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What goes on behind the counter, anyway?

Pharmacists make sure that your prescriptions are safe, appropriate and effectively tailored for you

It’s a typically busy Saturday afternoon and Mrs. T, one of my regular patients who I have known for many years, comes in to drop off her prescription. When we sit down to go over the prescription for her urinary tract infection I see that, due to her age, 86, the dosage is much too high.  I explain that I am going to adjust it so that the drug doesn’t build up in her body, which can contribute to significant side effects, especially in the elderly.  I go over how to take the medication properly, discuss potential side-effects, check for potential interactions, and advise her that if there isn’t an improvement in three days, to give me a call.

This is just one example from my pharmacy in Fredericton, NB, which highlights the services that pharmacists provide. Yes, we dispense medications, but we also make sure that your prescriptions are safe, appropriate, and effectively tailored for you.  

Canada’s 40,000 pharmacists see well over a million Canadians every day.  More than half of patients with health care issues seek out a pharmacist first, before any other health care practitioner.  We treat patients on the weekends and evenings, and, in many cases, 365 days a year.  On average, each pharmacist manages 1,300 patients in their community, which is comparable to physicians and nurse practitioners.

While you wait for your medication, here’s what we do: we verify that the medication you have been prescribed does not interact with your other medications and disease states; we make sure you won’t experience an allergic reaction to the medication; we ensure that the dose and medication prescribed is appropriate for you and the condition for which you are being treated.  We make sure you are receiving the correct medication as prescribed and that you are counselled on how to take your medication properly.  We answer questions you may have about your health without an appointment or long wait times.

All those activities that go into ensuring you get the right drug, at the right dose and at the right time are funded by a pharmacist dispensing fee – a modest, professional service fee that affords us the time to ensure that the medication you receive is the safest and most appropriate for you. Every once in a while I hear patients ask: why is your fee different from pharmacy to pharmacy?  I tell them it’s because some pharmacies provide longer hours, more comprehensive services and products which require more investment and hence, more funding.

Often I hear patients speak out about the cost of medications; I hear many patients struggle with the burden of having no drug coverage. I am very concerned with getting patients their medications and have therapeutically substituted lower-cost medications to help my patients afford their medications.  But as a pharmacist, I have no control over drug costs, they are entirely determined by global and government pricing.

What I can tell you is that pharmacists do their best to get medications to those who need them. That’s why I, as Chair of the Canadian Pharmacist Association, am also advocating for a made-in-Canada pharmacare solution that will ensure all Canadians have affordable access to their medications. Such a solution would build upon the best qualities from our provincial and private drug plan systems. It would also need to be coupled with improving access to the services provided by Canadian pharmacists to ensure we are getting the most out of those medications.

I was able to reduce the dosage of Mrs. T’s antibiotic and potentially prevented an adverse event which could have had serious consequences.  The doctor, Mrs. T, and I all worked together to keep her safe. Mrs. T’s story is not unique; it plays out every day in pharmacies across the country.  

While you might not see everything we do behind the counter, be assured that we are helping Canadians get the most out of their medications. And more than just pill counters, Canada’s pharmacists provide value as the last line of defense in preventing medication errors and potential drug interactions.

Alistair Bursey is Chair of the Canadian Pharmacists Association, and a pharmacist-owner in Fredericton, NB.

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