CEO Blog

March 28, 2022

Our healthcare system is fumbling, and our star quarterbacks are on the bench

By Renato Discenza

Illustration of football players

Imagine being in a crucial contest like the Superbowl. The stakes are high; it gets down to a final big play. You look at all the talent you have on the bench and need a field goal. You have a star field goal kicker, who has trained, practiced, and can get it through the uprights for you. You send them out for the big play, but then the ref tells you: “Sorry, I know you have a capable and trained athlete that can do the job, but because the Superbowl is being played in this state we don’t allow kickers to go for field goals… they can punt… but sorry, no field goals… not here.”

Frustration? Well, yeah!

Sometimes that is how I feel about the talent we have in our healthcare system. We have clinicians trained to do more than we allow them to do in some jurisdictions. When we think about the Health Human Resources (HHR) crisis in our system now, it seems like we are keeping some of our healthcare athletes on the bench for some plays that they can deliver upon.

Among the clinicians that are affected by this are pharmacists. Pharmacy Appreciation Month is a great opportunity to recognize the incredible work achieved by Pharmacists and Pharmacy Technicians, as well as discuss the opportunities that exist to further capitalize on their experience and expertise as we tackle the broader question of efficiency in care.

The COVID-19 pandemic has been an eye-opener for healthcare systems across Canada and around the world. In a recent article which appeared in CBC, the Ontario Medical Association “estimates the pandemic has delayed 21,000,000 patient services, including surgeries for preventative care to cancer screenings to diagnostic tests.”[i] That number includes a backlog of 1,000,000 surgeries in Ontario alone. In Manitoba, a surgical backlog of over 161,000[ii] was recently reported.

Part of the solution must be to reallocate the expertise in the system possessed by non-physician clinicians to address non-critical care, freeing up valuable resources. Allowing clinicians to work to their “full scope of practice” is a vital strategy in combating the HHR crisis. There is no point in training more clinicians if we are not willing to allow the existing ones to work to their fullest potential. This is a waste of training and opportunity. Also, it may limit the personal fulfillment of people who invest in this career path.

I see similar missed opportunities in using nurse practitioners, paramedics, support technicians and others. We are seeing some progress on better using our healthcare professionals, but it is inconsistent and spotty. If we look at the chart below, we see the allowable practices across Canada for pharmacists. The disparity from Alberta, where pharmacists have the widest scope of practices, to other provinces where the same pharmacist cannot perform the full scope of practice, highlights the problem. Similar inconsistencies exist in other healthcare professions. The act of simply crossing a provincial boundary suddenly restricts a trained professional from doing what they can safely do. It limits the delivery of care and hinders professional mobility across Canada.

Chart of Pharmacists scope of practice in Canada

Full document available

Addressing delays in our healthcare systems across Canada means we need to be ready to find efficiencies and innovative solutions. Status quo isn’t an option. We need a multi-layered approach, which includes allowing all clinicians to expand their work to the full and safe scope of practice. Nurse practitioners, pharmacists and paramedics can do more than we currently permit them to do, and we should allow them to use the full range of their training and skills - we need them. This reallocation of expertise could also contribute to creating more intimate and patient-centred care as physicians spend valuable minutes with patients in actual care, and less in administration, logistics, and internal processes that add little value to patient outcomes.

The expertise of our in-house Pharmacists and Technicians is highly valued by our member hospitals. As HealthPRO continues to expand our pharmacy contracting portfolio, recently surpassing $1 billion in national spend, the clinical expertise of our Pharmacy team is invaluable. Just recently the Pharmacy team evaluated over 3,000 individual product labels and packaging for potential safety concerns. For example, we started flagging look-alike labelling on common anesthetic drugs to be remedied before they make their way into the hospital. We rely upon the expertise of pharmacists to make frontline care safer before medications are even delivered. Pharmacists are valuable assets in the field that can expertly offload certain tasks across patient care. The Canadian Pharmacists Association rightfully states: “Canada’s pharmacists are doing more for their patients than ever before, but they continue to be an underutilized healthcare resource in many parts of Canada.”[iii]

Nova-Scotia’s Health Authority as an example is “collaborating on two walk-in clinics using a nurse practitioner and pharmacists to give more access to people without a primary-care provider.”[iv] The province is taking full advantage of the expertise of clinicians like pharmacists, and it is putting it to good use while offloading non-urgent care calls from hospitals.

Pharmacists proved critical in the field during COVID-19. Improving our healthcare system means rethinking how care is delivered in communities across Canada. That means we should not hold these professionals idle when they can contribute more.

Canadian Healthcare must enter a post-COVID-19 chapter of renewal. This new chapter must recognize the full potential of clinicians across the sector, including pharmacists.

Given the backlog of procedures and healthcare that has not been delivered during the last two years of COVID, the seconds are ticking for people who need care. Let’s make sure we get the best talent on the field.

It’s Go Time!