Clinical procedures, money, patient relations: What a survey of Quebec pharmacists found

With Bill 67 expected to soon come into full force, pharmacists employed in community settings are concerned about the increase in their clinical responsibilities, without any real reduction in their remaining workload or salary compensation, as well as the pressure related to public expectations.This is what the Professional Association of Salaried Pharmacists of Quebec (APPSQ) reports in its 2025 Survey on the Compensation, Work Environments, and Overall Health of Salaried Pharmacists in Quebec, a member version of which was reviewed by Profession Santé.This survey was conducted between Feb. 13 and April 13, 2025, and collected responses from 762 APPSQ members, including 601 salaried and locum pharmacists—58.2% of whom were full-time community pharmacists (≥ 30 hours/week), 10.3% locum pharmacists, and 10.1% practicing in family medicine groups. Most, 97%, of respondents indicated they work under an affiliated chain or banner.An increasing workloadAs with the previous survey, one of the key findings of this edition is the workload, which is "often" considered too high by nearly 45% of pharmacists, with an average volume of 20 to 40 prescriptions dispensed per hour on weekdays for two-thirds of respondents—while the APPSQ sets a maximum of 30 prescriptions to ensure the quality and safety of patient services.Furthermore, more than half of the respondents report carrying out between 15 and 30 consultations per day, a load considered "often" too heavy for the majority of respondents.Above all, almost all of them (97.7%) report an increase in this workload over the past year, mainly due to the increase in the number of additional procedures, the increase in the number of MVL advice, the increase in stockouts, the increase in prescription volumes, and the lack of qualifications of pharmacy technical assistants—the main obstacle to delegation according to the survey results.The result: extended hours for pharmacists employed in community settings. Indeed, two-thirds (61.3%) of them extend their shift at least once a week, most often by 10 minutes to an hour.An unrealistic compensation modelHowever, these increased responsibilities and new clinical procedures do not always have an impact on the compensation of community pharmacists. The vast majority of them (over 75%) receive, "no percentage of the revenue generated by billable procedures, even though this represents a new workload," the survey indicates.The APPSQ emphasizes that compensation models are no longer adapted to the reality of frontline healthcare needs and demographic pressures, since the average hourly wage of community pharmacists will reach $69.30/h in 2025, an increase of 1.8% compared to 2023, but still lower than the increase in the CPI.Although the majority of pharmacists acknowledge that their work environment provides favourable conditions for intellectual stimulation and for building good relationships with colleagues and patients, several reports still report progressive exhaustion linked to work overload, a loss of meaning, a feeling of helplessness, or even, "a dilution of clinical judgment in demanding, high-volume environments."Furthermore, the APPSQ emphasizes that, "The lack of time to explain, the fear of being compared, and the inability to protect oneself from emergencies explain this oppressive climate."Another major factor, according to the association: the implicit pressure felt by pharmacists. While 88% of them admit to having no formal objectives, they cite implicit performance expectations, particularly regarding billable clinical procedures, as well as an informal performance culture centred on billing.The consequence of this exhaustion, with 58.2% of pharmacists reporting symptoms of depression or anxiety, diagnosed or not, related to work, and 15.6% suffering from insomnia.That said, the majority of workplaces appear to have implemented tools to reduce the burden on pharmacists. First, there are measures aimed at patients: 87.9% of workplaces offer prescription refills online or via an app; 77% offer automatic refills; and 57.7% offer appointment scheduling for non-urgent procedures.Then there are technological measures, such as pill-counting robots, electronic task calendars, and electronic internal communication systems. Finally, the responding pharmacists indicate that their workplaces have also implemented organizational measures, such as daytime consultations with return calls (54.5%), the presence of a nurse in the pharmacy (54.1%), and defined time slots for the clinic outside of dispensing (38.5%).Patient pressureParticipating in these demanding work environments, patients themselves exert pressure on most employed pharmacists, according to the APPSQ survey. Indeed, 66% of respondents say they experience direct pressure from patients, 64% identify unrealistic or conflicting expectations and 61% mention a sense of moral obligation in interactions.This pressure from patients, tolerated by the employer, is one of the factors that can hinder professional independence for one in three pharmacists—the main factor cited being the working conditions themselves, including lack of time, a stressful environment and limited resources.Furthermore, more than one in two employed pharmacists say they have experienced verbal abuse from their patients in the past three years.It must be said that, despite their requests to optimize workspaces for greater privacy, the layout of community pharmacies generally does not allow professionals to work out of patients' field of vision.Thus, workstations remain "always" or "most of the time" within view of patients (82.2%), and less than half of employed pharmacists report being able to "sometimes" access a clinical workstation (analysis and validation of records, telephone consultations) allowing them to concentrate on providing pharmaceutical opinions, analyzing records, collecting DSQ information and communicating with patients by telephone.

Clinical procedures, money, patient relations: What a survey of Quebec pharmacists found

Register for free access or login.

Related Topics

Business Topic