Working with Pharmacy Professionals

Introduction

Over the past number of years there have been discussions between the Saskatchewan Medical Association  (SMA) and the Saskatchewan College of Pharmacy Professionals (SCPP) regarding pharmacists’ scope of practice, particularly with respect to the ‘minor ailments’ program, and the necessity of tangible, effective pharmacy to physician communication.

This website is meant as a resource for SMA members where they can educate themselves on the issues, and access tools that will help them develop a sincere, collaborative working relationship with pharmacists who serve their patients.

Collaborative Practice Agreement

All physicians prescribing medications in Saskatchewan are assumed to be in a collaborative agreement with pharmacists, unless the physician states otherwise.

The Saskatchewan College of Pharmacy Professionals (SCPP) bylaws state that pharmacists are allowed to do Level 1 prescribing (including prescribing for “minor ailments”) as long as there is oversight (collaborative agreement) with patients' physicians. In the SCPP's regulatory bylaws, this collaborative agreement is assumed, unless a physician specifically says that it doesn't exist for a particular patient or group of patients.

If a physician objects to a pharmacist prescribing medications for a urinary tract infection, for example, or any other medical problem, without direct involvement from the physician, then the template below can be used to send a letter to the pharmacist stating that the physician does not want them to do that kind of prescribing.

Then, according to the SCPP’s own bylaws, pharmacists in the scenario described above cannot do Level 1 prescribing for your patient/patients.

Recently, the SMA corresponded with the SCPP with respect to this issue. Both groups agreed that collaborative care, as referenced in the SCPP Bylaws, is the best approach to deliver collegial, safe and sustainable patient care management.

The agreement template available on this website has been shared with the SCPP and they have agreed that a transparent and sincere collaborative working relationship is a shared goal.

The SMA offers the agreement template as a tool for physicians to use if they encounter a situation which warrants more clarity on details about the collaborative relationship between pharmacist and physician.

To access the tool and for further instructions on how to implement it effectively, see the links below.

For further information, please a Question and Answer resource on this topic near the end of this page.

SMA Links:

How to establish and maintain a collaborative relationship with pharmacists who are treating your patients:

SMA Collaborative Agreement

Letter of transmittal – to be used when sending Collaborative Agreement Form

Do you have concerns about how a pharmacist handled a prescription?  How to file a complaint

Need help? Questions or concerns?

Call or email Dr. Susan Hayton, Director of Physician Advocacy and Leadership, SMA, at susan.hayton@sma.sk.ca; 306-657-4578.

External Links:

Saskatchewan College of Pharmacy Professionals:
https://www.saskpharm.ca

Collaborative Practice Framework
https://scp.in1touch.org/document/3385/Collaborative_Practice_Agrmt_Frmwk_20101109.pdf

Collaborative Practice Agreement
https://scp.in1touch.org/document/3386/Collaborative_Practice_Agrmt_Template_20170207.pdf

medSask:

Minor Ailments Assessment
https://medsask.usask.ca/documents/pdfs/UTI_assessment.pdf

https://medsask.usask.ca/professional/guidelines/index.php

Pharmacy Association of Saskatchewan
https://www.skpharmacists.ca/pharmacists/about-us

Questions and Answers

Why did the SMA create this agreement form?

The  SMA and SCPP have held talks regarding pharmacists’ scope of practice, particularly with respect to the ‘minor ailments’ program, and the necessity of tangible, effective pharmacy to physician communication.

Recently, the SMA and the SCPP agreed that collaborative care, as referenced in the SCPP Bylaws, is the best approach to deliver collegial, safe and sustainable patient care management. The agreement template has been shared with the SCPP and both SMA and SCPP agree that a transparent and sincere collaborative working relationship is a shared goal. The SMA offers the agreement template as a tool for physicians to use if they encounter a situation which warrants more clarity on details about the collaborative relationship between pharmacist and physician.

What is the specific purpose of sending this agreement to a pharmacist?

The agreement will help reset a collaborative working relationship between pharmacist and physician. It helps to outline areas where there is a good collaborative working relationship, and indicates clearly, and transparently, where you, as a physician, may have concerns when it comes to the pharmacist prescribing something for your patient.

How will this agreement affect my patients?

It depends on what you and the pharmacist agree upon. Generally, there should be no noticeable change for the patient. However, in some cases, a patient may need to see you before a prescription is given. The goal here is to enhance patient safety.

Could a pharmacist initiate a legal challenge against me if I send them this form?

The agreement springs from wording in the SCPP bylaws under which all pharmacists in Saskatchewan practice. It is unlikely that a pharmacist would initiate a legal challenge to the request that they engage in developing a more collaborative working relationship with physicians.However, if a pharmacist chooses not to have this conversation with a physician, the physician could sever the collaborative relationship with the pharmacist; that would mean the pharmacist could not prescribe for that physician’s patient although they could continue to dispense medications.

Where do I get pharmacists’ addresses?

The SMA has provided a link (below) to the SCPP’s public database of pharmacists in Saskatchewan.

Finding a pharmacist

What do I do if I don’t hear back from a pharmacist after I send the form?

You can try following up by phone, or try sending the agreement again. You are free to write to a pharmacist and formally sever the implied collaborative relationship. Such an action would mean that a pharmacist could not prescribe for your patients, but could continue to dispense medications for your patient.

Do I need to let the SMA know I am writing to my pharmacist(s)?

There is no requirement to notify the SMA when you send out this form; but please feel free to copy the SMA on your correspondence as we are monitoring this issue for all members.

Can I settle the questions in the agreement with the pharmacist over the phone or do I need to have the paper copy signed?

A written agreement is preferable. However, you can secure agreement by phone, provided you are comfortable with such an arrangement.

Miscellaneous Links

CBC Radio: Could expanding the role of pharmacists alleviate pressure on health-care system?

https://www.cbc.ca/radio/thecurrent/the-current-for-december-17-2018-1.4946991/could-expanding-the-role-of-pharmacists-alleviate-pressure-on-health-care-system-1.4947024

Dr. Joanne Sivertson - Patients should be wary of simple solutions (opinion piece published in StarPhoenix/Regina-Leader Post April, 2018)

https://leaderpost.com/opinion/columnists/patients-should-be-wary-of-simple-solutions

Dr. Intheran Pillay – Patient care is More Than a Prescription (opinion piece published in StarPhoenix/Regina-Leader Post, April, 2017)

http://www.sma.sk.ca/news/179/letter-to-the-editor-patient-care-is-more-than-a-prescription.html

Events