Y’know, with the scope of practice changes coming by varying degrees for pharmacists in each province across the country, one of the questions being asked is, who should be prescribing medications (or recommending a pharmacotherapeutic pathway) for patients?I’m a big fan of analogy—we use it all the time as a way to help patients understand the complexities of disease pathophysiology and pharmacology. It’s a simple way to share information that comes from our complex knowledge but that does not fit a patient’s frame of reference.So I was thinking, what if a patient asked me about how prescribing works today, how should it work, and why are things the way they are? Here’s the analogy I’d use:Chefs are professionals. They went to culinary school to learn the science of food. They studied not just the safe preparation of food, but how to assemble different flavours, textures and spices that work together.They also discovered what doesn’t work together, and why. They learned how to assemble these into a meal, and how to translate meals into a plan for food preparation and delivery over a period of time to a specific and particular clientele.Now, there are also many people who know how to cook. They may be good at a certain dish, or a few dishes. They may have even taken a cooking course, or specialize in a genre, like Italian or Asian food. They can follow recipes in a cookbook.But cooks aren’t chefs. They don’t have the comprehensive and holistic study and experiential background to adapt to changes in gustatory trends and behaviours, or to address special or unusual wants and needs or to customize, when necessary, for individual diners.In the world of pharmacotherapy, pharmacists are the chefs. There are plenty of other cooks in the kitchen—and there is nothing wrong with that, except that, due to the minuscule amount of pharmacist engagement in the world of prescribing, on the whole, people are not eating nearly as well as they could be.Ciao.Ken Burns is a pharmacist at the Diabetes Care Centre at Sudbury Regional Hospital.
