'Counsel has been retained': Ontario college takes zero-tolerance stance against corporate pressure on pharmacists

The Ontario College of Pharmacists (OCP) has adopted a zero-tolerance stance against unethical business practices such as quotas on medication reviews, after an online survey and a series of town halls revealed “compelling” information about corporate pressures in pharmacy practice in the province.“We heard that pharmacists’ concerns about inappropriate pressure to conduct MedsCheck reviews is a symptom of a broader issue involving corporate influence that diminishes their decision-making autonomy as healthcare professionals,” the college’s registrar and CEO, Shenda Tanchak, said through a March 25 press release. “We heard that volume-focused corporate pressure results in sub-optimal care and a greater risk of error,” said the release, which the college issued following a board meeting to discuss the results of the town halls and the surveys. “And we heard that these pressures affect the well-being of pharmacists who fear, or experience, reprisal if they fail to meet corporate objectives and whose health is suffering due to the tension between trying to deliver high quality care to their patients while coping with corporate pressures to increase the number of services delivered.”The college has retained legal counsel and is now “looking at all the legal options presented by the information we have gathered. We anticipate that this will most certainly include but not be limited to appointing investigators to investigate any ‘corporate-centric’ interference in registrants’ professional independence which are deemed to fall within our regulatory purview.”Read: The question of quotas: As pharmacists wait for answers, Ontario's Health Ministry responds with the status quoOf the nearly 4,300 pharmacy professionals who responded to the online survey—a record number for college surveys, according to registration director Susan James—about seven in 10 said they experienced some type of pressure from their employer to do more clinical services.Among these respondents who said they experienced corporate pressure, a large majority—close to 1,700—cited Shoppers Drug Mart as the place where they had these experiences. Nearly 600 said they were subjected to corporate pressure at a Loblaw pharmacy while just under 400 named Rexall.Shoppers has told Pharmacy Practice + Business it does not impose clinical service quotas on its pharmacists.About 200 respondents pointed to Walmart while an equivalent number said they experienced corporate pressure at an independent pharmacy. Other retailers—such as Costco, Sobeys and Jean Coutu—were also called out, but by much lower numbers of respondents.MedsChecks—Ontario’s program for pharmacy-based medication reviews—appears to be the biggest driver of corporate pressure on pharmacists. More than 2,200 survey respondents said they were pushed to do more MedsChecks while about 1,800 said they were compelled to cold-call patients for these reviews.About 1,500 said they were pressured to dispense more naloxone kits while just under 1,500 said there was pressure to do more appointments for minor ailments prescribing.Close to 80% of respondents who said they’ve experienced corporate pressure work for a corporate-owned pharmacy.Read: Between a 'quota' and a hard place: Many pharmacists tell us they increasingly face mandatory targets on clinical servicesIn addition to compiling statistical data to substantiate reports of corporate pressure on pharmacists, the college gathered statements and examples that illustrated the nature of these pressures and their impact on pharmacy professionals.One pharmacist talked about being told “I need to buy my shifts.” Another said the quotas imposed on pharmacists “make you feel like you have to choose between patient safety and keeping your job.”The college described its findings from the survey and town halls as “deeply troubling.”“We cannot stand by silently and allow business practices to interfere with the delivery of safe and effective patient care,” the college wrote in its press release.Read: Why are Manulife patients still being sent to Bayshore HealthCare and Loblaw-owned pharmacies?

'Counsel has been retained': Ontario college takes zero-tolerance stance against corporate pressure on pharmacists

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