It has been nine months since Pourya Eslami completed his doctor of pharmacy program at the University of B.C., and already he sees serious gaps in the system.
In a province where almost a million people are without a family doctor, Eslami believes pharmacists could play an important role in taking pressure off the primary-care system if they were given the ability to prescribe medication for minor ailments.
“It is frustrating for us, but more so for the patient,” Eslami said. “There is this pool of knowledge and skills that is not being used despite our current [family doctor] shortage.”
Allowing pharmacists to prescribe some medications is a strategy being used in Alberta and will soon take effect in Ontario. While B.C.’s health minister said it is an option on the table, there has been no firm commitment, despite the B.C. Pharmacy Association pressing the government for months to give community pharmacists the power to prescribe medication for self-diagnosed minor or common ailments.
Eslami, the pharmacy manager at Fort Royal Pharmacy on Hillside Avenue, said it’s difficult turning patients away to try their luck at a walk-in clinic when the medication is on the shelf right behind him.
In many cases, Eslami said, patients will be talking to a doctor through a telemedicine call, whereas pharmacists can interact directly with the person at the counter. He points out that a minor ailment such as a bladder infection can turn into a more serious kidney infection if not treated quickly. That could push some people into already overcrowded and short-staffed emergency rooms.
“In a lot of these cases, it just gets postponed because the patient can’t see a physician,” Eslami said. “And they essentially go to an emergency room with something that could have been prevented so easily.”
Currently, B.C. pharmacists cannot prescribe medication and can only renew prescriptions if they are less than a year old.
“In other provinces and around the globe, community pharmacists have prescribing authority for a range of self-diagnosable, limited conditions,” the B.C. Pharmacy Association wrote in a 2021 submission during the government’s budget consultations.
Expanded powers for pharmacists could be especially important in rural and remote communities where people have even more limited access to physicians, the association said.
Ontario recently announced that starting in January, pharmacists will have the ability to prescribe medications for minor ailments, something that has been done in Alberta since 2016.
Minor ailments include some urinary tract infections, dermatitis such as eczema or allergic reactions, insect bites and hives, conjunctivitis, oral thrush, cold sores, haemorrhoids, and sprains and strains.
Health Minister Adrian Dix said the province is considering expanding pharmacists’ scope of practice. “All of those issues are on the table,” Dix said last week. “I’m sure we’ll have more to say on those other issues around [pharmacists’] scope of practice and team-based care in a general sense in the coming weeks.”
Dr. Ramneek Dosanjh, president of Doctors of B.C., said expanding the powers available to pharmacists is not the best way to support family doctors.
“Prescribing and giving other options at this time is not the way to do things,” she said. “We have a crumbling foundation of our primary-care system. And that is what we need to support.”
According to the pharmacy association’s most recent numbers available, from 2013, it is estimated that $95 million is spent annually in B.C. to treat minor ailments.
If treating these ailments was moved to pharmacies, it could result in a $32-million savings to the system annually, the association said.
