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I’ve been hearing a lot about the issue of professionalism in pharmacy lately. There are two sides of this issue…
On one side, I hear some leaders in the profession say that we have too many rules, and that we should just rely on the professionalism of pharmacists and technicians to ensure that the public is well served. They assert that no professional would ever do anything that would jeopardize a patient’s health, so we should have fewer rules and leave it to their judgment. Fair enough. I agree…at least for the majority of us who are dedicated professionals.
On the other side, we have pressures on pharmacists and technicians to maximize their productivity, and not to do anything that takes time, and isn’t billable. I hear from many pharmacists who say they would love to do more for their patients, if only they could be paid for it. Or that the College should make more things mandatory so their bosses or owners would support them to meet the standard. In the same way, I’ve heard that pharmacists aren’t able to implement advances in their practice unless the College requires it, so they want more rules!
Then I reflect on the pharmacists whose situations have come across my desk. Complaints that have gone to the Inquiry Committee, and through its deliberations, uncover a lack of professionalism. Why does that happen? How did they get there? If they had been professional, we wouldn’t need any rules! Even the recent College decision that community pharmacies have time delay safes, highlights the need for rules. I have no doubt that without the College Board making this decision, the situation would have continued to escalate, and more and more pharmacy professionals would have been the victims of a robbery.
When we implemented the policy, we consulted with pharmacists, technicians, law enforcement, security experts, and others about what we could do to reduce the number of pharmacy robberies. It was clear that time delay safes needed to be brought into all pharmacies, but without a College requirement, it wasn’t likely to happen even though some were already using them. Similarly, we hear that unless we require that pharmacists do things like talk to their patients, they won’t do it, or that their bosses won’t allow it…so we need to make a rule to be followed. So what do we do? Over-regulate, in order to support pharmacists and technicians to do the right thing? Or, stay silent and assume that all pharmacists, technicians and employers would do the right thing for patients, even though it might cost the business some money?
I was recently at a presentation by Harry Cayton, of the Professional Standards Authority in the UK. He speaks about Right Touch regulation. This means that we don’t over or under regulate. We try to find the balance between making rules and allowing for professionalism to be applied. We are trying to do this at the College; finding that balance for clarity and to be supportive, but not overly prescriptive about the details.
In the past few weeks I’ve also received two personal letters from pharmacists. One had their license revoked as a result of discipline, and in an unrelated case, another pharmacist voluntarily surrendered theirs. Both pharmacists indicated to me that they viewed the pharmacy profession as one of the highest integrity, held it in high regard, and they were sorry to be leaving. I respect that despite their situations, they still hold the profession in high regard and want to do the right thing. Interesting circumstances, but I would consider this final act to be a sign of professionalism in the end.
Our professional values and ethics define us, and we should take care to regulate ourselves to do the right thing for our patients. I believe that the majority of us do. The College is here to support pharmacists and technicians to serve the public well. We need to consider how to achieve right touch regulation. The College wants the profession to advance as a whole, but we also need to ensure that everyone meets the standards. We cannot under regulate one group and over regulate another in order to accomplish that goal; there needs to be a balanced approach. The College sets standards to frame the pharmacy profession – we leave it to pharmacists and technicians to fill that frame though their own best practice.
Best,
- Registrar
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