‘Our job is to help patients and decrease the load on emergency departments,’ says Midland pharmacist; Ontario continues to expand role of pharmacists

Across Ontario, pharmacists are playing an increasingly important role in primary health care as the province continues expanding their scope of practice to improve access to care and reduce pressure on family physicians and emergency departments.

The latest expansion, introduced in July 2026, allows pharmacists to assess and prescribe for nine additional common ailments and administer six more publicly funded vaccines. Since the program launched in 2023, Ontario pharmacists have completed more than 2.4 million assessments for common ailments, with further expansions planned in 2027.

Ramez Raafat, owner of Remedy’s Rx in Midland and PharmaChoice Main Street Pharmacy, which opened March 24, 2026 at 135 Main St. in Penetanguishene, has witnessed that evolution firsthand.

“I’ve been practising in Canada for roughly 10 years,” Ramez said. “The last few years, especially after COVID, we started to see much more attention to pharmacists as primary health-care providers.”

During the pandemic, pharmacies remained open even as many medical offices limited in-person appointments.

“Patients would come in asking what they could take if they had COVID symptoms like coughing,” he said. “We could assess the situation, determine whether they needed to go to the hospital or whether we could help them with medications based on a pharmacist’s recommendation.”

While the expanded role comes with greater responsibility, Ramez believes it ultimately benefits both patients and the broader health-care system.

“Our job is to help patients and decrease the load on emergency departments,” he said. “Emergency rooms are already busy with people who have serious medical problems.”

One of the biggest changes has been pharmacists’ growing role in immunizations.

Although many people associate pharmacy vaccinations with COVID-19, Ramez said pharmacists now routinely administer influenza, shingles and pneumonia vaccines.

Under Ontario’s latest expansion, pharmacists can also provide publicly funded vaccines for tetanus, pertussis, diphtheria, pneumococcal disease and RSV, making pharmacies an increasingly convenient place for routine immunizations.

“We keep track of our patients and try to make sure they’re getting the vaccinations recommended for them, especially vulnerable populations,” he said.

Patients also increasingly seek advice about which vaccines they should receive.

“Sometimes physicians are very busy, and patients forget to ask those questions,” Ramez said. “When they come to us, we can review their situation and recommend the vaccines they should receive.”

The expanded scope has become particularly valuable in communities such as Midland and Penetanguishene, where many residents continue searching for a family physician.

“There are still many patients without family doctors,” he said. “They either go to emergency departments, walk-in clinics or come to the pharmacist.

“Over the past several years, we’ve seen many physicians retire, and replacing them hasn’t always been easy. In some cases, they’re not replaced at all, and in others, it takes a long time,” he said.

Treating common ailments

Today, pharmacists can assess and prescribe medications for a growing list of common ailments, including urinary tract infections, allergies, pink eye, eczema, tick bites, poison ivy and several other conditions added by the province over the past few years.

Each assessment follows a structured clinical questionnaire designed to determine whether treatment can safely be provided or whether the patient should be referred to a physician or emergency department.

“We help a lot with urinary tract infections,” Ramez said. “If the patient needs a referral, we send them to the appropriate place, but many patients can receive the treatment they need through the pharmacy.”

During poison ivy season, pharmacists can also prescribe medications that previously required a doctor’s visit.

“You don’t have to wait several days for an appointment,” he said. “We can prescribe anti-inflammatory medications when they’re appropriate.”

Pharmacists can also help people bitten by ticks.

“Tick bites are one of the advantages that have been added as a minor ailment,” Ramez said. “Previously, patients had to see a doctor to get preventive treatment for Lyme disease. Now they can come to the pharmacist, we’ll assess them using specific criteria, and if they qualify, we can prescribe the medication.”

Ramez said his background as a compounding pharmacist offers an added benefit for children.

“The medication that’s commercially available comes in one tablet strength,” he said. “For younger children, that’s often not appropriate based on their weight.”

Instead, he can prepare a customized liquid formulation that delivers the correct dosage.

If someone cannot swallow tablets, for example, pharmacists can often change the medication to a liquid form without requiring another doctor’s appointment.

Pharmacists also routinely review medication profiles for potential drug interactions and dosage concerns.

Ramez said patients receiving dialysis often require medications to be adjusted for kidney function.

“If I know the patient is on dialysis, I can adjust the dose to the appropriate kidney dosing to make sure it’s suitable for them,” he said.

When a different medication may be more appropriate, pharmacists can also work directly with physicians to recommend alternatives, helping patients avoid unnecessary delays in treatment.

He encourages patients — particularly seniors taking multiple medications — to meet with their pharmacist to review their prescriptions.

“I find many patients have been taking medications for years and don’t really know what they’re for anymore,” he said.

Medication reviews can also identify prescriptions that are no longer necessary.

“It’s not always about adding medications, sometimes it’s about decreasing them.”

Ramez expects pharmacists’ responsibilities will continue expanding as Ontario looks for new ways to improve access to primary care.

“There are lots of responsibilities that have been added, and they’re going to continue to be added,” he said.

For patients wondering whether a pharmacist can help with a specific health concern, he recommends speaking directly with their local pharmacy or reviewing Ontario’s list of pharmacist-treated minor ailments through the Ontario College of Pharmacists.