Y’know, sorry for being a bit late. You will have to take my word for it, but I had written an awesome blog a couple of weeks ago.Unfortunately, the wonderful system they provide where I work made it disappear, along with a day’s worth of documentation. Luckily, I print the latter out and give it to patients, so the record exists somewhere. I can’t say the same about my article.But now there is an election in Ontario. And like every other province, whenever there is an election pharmacists are waiting for the other shoe to drop. All of the provincial governments got on the austerity bandwagon a few years ago, where intruding on how pharmacists practise in retail became an all-out attack on the business models of the day.So today how much have those business models changed? Actually, a bit more in the last four years or so than for a long time since the late eighties when we could increase our fee every week and no-one complained—at least until someone complained.Indeed, change is happening. But is it the change we want to happen? The consolidation of pharmacy ownership is well under way (which, may I remind you, yours truly predicted almost 20 years ago in my very first article for Pharmacy Post).At the same time, tensions are rising between pharmacists and pharmacy owners as wages are attacked and unrealistic, unprofessional expectations are heaped onto frontline workers, who struggle to stand up for themselves, their patients and the value that they bring.Pharmacists are asked to trust that their employers will help protect pharmacy and preserve its integrity, as well as support an expanded role for the profession in the health system. It is fair to say that pharmacists trust owners about as much as they trust government.Associations are stuck in the middle, trying to keep the peace and present a unified voice for pharmacists to the public and to the elected ones who hold sway over our future. But because of the rancor, it is a diluted and muted voice.And when asked, pharmacists and pharmacy owners only seem to only agree on one thing – that the government of the day hates them.So what do we do in an election? The ill-fated tripartite arrangement of years ago in Ontario did nothing to impress government, although it did hasten the consolidation of pharmacy ownership (some also predicted that, but that is another story).Government consultants were brought in in droves, and those who didn’t say what people wanted to hear were fired and traded in for someone who did. Choices were made, and yet the largely myopic views of pharmacists in the day did not impress the regulators who, failing to hear better ideas, mostly continued on their merry path.And it is unlikely that any other government would have done much different, since every administration in every province did the same kind of thing regardless of political stripes.That is why asking a question about which party matters in an election year from the pharmacist’s perspective is a moot one. The right query is do pharmacists matter to any party in an election year.So maybe we should ask the right question. The party does not matter, so how do we matter? What do political parties care about? Right now their only goal is getting elected. What is going to get them the most votes?One government decides that cutting and slashing is good—not good for health care or pharmacists. Another one seems to want to stay the course, but that course has not been all that good for pharmacists in the past.And the other one says that they want to protect tax dollars, but have they offered any policy about pharmacists, or health care for that matter, to hang your hat on?There seems to be a tacit agreement between the parties that they won’t talk about health care because it is half of the money spent and, no matter who is there, they will be looking at shifting around the same or less dollars. In other words, no one is going to win with health care, so let’s not lose because of it since it is a no-win situation.Therefore, who is going to make politicians care about pharmacists? The answer is the electorate, because they are the ones who ultimately choose who the government is going to be.They take a long time to convince, though, and they are notoriously hard to educate about our side of the story. That said, have we ever really tried? Have we ever consolidated the goodwill and patient care into something they value enough to make a political choice?On the stick side, pharmacy tried scare tactics. But that didn’t work, as chains kept opening stores. They also cut staff, which in turn caused longer waits or limited access to pharmacists. Nonetheless, patients have such low expectations of us that it didn’t matter much.On the carrot side, we have taken opportunities like MedsChecks and other medication reconciliation, opinions and other expanded scope of practice things and underperformed magnificently. Some pharmacists even rip off patients with the infamous three-minute MedsCheck.And we wonder why nobody cares.So what will they care about? I have some ideas for next time—in the meantime, have at it.
