What we need is a more responsive health care system
To the Editor,
Your recent article
“UW study says pharmacists could save feds $42 million” is troubling. The piece says prescriptions for minor ailments such as upper respiratory infections, contact dermatitis (skin rash) and conjunctivitis (pink eye) could be more conveniently and cost effectively handled by a pharmacist, without a physical exam.
I am a physician and have been practicing family and emergency medicine in Waterloo Region for 30 years.
Let’s be clear about these ailments. None of them require any medication stronger than what you can currently buy off the shelf. The vast majority of upper respiratory infections are viral sinusitis, otitis media (middle ear infection) or acute bronchitis. Conjunctivitis is also almost always a self-limited, albeit irritating, viral condition. Prescribing antibiotics for any of these conditions will only add to cost, drug reactions and the expansion of the already serious problem of antibiotic resistance. Nearly 25 per cent of bacterial infections in Canada are now resistant to the antibiotics that used to work. New antibiotics are not being developed quickly enough.
Should a patient with one of these conditions fail to improve after a few days, they then require an exam from a properly trained and licensed physician. Perhaps the
“upper respiratory infection” is in fact an asthma flare, fibrosis of the lung, congestive heart failure or a pulmonary embolism (blood clot in the lung). What appears to be pink eye may be a vision threatening infection on the cornea or inflammation in the front of the eye requiring the care of an eye specialist. Huddling in the corner with a pharmacist, who is neither trained nor qualified in diagnosis and treatment (that’s what med school is for) will lead to over-treatment early on, and missed serious conditions later on in the course of many illnesses. The bottom line is that care will not be improved with this plan, but will in fact be made worse through over prescribing and incorrect diagnosis.
I am not without sympathy for the difficulty many patients have accessing their family physician, if they are lucky enough to have one. Our provincial government has mismanaged health care for so long, despite pouring increasing dollars into the system.
That has led to this sorry state of affairs. Government wastes enough health care dollars already. This plan will certainly add to drug costs. It is inconceivable to believe most pharmacists won’t recommend a more expensive prescription in most cases.
Rather than expand our system to allow unqualified pharmacists to “treat” so called minor conditions, what we need is a stronger push from the public demanding a health care system that is both affordable and responsive to our needs.
David Larke, MD CONESTOGO