Ontario relies on pharmacists to prescribe drugs — but can we trust the diagnosis?
- Iris Gorfinkel
- 20 minutes ago
- 2 min read
Dec. 18, 2025
By Iris Gorfinkel, Contributor
Iris Gorfinkel is a family physician and clinical researcher in Toronto.
Hardly a year passes that this doesn’t happen: a patient wakes up with a sore throat, but I’m away. It’s Christmas Day and the office is closed, as are walk-in clinics. Going to an ER is a possibility, but the problem doesn’t seem that urgent and besides, pharmacies are open.
Jan. 1 marks the three-year anniversary of Ontario’s experiment with pharmacist prescribing for minor ailments. When Ontario expanded pharmacist prescribing in January 2023, 2.3 million Ontarians lacked a family doctor.
A University of Waterloo modelling study predicted pharmacist prescribing could save Ontario $42 million annually. Provinces like Alberta and Saskatchewan showed that pharmacists could be the emergency release valve, so Ontario followed suit. The move was framed primarily as a way to save money and improve access, with very little public discussion of pharmacists’ diagnostic accuracy.
What began as 13 treatable conditions in January 2023 grew to 19 by October 2023. Draft legislation may add 14 more, including shingles and sore throat. Should it pass, it would also allow pharmacists to perform on-site strep tests and administer tetanus, shingles and pneumococcal vaccines.
Over two million patient assessments have been submitted to OHIP since the program started and there have been no clear safety alarms tied directly to the program. Pharmacists deploy algorithms, ongoing professional development and occasional physician input. But this doesn’t replace hard data on how accurately these 19 conditions are diagnosed, let alone the 33 Ontario is now considering.
Urinary tract infections are the easiest case. For UTIs, pharmacists are remarkably accurate: 99 per cent of prescriptions went to the right patients, following guidelines 95 per cent of the time — outperforming family doctors at 35 per cent. But UTIs are usually straightforward: classic symptoms, clear diagnosis.
What about other minor ailments?
(Pay Wall)