We thank you for reading our editorial1 and bringing up the important point of prioritization of limited resources. Certainly, many workplace environments cannot accommodate the provision of all services to all patients at all times. Tailoring (and prioritization) of services offered toward those providing the greatest impact on patient care and to meet the needs of each pharmacy’s patients is an important consideration. We also acknowledge and agree that the dispensing process is where many drug therapy issues are identified and resolved, highlighting the important role pharmacists play in determining the appropriateness of therapy as part of this process. This is indeed an area that would benefit from rigorous research focused on the patient care outcomes achieved rather than the surrogate outcome of number of drug therapy problems identified—a common limitation observed in pharmacy practice research.2
Our vision of broadening and harmonization of scope across Canada can align well with the concept of prioritizing services, by giving pharmacists the autonomy to determine if a given activity should be performed for a specific patient. In most provinces, unfortunately, legislative limitations prevent pharmacists from acting on identified needs even when it is deemed safe and effective to do so. If these arbitrary legislative restrictions were eliminated, and workplaces both supported pharmacists in providing these services and also refrained from imposing service counts that treat these activities as a commodity rather than a patient care activity,3 our profession could be empowered to determine where our value most lies and act accordingly. This consolidation of full scope, prioritization and professional autonomy would represent the best-case scenario for pharmacists and our patients. As health care professionals, we owe this to the society that we serve.
—Ross T. Tsuyuki
—Hiroshi Okada
University of Alberta, Edmonton, AB
—Sherilyn K. D. Houle
University of Waterloo, Waterloo, ON
sherilyn.houle@uwaterloo.ca
References
- 1. Tsuyuki RT, Houle SKD, Okada H. Time to give up on expanded scope of practice. Can Pharm J (Ott) 2018;151(5):286-7. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2. Tsuyuki RT. Designing pharmacy practice research trials. Can J Hosp Pharm 2014;67(3):226-9. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 3. Lamb S, Tsuyuki RT. Pharmacists vs employers: a showdown over professional autonomy and patient care? Can Pharm J (Ott) 2017;150(3):138-9. [DOI] [PMC free article] [PubMed] [Google Scholar]