Let's talk about . . . gaps

Nowadays, everyone in our field is feeling pretty stretched. Indeed, we are challenged to meet a demand that continues to rise, with a workforce that can never quite catch up. This trend is likely to remain for the next decade if not longer. After all, many of us Healthcare Professionals are reaching their retirement years and transitioning to Clients. Not surprisingly, within this context, gaps will naturally begin to form, and meaningful discussion on addressing them is warranted. The question becomes: how do we attend to our entire communities—leaving nobody behind—today, and for years to come?With a family doctor, addressing health concerns is relatively simple: one can secure prescriptions, stay on top of blood work and get referrals to specialists. The worst they might experience is some delay in accessing this world of services. But we all know that many across the country do not have a GP and must rely on walk-in or virtual clinics to meet their needs. While those are second-best options, we would all do well to recognize and appreciate their availability. Read: Let's talk about...staffingAdmittedly, after the initial shock to our community from losing multiple doctors back-to-back, our client base is adapting. We are even getting surprisingly positive feedback of those alternative resources, which is encouraging. But there are times when obstacles such as transportation or cognitive decline make the task of accessing care much more onerous than expected. I recently encountered a situation where a client could not comprehend the way to acquire new prescriptions. We had four distinct exchanges where phone numbers and a plan forward were discussed, but a true resolution was not achieved. This example highlights the fact that some individuals need extra help navigating our changing healthcare landscape. Without it, they cannot access the most basic level of medical services. For them, change has caused a gap they can’t bridge on their own. Of course, there are other instances when not having a doctor gets in the way of comprehensive care. To this day, I am unsure how unattached clients can secure bloodwork and referrals to specialists. In other instances, until a relationship develops, prescribers will hesitate to provide pain medications to clients despite a long history of being stable on their pain treatment. Imagine struggling with a debilitating form of arthritis and having to travel out of town to a walk-in clinic every month to get a prescription for the next month. While I would rather clients find non-pharmacological solutions to their pain management and tend to agree with conservative prescribing practices, I sympathize with clients in pain who are challenged in securing prescriptions. This gap is one of accessibility and, in the shadow of the ongoing opioid crisis, is not likely to go away. Read: Let's talk about...sleepAnother instance of gaps is while clients are new to a province. In B.C., Temporary Exceptional Coverage is occasionally granted and people can be lured into a false impression that their medications will get paid for going forward. When this coverage suddenly expires, some truly struggle to navigate the steps to resolution and their treatment is put into jeopardy for financial reasons. If they can’t afford their prescriptions, they are at a high risk of experiencing a decline in their conditions and social situations. Since, in pharmacy, we only find out after the fact, we are unable to warn them beforehand. Health care is shifting to adapt to our nation’s changing needs. Virtual clinics, if they existed at all, were certainly not mainstream just a handful of years ago. Expended scopes of practice, including within the pharmacy profession, have made it possible for time-sensitive conditions, such as UTIs to be addressed when it matters. We have definitely seen an overhaul of healthcare structure, but we have yet to come up with solutions to address emergent gaps. There are individuals within our communities who assist a handful of clients with their medical needs, but the scope of the issue is greater than that. Frontline professionals need somewhere to direct those who are falling through the gaps, with the least delay possible. We have come so far in finding solutions, let’s focus on that one next.

Let's talk about . . . gaps

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Selena Despres

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