march / april 2008 acpnews - alberta college of … unwieldy yo-yo, and likes to complain. how...

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In this issue...

ACP President Dianne Donnan robes a first-year student at the UofA’s Faculty of Pharmacy andPharmaceutical Sciences fourth annual White Coat Ceremony. See article on page 2.

newsacpsafe, effective, responsible

pharmacist practice

Meet ACP’snew ComplaintsDirector, Jim Krempien

He can buildigloos out ofmilk jugs, tamean unwieldy yo-yo, and likes tocomplain. Howfitting then, thatJim Krempienhas taken on the

role of Complaints Director with theAlberta College of Pharmacists.

Jim was attracted to pharmacy by itspromise of allowing him to listen topeople’s problems and concerns.Armed with his BSc Pharm (’91) fromthe UofA, Jim set out to help peopleresolve their medication and health

issues. After working as a pharmacistwith the Canadian Armed Forces, Co-op Pharmacy, and most recently,Canada Safeway Pharmacy, Jim saysthat it is the ability to positivelyinfluence someone’s health that heenjoys most about the profession.

Jim has been actively involved in theprofession for a number of years. Hewas an RxA board member from 2000-02, and an ACP council member from2005-07. He says, “I’ve always said thatyou don’t get to complain about asituation unless you’re willing to bepart of the solution. Anyone who hasworked with me knows how much Ilike to complain, so it seemed naturalthat I would be drawn towards gettinginvolved with both the Association andthe College.”

When asked what he thinks the biggestchallenge is for pharmacists right now,

continued on page 2

2 • Council election update• On the path to professional

pharmacist practice

3 • Registration renewal time• Renew online and WIN!• Registration fees• CE requirements for registration

renewal

4 • Your learning portfolioresponsibilities

• Online Continuing ProfessionalDevelopment Plan

• ACP/RxA Conference:Register now and save!

5 • Therapeutic substitution ormanaging ongoing therapy?

• TPP prescription pad changes• Legislation Orientation

Authorization

6 • Evaluate hand washing practices• PEBC assessors needed

7 • Off-label uses of drugs• Poor literacy can equal poor

health

8 • Investigating Committee reports

10 • Health Canada advisories

11 • Did you graduate in ’78?

12 • ACP is coming to a townnear you

• Dean’s Tournament of Golf• In memory

The class of 2011 reciting the Pledge of Professionalism.

Jim replied, “The changes to our scopeof practice and the expectations ofothers are just the first step. To trulyhave an impact, pharmacists need toput these new privileges into practice.Pharmacists need to continue to engagethemselves as medication managementexperts and work with their employers,College, Association and others to makethese recent changes meaningful.”

Jim will join the ACP administrativeteam on March 3, and will replace MervBlair on May 1, 2008 upon Merv’sretirement after nearly 18 years ofservice with the former AlbertaPharmaceutical Association and ACP.Jim is looking forward to working withpharmacists and others to demonstrateto all Albertans that “the trust earnedby our profession continues to beexercised responsibly.” Welcome Jim! �

Council electionupdateACP issued a call for nominations tovoting members in Districts 3(Edmonton) and 5 (Calgary). With theresignation of Jim Krempien fromcouncil, a new candidate will be electedin District 3. Lane Casement is theincumbent in District 5, eligible for asecond term on council.

An election will not be held in District 2(Lethbridge/Medicine Hat) this year, as

Rick Siemens has been installed asPresident Elect. However, an electionfor a two-year term will be held in thisdistrict next spring (2009). This is achange permitted through ACP’s newby-laws to accommodate improvedsuccession planning on council. �

On the path toprofessionalpharmacistpracticeOn the crisp evening of January 10th,the Faculty of Pharmacy andPharmaceutical Sciences held its fourthannual White Coat Ceremony at theUofA. Guest speaker Bunny Fergusonspoke of professionalism, integrity, andleadership–qualities that will beessential in the everyday lives of thesefuture healthcare professionals. Next,the students were “robed” in theirwhite dispensing jackets and were ledthrough the Code of Ethics by ACPregistrar Greg Eberhart.

It was a proud and symbolic eveningfor many. Emotions ran high as MCMatt Tachuk and Class of ‘57 alumnusVic Harrison spoke of their passion forpharmacy and the incredibleopportunity and adventure that theclass of 2011 is embarking on. Tocommemorate the evening, eachstudent was given a ceramic mug,crafted by Mr. Harrison and donated byWyeth Consumer Healthcare. �

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alberta college of pharmacists safe, effective, responsible pharmacist practice pharmacists.ab.ca 2

acpnewsis published six times per year

by the Alberta College of Pharmacists.Submissions for publication should be sent to:

Karen Mills, Communications LeaderAlberta College of Pharmacists

1200 - 10303 Jasper Avenue NWEdmonton, AB T5J 3N6

[email protected]

The deadline for submissions is April 7, 2008 for the May/June 2008 issue. Information about content and length of

articles can be obtained from Karen.

