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Pharmacy Across the Border: An Interview with Sherif Guorgui, VP of Pharmacy at the Ontario Pharmacists Association

By: Sang Hyo Kim, Staff Editor

For the brand new year, we present an interview with Sherif Guorgui, the current Vice-President of Pharmacy at the Ontario Pharmacists Association and the former 2011-2012 President of the Ontario College of Pharmacists in Canada. Mr. Guorgui graduated in 1998 from the Faculty of Pharmacy at the University of Cairo and has more than 15 years of experience in pharmacy practice and operations. With his range of independent, franchise, corporate, regulatory and advocacy experience, Mr. Guorgui has strong awareness and comprehension of current and future pharmacy practice opportunities and challenges.

In his free time, Mr. Guorgui enjoys volunteering, watching soccer and spending time with his family.

We are very grateful for his time and hope his words on the aspects of the evolving pharmacy profession can be as informing and inspiring to the student body and faculty as it was to our team members.

Q: You are the Vice President of Pharmacy at the Ontario Pharmacists Association and served as the President of the Ontario College of Pharmacists for the 2011-2012 term.  To address those of us who are unfamiliar with the aspects of the pharmacy profession in Ontario, can you please elaborate on your involvement in both roles, and expand a bit on the practice of pharmacy in Ontario?
A: In Canada, provincial governments have the authority to regulate work and professions. Hence, there are two ways pharmacy can be regulated, either by the College or directly by the government. By transferring its regulating function to the profession, the government is basically enacting the College as an agent to regulate its own members. In addition, by doing so, the government’s accountability to the public is therefore also transferred to the College. As such, the mission of the College, as the registering and regulating body for pharmacy practice, is to regulate the profession to ensure that the public receives quality services and care. Therefore, all pharmacists and pharmacy technicians must meet the professional qualifications set by the College and be registered by the College in order to practice in the province. Likewise, all pharmacies must meet set standards for operations and be accredited by the College.

As member of the College Council, I was actively involved in the regulation of the profession, advancing the standards of practice and governing pharmacies, pharmacists, and pharmacy technicians in a manner that protects and serves the public interest.

As President of the College, I led the Council to achieving the expanded scope of practice for pharmacists. I also implemented new outreach initiatives such as the president’s monthly newsletter and the president’s confidential mailbox, which were exceedingly successful in driving a much needed culture change through inviting, encouraging, and fostering ongoing and productive communications with pharmacists and pharmacy technicians.

With regards to the Ontario Pharmacists Association, it is the largest advocacy organization, continuing education, and drug information provider for pharmacy professionals in Canada. It is dedicated to working on behalf of patients, pharmacists, pharmacy students, and pharmacy technicians across the province to evolve the practice of pharmacy and advocate for the highest standards of professional excellence and fair compensation. The association speaks for all pharmacists, regardless of the environment in which they practice, and advocate for the quality care and well-being of their patients.

As Vice President of Pharmacy at the Association, I am responsible for the development of policies, procedures, guidelines, education and operational resources related to the advancement of pharmacy practice, in addition to advocating on behalf pharmacists and the profession with stakeholders such as government and other key policy makers.

I am truly fortunate to have had the opportunity to be actively involved in both the regulatory and advocacy bodies of the profession.

Q: How has your involvement and experience in the Pharmacy Operations as pharmacy manager owner and franchise associate owner, broadened your scope in the pharmacy field?
A: The experience I gained through the ownership and operations side, in both the independent and corporate sectors, enabled me to have a healthy comprehension of the various pharmacy business models and practice settings. It helped me understand the correlation between the practice of pharmacy and the business of pharmacy and recognize that they are heavily intertwined.

Q: What further goals do you have in mind as the Vice President of pharmacy at the Ontario Pharmacists Association? Are you still involved with the Ontario College of Pharmacists?

A: In my opinion, collaboration between the Association and the College is absolutely necessary. However, their separate existence is essential to ensure there is no conflict of interest as each carries out its own mandate. Therefore, when I joined the Ontario Pharmacists Association, I decided to resign my seat on the Council of the Ontario College of Pharmacists, in order to avoid any potential perception of conflict, and hence, continue to uphold the College Council values, in particular transparency.

My main goal with the Ontario Pharmacists Association is to support it in achieving its vision of an integrated and collaborative healthcare system where pharmacists are able to practice to their full potential, and the value of the professional healthcare services they provide is widely and appropriately recognized, in addition to unifying the voice of pharmacy owners, independent and corporate, under the banner and equity of the Association.

Q: What major changes have you seen when it comes to the role of pharmacists in clinical and corporate settings since you have become a pharmacist?
A: Over the past decade, the common theme in pharmacy practice was change. Our traditional role has been quickly changing from medication dispensers to healthcare providers. The reality is that the population is not only aging, but also living longer, often with co-morbidities, requiring multiple medications and ongoing care. As pharmacists, we are certainly well positioned to take a leadership role in addressing that increased demand on the healthcare system.

Q: What are the certifications for and independent coursework involved in regards to the Leaders for Change Program; Maytree Foundation, which you were part of?
A: I participated in the Leaders for Change program in 2001/2002. It is a leadership program committed to building the capacity and strengths of immigrants as potential leaders in the Canadian society. It is a nine-month program, offered through the Maytree foundation, and involves a variety of learning environments and opportunities, including mentoring, skills-based training and self-directed action projects. The program was launched in 1999 and has approximately 180 alumni to date.

