Better tools are needed for effective communication between physician and pharmacist

TRecord Staff

he Quebec Federation of Medical Specialists (FMSQ) welcomes the introduction of Bill 31, which aims to expand pharmacists' activities for the benefit of patients, but cautions against the increased powers that the bill would give pharmacists. The FMSQ is reluctant for pharmacists to be able to modify prescriptions, their dosage, or evaluate patients without first discussing them with an attending physician. According to the FMSQ, more appropriate communication platforms than fax are essential to ensure effective communication between physicians and pharmacists.

The federation pointed out that the Minister of Health and Social Services, Danielle Mccann, made a formal commitment to this in November 2018.

"For actions such as extending a prescription, or ordering a routine check-up, we are not concerned, because pharmacists are our daily partners. But medically, when it comes to changing a patient's dosage, prescription or condition, the pharmacist must inform the attending physician, otherwise they will become completely accountable to the patient," commented FMSQ President Dr. Diane Francoeur.

The FMSQ added that it supports any measure that will increase the vaccination rate in Quebec. "We also support pharmacists being able to administer a vaccine to children. This provision of the bill will encourage more children to be vaccinated in Quebec and will help to eradicate scourges such as measles. We even believe that it should be extended to all children, regardless of their age," explained the FMSQ president.

CONFLICTS OF INTEREST

The FMSQ also insisted on the importance of eliminating any notion of conflict of interest resulting from the dual role of the pharmacist authorized to prescribe and sell drugs. The authorization to prescribe over-the-counter drugs and the administration of vaccines amplify the appearance of conflicts of interest, the federation pointed out.

"We see no added value in the pharmacist's prescribing of over-the-counter drugs, other than to prevent the patient from paying taxes on these products," added Dr. Francoeur.

SUMMARY OF RECOMMENDATIONS

The FMSQ made eight recommendations to improve the bill, which would better respect the respective competencies and responsibilities of physicians and pharmacists:

- Add to section 17 (7) of the Pharmacy Act a requirement for prior consultation with the physician.

- Authorize the administration of a vaccine in pharmacies for any child under six years of age.

- Develop regulations to govern the prescribing of non-prescription drugs and maintain the current framework in relation to the prescribing of other drugs.

- Provide patients with a single electronic medical record accessible at all times with appropriate communication platforms for all health professionals.

- Maintain the current wording of section 17 (8) of the Pharmacy Act.

- Frame laboratory tests that may be prescribed by a pharmacist practicing in a community pharmacy and define the concept of other tests.

- Remove clause 2(a) from the bill to allow the pharmacist to assess a person's physical and mental condition in order to ensure the appropriate use of drugs.

- Allow pharmacists to consult directly with the attending specialist for complex patients requiring medication adjustment.