Alberta College of Pharmacists1200 - 10303 Jasper Avenue NW

Edmonton AB T5J 3N6(780) 990-0321

Toll Free: 1-877-227-3838 Fax: (780) 990-0328

Website: pharmacists.ab.ca

President: Dianne DonnanPresident Elect: Rick Siemens

Vice President: position vacantPast President: Jeff Whissell

Councillors:Wilson Gemmill, District 1

Rick Siemens, District 2Position vacant, District 3

Catherine McCann, District 3Jeff Whissell, District 3

Dianne Donnan, District 4Lane Casement, District 5 Anjli Acharya, District 5Donna Galvin, District 5

Merv Bashforth, District 6

Public members: Joan PitfieldPat Matusko

Councillors and our public members can bereached by email via our website at

pharmacists.ab.ca under About ACP/ Council,or by using the search feature to locate

them by name.

Staff DirectoryAll staff are available at (780) 990-0321

or 1-877-227-3838 or by fax at (780) 990-0328.

Their email addresses are available on ourwebsite at pharmacists.ab.ca under Contact Us.

Registrar: Greg EberhartDeputy Registrar: Dale Cooney

Competency Director: Roberta StasykComplaints Director: Merv Blair

Quality Pharmacy Operations Director: Jill MoorePatient Safety Advocate(Pharmacy Operations):

E. Randy FrohlichBusiness Manager: Lynn Paulitsch

Registry Leader: Linda HagenCommunications Leader: Karen Mills

New Complaints Directorcontinued from page 1

acpnews

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Registration renewal packages will bemailed in early April. Be sure to call ouroffice if you have not received yourpackage by April 30. Some key notes tokeep in mind:

� The renewal deadline forpharmacists is June 1, 2008. Yourregistration still expires on June 30,but the college must receive yourcompleted renewal form andpayment or online renewal byJune 1.

� Pharmacists who do not renewbefore July 1 will be immediatelysuspended and will be assessed a$247.80 reinstatement fee ($236.00 +$11.80 GST) in addition to theirannual permit renewal fees. �

Renew online and WIN!This year, registering online could makeyou a winner. Not only can you savetime and postage, one lucky registrantwho renews online before June 1, 2008will win the equivalent of his or her2008/09 renewal fee.

Your name will be enteredautomatically when you renew online,even if your payment is submitted bycheque. Don’t forget that you can alsoupdate your registration profile andmaintain your Continuing ProfessionalDevelopment Log online. �

2008/09 annualregistration feesThe annual registration fee for the2008/2009 licensing year will be:

� Clinical Pharmacist 2008/2009 -$743.40 ($708.00 + $35.40 GST)

� Associate - $215.25 ($205.00 + $10.25GST)

The increase from 2007/2008 representsa cost of living adjustment.

Individuals renewing after July 1 willbe also be assessed a Reinstatement Feeof $247.80 ($236.00 + $11.80 GST).

The complete schedule of fees for2008/2009 is posted on the ACPwebsite at http://pharmacists.ab.ca/Content_Files/Files/FeescheduleJul2008toJun2009.pdf.

The pharmacist registration fee doesnot include malpractice insurance.Malpractice insurance is a personalresponsibility of each pharmacist and isavailable through a variety of sources. �

CE requirementsfor registrationrenewalRemember, your registration renewalmust be received at our office by June 1.Have you already acquired theminimum 15 CEUs required forregistration renewal? Or will you bescrambling for continuing educationactivities in May? We encourage you toconsider what learning needs you haveand undertake learning activities toaddress these identified needs.

We encourage you to try the onlineContinuing Professional DevelopmentLog. You can find this in the MyRegistration Profile section of ourwebsite (pharmacists.ab.ca). Mostaccredited Canadian continuingpharmacy education courses areentered into the database, so you canchoose your course from a drop downlist. Once you find the correct courseyou just enter the date you took thecourse and the number of CEUs you’reclaiming and click Submit. Whenyou’re ready to renew your registrationyou can do the entire registrationrenewal process online, includingsubmitting your electronic CPD Log. �

New emailaddress?Please remember that ACP can notredirect pharmacist email to anotheraccount; we don’t have access to orpermission from your Internet serviceprovider. The only address that willbe registered at the college is the onefirst assigned upon licensure (e.g.,[email protected] or the [email protected]). Toforward your email to anotheraccount:

1. Go to the ACP website(http://pharmacists.ab.ca) and logon to Registrant Mail (the envelopeicon on the left side of thehomepage).

2. Choose Options from the menu onthe left side of the screen. A pagewith a list of headings will appear.

3. Choose General, the first option inthe list. A new page will appear.

4. Approximately half way down thepage is a box entitled Forward allmail to the following address. Enterthe email address you would likeyour messages forwarded to in thisbox.

5. Directly beneath that box is a verysmall box entitled Don’t deliver tothis mailbox. Click on the small boxto add a check mark to it. Thecheck mark signifies NOT todeliver to the Registrant Emailinbox, but to forward the mail tothe new email address youindicated. If you choose not to addthe check mark, any emailcommunications will be forwardedto both the new address and theRegistrant Email inbox, creatingduplicates of the same message.

By redirecting the account, you willensure that you don’t miss anyimportant information from thecollege.


