Correction, March 20, 2026 11:40 am: This article was updated to clarify the findings of the Journal of Health Economics study and the possible explanations for them.
In recent years, Canada’s provinces have empowered pharmacists to prescribe for minor ailments in the hope of reducing demands on doctors and improving health-care access for millions.
A new study in the Journal of Health Economics suggests the strategy is having mixed results: Increasing access for vulnerable population groups, driving improvements in access to health care and cutting visits to emergency departments, and also possibly increasing visits to other doctors’ offices and labs.
The study, which relies on mobile phone data, does not fully explain why emergency department visits are down while community doctors’ visits may be up.
“We won’t know the mechanism until we can analyze the OHIP billing claims data,” said Alex Hoagland, the study’s primary author and an assistant professor of health economics at the University of Toronto. That’s something his team is currently analyzing, but “there are a few competing hypotheses.”
One possibility, Hoagland notes, is that patients facing a minor emergency after their doctor’s office has closed for the day might be choosing to go to the pharmacy instead of an emergency room and then following up with their own doctor when their office re-opens. Another possibility is that pharmacists direct patients to additional clinical lab services.
“Another possibility,” he adds, “may be that patients are still building trust in pharmacists, and want to see a family doctor afterwards.”
‘Take a load off’
Health care is regulated provincially, so a hodgepodge of minor ailment prescribing laws and schedules apply to pharmacists across the country.
But in all 10 provinces, pharmacists are empowered to prescribe treatments for minor ailments. Minor ailments are common, uncomplicated conditions such as colds, athlete’s foot or mild acne that can be addressed through self care without medical intervention. However, when left untreated, some minor ailments can progress to more serious conditions.
Jamie Falk, an associate professor at the College of Pharmacy at the University of Manitoba, says pharmacists today receive significant training in clinical skills, making them well-positioned to manage minor ailments.
“Pharmacists continue to be the experts in medications. We know more than anyone else about those,” he said. “There are things where we can take a load off [doctors], where assessment is very straightforward.”
Data from the Canadian Foundation for Pharmacy, a national charity, shows billable pharmacy services did increase in 2023-24 compared to previous years, including for minor ailments.
But the Journal of Health Economics study suggests pharmacy consultations for minor ailments lead to overall increases in medical foot traffic outside of pharmacies.
The study used anonymized mobility data to track Ontarians’ foot traffic to pharmacies, hospitals, emergency departments and family doctors’ offices in the year after Ontario’s implementation of its pharmacist prescribing rules.
The study showed a 16 per cent increase in foot traffic to pharmacies and a four per cent increase in traffic to outpatient care centres, including family doctors, labs and walk-in clinics. It also showed a nine per cent decrease in foot traffic to emergency departments.
Foot traffic data from Alberta and Quebec over the same period did not show any comparable boost in traffic, suggesting Ontario’s new prescribing rules may have driven the changes.
The Ontario’s health ministry did not respond to requests for comment for this story.
Saskatchewan was the only province to provide a response for this story. Its health ministry said it does not collect data that would specifically identify doctors’ office visits for minor ailments.
“Minor ailment prescribing by pharmacists has been analyzed to understand whether patients who access these services in pharmacies have also seen a primary care provider,” the health ministry said in a written statement. “But it has not been used to assess an impact on primary care appointments.”
However, a 2016 journal article by two University of Saskatchewan researchers suggests pharmacist prescribing rules also drove an increase in traffic to doctors in that province.
The researchers collected feedback from pharmacists after Saskatchewan implemented its minor-ailment prescribing program in 2012. Pharmacists reported that 10 to 30 per cent of consultations for minor ailments needed re-consultation by a doctor.
Data from the United Kingdom echoed these findings. In the U.K., pharmacists have been able to prescribe medications since 1992 and are commonly the first point of contact for people with minor health concerns.
A 2016 review of non-medical prescribing by U.K. pharmacists showed that up to a quarter of pharmacy encounters led to reconsultation with a doctor.
‘Too early’
Both the U.K. and Saskatchewan examples highlight the need for consultation for more complex conditions.
They also suggest that the provinces’ prediction that pharmacist prescribing would alleviate pressure on primary care providers will not necessarily come true. In part, this is also because some provinces have not seen strong uptake of the new rules.
Robin Rai, a Winnipeg pharmacist, says assessing and prescribing for minor ailments involves onerous documentation. It is often easier to send patients who present with minor ailments directly to doctors’ offices.
“I would just direct the patients to the clinic because it was easier for the doctor to make the assessment and chart in their [doctor’s] chart than the amount of paperwork that [I] would have to do,” Rai said.
Currently, it is not clear that the provinces are collecting data to understand how well their changes are working. Ontario, perhaps, is an exception.
“Our [U of T research] team actually has been working with the Ontario government in partnership,” said Hoagland, the study’s primary author.
“It’s far too early to give you any preliminary data.”
