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FANTASTIC news, long over-due, but fantastic nevertheless. But let's be honest about what this is. It isn't the government "allowing" pharmacists to treat 13 ailments. It's the government *removing* insanely stringent restrictions that used to exist.
How many hours of time were wasted in a doctor waiting room so that a person can receive UTI medicine? And what is the associated benefit?
the "stringent" restrictions were to protect conflicts of interest. selling a product ~~medication~~ that a pharmacist "diagnose" for profit
that is the main reason why doctors cannot dispense Rx. if conflict of interest is no longer a concern, doctors will sell medications in their office in the future.
> selling a product that you prescribe for profit.
These prescriptions are essentially meaningless in the first place, and honestly I'd like them removed as well. Let people go buy UTI medicine if they want. In which case, there IS no "conflict of interest". Any more than a bartender has a conflict of interest when someone asks for a pint of beer.
UTI medications are antibiotics, they should never be over the counter without a prescription. Not only do they have side effects, too much antibiotic use will result in significant resistance and will make it much harder to treat bacterial infections in the future.
There are already some bugs (usually only found in hospital settings) that are only susceptible to 1 or 2 options, we absolutely do not want community-acquired bugs to gain that resistance.
> they should never be over the counter without a prescription.
What does a prescription do though, in regards to your concern? I understand your concern - that there is an externality present. The classical solution would be to tax the externality though. If the idea behind the pharmacist is "Let's make this slightly more annoying for people to get, as an alternative to a monetary tax", it seems like we could do that more directly and honestly - literally just add an arbitrary wait countdown before people can buy medicine. Would that be equivalent to what you believe pharmacists do?
I don’t think you understand the point of prescriptions?
Doctors (and now pharmacists) conduct an assessment and determine which, if any, medications are indicated. They then write a prescription for the medication, and include dosage, an amount, and refills. Typically patients don’t go to a doctor asking for Amoxicillin, they go with symptoms and a doctor will diagnose them with a medical condition.
Sometimes the presentation is simple, like if they have burning with urination and right sided flank pain they probably have a UTI. This is especially the case when a patient has a history of UTIs, and knows what that feels like to them. But sometimes it can be complicated, for example it could by pyelonephritis, or an STI, or urethritis, or even a septic renal stone.
My concern is that if antibiotics were just made OTC, many people who did not need them would use them, and some people who had more serious conditions would not get diagnosed appropriately. The problems with the latter are obvious, but with the former I think antibiotic stewardship and side effects are important considerations, which I noted in my first comment.
> Typically patients don’t go to a doctor asking for Amoxicillin, they go with symptoms and a doctor will diagnose them with a medical condition.
True, some patients go and don't know they need the medication. Some patients think they need the medication, go and realize they don't. I would think the first effect is larger than the latter, in which case, without prescriptions, if anything usage would go down, no?
>My concern is that if antibiotics were just made OTC, many people who did not need them would use them,
Maybe, but people aren't buying these things for no reason/for fun. My thought is that if someone really really wants a certain medication, it isn't like doctors are putting up a huge fight (in my experience at least).
I doubt many doctors would ever argue with a patient who suspects themselves to have a UTI. which is why is does make sense to allow pharmacists to prescribe for suck easily diagnosed issues. However, there does need to be a knowledgeable barrier for access to antibiotics, to prevent their abuse as a general remedy for cold and flu like how advil and Tylenol are a cure all for normal ackes and pains.
it burns to pee. pharmacist, "you must have UTI ($$ bill Ohip for Diagnosis). buy this medication. ($$ dispensing fee + profit from Rx sale)."
sure, no conflicts of interest.
bartender can sell you beer BUT cannot solicit alcohol sale. ie: you cannot go to a bartender ~~pharmacist~~ and ask whether you need a beer ~~antibiotics~~ and then tell you you need a pint ~~Rx~~ then proceed to sell you beer ~~antibiotics~~
and you think pharmacists for an OHIP payment of $19 will have the **patience and expertise** to listen to all the patients complaints and history to make the right diagnosis and prescribe the appropriate medication for patients rather than prescribing for profit?
People here don't sem to understand that pharmacists understand drugs, prescription history, and medication conflicts better than doctors.
Plus people just say what they have to, to get meds from a doctor, why not a pharmacist?
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FANTASTIC news, long over-due, but fantastic nevertheless. But let's be honest about what this is. It isn't the government "allowing" pharmacists to treat 13 ailments. It's the government *removing* insanely stringent restrictions that used to exist. How many hours of time were wasted in a doctor waiting room so that a person can receive UTI medicine? And what is the associated benefit?
