Transforming
Primary Care in Canada

Climbing the Summit: A front-line pharmacist’s experience at CPhA’s Transforming Primary Care in Canada Summit

Dr. Lisa Zaretzky, BScPharm, PharmD

I have practiced as a first-line health-care provider for most of my 30-year career, but more intentionally since 2005 when I opened my own pharmacy and wellness clinic. I obtained my post doctorate in 2013, solidifying my academic strengths to support my passion for holistic primary care. My role as a Doctor of Pharmacy has a unique place in a patient’s health journey, one that I am proud of and committed to.

I am a drug expert, a therapeutic detective, a collaborator, and above all, a great listener. I AM a primary health-care provider, but that doesn’t mean I work in a hospital; rather I am independently located in my community, available for walk-in or appointments for valuable pharmacist-led health interactions and consultations.

I wanted to attend CPhA’s Transforming Primary Care in Canada Summit to hear first-hand how pharmacy would be positioned to actualize primary care and what that could look like at ground zero. Top of my mind was: “Will politics finally align with our integral role in health care?” I was curious and eager to share my view of pharmacy primary care; and I was elated to be invited to attend this momentous event. I was excited to ‘climb to the summit’ and see the vista of excellence in pharmacy practice.

I arrived late on the eve of the Summit and early the next morning I ventured to the ‘base camp,’ grabbed my essential caffeine nutrition and mingled amongst my fellow adventurists. I was thrilled to meet some amazing influencers that I connected with on LinkedIn, and to reconnect with colleagues from years gone by. The line-up of panellists was stellar. I sipped my beverage and waited to begin our journey.

As the climb began, it was abundantly clear that pharmacists are well equipped for this trek, with the capacity to promote wellness, prevent drug related adverse outcomes and to manage chronic illness. Time is also of the essence as, although 85% of Canadians have a primary care provider on record, many cannot access this essential care. The health-care crisis cry was echoed throughout the day, and is admittedly not the struggle of one; we need the cooperation of all primary care providers to keep Canadians well.

No one profession owns the task of stabilizing our health-care system, we all do; and the patient has a central role on this taskforce. I am a firm believer that not only does the patient own their health information, but they own their health—period. Health-care providers need to AND are responsible to empower patients to decide what quality of life measures they want to work on and guide them in that direction.

The Summit leaders were cognizant of our sparse resources and strategized the importance of acknowledging the intersectionality of all health-care team members. As with an actual summit, the team must be cohesive and focused; and to that end, CPhA is best positioned to influence ALL pharmacy colleges and advocacy bodies to unite with one primary care–focused scope of pharmacy practice.

Colleges, policy makers and payers need to examine and reflect on the successful micro-summits from Nova Scotia and Alberta and let the patient experience help redefine what primary care practice can look like. It nearly brought tears to my eyes to see Nova Scotian health-care influencers together on the stage, united with the task of improving health for the citizens of their province. I hope all provinces will choose to emulate Nova Scotia’s efforts, especially my home province of Manitoba. Throughout the Summit journey, I was acutely aware that it will take the participation of all health-care providers to stop the futile band-aid approach to fixing what is surely broken and to focus on efficiently working together to get all Canadians to the top of their health.

I am also concerned that industry—the business of pharmacy—is not fully ready to commit to leveraging the power of pharmacy in primary care. The worth of community pharmacies goes beyond prescription numbers and must factor in quality of care. Yes, sometimes quality of care can have an upward effect on revenue, but sometimes it does not, as with deprescribing, as with palliative care, and with prevention-based consultations. The delivery of services has not yet found a tipping point in the financial matrix of the buyers’ multiple-value calculations. Our patients and our profession deserve a broad and committed investment in primary care services from the highest levels, beyond what we can accomplish individually at a grassroots level.

At the final stretch of the Summit, we neared the crest and stood to view the anticipated horizon; but instead, another mountain was there to climb. The mountains or challenges post-Summit are simple, but not easy. Just like with climate change, we all need to agree we have a crisis—a crisis of more needs than resources. We need to acknowledge that the hierarchy of the medical model is not sustainable. We have the capacity to diversify the medical model by maximizing the capacity or scope of nurse practitioners, registered nurses and community pharmacists; and to accelerate the licensing of valuable new professionals to Canada. We first must AGREE that there is a crisis that requires the entire health-care team to mitigate.

The first task for pharmacy directly is to normalize the standards of practice and scope of practice with all Canadian colleges of pharmacy—this is paramount. We must open pharmacy-led primary care clinics in every neighbourhood—not at some point but NOW, in 2024. Why let the health of Canadians suffer any longer? We did not have control over the pandemic, but we DO have control over this health-care crisis. I’m in, are you?

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Dr. Zaretzky was the pharmacist winner of CPhA’s Win a Trip to the Summit Contest. Take a look at some of the other incredible submissions we received on our website.

"My heart is in helping people with their health as it relates to medication therapy and disease state management. I practice pharmacy with a focus on the patient and their personal needs. My education as a Doctor of Pharmacy and my determination have guided me to be an entrepreneur in the community of Morden, Manitoba. I am passionate about my role in health care and in patient relationships. For me, it’s not just about drugs… it’s about LIFE!" – Dr. Lisa Zaretzky