|
I may have overstated the reporting. The actual number of cases I've personally seen reported in total hover around 3. And in each time, what led to the reporting would be us asking for the pharmacy to fax a report of the med review, and when they send us a blank form with just meds listed, and have no idea whether the patient switched from a CCB or BB (or if they are on both continuously - one example) we get frustrated, because the patient has no idea.
One thing that I can think of off the top of my head in terms of sustaining ourselves, I think the adaptation fee schedule should be changed. Adaptations for renewals can remain at $10 since it's not a super cognitive service (I always renew for 1 month max anyway b/c theres no lab work I can ever use to safely give a 3 month for). Drug substitutions, direction changes 15-20$ etc.
An MD bills approximately 30$ for a 15 minute appointment, we tell patients to stay in our pharmacy for 15 minutes after a flu shot and get ~14$ (correct me if I'm wrong) out of it? , maybe give us a little more for injection services because we still DO full assessments on whether or not it's appropriate, whether or not it's provincially funded, or out of pocket etc. After doing injections at high volume (100 injection/day) store, I think it's totally ridiculous how govt spending was mis-allocated to injections being given only by Dr's/public health nurses the last few years when we were already there and able to provide these services.
In addition, I think if we could properly document/bill all our work on pharmanet and get reimbursed for certain OTC counselling ($5), especially after hours when Dr offices are closed.
Last point. I can't remember the exact figures, and I may have already posted this in the thread somewhere here. But last year, I had a big corporate sponsored dinner where I had the chance to speak to some people from Ontario. They were saying that previously, the Ontario government was giving $100 million in funding for pharmacies, after the cuts, it's been brought down to $15 million (85% cut!) almost overnight. They took a huge chunk of money away and gave back 15% just to toss up in the air and say "you guys can use this for your 'clinical services' and be reimbursed from this pot of money". Obviously, even IF they maxed out on all the clinical services they could have possibly done, they would still end up nearly 85% short. The way our professions salary is dictated by the government is very scary, especially for those that have a mortgage/kids/debt.
Eventually, we will probably have to look at people paying out of pocket for these services for us to survive. Or hope that our profession changes enough in the right direction that we can find a different source of income somewhere (drug prescribing within limited scope?).
|