REACTION TO OSBORNE INTERVIEW:

Last week on the Morning Show we brought you
a couple of stories about a shortage of pharmacists in the province. Monday,
June 19, 2006  07:51AM  Item # 08 CBC Gander

MIKE AUCOIN: Last week here on the Morning Show we brought you a couple of
stories about a shortage of pharmacists in the province. We heard from the
Association of Allied Health Professionals who are worried about the
shortage and then we talked with Health Minister Tom Osborne about that
problem. Pharmacists who heard the interview with Mr. Osborne have some
concerns about the minister's understanding of their plight. To talk more
about that this morning, Randy is joined by Dr. Elizabeth Kozyra. She's a
clinical pharmacy specialist with Eastern Health and an assistant professor
with Memorial University School of Pharmacy.

RANDY LARCOMBE: Good morning Dr. Kozyra.

DR. ELIZABETH KOZYRA: Good morning.

RANDY LARCOMBE: So you heard or at least saw a transcript of that interview
I did with Health Minister Tom Osborne. What did you think?

DR. ELIZABETH KOZYRA: Well I think that there's a perception out there by
the public in general that pharmacists simply provide a product, and that is
the medication. So most people know that, for example when they go into a
hospital, that physicians tend to write out the prescription, that piece of
paper usually gets sent down to the pharmacy, the pharmacist prepares the
prescription, that prescription is sent back to the floor and the nurse
administers the medication. But I think what they public may not often
realize is that the hospital pharmacist actually has a much broader role to
play and that having a pharmacist there can have a significant impact on
their safety and their care. So I think part of is just essentially a
misunderstanding of exactly what clinical pharmacy services are actually all
about.

RANDY LARCOMBE: I don't mean in any way to speak for Health Minister
Osborne, but it seems that he is a little bit confused about what it is you
folks actually want, what pharmacists want. What do you want?

DR. ELIZABETH KOZYRA: Ok well, first of all, pharmacists are the only
members of the healthcare team that have five years of university education
that's devoted entirely to medications and medication uses and such they are
the medication experts. So it makes sense that if the pharmacist is present
at the time that the medication is being prescribed, that the healthcare
team and the patient will benefit from having the input of that pharmacist
and pharmacists are trained to do that. Pharmacists are trained to be there
to give their advice, to share their expertise to make sure that the
patients are receiving the best medication and the safest medication. So
that's the way pharmacists want to practice. Those essentially that are in
hospital really do want to be up on the floors, they want to be working in
that team environment with the physicians, with the nurses, with the other
members of the healthcare team and directly with the patients themselves
just to ensure that they are actually getting the best medication and the
safest medications and the patients are having the best outcomes possible.

RANDY LARCOMBE: So you don't do that now?

DR. ELIZABETH KOZYRA: We do do that now. It's, you will see pharmacists in
hospital doing a variety of things. Some of them are actually in the
dispensary, preparing the medications, preparing the IVs and that's a
critical role for pharmacists, there's no doubt about that, but we do have
quite a number of pharmacists who are actually up on the floors or in
various clinics throughout the hospitals that provide essential clinical
pharmacy services.

RANDY LARCOMBE: Again I got to ask you, what is it then that you folks want
here because this all has to do with the shortage of pharmacists apparently.

DR. ELIZABETH KOZYRA: It does.

RANDY LARCOMBE: And Health Minister Osborne says they're trying to address
some of the concerns you folks have. So, what is the concern you have about
pharmacists being on different floors of the hospital?

DR. ELIZABETH KOZYRA: Well, unfortunately what has happened is that a number
of health boards across the province have had to pull their clinical
pharmacy services and that's really as a result of this human resources
issue. There is no doubt that the shortage of pharmacists is a serious issue
and it needs to be addressed. If it's not addressed then the patients and
the healthcare teams don't have access to that, to those needed clinical
pharmacy services and ultimately patients safety will be at risk. So right
now we have a lot of pharmacists who have expertise in various areas who are
not able to do the thing that gives them that greatest job satisfaction, and
that's working directly with the patients and the healthcare team, again to
be sure that the patients are receiving the best care possible.

RANDY LARCOMBE: So they can't do that because they're occupied with doing
other things, is that what you're saying?

DR. ELIZABETH KOZYRA: Exactly. Essentially because of the shortage of
pharmacists, a lot of those that were providing those clinical based
services had to be pulled back into dispensary because that is certainly an
essential part of pharmacy services is making sure that the medications are,
get to those patients. So right now there's essentially only enough
pharmacists to be able to ensure that that is supplied.

RANDY LARCOMBE: All right. I just want to make sure I understand this
correctly then. So a pharmacist just don't want to be down in the basement
of some building writing their prescriptions and saying here you go and then
that's the end of their involvement in any patient's illness. Is that what
you're saying? They want to go up there, say here you go, this is what you
need to do and this is what it will do for you and then we'll monitor you
and that kind of stuff. Is that what you want?

