to go beyond, we’re stuck,” he said.
“It is a pretty limited scope that they have given us for the minor ailments but… that may once again expand.”
Read more about the family doctor crisis in Kings, Annapolis counties:
‘Relying more and more on us’
Rob Perry, an owner of Pharmasave locations in Middleton and Kingston, views the doctor shortage as a province-wide issue. Like Lycett, he believes local pharmacies could offer more frontline care options to patients if they were permitted to do so.
“The challenge is there are services that they would like us to provide, which aren’t within our scope of practice. There are also services within our scope of practice that do not seem to be presently in demand,” said Perry.
“We are limited in what we are able to prescribe for a set of minor ailments.”
Perry said patients are turning to the pharmacy for help in hopes of not having to go to an emergency department or walk-in clinic to get a refill for a routine prescription. But they don’t always like what they hear.
“Without a family physician, we can extend a prescription for a month under certain circumstances. It has to be a continuation of an ongoing therapy,” he said.
“All of a sudden, we’ve got physicians that have moved or retired and we’ve got a huge amount of people without any family doctor, so they’re relying more and more on us.”
Pharmacy manager Michele Forsythe, who works with Perry, says the physician shortage has resulted in pharmacists undertaking some more background work that is not always necessary when patients have family doctors.
“In some cases, we’ve become kind of the record keeper… we’re the ones that the hospitals have to contact when the patients show up to get all of their refills,” she said, adding that pharmacists have been increasingly becoming more involved in the patients’ therapy in recent years.
“We do so much more now.”
The increase in demand on pharmacy staff, coupled with more thorough procedures to follow, can result in longer wait times.
“Five years ago, we probably told patients ten minutes… now, if there’s nobody standing in the store, I tell them 20,” Perry said.
“The standard that we’re being held to is higher, and that’s a good thing.”
That said, Perry stressed that the priority continues to be to create more opportunities for pharmacists to interact with patients.
“We’ve designed our pharmacy to have the pharmacist spending more time with patients, which is the most valuable use.”
Did you know? Pharmacists can assess and prescribe for minor ailments. The fees for these services can vary, according to the pharmacy. See the list of minor ailments here: http://pans.ns.ca/public/pharmacy-services/assessing-prescribing-minor-ailments