Coaching as care: The human role in pharmacy’s future

Imagine it’s 2035, and AI support tools have become a standard feature in most pharmacies, including yours. This technology has improved efficiency, reduced errors, and freed up time previously spent on tedious, repetitive and data-intensive tasks—both administrative and clinical. What now remains uniquely human about the pharmacist’s role?This incredible potential for innovation comes at a time of high burnout rates, with up to 79% of pharmacists at risk, according to a 2023 survey. This highlights an opportunity for us to actively envision the future of pharmacy and define a role that reflects the values we want our profession to uphold. As automation takes on technical precision, the pharmacist’s value must shift toward relational precision: the ability to build meaningful relationships, guide behaviour change and support patients through ongoing health coaching. The concept of pharmacist health coaching is not new: billable programs like GreenShield’s Cardiovascular Health Coaching have existed since 2015, and other cognitive services like Ontario’s MedsCheck programs go back even further. However, in contrast to most currently-funded cognitive services, health coaching involves iterative patient-centred goal-setting and feedback over weeks or months, mirroring the lived process of behaviour change rather a single consultation that occurs within the dispensing workflow. Pharmacist coaching also has a broader biopsychosocial focus, encompassing behaviour, motivation, lifestyle, self-efficacy and monitoring. While medication is part of the plan, it’s not the sole focus. Rather, the pharmacist health coach model invites the pharmacist to partner with the patient to set actionable goals, monitor progress, adjust strategies, and help sustain momentum with the goal of facilitating sustainable behavioural change.A proven means of supportThere’s already early evidence to support this model of care. In a community pharmacist-led health coaching trial of participants with poorly controlled hypertension, three monthly coaching sessions by trained pharmacists resulted in significant improvements in exercise behaviour, medication management readiness, and a mean reduction of 7.53 mmHg in systolic blood pressure. Another systematic review of pharmacist health coaching reported positive trends but mixed significance: some studies showed improvements in blood pressure, lipids or adherence, while others found little or no effect, a variation attributed to differences in coaching intensity, duration, patient baseline risk, and settings.The studies cited above suggest that pharmacist-led coaching can improve patient behaviours and outcomes, highlighting a meaningful opportunity for coaching in the evolving pharmacy landscape. Yet the reality is that our funding models still measure output over patient outcomes, and major changes are needed to make coaching feasible. Early utilization of GreenShield’s coaching program was limited, likely because existing workflows limit pharmacists capacity to provide longitudinal coaching. Rather than being a solo feat for pharmacists, health coaching would overlap with physician‑ and nurse‑led models, which exist in Canada but currently remain limited to pilot programs or niche primary‑care initiatives. Ultimately, without reimbursement reform and collaborative system design, calls to “do more” risk adding to burnout rather than advancing care.To evolve, our systems must begin to value the unseen work of relational care as much as dispensing. Coaching would allow pharmacists to help patients connect medication management and clinical insights to their daily lived experience, resulting in meaningful lifestyle change. We know that health is more than the absence of disease, and that lifestyle change is often where the greatest impact occurs for chronic conditions. In my experience as a pharmacist, caregiver, and yoga practitioner, integrating prevention and lifestyle modification support into our fragmented and overburdened health care system is urgently needed.In yoga, we learn that awareness and presence—capacities that no machine can replicate—are powerful tools for engaging the body and mind. Perhaps the next evolution of pharmacy isn’t about keeping pace with automation, but about focusing on what only humans can do: witnessing, supporting and cultivating the kind of attuned relationship that transforms care through connection.