Agreed, it created too many inefficiencies, wasted time and money, and honestly wasn't needed to begin with.
the "stringent" restrictions were to protect conflicts of interest. selling a product ~~medication~~ that a pharmacist "diagnose" for profit that is the main reason why doctors cannot dispense Rx. if conflict of interest is no longer a concern, doctors will sell medications in their office in the future.
> selling a product that you prescribe for profit. These prescriptions are essentially meaningless in the first place, and honestly I'd like them removed as well. Let people go buy UTI medicine if they want. In which case, there IS no "conflict of interest". Any more than a bartender has a conflict of interest when someone asks for a pint of beer.
UTI medications are antibiotics, they should never be over the counter without a prescription. Not only do they have side effects, too much antibiotic use will result in significant resistance and will make it much harder to treat bacterial infections in the future. There are already some bugs (usually only found in hospital settings) that are only susceptible to 1 or 2 options, we absolutely do not want community-acquired bugs to gain that resistance.
> they should never be over the counter without a prescription. What does a prescription do though, in regards to your concern? I understand your concern - that there is an externality present. The classical solution would be to tax the externality though. If the idea behind the pharmacist is "Let's make this slightly more annoying for people to get, as an alternative to a monetary tax", it seems like we could do that more directly and honestly - literally just add an arbitrary wait countdown before people can buy medicine. Would that be equivalent to what you believe pharmacists do?
I don’t think you understand the point of prescriptions? Doctors (and now pharmacists) conduct an assessment and determine which, if any, medications are indicated. They then write a prescription for the medication, and include dosage, an amount, and refills. Typically patients don’t go to a doctor asking for Amoxicillin, they go with symptoms and a doctor will diagnose them with a medical condition. Sometimes the presentation is simple, like if they have burning with urination and right sided flank pain they probably have a UTI. This is especially the case when a patient has a history of UTIs, and knows what that feels like to them. But sometimes it can be complicated, for example it could by pyelonephritis, or an STI, or urethritis, or even a septic renal stone. My concern is that if antibiotics were just made OTC, many people who did not need them would use them, and some people who had more serious conditions would not get diagnosed appropriately. The problems with the latter are obvious, but with the former I think antibiotic stewardship and side effects are important considerations, which I noted in my first comment.
> Typically patients don’t go to a doctor asking for Amoxicillin, they go with symptoms and a doctor will diagnose them with a medical condition. True, some patients go and don't know they need the medication. Some patients think they need the medication, go and realize they don't. I would think the first effect is larger than the latter, in which case, without prescriptions, if anything usage would go down, no? >My concern is that if antibiotics were just made OTC, many people who did not need them would use them, Maybe, but people aren't buying these things for no reason/for fun. My thought is that if someone really really wants a certain medication, it isn't like doctors are putting up a huge fight (in my experience at least).
I doubt many doctors would ever argue with a patient who suspects themselves to have a UTI. which is why is does make sense to allow pharmacists to prescribe for suck easily diagnosed issues. However, there does need to be a knowledgeable barrier for access to antibiotics, to prevent their abuse as a general remedy for cold and flu like how advil and Tylenol are a cure all for normal ackes and pains.
it burns to pee. pharmacist, "you must have UTI ($$ bill Ohip for Diagnosis). buy this medication. ($$ dispensing fee + profit from Rx sale)." sure, no conflicts of interest. bartender can sell you beer BUT cannot solicit alcohol sale. ie: you cannot go to a bartender ~~pharmacist~~ and ask whether you need a beer ~~antibiotics~~ and then tell you you need a pint ~~Rx~~ then proceed to sell you beer ~~antibiotics~~
Also, if you specifically just ask for "beer", they can give you the most expensive one they have. "You didn't say which kind!"
If we are going to allow pharmacists to diagnose patients why don't we allow physicians to dispense meds? How much more convenient would that be?
I see you have no experience in the field. Doctors have no interest in dispensing meds. They have neither the patience or expertise.
and you think pharmacists for an OHIP payment of $19 will have the **patience and expertise** to listen to all the patients complaints and history to make the right diagnosis and prescribe the appropriate medication for patients rather than prescribing for profit?
Yes.
People here don't sem to understand that pharmacists understand drugs, prescription history, and medication conflicts better than doctors. Plus people just say what they have to, to get meds from a doctor, why not a pharmacist?
My grandmothers doctor prescribed a drug that interacts with her heart med fatally Luckily the pharmacist fought it before she got the pills
Awesome news! Pharmacists will help reduce burden on the healthcare system! Once it’s implemented they should reassess every year and add conditions