HOW DO WE DEFINE THE PUBLIC INTEREST?

 

There is no one perfect definition for what is in the public interest.  It is therefore largely left to the discretion of provincial regulatory authorities (PRAs) like the Ontario College of Pharmacists (OCP) to set their own frames of reference.  The definition could be narrow, or it could be broad, or it could be in between

The recent “Code of Ethics” booklet put out by the OCP states on page 4:

“In exchange for our promise (to act in the best interest of our patients and place their well-being first and foremost) society agrees to provide our profession with the autonomy to govern ourselves as a self-regulating profession with all the privileges and statuses afforded regulated healthcare professionals.”

The question that surfaces is this.  If the definition of what is in the public interest is interpreted at a very narrow level, to what degree does a regulatory body continue to deserve the privilege of self-regulation?

A look at how the profession of pharmacy has evolved over the last 50 years does not present a pretty picture.

The main issue is not education.  Today’s pharmacy graduates are several times more knowledgeable than graduates of even 25 years ago.  Schools like the University of Waterloo are doing an outstanding job of producing stellar grads with a re energized outlook as to how pharmacy should be practiced.

The main issue stems from the loss of control of the pharmacy profession to big business interests or Big Pharmacy Retail (BPR).  Until this is reversed, the profession will continue to spiral downwards until it ceases to be a profession and is relegated to a commercial activity within a retail mega-complex.

The one source for hope towards gaining back at least some of this control rests, not in the hands of pharmacy associations as is well known, it rests with the regulatory authorities…….if they only choose to exercise their mandate to protect the public interest utilizing a broader definition of what the public interest is.

The regulatory body governing jet pilots is extremely strict as to how many hours a pilot can fly…for good reason.

How is it then that pharmacists can be allowed/forced to work 12 or even 16 hours straight?…in many cases without a break.   This is not only dangerous, it is inhumane.  But more importantly, how is this in the public interest?

A recent CHN poll clearly indicates that this is routine for many pharmacists.  The OCP chooses to respond by stating that “business issues” are not their concern, but when these business issues cross over to safety issues it is definitely OCP’s concern.  If the predilection is always to define the public interest in the narrowest of terms, then a lot of important public interest issues could be overlooked.

In an even more overt and obvious example, what about the scourge of professional services quotas?  How can it be remotely in the public’s interests to force professionals to meet ever increasing quotas for services designed solely for the purpose of creating more dollar retail revenues and increased store traffic?  No one wants to touch this one.  Certainly not the pharmacy associations who rely so heavily on the continued support of BPR.  But why not the regulatory bodies?  This one is obvious.  It can only be assumed that they just don’t want to put up the fight.  It would be a hard fight and these guys are simply not fighters.

Let’s not even approach the embarrassment of flu injections.  Why are pharmacists being forced to personally inject people?  This is a technical act and borrows nothing from the knowledge skills of today’s pharmacists.  How many more road side signs do we need imploring people to “come in and get your shot”.

Unfortunately, as long as the OCP and other regulatory bodies continue to sit in their ivory towers and feign public protection while allowing significant transgressions and compromises to the public interests, this only encourages business interests to further push the pharmacy profession towards a product category, like the meat and produce departments.

How long can pharmacy remain a self-regulating profession when it so loosely and narrowly defines its raison d’etre?