Magda Konieczna

Prescription needed for pharmacist shortage

appeared in The Globe and Mail May 21, 2004

Ron Elliott has been a pharmacist in St. Thomas, Ont., since 1985. While he says he loves his job, he's found it has become more demanding over the years.

Like many Canadian pharmacists, particularly in rural areas, Mr. Elliott often finds himself short-staffed. In fact, he only recently succeeded in filling one of two vacancies he has had since August.

"My average week in the dispensary has grown from what used to be about 30 to 35 hours a week to now, averaging between 55 and, some weeks, 70 [hours]," he says. "I pick up the extra shifts when we're short."

Pharmacists have been in short supply for the last decade or more. In 2001, Canada was short more than 2,000 pharmacists -- almost 10 per cent of the 24,518 pharmacists registered at that time, according to an Ipsos-Reid survey commissioned by the Canadian Association of Chain Drug Stores. The shortfall remains, even with the current 27,612 registered pharmacists.

The need for more pharmacists stems from a wide range of factors, from the emergence of Internet pharmacies, which has brought large demand from south of the border, to an aging population, growth in private sector consulting and research, and more 24-hour pharmacies.

Canadians are also filling more prescriptions than ever -- in 2003 alone, the number grew by almost 8 per cent to more than 361 million, according to Intercontinental Medical Statistics, which tracks pharmaceutical sales.

Mr. Elliott's situation is echoed across the country. The struggle to attract pharmacists has prompted the industry to dangle plenty of incentives -- from payment of tuition costs to signing bonuses, coverage of moving costs and company cars.

Shoppers Drug Mart Corp., for example, offers 100 scholarships each year to pharmacy students, paying up to $45,000 in tuition costs and up to $30,000 in signing bonuses and moving costs on condition that recipients spend two years in a short-staffed pharmacy after graduation, recruitment co-ordinator Liz Landon says.

Jill Daley, student representative for the Canadian Pharmacists Association in Ottawa, says scholarships requiring post-graduation work commitments are common, as are no-commitment scholarships from pharmacies, pharmacy colleges, alumni and other sources.

She also says that most pharmacies pay exam and licensing fees for new pharmacists, and often include signing bonuses of $1,000 to $10,000. "They are a result of the increased demand for pharmacists."

Boosting the number of pharmacists would go a long way toward helping to meet that demand. But programs can't accommodate the number who want to enter the field.

The University of Toronto, Ontario's only school of pharmacy, accepts just 10 per cent of 1,800 applicants a year, says Dr. Wayne Hindmarsh, U of T's dean of pharmacy. The university four years ago received provincial funding for a building, not yet completed, that would allow it to increase its yearly enrolment to 240, he says.

But demand continues to outweigh supply. Setting up a new school or adding spaces to an existing program have proven difficult because of government reluctance to provide further funds, says Barry Power, director of practice development at the Canadian Pharmacists' Association in Ottawa.

A University of Ottawa initiative in the early 1990s, for instance, failed to gain government approval, although the university cited a need for 1,000 new pharmacists in the province at the time. "What you see is the chronic underfunding of universities," Mr. Power says.

Now, the University of Waterloo is stepping up to the plate with a proposal to start a pharmacy school in conjunction with U of T -- a plan Dr. Hindmarsh thinks might be more successful than previous proposals."The difference is that they are going to be a satellite of our university," he says.

A satellite school -- which George Dixon, U of W's dean of science, says could start offering courses as soon as 2007 -- would add 100 to 200 new pharmacy graduates a year. The Waterloo program would take advantage of U of T's curriculum and certification, and students would receive joint degrees.

In March, the schools signed a non-binding agreement to continue discussion. The next big hurdle, obtaining government approval, would have to come within a year for the program to start in 2007, Dr. Dixon says.

Mr. Power says educating more students is only part of the solution. He says that it is time to decide whether to keep pharmacists confined to their traditional role or allow them to take on "a more clinical role of acting as either a prescribing adviser or a medication manager and leave some of the more technical things to the technicians."

In the meantime, what does Mr. Elliott do? "Work." Can he do the job of two people? "That's a giant order," he says. "You just do what you've got to do."

Special to The Globe and Mail