The College of Pharmacists says corporate pressures are compromising care

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Pharmacists are angry, frustrated and concerned about their ability to provide safe and effective patient care as corporate pressures to perform billable services increase, according to the College of Pharmacists of Ontario.

In an extraordinary statement Tuesday, Registrar and CEO Shenda Tanchak said the university had collected compelling and disturbing information about the scope and impact of growing “business-centric” pressures on pharmacists during a recent series of virtual public meetings and written presentations from thousands of pharmacists. professionals.

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“We hear that volume-focused corporate pressures result in suboptimal care and increased risk of error. And we hear that these pressures affect the well-being of pharmacists who fear or experience retaliation if they do not meet corporate goals and whose health suffers due to the tension between trying to provide high-quality care to their patients while also coping to corporate pressures. to increase the number of services provided,” Tanchak said in a statement.

The university, he said, has hired attorneys and is exploring legal options. “The university will consider all available tools to address these concerns.” The university regulates pharmacists in Ontario.

Some of those pressures have been in the news recently, after frustrated pharmacists went to the media saying they faced pressure and fees to cold call patients and perform often unnecessary medication checks that are billable under the Insurance Plan. Ontario Physician (OHIP). Those accusations have been denied.

University officials said they heard similar stories from thousands of pharmacists and pharmacy technicians who participated in the town hall sessions or commented later. Among the comments the university gathered was this: “The pressures of time and quotas make you feel like you have to choose between patient safety and keeping your job.”

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And the push to conduct MedsChecks, for which companies can bill up to $75 per call, is not the only area where corporate pressures are increasing, the university says. The MedsCheck program is a one-on-one consultation between a pharmacist and an eligible patient that takes 20 to 30 minutes once a year to ensure they are adherent to their medications and to better understand how those medications may interact with each other and over time. over-the-counter medications, according to Ontario Health.

The university said the pressure many pharmacists were experiencing to carry out more MedsChecks was a “symptom of a larger problem”.

Tanchak said other services that pharmacists said were subject to corporate pressure included imposing time limits on conducting evaluations for minor ailments. The Ontario government has recently expanded the power of pharmacists to prescribe medications for minor ailments. Pharmacists can now prescribe for 19 minor ailments. Pharmacists have also reported facing pressure to dispense naloxone kits, among other things.

Tanchak said the pressures reported to the university were an ineffective use of health system resources, as well as contributing to feelings of burnout and stress that could hinder pharmacists’ ability to provide the type of safe, quality care that they wanted to offer. .

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Pharmacists told the university that the pressure most often came from non-pharmacists and those in corporate or regional headquarters.

The result is a loss of identity as health professionals and a loss of autonomy to make decisions for the benefit of patients.

“Pressure and focus on volume lead to errors, mistakes, and increased risks to patient safety,” the university said in a presentation to its board of trustees this week.

The vast majority of pharmacists who reported workplace pressures said it occurred at Shoppers Drug Mart, with the second highest number of reports from Loblaw pharmacies, followed by Rexall, the university said in its presentation. Significantly fewer reports occurred at other store pharmacies and independent pharmacies.

The university’s board of trustees also voted to work with the Ontario Ministry of Health to restrict the use of preferred provider networks, which are agreements between drug plan sponsors and pharmacies. One such agreement between Manulife Financial Group and Shoppers Drug Mart that would have required some patients to purchase medications at Shoppers or Loblaws pharmacies was canceled earlier this year after an outcry. The board, which will draft a statement on the issue, heard it could lead to potential harm to some patients.

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Meanwhile, Tanchak said the university planned to take action in the face of growing corporate pressures.

“The feedback we heard from pharmacy professionals was heartwarming and consistent,” Tanchak said. “The pressures they are experiencing are real and sustained and those who responded to us made it clear that they are members of a profession under stress and duress.”

He said the university had the authority to vet people and accredit pharmacies, which is necessary for them to operate.

“We are aware that the real solution to the problem will not lie with us alone and we will seek to collaborate with other partners in the system, including the government, to address these concerns effectively,” he said.

Loblaw’s public relations department said in a statement that it “remains adamant that drug reviews are a vital healthcare service,” adding that drug reviews had directly benefited patients, “reducing adverse reactions.” and ultimately keeping these patients out of hospitals.” and emergency care.”

The statement said the decision to provide a professional service “has always been and should be made by the pharmacist.”

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He added that the company “is listening to the concerns recently raised and is working with our teams to ensure we take a collaborative approach to patient care.”

The company did not directly respond to questions about whether pharmacists were pressured to perform medication checks or other services or whether they worked to time targets.

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