New Laws Give Alberta Pharmacists the Power to Prescribe Certain Medications
by: JAMES STEVENSON
Mar. 31, 2007
CALGARY (CP) - Pharmacists in Alberta will soon have the precedent-setting power to prescribe medications, but grave concerns remain over their ability to make the right diagnoses.
Laws that take effect Sunday morning will make Alberta pharmacists the first in North America to be legally and independently allowed to prescribe drugs for minor conditions or in urgent situations.
They will also be entitled to modify or alter the dosages and duration of prescriptions written by doctors.
Pharmacists are hailing the changes as a logical way to improve patients' drug therapy while easing the strain on overworked family physicians and jammed emergency rooms. They hope pharmacists in other parts of Canada will soon get the same powers.
Some doctors say too many questions remain unanswered - including what types of conditions and medications are involved and who is ultimately responsible when there's a disagreement between pharmacist and physician.
Jeff Poston, executive director of the Canadian Pharmacists Association, says the changes to Alberta's Pharmacy and Drug Act and Health Professions Act could be a shot in the arm for the health system.
"There are numerous examples where I think patients can get treatment for a number of disorders from a community pharmacy. They don't need to see the physician, they don't need to go to the ER and the pharmacist is going to be perfectly competent in terms of managing them," Poston said from his Ottawa office.
"Pharmacists are not going to be stupid about this. The patient who's got a headache and is also dizzy and has blurred vision, you're not going to sell them a new headache tablet. You're going to refer them to the emergency room straight away."
But the president of the Alberta Medical Association says doctors remain unpersuaded that pharmacists have the education and training to assess and diagnose patients accurately.
"If you're going to recommend a new treatment or new drug, you need to know with 100 per cent assurance that you're treating the appropriate thing," said Dr. Gerry Keifer, a pediatric surgeon in Calgary.
"That's why we go to medical school."
Keifer insists that concerns over the pharmacists' new powers derive not from "turf protection" but from concern that patients get the best care possible.
Some doctors say pharmacists should be held to the same standards as they are for care and accountability, including rules on record keeping, liability insurance and strict protocols on contacting physicians when prescriptions are altered.
Greg Eberhart, registrar of the Alberta College of Pharmacists, says many of the changes coming to Alberta on April 1 simply recognize what pharmacists have been doing daily for years.
"We are not talking about these pharmacists venturing into the world of diagnosis as physicians know it," Eberhart said from Edmonton.
"We're talking about pharmacists continuing to manage and work with patients and care for conditions that are presented in symptomatic form at pharmacy counters every day."
He argues the new laws are an extension of changes over the years that have allowed pharmacists to "prescribe" such over-the-counter medications as common anti-inflammatories or anti-ulcer drugs and nasal spray - all of which were once prescription only.
It will probably take until this fall for the college of pharmacists to start extending "additional prescribing privileges" to members who have clearly demonstrated knowledge and ability.
Eberhart says pharmacists will not be authorized to prescribe narcotics or controlled substances such as opiates or anabolic steroids.
Harvey Voogd, co-ordinator of the Edmonton-based Friends of Medicare, says his group is concerned about potential conflicts of interest.
He said pharmacists could prescribe medication and then charge a dispensing fee, and could possibly also get paid by pharmaceutical companies.
"I think we are concerned with the potential conflict of interest with pharmacists not only being retail operators, selling drugs, but now being in the position to prescribe.
"It's not yet clear . . . how that issue's going to be dealt with."
But practising pharmacists, including Carol Vorster in Fort McMurray, Alta., say the changes are a step in the right direction for the public.
Vorster said the changes will come in small steps that shouldn't alarm anyone. "We don't want the public to start thinking that we can start prescribing like a physician," said Vorster.
"The prescribing is really very limited and it's within a prescribed framework and definitely always in collaboration with other healthcare professionals."
by: JAMES STEVENSON
Mar. 31, 2007
CALGARY (CP) - Pharmacists in Alberta will soon have the precedent-setting power to prescribe medications, but grave concerns remain over their ability to make the right diagnoses.
Laws that take effect Sunday morning will make Alberta pharmacists the first in North America to be legally and independently allowed to prescribe drugs for minor conditions or in urgent situations.
They will also be entitled to modify or alter the dosages and duration of prescriptions written by doctors.
Pharmacists are hailing the changes as a logical way to improve patients' drug therapy while easing the strain on overworked family physicians and jammed emergency rooms. They hope pharmacists in other parts of Canada will soon get the same powers.
Some doctors say too many questions remain unanswered - including what types of conditions and medications are involved and who is ultimately responsible when there's a disagreement between pharmacist and physician.
Jeff Poston, executive director of the Canadian Pharmacists Association, says the changes to Alberta's Pharmacy and Drug Act and Health Professions Act could be a shot in the arm for the health system.
"There are numerous examples where I think patients can get treatment for a number of disorders from a community pharmacy. They don't need to see the physician, they don't need to go to the ER and the pharmacist is going to be perfectly competent in terms of managing them," Poston said from his Ottawa office.
"Pharmacists are not going to be stupid about this. The patient who's got a headache and is also dizzy and has blurred vision, you're not going to sell them a new headache tablet. You're going to refer them to the emergency room straight away."
But the president of the Alberta Medical Association says doctors remain unpersuaded that pharmacists have the education and training to assess and diagnose patients accurately.
"If you're going to recommend a new treatment or new drug, you need to know with 100 per cent assurance that you're treating the appropriate thing," said Dr. Gerry Keifer, a pediatric surgeon in Calgary.
"That's why we go to medical school."
Keifer insists that concerns over the pharmacists' new powers derive not from "turf protection" but from concern that patients get the best care possible.
Some doctors say pharmacists should be held to the same standards as they are for care and accountability, including rules on record keeping, liability insurance and strict protocols on contacting physicians when prescriptions are altered.
Greg Eberhart, registrar of the Alberta College of Pharmacists, says many of the changes coming to Alberta on April 1 simply recognize what pharmacists have been doing daily for years.
"We are not talking about these pharmacists venturing into the world of diagnosis as physicians know it," Eberhart said from Edmonton.
"We're talking about pharmacists continuing to manage and work with patients and care for conditions that are presented in symptomatic form at pharmacy counters every day."
He argues the new laws are an extension of changes over the years that have allowed pharmacists to "prescribe" such over-the-counter medications as common anti-inflammatories or anti-ulcer drugs and nasal spray - all of which were once prescription only.
It will probably take until this fall for the college of pharmacists to start extending "additional prescribing privileges" to members who have clearly demonstrated knowledge and ability.
Eberhart says pharmacists will not be authorized to prescribe narcotics or controlled substances such as opiates or anabolic steroids.
Harvey Voogd, co-ordinator of the Edmonton-based Friends of Medicare, says his group is concerned about potential conflicts of interest.
He said pharmacists could prescribe medication and then charge a dispensing fee, and could possibly also get paid by pharmaceutical companies.
"I think we are concerned with the potential conflict of interest with pharmacists not only being retail operators, selling drugs, but now being in the position to prescribe.
"It's not yet clear . . . how that issue's going to be dealt with."
But practising pharmacists, including Carol Vorster in Fort McMurray, Alta., say the changes are a step in the right direction for the public.
Vorster said the changes will come in small steps that shouldn't alarm anyone. "We don't want the public to start thinking that we can start prescribing like a physician," said Vorster.
"The prescribing is really very limited and it's within a prescribed framework and definitely always in collaboration with other healthcare professionals."
