Pharmacists handed new challenges, bigger role in patient care

By Peter Betts

Pharmacists take on a key role in keeping Canadians healthy.

Managing drugs is a daunting responsibility. The average Canadian fills 10 prescriptions a year, a number that’s slowly rising with an increasingly aging population. However, the duties of the people who dispense these prescriptions, more than $31 billion worth, has drastically shifted in the last couple of years. The functions of pharmacists – from the education level to the workplace – is changing.

“Pharmacy is a bit in flux right now, but it’s exciting,” says Ruth Ackerman, president of the Canadian Pharmacists Association. “The profession is changing and the new students are being educated to provide a more enhanced level of patient care than we’ve ever had before.”

The traditional role of pharmacists conjures up images of men and women in lab coats behind a counter, dispensing medications and printing precisely worded labels to stick on the bottles. However, this isn’t really the case nowadays, says Ruth. “You may still be at the drugstore, but you might not be at the counter as much,” she says. There’s a new pharmacist-patient relationship, connecting the two in a meaningful new way. In places like Alberta, pharmacists now have the power to prescribe and adapt medication.

This new role also has pharmacists working more closely with doctors. In a hospital, for instance, they might more likely be on a sick floor than in the institution’s pharmacy. Pharmacists are also moving into doctor’s suites where they have their own office, make appointments and meet with patients. With these new functions come new opportunities, says Terri Schindel, associate dean in the University of Alberta’s faculty of pharmacy. “The talents, knowledge and values that people have are really quite diverse and I think there are so many options for your role in pharmacy. You could be a researcher. You could work in policy in government. You could work in education. You could work in practice in a variety of settings,” she says.

There are lots of pills out there. The pharmacist plays a crucial role as health care advisor. (Photo by: Gayl Punzalan)

While pharmacists can work in many places, as Terri describes, the most common are community and hospital pharmacies. According to the Canadian Association of Pharmacists, out of 31,000 licensed pharmacists in Canada, 22,000 work in community pharmacies like Pharma Plus or Shoppers Drug Mart. Here, the patient-pharmacist relationship is more personal, where you might see a client repeatedly over a few years. In a hospital, pharmacists usually work on a team with nurses, doctors and other health experts like dieticians. “I’m seeing people come through with a real desire to work with patients hands-on,” says Terri. “If you have a real commitment to that then this profession will serve you well.”

While salaries fluctuate immensely depending on the type of pharmacy and the province, most pharmacists are paid hourly wages instead of a yearly salary. For a community pharmacy this usually starts at around $50 an hour.

The road to a pharmacist’s career is not necessarily an easy one, though. There are around 11 pharmacy programs across Canada, where most students spend two years in other studies before completing their four-year bachelor of science in pharmacy. Getting into the program can be difficult. Only one in five students who apply to the University of Alberta program make the cut. Throughout the program Terri says students get a taste of the wider pharmacy community, completing a practicum in hospitals and the community to better understand the health care world. After graduating, aspiring pharmacists must submit to an intensive two-part exam before being licensed by their respective provinces. “It’s quite an ordeal,” says Terri. “The point is that it’s not easy to pass.”

However, with a shift in the profession’s focus, education is about to change gears as well, says Ruth Ackerman at the pharmacy association. Universities across Canada are on the brink of changing the educational requirements, adding a two-year doctorate of pharmacy after the BSc. This is aimed at better preparing students for the hands-on patient care happening in the field. “Just filling a prescription and being paid to fill a prescription was too much time on the product and not enough on the patient,” says Ruth. “Who cares about the paper? It’s about you and your medicine and how it makes you feel better.”

Because of these changes, the type of person who makes a good pharmacist is changing, as well. “When the patient comes into the equation, it’s about really strong communication skills because the patient has to understand you. You have to have sensitivity to the different beliefs patients have,” says Ruth. Terri agrees, saying although qualities like attention to detail were important in past, now it’s about how you interact with people and their values.

Having responsibility for patients is what drew Terri to the profession in the first place. She graduated from the University of Saskatchewan licensed and went on to work in hospital pharmacies across Canada. “I knew some pharmacists growing up and I really admired them as role models. I found that they had a pretty important role in the community as health care providers. A lot of people relied on them for advice,” she says.

Providing this advice is what makes pharmacy so crucial. “There are a lot of medications out there,” Terri says. “There’s risk in everything with medication and that’s why our role is so important.”

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