SPRINGis registration renewal time

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Your learningportfolioresponsibilitiesAs we approach registration renewaltime, ACP’s competence departmentreminds you of your responsibilitiesregarding your personal learningportfolio and declaration of continuingprofessional development activities.

The competence committee hasdirected that if you are selected foraudit of your learning portfolio, youmay not renew your registration untilyou have fulfilled the requirements ofthe learning portfolio audit.

Further, the Health Professions Actstates that the competence committeemust make a referral to thecomplaints director if, on the basis ofinformation obtained from a practicevisit or continuing competenceprogram, the competence committeeis of the opinion that a regulatedmember has intentionally providedfalse or misleading information

related to their participation in thecompetence program. In other words,signing an intentionally false ormisleading declaration regardingcontinuing professional developmentactivities will result in a referral to thecomplaints director.

Preparing for registrationrenewal

As you complete your learningactivities for the 2007-08 registrationyear and prepare to submit yourContinuing Professional DevelopmentLog for registration renewal, ensurethat you:

� have supporting documentation forall learning activities claimed onyour CPD Log; acceptablesupporting documentation includescertificates for accredited programsand non-accredited learning recordsfor non-accredited learningactivities;

� file all your learning portfoliodocuments in a safe, accessibleplace; and

� carefully consider theprofessional declaration beforeyou sign it and ensure youunderstand what you aredeclaring by signing it. �

Online ContinuingProfessionalDevelopment PlanACP has completed the initialdevelopment of the online ContinuingProfessional Development Plan.Currently, several pharmacists arepiloting this new tool. They willprovide useful feedback to us on howto improve the system. We hope toroll this system out to all Albertapharmacists by June 2008 so you canbegin the new registration year bycompleting a self-assessment anddeveloping your learning plan for thecoming year. Stay tuned for moreupdates! �

C O N T I N U I N G P R O F E S S I O N A L D E V E L O P M E N T ( C P D ) P L A N

So much to learn,so little time!

acpnews

The advance program for thePharmacists on the Tightropeconference is included with thisissue of acpnews. This eventpromises to be an invigoratingmix of inspiring speakers,celebratory moments,motivatingworkshops, andfun-filled timewith peers. Youwon’t want to missit. And you won’t want to missthe early bird registrationdeadline either. Register by April 23 and save!

R E G I S T E R N O W A N D S A V E

Therapeuticsubstitution ormanaging ongoingtherapy? A practice tip for youPharmacists must consider the factorsinvolved in therapeutic substitution ona case to case basis. In all situations,pharmacists must be diligent inapplying Standard 2 – “Pharmacist’sDuty to Consider RelevantInformation” before making asubstitution decision. Fundamental tothese considerations is anunderstanding of the disease conditionbeing treated, the drug prescribed andany alternatives being considered, andthe therapeutic goal or target. Forexample, one should consider that notall statins have the same therapeuticeffect, and therefore can not simply beinterchanged just because they comefrom the same therapeutic class.

Limitations on therapeuticsubstitution

It is important to remember thedistinction between adapting aprescription by therapeutic substitution– an activity that all clinicalpharmacists* can perform – andmanaging ongoing drug therapy, whichrequires additional prescribingauthorization from ACP.

Adapting a prescription by therapeuticsubstitution will almost always belimited to new prescriptions. *Anypharmacist registered on the clinicalregister who has completed the

orientation program delivered by thecollege is authorized to adapt aprescription.

Therapeutic substitution occurring atthe time of refill to address side effectsor inadequate therapeutic effect isconsidered management of ongoingdrug therapy and may only beperformed by pharmacists who havebeen granted additional prescribingauthorization under s16(3) of theregulation. �

TPP prescriptionpad changes –easier and safer touseAs part of a quality improvementinitiative, the Triplicate PrescriptionProgram (TPP) is making changes to itsTPP prescription pads in 2008.

The size of the form and informationrequired remain the same, but severaldesign changes have been put in placeto make the pads easier and safer touse. What changes will you see?

� Larger spaces provided for patient’shealth care number.

� Two additional lines provided forwritten directions for use.

� Areas of the form that must becompleted are clearly indicated

� Blue ‘thermochromic’ ink at the topof the form has been added toprevent TPP pad forgeries. (The inkis heat sensitive – holding yourthumb on the ink or breathing on itwill make the ink disappear. Itreappears shortly afterwards.)

These changes will make faxed TPPprescriptions more legible forpharmacists.

When will the changesoccur?

TPP will begin filling prescription padorders with the new forms onceexisting supplies are used up, which isexpected in March 2008. Until this time,prescribers should continue to use their‘old’ TPP prescription pads.Pharmacists can accept TPPprescriptions written appropriately oneither version of the TPP prescriptionform. Transition to the new formsacross the province will take severalmonths.

The process for submitting forms is notchanging. Pharmacists should continueto mail copies of TPP prescriptions tothe CPSA as usual.

