Help Wanted: Clarifying Technician and Assistant Roles

When were you last on a job hunt? If you’re like me, and you are an experienced pharmacy technician who has found their niche, then it’s probably been a while since you looked at any job postings. If you are a newer technician, or if you’re someone who is looking for a position change, then you might have noticed a dangerous trend popping up in postings for our profession: the “Pharmacy Assistant/Technician” posting.  Even if you are not looking for a job, start reading the postings and see how prevalent this issue has become.

The Big Issue

Technician or Assistant?  Some of you are thinking, “What is the big deal? It’s not like there is much more that a technician can do that an assistant can’t.” Keep reading this blog, I think I am going to change your mind.

While it is not pointed out as frequently as it needs to be (if at all), non-regulated support staff (pharmacy assistants) are unable to perform any duties that require:

• entering into a professional relationship with a patient;
• the application of professional judgment;
• the training and skillset of a pharmacist and/or pharmacy technician.

A pharmacy duty that requires any of the 3 points above must be performed by either a pharmacy technician or a pharmacist.  So what does this mean?  Let’s look at some examples.

I have taken the following examples from real job advertisements that were publically posted. For the purpose of the blog, I have hidden any information that indicates a specific chain or corporation.  Let’s take a look and see if knowing what we know now, we think a posting is appropriate or not.

Example 1:

While this posting is advertised as looking for a pharmacy assistant, the majority of key responsibilities listed cannot be performed by non-regulated pharmacy staff. Take a moment and see how many you can identify.  Out of the 8 responsibilities listed, only 3 are clearly appropriate for non-regulated pharmacy staff, the others require a pharmacy technician.

• Patient greeting and confirmation of accuracy of all pertinent prescription information prior to filling.
  • This requires entering into a professional relationship, as well as the ability to apply professional judgment to confirm prescriptions are complete, authentic, and comply with all current laws, regulations and policies. How is this completed by staff without a formal, standardized education that have not been assessed to a defined level of competence?
• Data entry of patient care information into a patient record.
  • While data entry alone is appropriate for non-regulated staff, we need to consider the context of this duty. Gathering patient information and documenting it on a patient record requires entering into a professional relationship, as well as the ability to apply professional judgment to know when intervention by a pharmacist is required.
• Accurate dispensing of prescription medications.
  • Non-regulated staff are not responsible for ensuring accurate dispensing. This requires the professional judgment, training and skillset of a pharmacist and/or pharmacy technician.
• General OTC enquiries from patients and referral to a Pharmacist where required and necessary.
  • This requires entering into a professional relationship, as well as the ability to apply professional judgment to know when intervention by a pharmacist is required. Does the public know that they are asking for OTC information from individuals with little or no standardized formal education and no regulatory oversight?  If they did would they be comfortable with this? I believe this is a patient safety issue.
• Handling customer prescription pick up.
  • This requires entering into a professional relationship, as well as the ability to apply professional judgment to know when intervention by a pharmacist is required. Only a regulated pharmacy staff member may release a prescription to a patient.

Example 2:

Here we see a posting looking for a “Registered Pharmacy Assistant” which is not a role that exists.  In the first paragraph they actually refer to the person they are looking for as a Pharmacy Assistant and then a Pharmacy Technician, implying that they are interchangeable.  As we know the latter is a regulated individual with a protected title.  When we take a look at the responsibilities listed, we once again see that this pharmacy likely requires a pharmacy technician.  Of the 5 responsibilities listed, only 1 is appropriate for a pharmacy assistant.

• Maintain a clean and organized workspace and dispensary
  • Could be the responsibility of any and all pharmacy staff members

 Example 3:

Again, we have a posting that states it is for a Pharmacy Assistant. However, when we take a closer look we see that there are some red flags.

“…the Pharmacy Assistant reports to the Pharmacy Manager and is responsible for patient greeting, dispensing prescription medications, and answering any general questions from patients and referring to [a] Pharmacist when required.”

