Responding In Kind - 10/28/25
Responses and comments from my readers…I do receive periodic information from the many readers of the blog. While I have often responded individually, I decided that I should share more transparently. Hopefully, this contributes to an ongoing dialogue…
From Tom.R. – “France has had a fairly positive experience with pharmacists doing semi-primary care—as have multiple other countries,” as outlined in the International Journal of Health Policy and Management. “This article is just a start. No systematic review is easily at hand. My experience from teaching/researching health policy in France is that this has been an “accommodation” by physicians and the broader regulatory system to accept the reality of their willingness to take on a broader scope. OTH, one doesn’t see NPs and PAs in France — the pharmacists have largely filled that niche.”
My Response – As I noted in my commentary, “collaboration” with other health care professionals is the key, not necessarily “replacement.” For example, when I was in active practice, my team consisted of me (a Family Physician), a nurse, a Family Nurse Practitioner, a Pharmacist, and a Social Worker. Now, I admit this was in a different era (😊), but it was a “primary care” practice. We all tended toward staying in our lanes and bringing our training and knowledge to the table in the care of patients. In fact, I found that the NPs were far better at “educating” my young, pregnant patients (as well as me) than I was! But, they were trained “clinically” for such participation in the practice. My objection to pharmacists taking on clinical roles is not an objection to members of the team taking on additional roles. However, in doing so it is very important – from my perspective – to have appropriate training. Now, I might be wrong, but in my experience, pharmacists are not trained “clinically” beyond the use of medications in clinical practice. Therefore, providing care and oversight as a “primary care provider” would be a significant stretch. Finally, I’m assuming that the French pharmacists get additional training? Let me know if I am wrong!! BTW – thanks for the article…as well as the response!!