For more information:

Contact the Triplicate PrescriptionProgram at (780) 423-4764, toll free at 1-800-561-3899, email [email protected] or visitwww.cpsa.ab.ca/collegeprograms/tpp_resources.asp. �

LegislationOrientationAuthorization –have you receivedyours?Under our new legislation, clinical(practising) pharmacists in Alberta areeligible to prescribe for the purposes ofadapting prescriptions and foremergency situations. You can only dothis if you have completed anorientation to the new legislation. Westill have over 300 pharmacists whohave not completed this yet!Pharmacists wishing to continue topractice after July 1, 2008 mustcomplete this orientation by June 2008in order to renew their practice permit.The orientation can be completedonline through our website(http://pharmacists.ab.ca/news_events/default.aspx?id=5899). �

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acpnews

Have you moved recentlyand forgotten to let thecollege know?

Don’t take a chance on not receivingnews and information. Update yourinformation online using MyRegistration Profile, drop us an email [email protected], or send us a fax at 780-990-0328—butlet us know where you are so we cankeep you up to date.

New digs?

PEBC assessorsneeded for May 25examThe Pharmacy Examining Board ofCanada invites interested pharmaciststo apply as assessors for the nationalcertification exam on Sunday, May 25,2008 at sites in both Edmonton andCalgary.

To qualify you must have been licensedin Canada for at least three years andyou must currently be a member ingood standing and providing ordirectly supervising patient careservices, including dispensing, clinicaland drug information services.

Assessors will be involved in theobjective structured clinicalexamination (OSCE).

Preceptors in the practice setting(e.g., for structured practicaltraining, internship and clerkshipprograms) and occasional teachingassistants in years 1 and 2 of theacademic program would normallyqualify as assessors.

Information about the exam, guidelinesfor the selection of assessors, as well asan assessor interest survey andresponse form, can be found on thePEBC website at: www.pebc.ca/EnglishPages/OSCEAssrs/AssrHomePage. html

Interested pharmacists outside ofEdmonton and Calgary are welcome toapply as assessors. Some travelexpenses may be paid to out-of-townassessors.

Edmonton contact:

Please send your response form byemail (preferred) or fax to:Judith Makarowski Fax: 780-492-2874 Email: [email protected]

Calgary contact:

Please send your response form byemail (preferred) or fax to: Yoshiko ShimizuFax: 403-475-0566 (between 9am-9pm)Email: [email protected] �


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On Jan. 16, 2008, Hon. David Hancock, Ministerof Health and Wellness, announced a provincial

Infectious Disease Strategy. “The strategy andstandards were developed in response to

findings of the Provincial Infection Prevention andControl Review, released in August 2007. A key

component of the strategy is the Alberta HandHygiene Strategy, developed in consultation with

regional public health and IPC specialists,representatives of the Community and Hospital

Infection Control Association Canada, theCanadian Patient Safety Institute, the federal FirstNations and Inuit Health Branch of Health Canada,and other stakeholders.”

“Adequate hand hygiene is the most effective meansof reducing the spread of infection in the health-caresetting, other service sectors and the community.”

A copy of the strategy and associated standards are athttp://health.gov.ab.ca/resources/pub_infection-

prevention.html. Much of the strategy focuses ongovernance and practice within regional health

authorities; however, the standard on hand-washing isrelevant to all pharmacists. Pharmacy licensees and

regional directors of pharmacy are encouraged toreview this standard in conjunction with

existing infrastructure and operatingpolicies and procedures. Ask yourself:

� Does your practice setting have anadequate area and equipment tofacilitate routine hand washing byyour staff?

� What hand washing practices doyou expect of your pharmacistteam?

� When and how often do youexpect that hand washing occur?

� Have you consideredincorporating “sanitizing

dispensers” in your pharmacyfor your staff, and/or in patient

access areas to your pharmacyfor patients?

� Do your practices comply withthe provincial standards?

Evaluatehandwashingpractices

Pharmacists are reminded that it isgood practice to critically evaluate andreflect on information gained throughcontinuing professional development,regardless whether the learning activityis accredited or non-accredited. It isthrough reflection that you canconsider the new information – thevalidity of the information, how it fitswith other knowledge you have, if youneed further information, and how youmay incorporate this new knowledgeinto practice. You may want to seekadditional information fromindependent, objective, and peer-reviewed scientific literature.

You may want to be particularlydiligent when considering informationprovided regarding off-label uses ofapproved drugs. It is not illegal todispense drugs prescribed forunapproved indications, nor is it illegalor contrary to accreditation guidelinesfor a continuing education program todiscuss unapproved indications. (It iscontrary to the Food and Drug Act for

pharmaceutical manufacturers topromote their approved drugs forunapproved conditions.) However, lackof approval means that Health Canadahas not reviewed the safety andeffectiveness of this drug for thisindication.

You are reminded that the Standards forPharmacist Practice state that apharmacist must not dispense a druguntil the pharmacist has determinedthat the prescription is appropriate. TheStandards go on to say that whendetermining the appropriateness of aprescription, the pharmacist shouldconsider whether the prescriptionorders a drug for an indication that isapproved by Health Canada,considered a best practice or acceptedclinical practice in peer-reviewedclinical literature, or part of anapproved research protocol.

