Exodus of SA doctors and nurses places more responsibility on pharmacists

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Currently, the primary care physician-to-patient ratio in SA is 60 to every 100 000, compared to the global average of 152 to 100,000 patients. Nurses too are in short supply.

The problem is further compounded with only a fraction (17%) of South Africans who are able to afford private medical care leaving millions without easy access to GPs, dentists and medication. Even for those with medical aid, many have downgraded to less-expensive medical-aid plans with less coverage.

Nicole Jennings, spokesperson for Pharma Dynamics says while the shortage of highly skilled and experienced health workers has left the country with a dearth of fundamental skills, pharmacists should be lauded for the role they have played in helping to address the disparity.

“Less than a decade ago, pharmacists were the most underused resource in medicine. Modern society moulded their profession into medical shopkeeping, but pharmacists have much more to offer. They undergo rigorous educational training similar to that of doctors, but are often in a better position to devote more time to patients.

“Doctors are primarily responsible for diagnosing medical conditions, prescribing medications and creating treatment plans. In most instances, they have limited time for each patient due to the volume of patients they need to see in a day.

“In contrast, pharmacists often have more time to spend with patients in retail pharmacy settings, answering questions and providing medication counselling. In some cases, pharmacists in clinical or hospital settings may also have more direct patient interaction, particularly in medication therapy management programmes.

Empowering healthcare access

“Recent studies suggest that South African patients visit community pharmacies more often than they do doctors. Therefore, community pharmacies provide patients with easy access to healthcare professionals closer to home. Another positive is that the number of community-based pharmacies in the country are increasing, which again makes them ideally placed to provide expanded healthcare services.

“There has never been a greater need for people to access high-quality healthcare in our country. By refocusing the profession of pharmacy from primarily supplying medicine to providing services that attend to patient needs, will allow pharmacists to play a more active role in SA’s care system, while also reducing costs and optimising health outcomes.”

She says worldwide, pharmacists are becoming increasingly important in healthcare systems by providing:

• Medication management: Pharmacists play a critical role in ensuring safe and effective medication use. With the rise of chronic diseases and complex treatment regimens, pharmacists help patients manage their medications, preventing adverse drug interactions and optimising treatment outcomes. This becomes even more important when people are facing challenges in accessing medical aid and healthcare services.
• Patient education: In the absence of comprehensive medical insurance, people might rely more on self-care and over-the-counter (OTC) medications. Pharmacists are valuable sources of information, educating patients about proper medication use, potential side effects, and available alternatives. This empowers patients to make informed decisions about their health.
• Primary care access: As the shortage of primary care physicians continues, pharmacists have stepped in to provide basic healthcare services. They can administer vaccines, conduct health screenings, offer point-of-care testing (for diabetes and cholesterol levels), and refer patients to appropriate healthcare providers when necessary.
• Preventive care: Pharmacists can engage in health promotion and disease prevention activities. By offering counselling on lifestyle modifications related to diet and exercise, for example, and providing guidance on smoking cessation and immunisations, they contribute to reducing the burden of chronic diseases.


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• Tele-pharmacy and remote services: The expansion of tele-health and remote healthcare services is allowing pharmacists to provide consultations and medication management remotely. This is particularly useful in reaching underserved populations or individuals without medical insurance.
• Medication adherence: Non-adherence to prescribed medications is a significant issue in healthcare. Pharmacists work to improve adherence by simplifying medication regimens, providing reminder systems, and addressing patients' concerns and barriers to taking their medications.
• Medication cost management: In the absence of medical aid, patients might face challenges affording their medications. Pharmacists can help by suggesting cost-effective alternatives and exploring prescription assistance programmes.
• Collaborative care: Pharmacists are increasingly being integrated into interdisciplinary healthcare teams. They collaborate with physicians, nurses, and other healthcare professionals to ensure co-ordinated and comprehensive patient care, which is especially important when medical-aid coverage is limited.
• Public health initiatives: Pharmacists can contribute to public health efforts by participating in vaccination campaigns, providing education during disease outbreaks and promoting healthy behaviours.

“The role of pharmacists is expanding to fill gaps in healthcare access and provide essential services, especially in the context of decreasing medical insurance coverage. Their expertise in medication management, patient education and preventive care positions them as valuable allies in promoting better health outcomes for individuals and communities at large.

“We want to thank pharmacists throughout the country for their remarkable contribution in the wake of World Pharmacists Day. You serve on the front lines and are often available 24/7 to provide millions of patients with care, at great personal expense. Your efforts do not go unnoticed,” says Jennings.