College registrants have a legal and ethical obligation to promote and protect the best interests of their patients. The majority of College registrants are competent and skilled practitioners who work hard to uphold this obligation and maintain patient confidence by providing safe and effective pharmacy care.
However, there are times when a patient, co-worker, employer or other health care professional may have a concern about the pharmacy care delivered by a pharmacist or pharmacy technician. The College’s complaints resolution process is designed to deal with such circumstances and is grounded in the College’s mandate to protect the public.
Contacting the College about a Complaint
If you have a concern about the care you received from a pharmacist or pharmacy technician, the best place to start is to speak directly with that person about your concern. Simple miscommunications are often at the root of many complaints, and although it may be difficult, a face-to-face discussion is often the best way to resolve an issue.
If you are unable to resolve the concern with the pharmacist or pharmacy technician, it may be appropriate to contact the College’s complaints line 1-877-330-0967.
Learn more about the complaints process at bcpharmacists.org/complaints.
In response to the concerns received from the Ministry of Health, members of the public, registrants, and other health care professionals regarding the dispensing of Methadone Maintenance Therapy (MMT) from pharmacies, in June 2015 the College Board approved a four-year MMT action plan (Methadone Maintenance Treatment: Enforcing Standards) to address the concerns raised and to take action with respect to alleged non-compliance with legislative requirements and practice standards.
One of the goals in the four-year MMT action plan was for the College, in collaboration with the Ministry of Health, to develop, plan, and implement a minimum of six new undercover investigations, given the significant findings yielded in undercover investigations conducted between 2010 and 2012. The undercover investigations were to occur over the four-year period of the action plan and would focus on the identification of non-compliance with legislative requirements, practice standards, and ethical standards. Based on the findings of the investigations, the College would take appropriate action, including, if justified, referral to the Inquiry Committee.
Between 2015 and 2017, after consulting with the Ministry of Health and reviewing concerns received, the College retained an investigations company to conduct undercover investigations for nine pharmacies.
The undercover investigators were all provided with patient pseudonyms to use while undercover. These pseudonyms were used to investigate more than one pharmacy. Therefore, the need to protect the identity of the undercover investigators and to not jeopardize the validity of the undercover investigations made it necessary to delay the presenting of all undercover investigation results to the Inquiry Committee until all investigations were complete.
Between March 2018 and November 2018, the Inquiry Committee and College inspectors spent considerable time reviewing the results of the nine undercover investigations. Registrants at six of the nine pharmacies were observed to have significantly contravened legislative practice requirements. The Inquiry Committee is currently in the process of resolving the dispositions with the registrants at these six pharmacies.
Inappropriate Use and Acess of Personal Information
Between January 1, 2014 and November 5, 2017, over 15,000 transactions for over-the-counter (“OTC”) and/or vitamin products were processed on a daily or weekly basis on the PharmaNet records of seven individuals. These seven individuals were not prescribed and had not received any of the OTC and/or vitamin products processed on their PharmaNet records, and had not willingly consented to having these transactions on their PharmaNet records.
These transactions all originated from the same pharmacy.
The pharmacy manager at the time had directed pharmacy assistants to process these transactions on PharmaNet weekly in order to artificially inflate the pharmacy’s prescription count. The pharmacy assistants used the registration numbers of various pharmacist registrants as the dispensing pharmacist and/or prescriber for each transaction, without the consent and knowledge of the majority of these pharmacist registrants.
There were four registrants who were aware of these actions and should have known that the processing of the transactions were an improper use and access of personal information. However, at no time did these registrants make a report to the College about them. The Inquiry Committee was concerned that these registrants did not take personal accountability and “turned a blind eye” to the improper practices for which they were aware, enabling the improper practices to continue for over three years. While these registrants did not stand to gain financially from what occurred, it was their professional responsibility, to the public as well as the profession, to ensure that practice and ethical standards were being met at all times while on duty. As a member of a professional body, registrants are responsible not only for their own actions, but are accountable for others in the workplace when they know, or ought to know, that inappropriate practices were occurring and ongoing. These registrants’ actions, or lack thereof, were contraventions of legislation involving protection of personal information and supervision of pharmacy assistants. They also contravened standards of the Code of Ethics involving protecting and promoting the well-being of patients, benefitting society, and committing to personal and professional integrity.
All four registrants entered into Consent Agreements with the Inquiry Committee. All of these registrants consented to reprimands, taking an ethics course, re-taking the Jurisprudence Exam, and successfully completing the BC Community Pharmacy Manager Training Program. Two registrants also consented to 60-day suspensions.
The Inquiry Committee considered the terms of these Consent Agreement necessary to protect the public, as well as send a clear message of deterrence to the profession. Inappropriate access of personal health information, without consent, compromises the public’s trust in the pharmacy profession as a whole. At all times, registrants must uphold legislative requirements and ethical obligations to protect personal health information.
