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Thursday, December 9, 2010

Pharmacy Profession changing by Force?

Pharmacists deserve a more democratic governing model.Written by Cristina Alarcon on November 3, 2010 for CanadianHealthcareNetwork.ca

I hope Manitoba pharmacists realize just how lucky they are. Their Governing Body, The Manitoba Pharmaceutical Association, is one of a kind, a pearl to be prized…

As reported for Drugstore Canada by Judy Waytiuk, Manitoba pharmacists are one of the only Canadian health professions with individual voting authority over their practice regulations. This is unlike the rest of Canada, where the regulatory body consults on, sets and implements practice changes.

And so, lucky Manitoba pharmacists get to voice their concerns on important issues ranging from technicians’ scope of practice, to prescribing authority, to a position on inducements.

Input is not merely advisory in nature, and pharmacists get the respect they deserve…

True, the Manitoban-democratic-approach can potentially slow down and—to the horror of policy drafters—squash brilliant initiatives. But pondered delay is not only salutary, it is essential.

Sure, asking for full membership participation in proposed regulatory changes would be a tedious, time-consuming task, but as the Manitoba experience shows, the licensing body is better off for it.
Never is this truer than when clouds loom dark on the horizon, something not uncommon in British Columbia… where, in fact, an event of unprecedented importance took place this year….

Welcome to Vancouver EGM 2010
At the petition of 500 community pharmacists, an Extraordinary General Meeting (EGM) was convoked by the College of Pharmacists of British Columbia and held in Vancouver on July 13, 2010. Over 160 pharmacists from across the province took great pains to be present in order to voice their concerns over regulatory changes that will make technicians a new class of College registrant, authorizing them to perform final prescription checks and take verbal orders from physicians.

Highlighting this event was the resignation of Board members Doug Kipp and Bev Harris, who courageously stepped down—later to be re-elected in landslide wins—so they could speak out freely against College policy changes, bypassing a newly reinforced rule requiring all Board members to “Speak with One Voice” .

Later, the tidy Board-approved minutes would fail to capture the lively exchange that transpired on that historical July evening when over 160 pharmacists took the College to task, leaving those who were there with a taste of Orwellian Double-Speak…

There, a resolution was presented calling on the Board to “reconsider its decision to establish the profession of Regulated Pharmacy Technicians for community pharmacy”. It was supported and passed by an overwhelming majority.

Attendees were reminded, lest they forget, that due to the College’s overriding mandate to protect the public the vote would be only advisory in nature. However, they added, results would be given “due consideration” at the next regularly scheduled Board meeting in September. Pharmacists did not hold their breath.

Come September…
On August 1st, just weeks after the EGM and over a month before the much-awaited September Board meeting, Ministerial approval of revised HPA Bylaws (inclusive of regulated pharmacy technicians) came into force. The changes will allow the College to bulldoze ahead in the New Year as planned, leaving pharmacists with the impression that “due consideration” of their resolution had never really been intended at all.

Having previously resigned her position, Bev Harris attended the September 24th Board meeting as an observer. “It all took about 30 seconds,” she told me.

The BC College of Pharmacists’ Board consists of elected members and non-pharmacist government appointees. At this meeting, one non-pharmacist moved the motion that the College go ahead as planned with technician regulation. This was seconded by another government appointee. The majority voted in favour, and so, it was…

No discussion ever took place.

And so it is that, in spite of unresolved concerns, the final step in the approval process regarding the legislative authority to register pharmacy technicians as registrants of the College of Pharmacists of BC is now complete.

After only eight months of training, technicians will be allowed to perform final med checks and take verbal orders. Meanwhile, pharmacists’ concerns—ranging from liability, to employment loss, to patient safety—remain unaddressed.

In all fairness, the College has expressed the need for “further communication and support to help manage change”. However, there is something terribly wrong with a professional governing body that appears to listen but fails to act on the concerns of its registrants, seeking instead to impose change by force. Alienation is the only possible outcome.

Re-education anyone?

Sure, asking for full membership participation in proposed regulatory changes would be a tedious, time-consuming task, but as the Manitoba experience shows, the licensing body is better off for it.

If anything, a more democratic governing model would ensure that our yearly dues were better spent. It would also shield the governing body against perceptions (however unfounded) of government run amok.

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