Thank you very much, Mr. Chair.
It was a very excellent presentation from all of you and I do support the concept of scope of practice expansion with pharmacists working in a team setting. However, I just wanted to pick up on some of the things that Mr. Lizon asked earlier on. I think I agree with Mr. Lizon. I believe that the ability to diagnose a patient is a scope of practice for a physician.
I have myself been the beneficiary of having my asthma medication quickly given to me from the pharmacist when my doctor has been away. I understand that this is all very appropriate scope of practice.
There is one thing that I keep hearing and so I wanted to ask about it. If someone walks into a pharmacist office and as Mr. Lizon asked, had what seems like a cold, it's very easy to say well let's give them some antihistamine, some Tylenol to bring down the fever, etc. Is that appropriate practice, however, if one hasn't had the ability to be in touch with the family physician or the attending physician to find out if that person has other coexisting reasons or is taking other kinds of medication? It may be inappropriate to give the kinds of medication you may be giving them.
For me, that ability to talk to each other before giving any kind.... Even over-the-counter stuff, as you well know, can be harmful if somebody is taking medication that's going to be contra-indicated to take those things. How does that happen if somebody just walks in? This isn't a patient you've always seen, somebody you've talked to the physician about on a constant basis and therefore shared the history and shared the knowledge about the patient.
That's the first question I want to ask. How does that work and what are the risks of that kind of practice?
The second thing is, and this is the one that I've heard possibly from physicians and others, so it's a biased question actually.... I'm just asking it because I really would like to hear the answer and I'm sure you have a good one. Is it because pharmacists, generally speaking, tend to benefit directly from prescribing anything or giving anything even if it's over the counter because they also own or run the pharmacy or drug store? Anytime they give anything, they get a financial benefit from that medication.
What are the ethical guidelines? Maybe the college might answer that better.
What are the ethical guidelines put in place to ensure that pharmacists are not being pushed from monetary gain only to make sure that everybody who walks in and has something, gets a medicine, over the counter or otherwise? That's a big question in terms of the ethics of it. I don't know if you have ethical guidelines on that. I don't know how one tracks how that works. Of course, the prescription fee that one gets for dispensing and all that.... I can see all of this working so well in a community care setting, as you said.
But I just wondered if there is a way of looking at how that ethical guideline is observed. What are the ways that one is ensuring that those monetary gains are not made from pharmacists who may or may not...? We've got doctors who do all kinds of things that they shouldn't be doing. I'm asking the same thing. How do you monitor that and make sure that there isn't medicine being given every time somebody walks in even for a little cold because one gets a monetary gain from it? So that's the ethical piece I wanted to talk about within the scope of practice.