– This story is part of our Prairie Spirit series about the people and
actions that build communities. –
FORT QU’APPELLE, Sask. – From the high counter that blocks a customer’s view, Janet Bradshaw and her colleagues can cast surveying eyes over the drug store.
Seven million prescriptions are filled each year in Saskatchewan from such perches.
Pharmacists practise health care with their own style of two-tier system. At the higher level they use computers and phones to talk to customers, look up records and fill medicine prescriptions.
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Come down two steps and they are on the public level. Five padded chairs relax a waiting area in the Pharmasave store in this town of 3,000 in southern Saskatchewan. Off to one side is a consultation room for more private talk.
Bradshaw and her fellow pharmacists say they want to get off the pedestal. They are also ready to discard an old image as mere pill pushers.
Instead, they want to be seen as a piece of the health team, standing as partners with the doctors, nurses and therapists the average patient sees.
Bradshaw said patients often need the pharmacist to repeat the information about their medication.
“Whether the doctor didn’t say or they don’t hear or it’s a blur, we need to help them with their compliance.”
Seniors use more medications than the rest of the population, so that is the bulk of customers that pharmacists see. And in rural areas like Fort Qu’Appelle, those customers tend to be local and loyal, something not always seen in the more transient traffic of city drug stores.
The seniors Bradshaw sees say they are not concerned about confidentiality of their cases. They’d rather the pharmacist knows the details and can help treat them.
That’s a plus for the proposed Saskatchewan Health Information Network that is trying to gather each patient’s history for easy retrieval by all parts of the health system, yet maintain the individual’s privacy. A card that acts as a portable filing cabinet can reduce the chances of double doctoring, duplicated tests or conflicting medications. It is being tested in a pilot project in southeastern Saskatchewan. Until then, there are “some big voids in the system,” said Bradshaw. That is why it is important that pharmacists know more about their patients’ conditions to determine if they are getting the right medicine at the correct level.
“There is the pain of shingles, migraine or depression – one drug can treat it all. You’re trying to extract information without alarming the patient.”
Bradshaw has been president this past year of the 1,100-member Saskatchewan Pharmaceutical Association. Through it, pharmacists have representation on various organizations. Bradshaw said the trouble with medicare is that there is “no one co-ordinating body. Everybody has taken pieces of it. Funds would be better utilized. We see ourselves and we tell government we should be one of the leaders in this part of the health-care team.”
At mid-morning in the store a surge of customers fogs the waiting area with cold. People are jovial despite the -25 temperatures outside. They greet each other by first names and chat with one of the four pharmacists who gets their medicine. Until health teams are set up, this is the front line for counseling.
It is a familiar scene for Bradshaw who has been a pharmacist for 26 years. After training in Saskatchewan she worked in British Columbia where her husband was in the armed forces, before they returned to farm near Dysart. While her husband grows grain and cattle, she brought in off-farm income.
“I didn’t want to stand at a cash register ringing in tuna fish and motor oil. So not wanting to drive an hour to Regina, for 14, 15 years I did relief pharmacy around this area.”
She got involved in her professional association to keep in touch with others and up to date with her education. She also wanted to see pharmacy from a different angle than across a retail counter. One challenge she expects in the future will be the baby boomer generation. This group “won’t take the doctor for his word” and will want to have a say in their health treatments. Pharmacists must match the new generation’s knowledge and interest in alternatives such as herbal drugs.
“Our mandate is protection of the public. That’s the basis of our concern about health food stores and grocery stores (selling herbals). No one is there to ask the appropriate questions.”
Assisting pharmacists as they change their role is economic clout. There is a shortage of pharmacists and that is pulling their wages up and giving them more job options. Bradshaw said part of the shortage is the decision of grocery chains to get into the pharmacy business. More outlets require more staff and competition.
This year the University of Saskatchewan will graduate 70 pharmacy students at the end of their five-year course. Big American dollars will lure many of them south of the border. And over half of those students are women, who tend to work less than full time due to pregnancy and family.
Bradshaw said to combat the shortage, pharmacy associations will have to set national standards to allow more mobility among provinces. Also, as with nurses and doctors, health systems will have to work harder to retain the already trained and to persuade them of the advantages of a rural lifestyle.
Her boss, Dennis Palmier, said in his 30 years in Fort Qu’Appelle, the drug store business has changed. He used to be the only store in town, customers and paperwork were less demanding and there were fewer drugs but bigger profit margins. Three years ago he demolished the old buildings that represented the town’s first drug store and built the new modern, bright pink building on Main Street.
A homage to the original Dunk the druggist is the mural on an outside wall. It symbolizes his view of a drug store as a community-friendly facility. To keep customers loyal Palmier has sent letters reminding them that they are not just buying a product from him, but a service.
With a drug inventory worth $100,000 and Regina stores only 45 minutes away, it is important to remind people of the importance of shopping at home.
“I think people born and raised in a small town understand small town economics – keep the dollars rotating.”
Palmier said the farm economy’s ups and downs have less effect on the pharmacy because people will always pay for the medicines as they need them. When farmers have money, they don’t stock up on health-care products.
But like farmers, Palmier sees an issue of succession. When the owner of a small-town pharmacy is ready to retire, there may be no one willing to buy his business.
“I have a friend who will just have to shut the door and walk away from it.”
