November/December 2023Editorial: Pharmacists provide exceptionalpatient-centred care (but what if you're Black?)

Pharmacists provide exceptional patient-centred care (but what if you’re Black?)
Ross T. Tsuyuki, BSc(Pharm), PharmD, MSc, FCSHP, FACC, FCAHS, ISHF© The Author(s) 2023
Article reuse guidelines:sagepub.com/journals-permissionsI hope this title got your attention. I really urge you to read the paper “Understanding the experiences of Black Nova Scotians with community pharmacists” by Afomia Gebre and colleagues,¹ and then you can be disturbed with me.In this qualitative study, Gebre interviewed 16 Black Nova Scotians to explore their experiences with community pharmacists.¹ What they found can be summarized thematically as:

Difficulties navigating a pharmacy as a Black person: This included microaggressions, stereotyping and race negatively affecting the quality of care received.

Lack of inclusivity and cultural competence in the pharmacy: This included things like lack of Black pharmacists/pharmacy team members and a system that was not made for Black people to thrive in. Pharmacists were not felt to provide culturally safe care.

(Only) transactional relationships with pharmacists: The lack of any patient care relationship between Black patients and pharmacists led to a “transactional” relationship only—with pharmacists seen as standing between their physician and receiving their medications. Pharmacists were not felt to be part of their patient care team, and were only a last resort for any medication-related issues.

All of these themes point towards inadequate care provided by pharmacists to Black patients. Inadequate care. We keep saying that we are the most accessible primary health care professional and have a broad scope of practice, but is it only for white people? This requires some reflection.Pharmacists have a responsibility to provide equitable care. This should be a wake-up call for the profession, and we should be grateful to Gebre and colleagues for bravely pointing this out. And this doesn’t just affect our Black patients—you could substitute Indigenous, or refugee, or anyone experiencing the systemic racism that is present in our health care system. Indeed, our own Dr. Jaris Swidrovich, in an interview with CPhA, said “As pharmacists, we hold a lot of ‘power’ in our communities and across the country. Millions of lives across Canada are dependent daily on our competence and service. We must consider the power we hold, especially as a national collective, and use our voices to effect change with respect to how our colonial systems, policies and procedures. . . affect Indigenous Peoples’ health.”²Cultural safety (see Figure 1) is described as a continuum, which includes consideration of the political, social and historical contexts.^3,4 It requires self-reflection on the part of the practitioner. And it is not an option any more than is knowledge on how to manage hypertension. This is a wake-up call—we need to do better (and I am confident that we can. . .).Fig1Figure 1 The Continuum of Cultural Safety and Humility^3,4Reproduced with permission from Common Definitions on Cultural Safety, Public Health Agency of Canada³ and adapted from Brascoupé and Waters.⁴References

Gebre A, Bowles S, Minard LV, Hamilton-Hinch B. Understanding the experiences of Black Nova Scotians with community pharmacists. Can Pharm J (Ott) 2023;156(6): 316-23.

Canadian Pharmacists Association. Pharmacy check-in: meet Jaris Swidrovich. Available: https://www.pharmacists.ca/news-events/news/pharmacycheck-in-meet-jaris-swidrovich/#:~:text=Dr.,teaching%20and%20various%20administrative%20roles (accessed Sept. 15, 2023).

Public Health Agency of Canada. Common definitions on cultural safety. Available: https://www.canada.ca/en/health-canada/services/publications/health-system-services/chief-public-health-officer-healthprofessional-forum-common-definitions-cultural-safety.html (accessed Sept. 15, 2023).

Brascoupé S, Waters C. Cultural safety: exploring the applicability of the concept of cultural safety to Aboriginal health and community wellness. J Aboriginal Health 2009;5(2). Available: https://jps.library.utoronto.ca/index.php/ijih/article/view/28981/23928 (accessed Sept. 15, 2023).

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