With regards to prescribing, theStandards state that a pharmacist mustnot prescribe a drug or blood productunless the intended use:

1. is an indication approved by HealthCanada,

2. is considered a best practice oraccepted clinical practice in peer-reviewed clinical literature, or

3. is part of an approved researchprotocol. �

ReminderDon’t forget to put into practice theguidelines in Ensuring Safe &Efficient Communication of MedicationPrescriptions in Community andAmbulatory Setting. The document,jointly published by CPSA,CARNA, and ACP is available onACP’s website athttp://pharmacists.ab.ca/practice_ ref_library/standard_guidlines.aspx

Resources

Poor literacy canequal poor healthPoor reading skills can make thedifference between taking three pillsonce a day or one pill three times a day.

Canada spends $2 billion a year onhospital admissions as a result ofpeople taking their medicationsincorrectly in their home. People withlow literacy skills experience morehealth problems; prescription labelsand written instructions aboutmedications are useless to patients whocan’t understand them.

And health information on the Internetis often at an even higher level, makingit incomprehensible to most of thepeople accessing medical informationonline.

A recent Ontario literacy council reportshowed that at least 42 per cent ofCanadians hide their low literacy skillsand are less likely to feel confident toask questions of their health-care

providers. The study found they mayalso overestimate their literacy skillsand few health-care workers are awareof how common literacy problems are,or how to identify people who havepoor reading and writing skills.

“Literacy is hidden. It’s a shamefulthing. People who have literacy issuesdon’t disclose it. They don’t disclose itto the people who really need to knowit, who are their family practitioners ortheir pharmacists,” said Julie Patterson,a literacy and health program managerat the North Bay Literacy Council.

In addition to following the steps inStandard 7 of the Standards forPharmacist Practice (Pharmacist’s dutyto provide sufficient information topatients in relation to Schedule 1 drugsand Schedule 2 drugs), take intoconsideration the possibility of lowliteracy when counselling patients.Verbal instructions, having the patientrepeat back and/or paraphraseinstructions, and using diagrams whenpossible may increase patientunderstanding and compliance. �

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acpnews

Off-label uses of drugs – exercise caution

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InvestigatingCommittee reportsummariesThree investigations into theprofessional conduct of pharmacistshave recently concluded. Following aresummaries of the InvestigatingCommittee reports for each case. Youcan find the full reports on ACP’swebsite (pharmacists.ab.ca) underComplaints Resolution/InvestigatingCommittee Reports.

ACP is publishing these reports for tworeasons. First, ACP is committed toestablishing and maintaining atransparent complaints resolutionprocess for our registrants and thepublic whom we serve. Secondly, webelieve that there are important lessonsto be learned from each case and hopethat by publishing these summaries,others will gain a clearer understandingof what constitutes acceptableprofessional pharmacist practice.

Case 1

Introduction

The Council of the Alberta College ofPharmacists appointed an InvestigatingCommittee to investigate apharmacist’s conduct as both apharmacist and as the licensee/pharmacy manager, under the terms ofPart 7 of the Pharmaceutical ProfessionAct, R.S.A. 2000, c. P-12.

Allegations

The Investigating Committee held ahearing to inquire into the followingcomplaints or matters that arose fromon-site visits by representatives of theACP:

1. The state of the dispensary area wasso cluttered, messy anddisorganized that tworepresentatives of the AlbertaCollege of Pharmacists wereconcerned that public safety was atrisk.

2. The pharmacist/licensee did notmaintain the dispensary equipmentor area in clean and sanitarycondition and in proper workingorder. The condition of thedispensary area was such that thepharmacist/licensee was not able toensure that he could comply withthe requirements regarding thestorage and disposal of drugs andnonprescription medicines.

3. The pharmacist/licensee had notdemonstrated that he wasknowledgeable about the properstorage and disposal of drugs andnonprescription medicines. Neitherdid the pharmacist/licensee ensurethat his pharmacy’s operations weredesigned to protect the public andthe people working on the premises.The general disarray, clutter,disorganization and condition of thedispensary placed patient safety at

risk and failed to protect andadvance the health and safety ofclients of the pharmacy.

It was alleged that this conduct on thepart of the pharmacist/licenseeconstituted unskilled practice ofpharmacy or professional misconductor both, and that it also constitutedproprietary misconduct.

Findings

The committee found that thepharmacist/licensee engaged inconduct of professional misconductand/or proprietary misconduct. Thecommittee noted that the operationswere in such continuous disarray andcarried on in such an unprofessionalmanner as to create the potential fordanger to the public. The committeealso held that the pharmacist’sworkload was a danger both to himselfand to the public and that staffinglevels were totally inadequate. (Thepharmacist was the only pharmacistpracticing at the location.)

After the committee made its findingsof professional misconduct andproprietary misconduct, it was advisedthat the pharmacist had beendisciplined on three previous occasionsover the last 20 years for similarconcerns.

Orders

The Investigating Committee orderedthat:

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1. The pharmacist be suspended fromthe practice of pharmacy for a three-month period.

