The Renaissance Pharmacist

Negar Golbar

Pharmacy is in my blood. My mother graduated from the University of Saskatchewan with her bachelor of science in pharmacy (BSP, a moniker specific to U of S grads) in 1999, and I graduated with the same degree in 2013. My husband and my brother-in-law both hold BSPs, too. But that designation is a bit of a dying breed. Now, new graduates finish as PharmDs. And the U of A has a postgraduate program for practising pharmacists — including BSPs like me — to obtain their PharmD. Both programs reflect how the overall scope of practice for pharmacists has been expanding. 

At this point in my career, I’ve worked in nearly every pharmacy role and setting. I got my first taste of pharmacy in high school, when I was an assistant at a Superstore. I was promoted to intern, which meant I could apply what I learned to real-life settings. Of course, the pharmacist was there to mentor me and ensure accuracy. Throughout my undergraduate years, I worked as a pharmacy student and had the opportunity to counsel patients, dispense drugs and do what I could to ease the burden on the pharmacist, who was the final set of eyes.

When I graduated, I was lucky enough to get a “floater” role, filling in at various pharmacies, which started my career. I developed my skills and learned how different pharmacies operated. It was a great experience, but I knew I wanted to be a hospital pharmacist. When I was offered a job at the Royal University Hospital in Saskatoon, I jumped at the opportunity.

I was ecstatic to practise hospital pharmacy. Before that, I had felt as though the disconnection between me and my nursing and physician colleagues wasn’t allowing me to provide patient care to its full potential. For community pharmacists, reaching nurses and physicians is challenging as they’re on a tight clinic schedule. In the hospital, I could have face-to-face conversations with my nursing and physician colleagues. I think my community counterparts should have these same privileges and opportunities to liaise with the health-care team. These privileges and opportunities exist to some extent in the Primary Care Network but not everywhere.

Even after three years as a hospital pharmacist, building my skills and knowledge, I felt as though I wasn’t up to the level of the hospital pharmacists around me. So I decided to do a postgrad doctorate. I wanted to remain in a clinical role, so I pursued the PharmD for Practicing Pharmacists degree at the U of A, a professional doctorate. In the program, you must meet a minimum number of rotations on-site in specific disciplines, which was the game changer for me because I am a hands-on learner.

I applied my new knowledge as a hospital pharmacist in Calgary. The move to Alberta has been great professionally. Alberta is a world leader in pharmacy from both a logistical and therapeutic perspective. I was able to expand the scope of my practice.

In Alberta, pharmacists are, at baseline, able to adapt prescriptions, order lab work, apply for special coverage, get compensated for doing medication reviews, renew prescriptions — the list goes on. But the real game changer is the APA designation (Additional Prescribing Authorization), which allows a pharmacist to write new prescriptions for patients, excluding controlled substances. In other provinces, pharmacists would have to send the patient to the emergency department or a walk-in clinic, only to see a physician who likely doesn’t know the patient as well as the pharmacist does. APA is a huge cost saver for our health-care system. Since we’re supposed to have universal health care in this country, it baffles me that this isn’t the standard across Canada. This doesn't seem very “universal” to me.

Pharmacists do so much in Alberta! That became clear during the pandemic. When patients couldn’t see doctors or even book phone consultations, we were diagnosing patients and using our APA to prescribe medications. The narcotic restrictions were lifted temporarily by the Alberta College of Pharmacy to help patients at a time of overflowing emergency departments. Supply chain issues meant drug shortages, and pharmacists were tasked with finding therapeutic alternatives at equipotent doses of different life-saving drugs. People needed vaccines and boosters. Pharmacists took all that on and received little recognition. COVID-19 demonstrated how much responsibility pharmacists have in providing patient care.

A lot of people don’t know what a pharmacist does, beyond dispensing medication. In fact, dispensing is often the responsibility of our amazing technicians and assistants, especially in the hospital setting. They keep the medications flowing. The scope of practice for pharmacists in Alberta has made us an even more important part of the health-care system in the province, and I think our roles definitely need more exposure and advocacy.  

This story is from the Winter edition of The Mortar & Pestle Magazine.