Why this Ontario pharmacist started an orphan patient clinic

Over 6.5 million Canadians are orphan patients—meaning they don’t have a primary care provider. That's why, for the third time, Southampton, Ont. pharmacist and owner Kristen Watt held a primary care clinic at Kristen's Pharmacy. “We have over 4000 orphan patients in our region,” Watt says, adding that that figure might be an underestimation, given the number of people moving to the rural area from nearby urban centres like Toronto and Kitchener-Waterloo who don’t drop their family doctors if they can’t find a new one locally. “They’re not considered orphan, but they don’t have regular access to care.” To respond to that need for primary care, Watt connected with a local physician who had retired from family practice and had provided telemedicine services during the pandemic. She lent her pharmacy office out for a day and patients from around Southampton and larger municipality Saugeen Shores came to seek out care from the physician. Patients who had blood work or imaging requisitions would be set up with a follow-up appointment through the pharmacy to review the results. In a LinkedIn post at the end of the day, Watt noted that 18 patients were seen at the one-day clinic. Of those patients, over half needed blood work, a few required specialist referrals and many needed repeat prescriptions. And, she added, on the same day the pharmacy held a vaccination clinic where 40 Covid shots and 40 flu shots were administered. The orphan patient clinic isn’t just a service being provided. Watt says that she hopes the clinic showcases the importance of expanded scope of practice for Ontario’s pharmacists. “It’s frustrating, because there’s a lot I can do [to help patients with complex needs] if I had the scope,” Watt says. “Not having the authority in Ontario to initiate new medications based on a diagnosis that’s already established, for example, is incredibly frustrating. Especially considering my counterparts in other provinces with the same licence can do that.” While pharmacists in Ontario can assess minor ailments and can prescribe some medications, scope in Ontario is “dreadfully behind other provinces at this point,” Watt says. She wants to be able to prescribe for more conditions and make substitutions if needed. “We are trained to be able to provide that care, we’re just legally limited in doing so, and it’s becoming challenging for our patients to access care.” For patients, going through the clinic is simple: begin by filling out a form electronically and signing up for a time slot. Then, they meet with Watt who gives them information on registering as an unattached patient, how they can access their imagine and blood test results and encourages them to become a patient at her pharmacy. If the physician prescribes a medication, patients can have their prescriptions dispensed at Kristen's or can take it to their home pharmacy. Through MedEssist, Watt can see whether or not blood work was ordered—if it was, she schedules a follow-up with the patient to discuss the results. “There are so many communities across Ontario that have a community pharmacy but don’t have any physicians—so often, the only place people can access care is a community pharmacy,” says Watt, who is also the vice-chair of the Ontario Pharmacists Association. “So we decided to leverage that and see if we could make an unattached orphan patient walk-in type clinic work in a small community pharmacy.” “We’ve been able to identify patients with really high needs who… I don’t know where they would’ve gone otherwise.”Meet the Pharmacy Practice +Business Award winner for Raise Your Voice Kristen Watt: Fearlessly promoting pharmacists in Canada and beyond

Why this Ontario pharmacist started an orphan patient clinic

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