On June 13, 2019, the Québec Health Minister tabled Bill 31, a law that, when adopted, broadens the scope of pharmacists in Québec to provide vaccinations and have additional prescribing rights.
Across Canada, pharmacists can now administer flu vaccines and impart enhanced patient care. This is a much-needed advancement in the profession, but it is not time to savour victory in this battle. It is time to stop patting ourselves on the back. Instead of celebrating a small conquest, let’s get our platoons to work because we are finally on the inside and need to mobilize our garrisons and begin the successive expansion towards our subsequent fortress.
Next phase? Certainly. Pharmacy needs to be reconceptualized. We are the most accessible health care professional. Pharmacists should be considered the primary health care provider, and our pharmacy wellness clinics are at the gateway for health care and referral.
Why should we feel satisfied simply for providing vaccinations in some jurisdictions from a limited list? Clearly, a pharmacist should be trained and able to prescribe and furnish all vaccinations for all our patients where indicated. With the exponential advent of the development and use of biologics and biosimilars, pharmacists should have the ability to extend bolus extravascular doses of vaccine biologics to vascular and extravascular short- and long-term infusions of medications for the same patients.
With the ingress of point-of-care measurements and the ease, access and affordability of diagnostic examination, pharmacists can initiate laboratory tests for their patients in their pharmacies and work collaboratively with physicians and nurse practitioners more seamlessly for optimal care. Likewise, we already train pharmacists in physical assessment, but clearly this can be unchained and expanded to put our clinical skills to greater use.
All of these musings are consistent with our polished pharmacy mantra of “medication expertise for patient-centred care.” For we are a profession that has 2 hearts: the product and the patient. This is our strength and our identity, shared by nobody else, and we are proudly “scientist-clinicians” by training, instinct and necessity.
Metaphorically, pharmacy’s Trojan horse flu vaccine adroitness has enabled governments to invite our pharmacists into the securely protected clinical bastion long held only by physicians. We are inside now, and the elite armies within all of us should be deployed forthwith to further evolve our troops’ scope to the fullest extent possible for the benefit of Canadian health. Forward march! ■
Neal M. Davies, BSc(Pharm), PhD, RPh
Pharmacist, Professor and Dean
Faculty of Pharmacy and Pharmaceutical Sciences
University of Alberta