2. The pharmacist must not engage inthe sole practice of pharmacy for aperiod of 10 years. During this 10year period, the registrant mustpractice pharmacy as a pharmacistonly under the supervision of apharmacy licensee/manager.

3. The pharmacist cannot be a licenseeof a pharmacy in Alberta for aperiod of 10 years.

4. The pharmacist be fined a total of$30,000 as a result of the findings ofprofessional and proprietarymisconduct from the decisions of theInvestigating Committee.

5. Random pharmacy inspections ofthe location by the College willoccur six times per year for the firsttwo years. Then, four times per yearfor the balance of the 10-year termthat the pharmacist is not a licenseeof a pharmacy. The costs of theseinspections are to borne by thepharmacist/licensee.

6. The Investigating Committee furtherrecommended that all officialCollege pharmacy visits orinspections be documented eachtime by the College when visitingany pharmacy in Alberta. Thepharmacist and/or pharmacylicensee in turn will alsoacknowledge that such a visit orinspection has occurred.

7. All costs associated with this hearingand the investigations by theCollege are to be the responsibilityof the pharmacist/licensee.

In making these orders the committeenoted the previous disciplinary actionsinvolving the pharmacist and statedthat it was necessary to make clear tothe pharmacist how serious thesituation was and to set conditions toensure that this conduct was notrepeated.

Case 2

Introduction

The Council of the Alberta College ofPharmacists appointed an InvestigatingCommittee to investigate the conduct of

Laurel Rankine under the terms of Part7 of the Pharmaceutical Profession Act,R.S.A. 2000, c. P-12.

Allegations

The Investigating Committee inquiredinto the following complaints ormatters.

It was alleged that Laurel Rankine:

1. Entered into arrangements withSullivan Health Care (SHC) whichinvolved dispensing drugs topatients in circumstances where Ms.Rankine and her pharmacy wereunable to comply with theobligations of the PharmaceuticalProfession Regulation, and theStandards of Practice;

2. Entered into arrangements withSHC that assisted SHC, a non-pharmacy to sell drugs to U.S.customers in breach of the Food andDrug Act, the Food and DrugRegulations, and the PharmaceuticalProfession Act;

3. Participated in arrangements withSHC where prescriptions werereceived from Drs. M and A daily incircumstances which Ms. Rankineshould have known did not complywith the Code of Ethics;

4. Participated in arrangements withSHC whereby SHC Budget Rxreceived a financial benefitfacilitated by Ms. Rankine’spharmacy in return for prescriptionsbeing directed to Ms. Rankine’spharmacy to have prescriptionsfilled;

5. Breached the Internet PharmaciesGuideline Policies of the Council ofthe Alberta College of Pharmacists;

6. Failed to comply with the DrugError Management Policy of theAlberta College of Pharmacists andStandard 6.4 of the Standards ofPractice from March 2003 to October2004;

7. Failed to comply with section15(6)(h) of the PharmaceuticalProfession Regulation for the periodfrom March 2003 to July 23, 2003;

8. Maintained patient records jointlywith SHC in a manner that failed tocomply with section 17(2)(a) and

17(3)(d) of the PharmaceuticalProfession Regulation;

9. Generally engaged in conduct inrespect to the arrangements withSHC that displayed a lack ofknowledge of or a lack of skill orjudgment in the practice ofpharmacy.

Findings

The hearing proceeded by way of anAgreed Statement of Facts andAdmissions. It involved a situationwhere SHC, a non-pharmacy operatinga call centre in Manitoba referred largevolumes of prescriptions to an Albertapharmacy. SHC handled all aspects ofdealing with the clients except for theactual dispensing and shipment of theprescriptions for which the pharmacyreceived a dispensing fee. SHC orderedand paid for the drugs delivered to andused by the pharmacy and paid allshipping charges. All invoicing wasdone by SHC which determined theprice to be changed to the patient andthe pharmacist did not know whatmarkup was charged to the patients orwhat fees were charged by SHC.

The Committee accepted the agreedstatement of facts and admissions anddetermined that the allegations againstMs. Rankine were indeed well founded,and that the conduct of the memberconstituted professional misconduct.

Orders

The Investigating Committee orderedthat Laurel Rankine:

1. Receive a letter of reprimand for heractions that stays permanently onher personal registration record atACP,

2. Be fined $2500.00,

3. Be assessed the cost of theinvestigation and hearing in theamount of $12,500.00,

4. Be ordered that in her futurepractice, she:

a. Shall not enter into arrangementsdirectly or indirectly with anyCanadian physician to reviewand co-sign American (U.S.) orother international prescriptions

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continued on page 10

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without the opportunity to seethe patient, unless Ms. Rankinecan confirm with the physician’smedical college that the proposedarrangements are satisfactory andMs. Rankine provides a copy ofthis confirmation to ACP,

b. Shall not knowingly enter intoany arrangements with any non-pharmacist that permits the non-pharmacist to participate in thesale of drugs,

c. Shall not knowingly enter intoany arrangement whereby she orany pharmacy she is associatedwith provides something of valueto another party in return forhaving patients or prescriptionsreferred to the pharmacy.

