Y’know, we pharmacists have long lamented our state of affairs and how we are underutilized, unappreciated, and not integrated with other health professions the way we should be.There seems to be an undercurrent of feelings that it is time to do something. There is, of course, the question of what can we do, and what should we do.Here's what I am going to do. I am going to ask my provincial association to start to represent pharmacists and their professional practice, and in particular community pharmacists, because that is where most people are practising.I am going to ask them to stop representing pharmacy owners, because they are the barriers to this profession actualizing its great potential.I could wax long and poetic about all of the reasons this has happened—the commoditization of our professional service, the devaluing (through waiving and discounting) of our professional contribution as if it were toilet paper on sale on an end aisle, the struggle to be new and innovative when myopic retailers cannot see the benefit of fully engaging a profession whose very breast they have leached off of for years…Or I could just state the obvious. It has not worked so far, and we are getting farther behind our colleagues in other professions in integration and recognition, and now in payment as well.A pharmacy owner and a pharmacist are fighting over the same dollar, and yet our associations try to represent both. Nice try, but it does not work.Does the Ontario Hospital Association represent physicians? I don’t think so. (I apologize for being Ontario centric but the analogies are across the country, I believe.)Pharmacy owners want profit and growth. Good for them. Pharmacists need to realize their professional goals and work to the benefit of patients and their health outcomes.The pharmacist needs to be the buffer between the patient and the uncaring retail marketplace (don’t confuse marketing with caring) and advocate for what the patient needs for their health, not just what corporate profiteers want to give them.The wage cuts we are seeing are a smack in the face for the future of our profession.New pharmacists are here to join the effort in a health system with an increasing demand and need for them to practise to their full potential, not to create a glut to discount the worth of that practice.The young and those coming to Canada looking for better lives are particularly subjected to these cuts—talk about preying on the defenseless.I am going to ask my provincial association to protect everyone’s wage, including that of pharmacy owners, by whatever means available and necessary. Right now.And then I want pharmacists to receive direct payment for all professional services, including dispensing, as well as all proceeds from that function including margins, and revenue from pharmacy only sales through to all clinical activities.That way the pharmacist has the discretion to advocate for the patient.This actually helps owners, because the pharmacist becomes fully engaged in patient care and activities that provide reimbursement.It helps payers and government, because the responsibility for professional service rests with the individual who is providing it.And it is in patients’ best interests, because they get what they need from pharmacists.This works for lots of professions—doctors, lawyers, and accountants for example.And professionals being paid directly can work attached to retail environments. Witness the physicians and other clinicians’ offices being launched in large retailers with pharmacists attached (I am pretty sure the doctors get paid in their name).I am going to my annual meeting to make this proposal, in the form of a resolution.In Ontario, we can ask for resolutions about how our association conducts itself—we all have a say.I am curious about who would vote against pharmacists gaining control of their own destiny. Surely other pharmacists wouldn’t object.If we want to make sure we are heard and unified, maybe the first step is to tell our associations what they have to exist for the benefit of our profession and those who practise it.I don’t know if it will work, but it is our chance to take back our future. We will see how pharmacists respond.Ken Burns is a pharmacist at the Diabetes Care Centre at Sudbury Regional Hospital.