Q: Some pharmacists may find the thought of regulated pharmacy technicians (RPhTs) unsettling. You mentioned in a previous interview: “waiting to have a wide adoption of more patient-centered services by pharmacists before the introduction of regulated pharmacy technicians was not necessarily going to be a more effective strategy.” How much do you support the idea of expanding the role of technicians in pharmacy setting?
A: There is no doubt that one of the main barriers preventing pharmacists from properly adopting the expanded scope of practice and enhanced patient-centered services – is time. Therefore, in order to be able to incorporate additional services into daily practice, changes must be made to both the traditional workflow and business models. That’s where the incorporation of regulated pharmacy technicians into the workflow would be extremely valuable.

The initial step for a successful transition would be for pharmacists to stop performing the counting, packaging, labeling and checking routines and delegating these technical functions to qualified pharmacy technicians. Please note that pharmacy technicians in Ontario now have an independent authority to sign off on the technical aspects of the prescription preparation, allowing pharmacists to focus on the therapeutic appropriateness and clinical consultations/services. Perhaps one of the reasons why the majority of pharmacists are yet to capitalize on the incorporation of regulated technicians into their practice is because, in the current/traditional workflow, the function of doing the final (technical) check of a prescription and determining its therapeutic appropriateness is done as one step, by a pharmacist, at the end of the dispensing process.

However, these are in fact, separate functions that can be done by two distinct regulated healthcare professionals (ie. a pharmacist and a regulated pharmacy technician). There is no doubt that the evident net result of having a pharmacy technician responsible for independently authorizing the final check of prescriptions is that pharmacists will have much more time than they currently do, which would ultimately allow for more opportunities to deliver on their expanded scope and enhanced services.

Q: What is your opinion of the creation of the Pharmacy Technician Accreditation Commission (PTAC), which will be tasked with assuring and advancing the quality of pharmacy technician education?
A: This is certainly an important step in the right direction. In Canada, Ontario was the first province to regulate pharmacy technicians in December of 2010. This means that now pharmacy technicians have to meet entry-to-practice requirements in order to be registered with the Ontario College of Pharmacists (the College). As such, they have to graduate from an accredited pharmacy technician program, and complete a twelve-week internship under the supervision of a preceptor. In addition, they must successfully pass the Pharmacy Examining Board of Canada qualifying examination, as well as the College’s jurisprudence exam. They must also pay an annual registration fee with the College and maintain personal professional liability insurance. In addition to having continuing education requirements and being subject to the College’s quality assurance, complaints and discipline processes. Therefore, a “pharmacy technician” is now a restricted title in Ontario. If someone wants to work in a pharmacy without going through the above process, they would be called a “pharmacy assistant.”

Q: In past interviews, you emphasize the need for pharmacists to accept and embrace the “expanded scope” in acquiring the confidence to practice beyond the traditional comfort zone. Can you explain to us the specifics of the “expanded scope” and what we as students should expect in the future?
A: In October 2012 the Ontario government officially announced the regulation permitting an expanded scope of practice for pharmacists. Under the new scope, pharmacists are now able to:

  • Prescribe specified drug products for the purpose of smoking cessation;
  • Renew and adapt (alter dose, dosage form, regimen, or route of administration) prescriptions
  • Perform a procedure on tissue below the dermis to support patient self-care and chronic disease monitoring;
  • Administer, by injection or inhalation, substances listed in the regulation for the purpose of education and demonstration; and
  • Administer influenza vaccine to patients five years of age and older in accordance with Ontario’s Universal Influenza Immunization Program (UIIP).

Furthermore, the Ontario Pharmacists Association is heavily advocating for further scope expansion to include routine immunizations, prescribing for minor ailments, making therapeutic substitutions and authority to order lab tests.

Hence, as the pharmacist’s role continues to expand, as the use of technology continues to grow, and as the practice and business models continue to evolve, you should expect that in the future your main role and responsibilities will in essence be beyond the counter. You will be more involved in patient care and their medication therapy management. Employers will be looking for pharmacists who can utilize their cognitive skills to effectively communicate with patients and deliver on clinical services. Moreover, there will be a much needed transition from “black or white” practice rules to practicing in the “grey”. As patients’ conditions and medications get more complex, pharmacists would be expected to rely more on their professional judgment to make decisions tailored to their specific individual patient’s needs. That’s a fundamental shift from the traditional role of following directions to a new role of making decisions.

Q: You have had international pharmacy experience as a member of the American Pharmacists’ Association and the International Pharmaceutical Federation. Can you describe what that has been like for you? How did these international experiences influence your perception of the pharmacy industry?
A: Exposure to international pharmacy practice has been an invaluable experience. It is a great opportunity to connect with colleagues from around the world, share information, best practices and resources, as well as exchange views and solutions to common challenges.

Q: For students studying pharmacy at St. John’s University, can you give us some words of advice from your college and work experience?
A: As you begin your career in pharmacy, make sure you take the time to properly explore the wide range of career paths options available to you. Your pharmacy degree offers you a variety of sectors to practice in such as community/retail, hospital, research, academia, industry, regulation, advocacy, administration, etc. Never make your career choice based on short term gains (such as a higher starting salary for instance), but rather plan your career in advance and make your decision based on where it would lead you five and/or ten years later. Also, as I mentioned earlier, the practice of pharmacy and the business of pharmacy are intertwined, so make sure you understand and learn about the economics of pharmacy. Lastly, as the future leaders of the profession, it is paramount that you seek active involvement in local and/or national professional organizations. In addition to contributing immensely to your personal and professional growth, such involvement would also provide you with fulfillment from giving back to your profession.

Q: What is your opinion of the Rho Chi Post? Do you think, as a student run newsletter, there is anything we should be focusing more on?
A: I am extremely impressed with your newsletter, the quality of the articles, and the choice of topics. I also have to commend you for reaching out to interview local, national, and international thought-leaders in the profession. Keep up the good work.

The Rho Chi Post would like to thank Sherif Guorgui for sharing his time and expertise!

Published by Rho Chi Post
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