The committee noted in making itsorders that one of the factors itconsidered was Ms. Rankine’sforthright cooperation with theinvestigative process conducted by theCollege.

In its letter of reprimand to Ms.Rankine, some of the concerns noted bythe committee included the following:

� Almost all contact with the patientwas managed by SHC and in mostcircumstances the prescriptionwould be dispensed to a patientwithout any contact with the patientso no professional relationship wasdeveloped with the patient andthere was no verbal counseling;

� The business arrangement with SHCallowed a non-pharmacy to sellprescription drugs and enabled SHCto act as a call centre and marketingagent to patients requiring aprofessional service;

� Participating in an arrangementwhereby Canadian physicians co-signed prescriptions written by U.S.physicians without seeing thepatient and establishing a properprofessional relationship;

� Allowing SHC to benefit financiallyby directing prescriptions businessto the pharmacy breached section32(8) of the Pharmaceutical ProfessionRegulation.

Case 3

Introduction

The Council of the Alberta College ofPharmacists appointed an InvestigatingCommittee to investigate the conduct ofAndrew Kwok Fai Wong under theterms of Part 7 of the PharmaceuticalProfession Act, R.S.A. 2000, c. P-12.

Background

The College made several attempts,using different delivery modes, to servenotice of the hearing to Mr. Wong. Mr.Wong did not respond to any of thenotices. The Investigating Committeedetermined that the College had metthe requirements of proof of serviceunder section 65 of the PharmaceuticalProfession Act. The InvestigatingCommittee proceeded to hear thematter in the absence of Mr. Wong.

Based on the evidence presented at thehearing, the Investigating Committeefound that Mr. Wong breached:

1. Principles VI “A pharmacist actswith honesty and integrity” and VII“A pharmacist preserves highprofessional standards” of the Codeof Ethics when he:

a. Appeared before an InvestigatingCommittee on October 13, 2006with a signed Agreed Statementof Facts and a Joint Submissionon Penalty confirming that hehad:

i. Voluntarily ceased his Internetpharmacy business in May2005,

ii. Terminated business relationswith Canadian Budget Rx,

iii. Terminated his relationshipwith Dr. Richard Heinrichs,and

iv. Wished to cease activities notapproved by ACP.

Mr. Wong declared thesestatements to be true when in factthey were not and heintentionally misled ACP and theInvestigating Committee.

b. Allowed the InvestigatingCommittee to rely on the AgreedStatement of Facts and Joint

acpnews

Healt

h C

anada

Investigating Committee reports continued from page 9

Health CanadaadvisoriesAfter the last edition of thenewsletter went to print, HealthCanada placed the followingadvisories on its website. You can obtain a copy by usingthe links below or by contactingJanet Spence at the collegeoffice at (780) 990-0321 or 1-877-227-3838, or by email [email protected].

The links will take you to theHealth Canada website.

� Safety Advisory -Alertecwww.hc-sc.gc.ca/dhp-mps/medeff/advisories-avis/prof/2007/alertec_hpc-cps_e.html

� Recall of Ultiva(remifentanilhydrochloride) 1 mgvialswww.hc-sc.gc.ca/dhp-mps/medeff/advisories-avis/prof/2007/ultiva_hpc-cps_e.html

� Unauthorized healthproducts manufacturedby Wild Vineyard maypose health riskswww.hc-sc.gc.ca/ahc-asc/media/advisories-avis/_2007/2007_179_e. html

� Foreign product alertswww.hc-sc.gc.ca/ahc-asc/media/advisories-avis/_fpa-ape_2008/index_e.html

Submission on Penalty todetermine their penalty whichincluded reduced costs andpenalties.

c. Continued his Internet pharmacybusiness from the location of hisnew pharmacy (Concerned CarePharmacy).

d. Maintained his deceptionthroughout the discipline processthat led to the Agreed Statementof Facts submitted to the October2006 Investigating Committee.

e. Continued a businessrelationship with CanadianBudget Rx.

f. Continued his relationship withDr. Richard Heinrichs.

g. Continued participating inactivities which were notapproved by ACP despite havingmatters referred to InvestigatingCommittees and despite havingrepresented that he had stoppedthese activities.

2. Sections 57(a)(i) “Conduct of amember or proprietor that (a) isdetrimental to the best interests ofthe public” and 57(a)(v) “bydiplaying a lack of knowledge ofor a lack of skill or judgment inthe practice of Pharmacy” of thePharmaceutical Professions Act bymisrepresenting his intentions tothe Investigating Committee andACP.

The Investigating Committeeconsidered that Mr. Wong’sintentional disregard for authorityand his willful intention to misleadan Investigating Committee andACP as detrimental to the public’sbest interest and as displaying a lackof judgment in the practice ofpharmacy.

Findings

The Investigating Committeedetermined that Andrew Kwok FaiWong had engaged in professional andproprietary misconduct by breachingPrinciples VI and VII of the Code ofEthics and sections 57(a)(i) and 57(a)(v)of the Pharmaceutical Professions Act and,more seriously, had shown blatantdisregard towards his professionalobligations as shown by his conducttowards ACP and the InvestigatingCommittee appointed for a previoushearing held on Oct. 13, 2006.

