On pharmacists and primary care
November 2024

It’s fall, which means that community pharmacies are buzzing with activity.

The phones are ringing non-stop, faxes are coming in faster than you can get to them, there’s a growing line of patients waiting to drop off prescriptions, pick up medications or ask questions. Somewhere in the middle of it all, you’re contacting prescribers, managing drug orders, reconciling claims, counselling on new prescriptions and providing assessments for common ailments or administering vaccinations… and the list of “to dos” goes on and on.

Sound familiar? It should—this is our reality, day in and day out. And we do it while upholding the highest standards of quality and safety; keeping patients’ well-being as our top priority.  But how often do we pause and take a moment to reflect on just how much we’re accomplishing each day and how critical our work is?

I’ll be honest—it’s not something I used to do very often. Like many of you, I got so caught up in the daily grind that I didn’t take the time to appreciate the broader impact of our work. But lately, I’ve been thinking about the unique role pharmacists play in the health-care system, especially in the context of the current primary care crisis.

The unfortunate reality of our health-care system

The state of primary care in Canada has forced us to reexamine how care is delivered. It has created the opportunity to evaluate new solutions to address access to care and support the limited workforce of health-care providers who are carrying a great deal of responsibility.

What’s most striking, however, is that the narrative around the role of pharmacists in primary care remains overshadowed by misconceptions and debates dominated by the perspectives of those who may not fully grasp the realities of our profession. Attempts to question our integrity, competency and/or commitment to the safety and well-being of our patients over bottom lines are ill-served.  

When we strip back all the noise and distractions, the fact of the matter is that right now, pharmacists across the country are supporting an overstretched health-care system. Every day, we help patients who don’t have access to a family doctor or nurse practitioner. And yet, the discussions around our role in primary care still don’t reflect the reality we live. Too often, our contributions are overlooked, misunderstood, or—worse—undervalued. Some even question our ability to provide high-quality care, as if the years of education, training and ongoing learning we commit to mean nothing.

Here’s the truth: we are not just capable of primary care—we are already doing it. Every single day. Despite the countless barriers and with or without support, we are doing our best to work within the parameters of our authority to positively impact the lives of our patients.   

What’s holding us back

The issue isn’t whether pharmacists can step up. The issue is the barriers we face. Outdated regulations, inconsistent policies and funding models that don’t align with our scope of practice are holding us back. Add to that a lack of integration into the broader health-care system—like real-time access to electronic health records—and you can see why it feels like we’re working uphill.

Removing barriers would liberate pharmacists to provide care effectively and in many cases help alleviate the moral distress we often feel when we know how to help a patient and what needs to be done but aren’t allowed to do it.  

Let’s not forget the strain of trying to do more with less. Many of us are in work environments that prioritize volume over care, where the pressure is constant and there’s minimal time or support to focus on what really matters—our patients.

But here’s the thing: it doesn’t have to be this way.

Take a moment to imagine…

Imagine a health-care system where pharmacists can practise using their education with full scope, without unnecessary restrictions or barriers. A system where we have the tools and infrastructure to collaborate seamlessly with other health-care providers. A system where our work environments are designed to support our professional autonomy, mental health and ability to deliver the best care possible.

That vision isn’t out of reach. It starts with:

• Consistent policies and funding models across provinces that allow pharmacists to fully utilize their expertise.
• Integrated infrastructure to connect us with electronic health records and streamline communication with other providers and with our patients.
• Supportive workplaces that empower us to focus on clinical care while leveraging the skills of our well-resourced teams that include pharmacy technicians.
• Redesigned workflows and spaces that reflect the shift from a product-based model to one focused on patient care.

It’s 2024! We have everything that’s required to execute on a thoughtful, strategic, value-based plan for system-wide primary care transformation—so let’s do it!  And it’s not just CPhA saying it. A recently published report by the Conference Board of Canada highlighted the multiple ways pharmacy teams support a more equitable health system. We are accessible, we serve vulnerable populations who otherwise may not receive care and our workforce is extremely diverse.  I’ve said this before, but it cannot be understated, our diversity is our strength. Pharmacists are delivering care in ways that overcome language and cultural barriers across this nation—we are reaching patients from all walks of life and in the most remote of locations.

Progress is happening

Earlier this year CPhA held a national summit to talk about the role of pharmacy in primacy care. Our published Communiqué provides a list of recommendations we made coming out of that meeting. You can also read about the discussions in a white paper that was published in the Canadian Pharmacists Journal.

Across Canada, creative models are already demonstrating the value of expanded pharmacy roles.

In Nova Scotia, we’re seeing what’s possible when governments, regulators and associations come together to expand pharmacists’ roles thoughtfully. Pharmacist-led walk-in clinics and common ailment prescribing programs are transforming care delivery, and the results speak for themselves. These changes aren’t just about expanding scope—they’re about making it possible to use that scope effectively. It’s about creating an environment where we can thrive as professionals and focus on what we do best: caring for our communities. Consulting rooms and retrofitted spaces for patient care must become standard in older pharmacies. I’d like to believe the days of “discount drug” culture are over, and we can finally focus on delivery of quality care.

Without a doubt there will be pharmacists that are not going to embrace our new place, but that’s ok—it’s the case in any profession. However, as we continue to work together to support the vision of pharmacists as primary care providers, the hope is that every pharmacist will be able to find joy and fulfilment in their careers.

Future changes on the horizon

With a declining workforce, supporting pharmacists to practise in a way that allows them to grow and develop as a professional in their career becomes critically important. We are asking pharmacy students and new practitioners about their workplace expectations in a national survey. We want to advocate on behalf of the newest members of our profession to establish practices that meet not only community needs, but pharmacists’ needs as well.  

I’m also excited to share that we have been working behind the scenes to develop and advance a national standard that allows pharmacists to practice to their full education. We’ve done extensive consultations with pharmacy stakeholders to find consensus and clearly define the capabilities of pharmacists based on their education. Our intention with this Benchmark Project is to advocate for legislative changes required to advance our profession. 

It's important to note that while we are advocating to remove restrictions on what a pharmacist is allowed to do, we also recognize the importance of setting expectations that pharmacists should have the freedom to choose how they use their scope and the professional autonomy to build a practice that meets their needs and the need of the community they serve.

I know this profession can be exhausting, especially in times like these. But I also know how resilient we are, how much we care about our patients and how committed we are to making a difference.

A call to action

So, here’s my challenge to you: let’s keep pushing. Let’s advocate for the changes we need to do our jobs better. Let’s support each other in creating workplaces where we can thrive. And let’s remind the world that pharmacists aren’t just health-care providers—we’re essential to the future of primary care.

Because at the end of the day, it’s not just about what we do—it’s about who we are. And who we are is pretty remarkable.

You are making a difference every single day. Don’t ever forget that.

Be well,