Letter to the editor: Patient care is more than a prescription
The article “Pharmacists hope to further expand their role in health-care system” (Regina Leader-Post, April 5) paints an optimistic and somewhat uncomplicated picture of a world where pharmacists have an expanded health care role. Physicians understand and welcome the need to expand the role of pharmacists. However, such an expansion must be done carefully, and patient care and safety should always be the top priority.
First and foremost, patients need a robust clinical assessment and diagnosis, something that, with minor exceptions, can only be done by a physician. After a proper diagnosis, patients need pharmacists to monitor and supervise their drug therapies. Expanding the role of pharmacists runs the risk of muddying the line between diagnosis and treatment.
Treating a “minor ailment” sounds simple enough, but there are pitfalls. There are cases where a drug treatment might seem straightforward, but at other times, a careful review of a blood test might be required before or after a therapy is administered. Sometimes a simple symptom like a sore throat — something pharmacists are seeking to treat — can be a sign of a more serious health issue, and may need further investigation and testing. Treating a patient in the absence of a documented patient history carries risks. Change is fine provided we strive to offer patients optimum care, not merely convenience.
Currently physicians fully support collaborative health care models in the management of chronic diseases like diabetes and hypertension. Drug therapies are critical in these contexts. Dosage levels, contraindications and monitoring for adverse side effects are legitimately the purview of the pharmacist. Both the Saskatchewan Medical Association and the College of Physicians and Surgeons of Saskatchewan advised the College of Pharmacists about concerns regarding patient safety when it comes to expanding the list of minor ailments which a pharmacist can treat. We hope for the sake of patient safety that our concerns will be addressed.
Traditional care models need revamping. Innovative approaches are welcome. Should pharmacists have an expanded role? The discussion is certainly needed, but let’s make sure we keep patient safety and health in mind above all else.
Dr. Intheran Pillay
President, Saskatchewan Medical Association