In a quiet consultation office at Clarke’s Pharmacy, local pharmacist Jaden Brandt spoke March 17 with Kelly Bindle, the Progressive Conservative candidate for Thompson in the April 19 provincial election, to outline the financial and policy challenges which pharmacists in Manitoba hope to see addressed in the coming election.
Brandt, a lifelong Thompsonite who sits on the Pharmacists Manitoba board of directors as chair of membership services, noted that as Manitoba faces an increasingly burdened healthcare system, policies have prevented pharmacists from fulfilling a much-needed support role in the healthcare system. Universal healthcare means most Canadians aren’t used to being billed for the majority of their medical services. But pharmacy remains rather firmly in the private sector, especially in Manitoba, which Brandt believes has prevented pharmacists from providing relief to an increasingly burdened healthcare system. “Pharmacy is an industry that’s very product-oriented, not so much focused on filling in the gaps where physicians are not able or have the time. We have an aging population, and physician wait times are becoming too long. Physicians should be focused more on the complex cases that pharmacists aren’t able to manage. A person shouldn’t have to spend three hours in a waiting room just to get an acne medication.”
Patients can, in fact, come to pharmacists for a variety of services, such as medication reviews, vaccinations or the treatment of minor ailments. But while much ado has been paid to the coverage of medications themselves, the cost of services provided by pharmacists has been almost entirely overlooked in Manitoba: Brandt pointed out that many insurance companies will not cover the consultations required for such things as minor prescriptions, pushing many individuals back into the overcrowded waiting room of the walk-in clinic.
Brandt provided an infographic outlining several pharmacy services that are subsidized by provincial governments across the country: medication reviews (standard, comprehensive, and diabetes-specific), minor ailment assessment and prescribing, smoking cessation services, immunization, and prescription adaptation and renewals. Out of these services, Manitoba came in dead last for service coverage: only vaccinations were provincially funded, a service which Brandt notes is one of the last things he’d want the government to prioritize: “I’m happy that they’re covering it, but I say leave that to nurses and doctors: they’re the ones that are better trained to provide injections. Let me handle the medication management, and retain my professional role.”
Pharmacies are currently paid $7 per vaccination by the province, which according to Brandt, hardly constitutes incentive to provide them as a primary service. “Cost-effectively, my time is better spent behind the counter, counselling patients and running medication management.”
But where Brandt sees the most room for improvement, and indeed, the most need, is patients under federal jurisdiction, particularly First Nations groups in remote communities. Physicians travelling to remote communities are often overwhelmed with the number of patients seeking aid in the short time they have, leading to a diminished quality of care per individual. There’s also no guarantee of continuity: a visiting physician will have little idea of a patient’s history, and the treatment prescribed by the doctor before him. For Brandt, pharmacists have the potential to bridge the gap between patients and physicians in these scenarios. But in communities often rife with poverty, the need for subsidies once again rears its ugly head: “If I’m to sit down and do a medication review for a patient, and charge a reasonable $120 for a care plan that will stabilize them for the next six months, that review has to be paid for somehow, and it probably isn’t coming from the patient’s pocket.”
Brandt extended invitations to both Bindle and current NDP MLA Steve Ashton to hear his case. While Ashton could not be reached, Bindle agreed that more had to be done to provide more options in healthcare for Manitobans: he says that Manitoba does, in fact, have the longest hospital waiting times in Canada, and arguably the whole world. Bindle stressed his role was a liaison, but he did note that part of the PC platform was to recruit a task force charged with reducing hospital wait times, in which pharmacists could play a powerful role.