Ethical conduct is a must when operating a pharmacy
August 21, 2019
Lessons Learned: Honesty and integrity are required in complying with third-party contracts.
A Hearing Tribunal has issued its written decision on the merit and orders about the conduct of a pharmacist who was the licensee and sole practising pharmacist during the period of the alleged misconduct. Central to the allegations were concerns from a third-party insurer about hundreds of claims, worth more than $100,000, submitted by the pharmacy that could not later be supported with corresponding inventory purchase records. The insurer also expressed concern that the pharmacist failed to properly cooperate with the insurer’s claims audit. Additionally, the Hearing Tribunal considered allegations that the pharmacist had created false dispensing records and stored pharmacy records outside of the licensed premises without authorization.
The Hearing Tribunal found that the pharmacist, as the licensee, was the person most responsible for the operation of the pharmacy, including the pharmacy’s submission of the audited claims to the third-party insurer, and the creation of the associated patient records. The Hearing Tribunal concluded that the registrant’s conduct was unprofessional, both with respect to their responsibilities as a pharmacist and a licensee. The Hearing Tribunal found that his actions had harmed the integrity of the profession and warranted significant sanctions.
In this matter, the Tribunal imposed significant penalties even though the pharmacist had no previous disciplinary record. The Tribunal ordered the following:
- a reprimand;
- a suspension of the pharmacist’s practice permit for a period of 12 months;
- fines totalling $30,000;
- the pharmacist not to be an owner, proprietor or licensee of a pharmacy for a period of five years;
- payment of all costs of the investigation and hearing (approximately $56,000);
- the pharmacist to provide a copy of the written decision to the licensee of any pharmacy where he works as a pharmacist for five years; and
- a requirement for the pharmacist to successfully complete the ACP’s Ethics and Jurisprudence exam prior to reinstating as a pharmacist.
Also, the Tribunal directed that a copy of their decision be sent to the Minister of Justice and Solicitor General.
Rationale for the Tribunal’s decision is reflected in the following statements from its March 15, 2019 (merit), and July 2, 2019 (penalty), decisions:
Creating false records harms the integrity of the profession and is detrimental to the best interests of the public. [The pharmacist’s] conduct constitutes clear contraventions of the Act. An insurer must be able to rely on the accuracy and truthfulness of the information that is submitted by a pharmacist.
It is not in the best interests of patient care to upload records into Netcare that were not provided to patients and for which there were no invoices to support them being filled. This was clearly done to benefit [the pharmacist] and to the professional detriment of safe patient care.
Appropriate recording keeping goes to the heart of the integrity of the profession. There must be confidence that the information submitted to insurers is truthful and accurate. The conduct in question harms the integrity of the profession.
Licensees – incorporate these lessons into your practice:
- Review the Pharmacy and Drug Act , the Pharmacy and Drug Regulation, and the Standards for the Operation of Licensed Pharmacies with regard to your responsibilities in the operation of your pharmacy.
- Review and discuss your obligations and the professional requirements of the pharmacy with your pharmacy’s owner and pharmacy staff to ensure that the pharmacy has the resources needed to meet these obligations.
- Don’t assume or “cut corners,” especially when creating or maintaining patient records or submitting claims to third-party insurers. When in doubt, ask and confirm.
- Always approach your, and your pharmacy’s, contractual obligations with honesty and integrity.
- Understand that pharmacy purchase records for drugs and health care products MUST be maintained at the pharmacy.