Wednesday, March 22, 2017

“Excuse me, where is the orange juice?”


Last summer, I had the opportunity to work in a supermarket-pharmacy. Originally, I was concerned that there might be a “Supermarket-first-Pharmacy-second” mindset that would undervalue a pharmacist’s role. I thought that a dedicated pharmacy would be a more appropriate environment to practice in. However, I quickly learned that supermarket-pharmacies can be a mutually beneficial business model that allows pharmacists more opportunities to promote health and wellness.



One advantage of supermarket pharmacies is the increased foot traffic. The average adult may go grocery shopping 1-2 times a week whereas visits to a pharmacy are likely less frequent. Thus, supermarket pharmacies allow pharmacists to interact with their patients more frequently. This would facilitate easier follow-ups and long term relationship with patients.

Supermarket-pharmacies are also unique positioned for collaboration. Some supermarkets employ registered dieticians to help consumers make healthy food choices. Consequently, pharmacists who identify patients with dietary restrictions (ie: Diabetes, hypertension) may benefit from referrals to on-site dieticians. This partnership between pharmacists and dieticians can greatly improve patient outcome.

Patients are also tolerate wait times more because they can do grocery shopping while their medication is prepared. 

The only disadvantage is that there may be some role confusion. If you wander around the supermarket with a name tag, consumers may ask you where certain food items are!
Overall, supermarket pharmacies can be an interesting environment to work in. By embracing the setting, pharmacists can actually improve the pharmaceutical services they provide to the public.

Kevin

Friday, March 10, 2017

Thx Doc! TTYL!


Maple, Canada’s first 24/7 online service that allows virtual doctor’s visit, was launched in Ontario January 2017. Maple is a service that permits online consultation with registered Canadian doctors via instant messaging or video chat. This is not an entirely novel service. Akira, which also operates in Ontario, utilizes a similar model (though not 24/7). This type of service is coined “Telemedicine.” It intends to use telecommunication to provide care to patients from a distance. In countries such as U.K. and United States, massive adoption of these services has already taken place.


An encounter with Maple doctors consists of the following: describing your symptoms, talking with a doctor via instant messaging or video chat, and a wrap up. Doctors are able to write prescriptions (except for narcotics and control substances), write sick notes, and diagnose.

Maple certainly addresses some significant downfalls with our current healthcare system. A report noted “Only 31-46% of Canadians could get an appointment the same day or the next day, not including emergency department visits.” Maple claims that patients would be able to see physicians online “within minutes.” In terms of convenience, Maple may be appealing due to being accessible from anywhere:  home, vacation, or office. The advantages mentioned may be further magnified for patients living in rural/remote areas as there is a deficit of doctors areas available in these areas.

There are also several elements that prevent Maple from being widely used. Due to the nature of the interactions, a physical examination would not be possible. This can be concerning because accurate diagnosis of many medical conditions may rely on physical examinations. However, Maple has cited that up to 70% of non-emergency issues can be resolved without ever needing a hands-on physical exam. Another disadvantage is that patients are unable to pick their own doctors using Maple. This makes it difficult to establish long term relationships and to follow up on any issues. In addition, the services have to be paid for because OHIP does not currently cover these services. Lastly, there are limitations to the physician’s scope of practice. They are unable to prescribe narcotics and controlled substances, authorize a specialist referral or order lab tests, and finally consultations are not intended for emergency situations.

Maple and telemedicine are unique services. Given the technology driven age we live in, it would be exciting to see if this service will grow. Currently, the lack of public coverage significantly limits its use. Despite this, there are select groups of patients with limited access to doctors that could benefit greatly from this service.

It would be interesting to hear from patients who have firsthand experience with these types of services.

Kevin

References

CBC news. “Canadian Patients wait longest to see family doctors”. January 20, 2014.
Retrieved from
http://www.cbc.ca/news/health/canadian-patients-wait-longest-to-see-family-doctors-1.2501468  on March 9, 2017


CNW. “First 24/7 virtual doctor’s ‘office’ arrives in Canada: New services launches to connect doctors and patients in minutes.” January 30, 2017
Retrieved from
http://www.newswire.ca/news-releases/first-247-virtual-doctors-office-arrives-in-canada-new-service-launches-to-connect-doctors-and-patients-in-minutes-612141113.html on March 9, 2017


Maple. “Maple – Frequently asked questions.” 2016.
Retrieved from
https://www.getmaple.ca/faq on March 9, 2017


OTN. “What is Telemedicine.” 2017.
Retrieved from
https://otn.ca/what-is-telemedicine/ on March 9, 2017

Thursday, March 2, 2017

Hello rxBriefCase!


My name is Kevin and I am a 4th year pharmacy student at the University of Toronto. I will be joining the team for the next 5 weeks as part of my Advanced Pharmacy Practice Experience (APPE) placement. This is my final APPE rotation before heading out into the real world.

Growing up, I have always wanted to be a teacher because I enjoyed sharing knowledge and having a positive influence on others. However, my pursuit for a teaching career came to an end when I discovered that I was not too fond about spending the rest of my life in school! I shifted my focus onto pharmacy because I realized pharmacists are in an optimal position to both share knowledge (ie: counseling) and positively influence others (ie: advocate for healthy lifestyle, vaccination, etc.). I have not looked back since!

Outside of school, I am dedicated to an active lifestyle because I believe healthcare professionals should practice what they preach. In the past, I was an avid runner and was able to complete a marathon. Since retiring my running shoes, I continue to be an active member at the gym. The gym is a place where I can temporarily leave my stress behind as well as push myself at the same time.

This rotation will be significantly different from others - there will be no sick patients, no pill counting, and no MedsChecks! During my time at rxBriefCase, I will be responsible for writing an eNewsletter, an article in MedSchool For You (MSFY), and a eCME critical appraisal. I am excited to work in this new environment and look forward to meeting everybody in the coming weeks!

Kevin