Orders

The Investigating Committee orderedthat:

1. The Alberta College of Pharmacistsimmediately revoke Andrew KwokFai Wong’s certificate of registration,

2. Mr. Wong be assessed a fine of$10,000 for professional misconduct,

3. Mr. Wong pay the total costs of theinvestigation, and

4. That the Registrar inform allprovincial pharmacy regulatorsregarding this decision. �

� � � � � ��

acp xPressJan. 31 � Call for council

nominations (Districts 3and 5 only)

acp emails Issued between Dec. 18, 2007 and Feb. 6, 2008.

External

Dec. 18 � The OCP joins NAPRAJan. 2 � Jan. 2008 issue of

Adverse ReactionNewsletter nowavailable

Jan. 3 � Due Quarterly notice� Input: Chronic Disease

Management &Alternate RemunerationPrograms

Jan. 9 � New model, new fees?We need your input

Jan. 23 � PEBC assessors neededfor May 25 exam

Jan. 28 � New model, new fees?We need your input thisweek

Feb. 6 � New model, new fees?More input needed

Operations

Jan. 28 � Additional prescribingauthorization processapproved

Jan. 30 � ACP announces changesto staff and council

Jan. 31 � Send us yournominations!

Practice Issues

Dec. 18 � Notice of pharmacistsuspension

See Health Canada advisories on page 10.

M A R C H / A P R I L 2 0 0 8


acpnews

Date: September 13, 2008

Location:Village Creek Inn, Pigeon Lake1.877.688.006 (please book rooms)

Email for more details: Karen Brown at [email protected]

Deposit: Send $75.00 per person forhall/dinner/breakfast to:

Marg Barr5238 – 42 Street Ponoka, AB T4J 1C9

Don’t forget to call your classmates andlet them know about the reunion!

Did you graduate in ’78?

If you did, youwon’t want tomiss the UofAPharmacy Class of 1978Reunion!

ACP is hosting a series of meetingsthroughout the province to update youon the changes to pharmacist practice,ask for your input on some key issues,and answer any questions you mighthave about the new practiceframework, college initiatives, and anyother practice-related issues. We’d loveto see you there!

Mark your calendars

All meetings will be held in March and will run from 7 to 9 p.m. unlessindicated otherwise.

Mar. 4 – HintonMar. 6 – Grande PrairieMar. 11 – VermilionMar. 12 – Red Deer Mar. 13 – EdmontonMar. 18 – Medicine Hat (7 to 8:30 a.m.)Mar. 18 – LethbridgeMar. 19 – Calgary

Meeting venues will be announced byemail.

Participants can record their attendanceas non-accredited learning in their CPDlogs. The names of all meetingparticipants will also be entered into adraw for one free registration to thisMay’s Pharmacists on the Tightropeconference. Two lucky attendees, onefrom northern Alberta and one from thesouth, will also each win a $150chapters.indigo.ca gift certificate. �

�12

Canadian Publication Agreement Number: 40008642

Return undeliverable Canadian addresses to:Alberta College of Pharmacists1200 -10303 Jasper Avenue NWEdmonton AB T5J 3N6

newsacp

In memoryRobert Fahlman passed awaysuddenly on Feb. 3, 2007 at the age of68 years. He was born in Regina,Saskatchewan and received his degreein pharmacy from the University ofSaskatchewan in 1964. After workingfor many years in hospital and retailpharmacy he returned to his firstpassion, horticulture.

Robert had great love and respect forthe natural world and left softfootprints as he worked in it andwalked through it. He always broughthis warm and generous nature toeverything that he did and is lovinglyremembered by his wife Lynne, family,and friends.

Donald Victor French died on Dec.27, 2007 at the age of 70 years. BornJune 5, 1937, in Edson, Alberta, hereceived his B.Sc. in Pharmacy from theUofA in 1960, where he was a memberof Phi Kappa Pi.

Among other locations, Don workedfor 10 years at the Brewerton MedicalCentre Apothecary in Calgary. In 1988,Don moved to South Carolina andbegan working at White OakPharmacy. He met and married hiswife, Mary Miller French, in 1998,became a US citizen in 2005, andretired in August 2007. Don is misseddearly by his wife Mary and all of hisfamily and friends.

Arn Irion passed away on Sept. 16,2007 at the age of 65. A 1966 graduateof the UofA, Arn most recently workedat Legal Drugs in Legal, until hisretirement in 2005. Arn will be verymuch missed by his family and friends.

�

newsacp M A R C H / A P R I L 2 0 0 8

This newsletter is printed on Rolland Enviro 100 Print, a 100% post consumerpaper, certified Ecologo, Processed ChlorineFree, FSC Recycled and manufactured using biogas energy.

Tuesday, June 3, 2008 at the Blackhawk Golf Club

�Registration forms at

www.pharmacy.ualberta.ca. Click on Upcoming Events.

9 T H A N N U A L

Dean’sTournament

of Golf

ACP is coming to a town near you

march / april 2008 acpnews - alberta college of … unwieldy yo-yo, and likes to complain. how...

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