The Inquiry Committee is currently in the process of resolving the disposition of this matter with the pharmacy manager, and therefore cannot provide a report on the pharmacy manager’s disposition at this time.
Between April 2013 and December 2017, a Registrant falsified prescriptions for 18 individuals, including himself. These falsified prescriptions resulted in 208 transactions processed on PharmaNet, all which were for medications that required an authorized prescription. The majority of medications involved were controlled medications.
The Registrant used the names and forged the signatures of eight different physicians as prescribers on these prescriptions, all without the knowledge, consent, and/or authorization of these physicians. In addition to billing PharmaCare for these transactions, the Registrant also billed third party insurance plans for payment of the transactions, which he knew to be false or misleading claims.
The Registrant entered into a Consent Agreement with the College’s Inquiry Committee, wherein the Registrant consented to suspend his registration as a pharmacist for a total of 180 days, not be a pharmacy manager and/or director of a pharmacy, and a preceptor for pharmacy students for period of five years from the date that his suspension ends, successfully complete and pass an ethics course for healthcare professionals, pay a fine, appear before the Inquiry Committee for a verbal reprimand, and write letters of apology to persons affected by his conduct.
The Inquiry Committee considered that in this case, in addition to the serious misconduct, the Registrant placed himself and others at significant risk of harm when he provided unauthorized medications for personal use, inappropriately used personal information, and created inaccurate PharmaNet records. His actions were a serious contravention of standards in the Code of Ethics, and compromised the public’s trust in the pharmacy profession as a whole.
The Inquiry Committee therefore determined that the Registrant required serious remediation and deterrence regarding his conduct. After also considering mitigating factors, the Inquiry Committee considered the terms of the Consent Agreement appropriate to protect the public, as well as send a clear message of deterrence to the profession.
Between March 6, 2016 and January 18, 2017, while engaged in the practice of pharmacy as a pharmacist and pharmacy manager, a Registrant processed 526 false prescription claims to his insurance provider for reimbursement. The Registrant acknowledged that by processing false prescriptions, he also falsified pharmacy drug and inventory records.
The Registrant also acknowledged that while he was pharmacy manager, he was responsible for multiple practice deficiencies including processing prescriptions for his family members to artificially increase the pharmacy’s prescription count, engaging in a conflict of interest, and backdating prescriptions (meaning that dispensing records for these prescriptions were created on dates later than the dates on which the drugs in question were actually dispensed).
The Registrant entered into a Consent Agreement with the College’s Inquiry Committee, wherein the Registrant consented to suspend his registration as a pharmacist for a total of 365 days, meet with the Inquiry Committee to discuss his reflections on his conduct and what he has learned; and complete an ethics course at his own expense. The Registrant will also be limited from being a manager, direct owner and/or indirect owner of a pharmacy for a period of three years from the date his suspension ends.
The Inquiry Committee considers this agreement necessary to protect the public, as well as send a clear message to the profession that the College does not tolerate this type of conduct.
Data Transmission to PharmaNet
Between January 1, 2013 and May 19, 2015, while the Registrant was a director and pharmacist at two different pharmacies and pharmacy manager of one of these pharmacies, many prescriptions at both pharmacies were backdated, meaning that dispensing records for these prescriptions were created on dates later than the dates on which the drugs in question were actually dispensed, contrary to section 35(1) of the Bylaws to the Pharmacy Operations and Drug Scheduling Act. Section 35(1) states that:
A registrant must enter the prescription information and transmit it to PharmaNet at the time of dispensing and keep the PharmaNet patient record current.
The Registrant also acknowledged that during the time period he was pharmacy manager at one pharmacy, many claims were billed on PharmaNet for patients who according to the provincial
Discharge Abstract Databased had been admitted to hospital at time of claim, suggesting that these patients may not have received the supplies claimed.
The Inquiry Committee was concerned that the Registrant had previously consented to remedial undertakings to fully comply with legislated practice standards, and he had not done so for this current matter. The Inquiry Committee therefore considered this constituted a “serious matter” pursuant to section 26 of the Health Professions Act, and that the Registrant required serious remediation and deterrence in order to come into compliance.
The Registrant entered into a Consent Agreement with the College’s Inquiry Committee to suspend his registration as a pharmacist for 90 days, not be a pharmacy manager and preceptor for a period of two years from the date that his suspension ends, to pay a fine, successfully pass the College’s Jurisprudence Exam, appear before the Inquiry Committee for a verbal reprimand, and a Letter of Reprimand on his registration record.
The Inquiry Committee considered the terms of the Consent Agreement appropriate to protect the public, as well as send a clear message of deterrence to the profession.