Since coming to power, the Ford government has aimed to improve Ontarians’ access to primary healthcare despite significant challenges, notably a longstanding shortage of primary care providers. This shortage is complex and systemic, having persisted across various administrations. Addressing it requires more than financial input or simplified solutions due to the many stakeholders involved, each with distinct interests. While healthcare professionals universally support efforts to address the problem, there’s no consensus on a solution.

The Ford government has implemented several initiatives to tackle these issues:

Increasing Medical School Access for Ontarians: By prioritizing local students over international applicants, the government hopes to encourage Ontario graduates to remain in the province to practice.

Reducing Barriers for Out-of-Province and Internationally Trained Professionals: Streamlining credentialing for physicians and nurses trained elsewhere allows them to work in Ontario more easily.

Expanding the Scope of Pharmacists and Nurse Practitioners (NP’s). Pharmacists and NP’s are now permitted to diagnose, treat, and prescribe for conditions within Scope of Practice.

Some of these initiatives will take time to come to fruition and some of these initiatives are clearly very successful and well received by the public. One such initiative is the Minor Ailment Prescribing by pharmacists. Today, Pharmacists in Ontario can prescribe for 19 common ailments, including acne, dermatitis, oral thrush, and pink eye. Nearly every Ontario pharmacy provides this health service to patients. Across the country, all provinces, as well as the Yukon Territory, allow pharmacists to prescribe for some minor or common ailments. The government is seeing this success and is planning to add 14 more common ailments. Pharmacist prescribing has demonstrated valuable benefits and relief to the health system at a time of great strain. In Nova Scotia, the expanded scope of pharmacies contributed to a 9.2 per cent decrease in emergency room visits for minor ailments. 

The expansion of Pharmacists’ scope of practice has been widely praised, with strong support from many except for a small group of physicians. Advocates argue that pharmacies should be leveraged as healthcare hubs, given pharmacists’ trusted relationships with their patients and their untapped potential in delivering care. However, some doctors remain skeptical. Ontario Medical Association President Dr. Dominik Nowak contends, “The bottom line here is that pharmacists are not doctors”. 

In response, Ontario Pharmacists Association CEO Justin Bates expressed disappointment over some doctors’ comments, calling concerns about patient safety “misinformation.” “I support the OMA and primary care efforts, including hiring more doctors, but expanding pharmacists’ scope doesn’t need to undermine other healthcare professionals,” he stated. “This isn’t a zero-sum game. We want physicians to be comfortable with this, but some of the pushback from doctors feels almost like hysteria.”

So, it is in light of this backlash from physicians, who incidentally are in the middle of their heated renumeration negotiations with the government, the Ford government recently voted down Bill 203, a private member’s bill aimed at banning nurse practitioners (NPs) in Ontario from charging patients directly for healthcare services. Known as the Keeping Primary Care Fair Act, the bill sought to prevent private clinics led by NP’s from charging for appointments or annual memberships, addressing an ongoing issue where some NPs have charged up to $80 for a single visit or hundreds of dollars in annual fees. The bill’s supporters argue that these fees exist because the Canada Health Act does not include services provided by NP’s and Ontario lacks a direct remuneration model for self-employed NPs.

The Ontario government contends that it’s the federal government’s responsibility to close this loophole in the Canada Health Act, and if Ontario acted independent NP’s would leave Ontario in droves to go to Quebec or Manitoba, further exacerbating access to timely healthcare by Ontarians. The Ontario Government argues that we need a Canada-wide solution. However, opposition politicians disagree, claiming that Ontario should act independently to fully integrate NPs into the healthcare system. Ontario Liberal MPP Dr. Adil Shamji, who sponsored Bill 203, argued that the bill’s purpose was to give NPs the recognition and funding they deserve, making them more accessible to Ontarians who lack a family doctor. Shamji urged the province to legitimize NPs fully, arguing that this would help address the shortage of primary care providers. Empowering NPs without broader systemic changes could spark backlash from powerful physicians’ associations. Opponents of the bill suggest that if physicians were to protest, it could lead to work stoppages and chaos within the healthcare system, leaving patients in need of urgent medical care to suffer. They also argue that such a bill could drive NPs to leave Ontario for provinces like Quebec or Manitoba, exacerbating healthcare challenges in the province. The Ford government maintains that Bill 203 was a political move by the opposition, potentially adding pressure to an already strained healthcare system; all because the opposition wanted to score a few political points.  This private members bill is simply a political stunt by the opposition Liberals.  Dr Samji, being a physician himself, knows full well that the powerful Physicians’ lobby would not stand for this and the ensuing turmoil would spell disaster for Ontarians seeking timely medical care; all because Dr. Samji and his liberal opposition want play politics. 

Adding to this debate, a report from the C.D. Howe Institute advocates for a significant increase in Np’s in primary care and a shift towards multi-disciplinary clinics. Economist John Richards, the report’s author, notes that doctors’ groups hold too much influence and have resisted expanding roles for NPs due to fears of competition. Richards highlights that physician remuneration in Canada is already higher than in many OECD countries, yet doctors’ productivity, measured in working hours, has declined over recent decades. Richards points to studies indicating that NPs can achieve comparable patient outcomes to doctors in many scenarios, often at a lower cost.

Amid this tension between expanding healthcare roles and preserving professional boundaries one thing has remained clear. The ability for pharmacists to provide Minor Ailment Prescribing has been a resounding success. In reality, most physicians are happy with this initiative, but their association, being in the middle of an acrimonious contract negotiation, is posturing to shine a disparaging light on a program that has been very well received by the public. This initiative is not just a testament to pharmacists’ capabilities but also a significant step toward alleviating the strain on the broader healthcare system. The ability for pharmacists to prescribe and assess for minor ailments includes over 19 conditions and will soon be expanded even further. 

If you need treatment of one of these conditions such as pink eye, hemorrhoids, or Urinary tract infections, you do not have to wait hours at the emergency department of for days to see your doctor (if you even have one). You can just walk into Centrum Pharmacy or make a telephone or online appointment and one of our knowledgeable pharmacists will be able to assist you. 

Although in some cases pharmacists and nurse practitioners may not be able to help you because your condition is beyond their scope, at least you are able to see someone who can still refer you to the correct health care provider and make recommendations for temporary treatment measures until you can see that correct health care provider. Isn’t that better than not being able to access care at all?

Disclaimer: The medical information on this site is provided as an information resource only and is not to be used or relied on for any diagnostic or treatment purposes. This information does not substitute for professional diagnosis and treatment. Please do not initiate, modify, or discontinue any treatment, medication, or supplement solely based on this information. Always seek the advice of your healthcare provider first. Full Disclaimer.