Has scope expansion fragmented patient care? Doctors group says better coordination is needed

The scope-of-practice expansions in recent years for Ontario pharmacists and other healthcare providers have led to “further fragmenting” of the healthcare system and should have been considered more carefully with input from the province’s doctors. This was one of the observations shared on October 12 during an Ontario Medical Association virtual press conference that discussed how creating more family health teams could ease the province’s ongoing healthcare crisis. “We have tremendous respect for pharmacists and nurse practitioners and other allied health professionals … and we want to be able to really advocate for a system that allows the appropriate players in the right places to make the right decisions on patient care,” said OMA president Dr. Andrew Park. “Adding parallel streams of care is not an efficient or cost effective or patient centered approach to preventative … (and) long-term longitudinal care. I think this creates further silos in our system rather than integrating us as a group of professionals that are able to provide care in the most effective fashion.” Read: Frustration of fragmented care David Barber, chair of the OMA’s section of family and general practice, said he is fortunate to have a pharmacist working as part of his health team—an ideal setup that allows other healthcare professionals in the group to consult the pharmacist whenever they need to and coordinate patient care seamlessly. “The pharmacist should be embedded in some way with the team, where you can discuss things,” he said. “We have a pharmacist on our team that we consult with frequently and so there's no fragmentation of care for the patient.” Dr. Barber noted that the Ontario government did not consult the OMA when it considered, and ultimately approved, the expansion of pharmacists’ scope of practice. “I really wish the government had consulted us,” he said. “We could have done things a lot better. We need that coordination, we need to talk so that we can create a system that's best for our patients.” Read: OCP calls for expanded scope for techs Because the province gave “no thought” to how pharmacists and doctors could communicate effectively, physicians must now deal with faxed messages in varying formats from the pharmacists who provide prescribing and clinical services to their patients, said Dr. Barber. “We get a paper fax from the pharmacist and they’re all different—there’s no standardization—so we don’t really know where to look … to know exactly what’s happened,” he said. “That just makes our lives more difficult and a lot of times I think it actually does not help patients.” A better system for communication between pharmacists and doctors would help ensure continuity of care and lead to more stable primary care, added Dr. Barber. Read: 5 tips: How pharmacy-based telemedicine and integrated data can help improve patient outcomes

Has scope expansion fragmented patient care? Doctors group says better coordination is needed

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