What are the pros and cons of a pharmacist?

Should the US allow the practice of legally buying prescription medication after a consultation with a pharmacist? What are the pros and cons?

• In places like Hong Kong, you can consult with the pharmacist and legally buy some prescription medicines including antibiotics so you can avoid the trouble and expense of seeing a doctor.

• Answer:

  I agree somewhat with your answer.  Here in Canada, the provinces and territories are moving forward with a large-scale practice expansion for pharmacists. If anyone would like more information on it, just Google "Blueprint for Pharmacy" and you'll get more than enough hits. The extended scope of practice varies from province to province, but here in my home province of Manitoba, one of the new tasks that pharmacists are allowed to practice is the prescribing of certain drugs.  After completing additional training, currently practicing pharmacists are allowed to prescribe from a limited list of drugs for a variety of minor ailments. An example of this would be prescription-strength hydrocortisone cream for a person with a flare of eczema. If they complete another extra course, they are allowed to prescribe certain drugs for smoking cessation. This would include the well-known prescription medication Champix (varenicline). Personally, I think this is a great step forward in health care for Canadians. And I don't just say this because it means I'll get to "play doctor" in the future (I plan to work in a hospital setting, which means I would never need this course as I'd always be able to page an on-call doctor for a verbal order). I say this because it stands to vastly improve the way Canadians access healthcare. Pharmacists are one of the most-trusted and most-accessed healthcare professionals in Canada. Across the country, many people trust us for our professional knowledge of both prescription medications as well as more common minor ailments, like athlete's foot or a head lice infestation. We are seen as approachable, and the extended hours of most pharmacies means we are available when your child gets a fever in the middle of the night to help you dose Tylenol, a time when your child's doctor's office is closed. That is not meant as a shot against doctors, because they are some of the hardest-working professionals I know, and deserve great respect. However, the unique accessibility of the pharmacist puts us in a prime position to assist patients with both acute and chronic healthcare needs. Since the current regulations only allow prescribing of certain drugs for certain ailments, I believe it creates a good balance. We are allowed to help our patients in situations we can handle, and this helps reduce burdens on the healthcare system. For example, following the eczema example above, a patient who has had eczema for 15 years and is experiencing all their normal symptoms of an acute flare, and who can't get in to see their doctor for 2 weeks, now has the option of visiting their pharmacy for treatment, rather than waiting hours at a walk-in clinic or emergency room. Pharmacists are not only trained to recognize the treatable symptoms of an ailment from the pre-set list, they are also trained to recognize red flags that would warrant treatment from a doctor, such as pus leaking from the eczema area or fever that would indicate infection. We are also able to renew/extend prescriptions, especially in emergent cases. If a patient was leaving on a week's vacation and had run out of their blood pressure pills with no time to see the doctor before they left, we are qualified to give them short-term refills until they can next see their doctor. We are also able to order and interpret lab tests, for example to check drug blood levels to see if the patient is compliant, or if we should work with the physician to adjust dosing. Antibiotics are not on the extended practice list of drugs we are able to prescribe. This is because we know as well as physicians do that they are over-prescribed. In fact, I see pharmacists frustrated every day in the hospital that I work in because antimicrobial therapy could be more optimized to help prevent resistance. Physicians also are the correct medical professionals to be assessing infections for their severity and potential for hospitalization, etc. That's something a pharmacist isn't qualified to do. We also understand that there is no way we can manage a complicated depressive patient, or patient in heart failure, alone. That's why we're part of a healthcare TEAM, with the physician amongst others, to optimize healthcare for these patients. We're trying to make patient's lives easier, both by improving their health as much as we possibly can, and by improving convenience wherever we can. No pharmacist with any shred of professional judgement would attempt to manage such complicated conditions alone. In the USA, the healthcare system is very different from Canada. I'm not sure if all the reasons I outlined above are applicable to the USA, and the struggles you face with healthcare there. In Canada, the main problem as I see it is accessibility, and pharmacists are in a prime position to help improve this. Doctors and pharmacists need to learn to play nice together... we are both in this for the same goal: to help the patient.