 “Evaluate the legality of a prescription…..” 

How is that done by staff that have not completed national licensing exams and adherence to provincial pharmacy practice regulations?

Why is This Happening?

There are a number of factors that are contributing to this issue.

1. Historical Practice and a Lack of Information

For years, the terms “technician” and “assistant” were used interchangeably. Only pharmacists were regulated and therefore pharmacies independently decided what support was required, and practice was widely inconsistent across Canada. This changed as Pharmacists looked to take on expanded clinical roles. Pharmacy Technicians were regulated to ensure patient care and safety standards were maintained as they took over the production and distribution aspects of pharmacy care.  While this was the intent, not all pharmacies have effectively integrated Pharmacy Technicians.

We see that many community pharmacies continue to follow historic practices of using assistants and technicians interchangeably. Some pharmacies have suggested movement toward transitioning duties to assistants without clear understanding and/or careful review of the appropriateness.  Currently, there is not enough clear, concise information available that accurately outlines the difference between non-regulated staff (Pharmacy Assistants) and Pharmacy Technicians. Many Pharmacy Technicians are also unclear on the difference, making it difficult to self-advocate.

2. Shortage of Technicians

Currently in Canada, there are 42, 603 registered pharmacists, 8, 864 registered pharmacy technicians, and 10, 682 registered community pharmacies. (https://napra.ca/national-statistics). In Alberta, we have 5, 443 registered pharmacists, 1, 512 registered pharmacy technicians and 1, 382 registered community pharmacies. (https://napra.ca/national-statistics). This demonstrates that there are not enough of us to support every community pharmacy in Canada – and since the majority of registered technicians are working in hospitals, this statistic is even more alarming. There is a lot of room for growth in our industry.

3. Integration into the Healthcare System

Pharmacy Technicians are in the best position to lead pharmacy production and distribution, as demonstrated below by the weightings used by the Pharmacy Examining Board of Canada to develop the entry-to-practice qualifying exams (https://www.pebc.ca/):

Pharmacists and Technicians have a number of areas weighted similarly, however product focus (distribution) is greatest for pharmacy technicians and patient focus is greatest for pharmacists. If we consider that most educational institutions will emphasize curriculum components to match the weightings applied by PEBC, it stands to reason that pharmacists are no longer being taught the comprehensive details of distribution and medication preparation related practice.  As pharmacists become increasingly involved in clinical care activities, distribution and production related activities have become the pharmacy technicians’ area of expertise.

In order to efficiently lead pharmacy production and distribution, Pharmacy Technicians need to be integrated not only into community pharmacy practice, but also engaged and empowered to participate on committees making production and distribution related decisions.  We need to fill leadership roles that have us not only supervising, but managing, non-regulated staff and developing and leading our technician colleagues.

What Can We Do?

Hopefully, if you have made it this far, you agree that this is an issue that not only impacts our profession, but puts our patients at risk.  As regulated health professionals we have an ethical responsibility to address this and as such, PTSA has a plan.  We intend to approach this issue from multiple angles.

Firstly, our PTSA Advocacy committee will be sending emails in response to any job postings brought to our attention that conflates pharmacy technicians and pharmacy assistants. You can flag any questionable postings you see to us by emailing link to the posting to: advocacy.director.south@ptsa.ca

Secondly, we recognize that it is not enough to just send letters. We need to take time to educate our colleagues and the public at every opportunity. That means that if we visit a pharmacy and find a non-regulated staff member is performing a duty that requires a pharmacy technician or a pharmacist, we ask why that is happening and engage them in a discussion around this issue. If the situation warrants it, we need to report the pharmacy to our regulatory authority.

Finally, our Advocacy Committee is working on a tool that will highlight the difference between the scope of a pharmacy technician and the role of non-regulated staff.

I want to thank each and every one of you for your attention to this important matter. I know that Albertans can count on you to ensure their safety by taking action and following up to educate the public on our vital role.