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Licensees: understand your responsibilities in operating your pharmacies

January 22, 2020
Lessons learned: Ethical conduct requires honesty and integrity in complying with third-party contracts.

A recent Hearing Tribunal issued its written decision on the merit and orders regarding the conduct of a pharmacist who was the licensee and sole practising pharmacist during the period of the alleged misconduct. Central to the allegations considered were concerns raised by a third-party insurer about hundreds of claims, worth more then $170,000, submitted by the pharmacy that could not later be supported with corresponding inventory purchase records. The Hearing Tribunal found that the pharmacist had created false dispensing records. The third-party insurer is pursuing repayment of the $170,000 and has already recovered most of the funds.

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 the registrant’s conduct to be 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 the following significant penalties:

  • a suspension of the pharmacist’s practice permit for a period of 24 months, commencing the day following the end of the 12-month suspension ordered by a previous Hearing Tribunal in its decision on sanctions dated July 2, 2019;
  • fines totalling $20,000;
  • the pharmacist to complete an ethics course prior to being reinstated as a clinical pharmacist;
  • the pharmacist not to be an owner, proprietor, or licensee of a pharmacy for a period of five years, commencing the day following the end of the previous five-year prohibition ordered by the previous Hearing Tribunal;
  • a condition that if the pharmacist reinstates onto the clinical pharmacist register, his practice will be subject to direct supervision for one year, with monthly reports to be provided to ACP from his supervisor; and
  • payment of all costs of the investigation and hearing (estimated to be approximately $18,000).

Also, the Tribunal directed a copy of its decision to be sent to the Minister of Justice and Solicitor General.

Rationale for the Tribunal’s decision, is reflected in its following statements from its December 18, 2019, decision:

[The pharmacist’s] conduct also demonstrated that he allowed his professional judgment to be impaired by financial gain, contrary to principle 1(1) of the Code of Ethics. The public should be entitled to expect pharmacists to be honest in their dealings with others in the provision of healthcare services. The public should also be entitled to expect that pharmacists will not allow their own financial interests to take precedence over the professional obligations and judgment.

The rules and standards for the creation and maintenance of accurate pharmacy records and records of care exist to enable regulators like the College to regulate effectively in the public interest. Breaching them is unprofessional.

Licensees – Incorporate these Lessons into Your Practice

  1. 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.
  2. 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.
  3. 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.
  4. Licensees and pharmacy team members should review, become knowledgeable about, and comply with all third-party contracts that they enter into.
  5. Always approach your, and your pharmacy’s, contractual obligations with honesty and integrity.
  6. Understand that pharmacy purchase records for drugs and health care products MUST be maintained at the pharmacy.