Family doctors skeptical of giving pharmacists more say in Estonia
The Ministry of Social Affairs wants to significantly expand the rights of pharmacists, allowing them, for example, to vaccinate adults and extend prescriptions for patients with chronic illnesses. Although the changes are justified by the desire to reduce the workload in primary care, family doctors are very skeptical about expanding these powers.
The Ministry of Social Affairs wants to grant pharmacists new rights that have traditionally been the domain of family doctors. The proposed changes are justified by the fact that pharmacies are often conveniently located for people and are usually open in the evenings after work hours and on weekends, as reported by "Aktuaalne kaamera" news.
"I think it's very important to look at the pharmacist's role in a new light. The more we move them away from the traditional role of dispensing or selling medication and into providing more health services, the more the pharmacist's principle and role will begin to change. This is a long-term plan, and these are the first steps, but it's part of a wider vision where we want to see pharmacists as more than just sellers of medicine," said Laura Viidik, an advisor from the Ministry of Social Affairs' pharmaceuticals department.
According to the draft legislation, pharmacists could start administering flu vaccines to adults, offering smoking cessation counseling, assisting with screening procedures and, in the long run, gain the right to extend certain prescriptions. Family doctors remain skeptical of these changes, noting that the proposed reforms would only marginally reduce their workload.
"We've often combined vaccinations for both children and adults with other health check-ups and assessments. But if someone goes to a pharmacy in a shopping mall in the evening, I'm concerned that they won't have the legal or practical capacity to provide a comprehensive overview. Vaccinating someone without considering the broader health context could be problematic," said family doctor Le Vallikivi.
Estonia currently follows the principle that the person prescribing medication cannot sell it. Vallikivi also noted that in quitting smoking counseling, pharmacists might have an interest in recommending several products for sale, some of which may be of questionable effectiveness.
Ly Rootslane, head of the Association of Pharmacy Owners (Eesti Proviisorapteekide Liit), emphasized that there are established guidelines in place for conducting such counseling. "The primary recommendation is not to immediately suggest nicotine replacement therapy products but rather to motivate the person to consider quitting altogether," Rootslane explained.
Laura Viidik from the Ministry of Social Affairs acknowledged that granting pharmacists additional rights may come with some pressure related to sales activities.
"We can't entirely rule out any activity, but we believe that if we have a predefined framework, we will also have the ability to monitor and mitigate these risks both during planning and supervision," Viidik said.
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Editor: Aleksander Krjukov, Marcus Turovski