Pharmacy in health care
HEALTHCARE
MONEY IS ONE PROBLEM
PHARMACY CAN BE ONE ANSWER
It is my belief that there is an UNWRITTEN AGREEMENT between health care colleges that they should avoid interference in one another`s affairs and jurisdictions.
It is my belief that physicians feel that no changes should be made in their area of jurisdiction.
It is my belief that the cost of health care under present conditions is unsustainable.
Health care spending is set to reach its highest level ever–$171.9 billion this year or $5170.00 per person growing faster than the economy and outpacing inflation. Hospitals account for the biggest share at $48.1 billion but their 28% of the total budget is in decline. In 1975 hospitals accounted for 44.7% of the total health care costs.
Spending on drugs, both prescribed and over-the-counter, continues to rise and is at $30 billion or 17.4% of the total—double the amount of 1975. Physician’s costs remain the third biggest cost at $23 billion.
The Regulated Health Professions Act (RHPA), an Ontario piece of legislation, is an omnibus or umbrella law which applies equally to 23 health professions. Essentially this act governs the relationship between the Ministry of Health and Long Term Care and the professions as governed by their colleges. The colleges are established under a health professions act and supervise the practice of the individual professions. In this act (RHPA), “minister” means the minister of health and long term care and it is the duty of the minister to ensure that the health professions are regulated and coordinated in the public interest.
The Pharmacy Act is the legislation governing the profession of pharmacy and the governing body is the Ontario College of Pharmacists. The members of the council of the Ontario College of Pharmacists that govern the profession are elected by the pharmacists by district. In the last few years the government appoints some members from the public and very recently up to four members are persons who hold a certificate as a “pharmacy technician” or “pharmacist assistant”. The major problem today involves the pharmacists and the technicians who are employed by corporations that have no real interest in the profession or for that matter in helping the government provide good health care at minimal cost. The new jobs engaged in by the pharmacist pays the corporation not the individual pharmacist. Each individual pharmacist does not have a “billing number” This must change to give the pharmacist an incentive to learn more skills.
The work load of any profession is governed by law and by tradition. A change within the professions and between professions is not easy to accomplish and usually leads to dissension. The provincial government tries to avoid getting involved, but sometimes they do act. To-day when you need dentures you can go to a denturist. This was not always so. In my youth you had to go to a dentist, who measured your mouth and the work went to a dental laboratory. The laboratory employed skilled technical people who formed the dentures, and then the laboratory sent them back to the dentist for fitting. The professional work was done to a great extent outside the dentist`s office but the dental profession did not want to give up control and money. They argued that without their input the dentures would be inferior. After a long and bitter fight with the profession of dentistry the government relented and denturists became a profession with their own college. Dentures produced to-day are just fine.
Very shortly the senior population, including the baby boomers, will sky-rocket, along with health care costs The pharmacist is in a unique position to give quality health care for less money.
Some doctors to-day require an office visit to repeat a presecription, at an extra cost. The pharmacist can take on that job. Doctors are in the habit of using newer more expensive drugs when the old ones will do the job. The pharmacist can advise if the change is warranted. Minor ailments can be examined in the pharmacy by the pharmacist and then sent on to the physician if necessary. It would require some extra training for the pharmacist but the savings could be immense.
To-day the work done by all health professions should be examined to see if the services can be performed by other professionals at a lower cost