DR. ELIZABETH KOZYRA: That's correct and that's what pharmacists are trained
to do in their five years of university training that they get that
training, and evidence has shown that if you do have a pharmacist directly
involved with the healthcare team you do improve patient outcomes, you do
improve overall safety and you can, you have more effective use, more cost
effective use of medication.

RANDY LARCOMBE: Ok I understand clearly now. So what do you see as a
solution to this problem though?

DR. ELIZABETH KOZYRA: Well I think there are a number of things that can be
done. First of all, we do have to look at the shortage of pharmacists and in
the short term the first thing to do is to ensure that hospital pharmacists
receive comparable salaries to hospital pharmacists in other Atlantic
provinces or even to those in retail pharmacy. Right now there is a pay
discrepancy and so this is enticing a lot of pharmacists who are currently
in hospital settings here in Newfoundland to pack up and leave and go to
hospital pharmacies in other Atlantic provinces or even to go to community
pharmacies.

RANDY LARCOMBE: Can I just interrupt you there for a moment?

DR. ELIZABETH KOZYRA: Of course.

RANDY LARCOMBE: I don't expect you to tell me how much money you're making,
but can you tell us what the difference could be, that discrepancy, how much
of a discrepancy there could be?

DR. ELIZABETH KOZYRA: You're probably talking about 20 percent.

RANDY LARCOMBE: Really, that much?

DR. ELIZABETH KOZYRA: Yes. Some case even more. We have new grads that are
leaving to go to, for example, Ontario and Alberta for significantly more
than you could potentially ever make here.

RANDY LARCOMBE: Yeah. Money is not just the only thing though right.

DR. ELIZABETH KOZYRA: It's not. The second big issue is job satisfaction. As
I said, pharmacists are trained to provide clinical pharmacy services and if
you're in a hospital, if you're practicing as a hospital pharmacist here and
you're not able to be up on the floors and that's the one thing that gives
you that job satisfaction and you're pulled back into dispensary to provide
those essential services, then a lot of pharmacists are going to end up
looking at hospitals outside of Newfoundland, working, again, community
pharmacies just to be able to get that job satisfaction.

RANDY LARCOMBE: Yeah. So with a simple hiring of more pharmacists clear up a
good deal of this problem, do you think?

DR. ELIZABETH KOZYRA: Well in, that would be a short term and so if you were
able to make comparable salaries, then that would entice some people, to
first of all, stay.

RANDY LARCOMBE: Yeah.

DR. ELIZABETH KOZYRA: There are a lot of hospital pharmacists who want to
stay and second of all, it may entice some new graduates to stay within the
province because I know a lot of new graduates are quite interested in
clinical services. So the salary is one issue and then if you're able to get
more pharmacists out of dispensary, and by doing that I think what we have
to do is look at using pharmacy technicians to a greater degree in the
dispensing process. And if we're able to do that and using more automation
technology, then we can free up those pharmacists from dispensary and allow
them to be up on the patient floors where they want to be.

RANDY LARCOMBE: Is it true, and I've heard this, that after someone enters
the School of Pharmacy, you know, they're there for maybe, in their first
year and they're already being wooed by hospitals and companies worldwide
with exorbitant amounts of money and all kinds of other perks, is that true?

DR. ELIZABETH KOZYRA: It is true. A lot of pharmacy, a lot of the pharmacy
students are approached, usually in their first or second year, especially
be a lot of the chains. Most of them tend to be local, but we do tend to get
some from the US as well, some of the retail pharmacy chains that do ask the
students to sign contracts, usually for two, maybe even three years of
service after they graduate and in return for that they're provided with
money to help them finance their education as they go through.

RANDY LARCOMBE: Yeah.

DR. ELIZABETH KOZYRA: So it is very enticing for those students.

RANDY LARCOMBE: Sure. So what do you folks do now? I mean you've put you're
plight forward to Tom Osborne, what do you do now? What happens next do you
think?

DR. ELIZABETH KOZYRA: Well I think it's just, essentially from our point, we
still want to advocate that this is where pharmacy needs to be and I think a
lot of the services that have been pulled, I think a lot of those healthcare
teams that are used to having a pharmacist on board and all of a sudden
don't, they probably realize what's happened as well and that the pharmacist
is no longer there and able to provide their service to the extent that they
were able to previously. I think we just got to hope that the Minister of
Health and the various health boards are going to realize what's going on
and how essential this service is and try to correct it.

RANDY LARCOMBE: Listen, I hate to cut you off there, but we got to make way
for the news. I want to thank you so much for coming by and clearing all
this up this morning. I do appreciate it.

DR. ELIZABETH KOZYRA: No problem. I appreciate the opportunity.

RANDY LARCOMBE: All right, take care.

DR. ELIZABETH KOZYRA: Thank you.

RANDY LARCOMBE: Bye, bye.

DR. ELIZABETH KOZYRA: Bye, bye.

RANDY LARCOMBE: That's Dr. Elizabeth Kozyra; she's a clinical pharmacy
specialist with Eastern Health and she's also assistant professor with
Memorial University's School of Pharmacy.