Manitoba pharmacists can now assess, prescribe and administer certain forms of birth control, following an expansion of their scope of practice announced by Health Minister Uzoma Asagwara August 7. 

As noted in the Free Press and CBC, Doctors Manitoba raised concerns that physicians were not consulted ahead of this announcement, which is important as birth control prescribing becomes a shared task between different health professions.

What’s happening: The province says more than 200 pharmacists are currently trained to provide the expanded services, with training available to others who want to participate.

Pharmacists will be able to prescribe and administer the following forms of birth control:

• Oral contraceptive pills
• Hormonal patches
• Vaginal rings
• Intramuscular contraceptive injections

Our concern: Doctors Manitoba supports improving access to care, but we are disappointed physicians were not proactively consulted before this change was announced, especially as the government had promised a consultation on this issue in last year’s Throne Speech.

What’s still unclear: We need answers to some important questions before we can understand how this will work in practice.

• Notification: How will a physician know when a pharmacist has assessed a patient and issued a new prescription?
• Communication: What information will be shared with the patient’s primary care provider, and through what system?
• Follow-up: Who is responsible for monitoring the patient, managing complications or adverse effects, and arranging follow-up when needed?
• Continuity: How will pharmacists and physicians work together when a patient’s needs extend beyond the pharmacist’s scope?

The bigger picture: Expanding scopes of practice can be one part of improving access to care. But it should not create more silos with new gaps for patients to fall through. 

• Read our recent op ed about expanding scopes and roles through true team-based care instead of more fragmented silos. 

Your voice matters: We want to hear from physicians about how this change is working in practice. Have you had a patient receive a new contraceptive prescription from a pharmacist? Did you receive notification? Are you clear about who is responsible for follow-up?

Please write to us at practiceadvice@​doctorsmanitoba.​ca.