Consultant Pharmacists In Modern Healthcare: Dispelling Myths With Global Evidence-By Reuben Zirahgi Markus

The recent Nigerian Medical Association (NMA) Lagos State statement opposing the implementation of the Consultant Pharmacist Cadre in FMC Ebute Metta and FNPH Yaba raises serious concerns about the future of multidisciplinary care in Nigeria. While it’s essential to protect the integrity of every profession, it’s equally vital that our healthcare system evolves based on evidence, global best practices, and patient-centered models.

Below, we debunk the NMA’s claims with international examples and legal logic.

Claim 1:Consultant Pharmacists Undermine Clinical Decision-Making Hierarchy

Debunked: In advanced health systems such as those in the UK, Canada, Australia, and the US, consultant pharmacists are not replacements for physicians, but highly skilled specialists who enhance the decision-making process by ensuring medication safety, effectiveness, and rational use.

In the United Kingdom, consultant pharmacists were formally introduced under the National Health Service (NHS) and have clearly defined scopes of practice, particularly in antimicrobial stewardship, oncology, geriatrics, and cardiovascular care.

Peer-reviewed studies in journals like BMJ and The Lancet consistently show improved patient outcomes, reduced medication errors, and lower readmission rates when consultant pharmacists are involved in clinical teams.

Reality:Consultant pharmacists operate collaboratively, not competitively. They support physicians and nurses by providing expert medication reviews, especially in complex cases like polypharmacy in elderly patients.

Claim 2: Lack of a Legal Framework and Patient-Centered Care Model

Debunked: The Pharmacy Council of Nigeria (PCN), empowered by the Pharmacy Council of Nigeria Act 2022, legally regulates the training, certification, and practice of pharmacists including advanced cadres like consultants. The West African Postgraduate College of Pharmacists (WAPCP) provides accredited training analogous to medical fellowships, meeting international standards.

Globally, similar models exist:

Board Certified Pharmacotherapy Specialists (BCPS) in the US

Advanced Clinical Pharmacist Consultants in Canada and Australia

These roles are patient-centered, often involving direct patient interactions, especially in chronic disease management, palliative care, mental health, and primary care settings.

Reality: A well-trained consultant pharmacist is not only legal but integral to a functioning, modern, patient-centered health system.

Claim 3: Implementation Will Cause Industrial Disharmony and Role Ambiguity

Debunked: The World Health Organization (WHO) and International Pharmaceutical Federation (FIP) promote interprofessional collaboration as key to health system resilience. Rather than breed conflict, countries that embraced multidisciplinary teams saw increased harmony through clearly defined roles, mutual respect, and improved patient outcomes.

Canada’s Collaborative Healthcare Teams include consultant pharmacists, nurse practitioners, social workers, and physicians. Each plays a complementary role.

In Australia, the presence of consultant pharmacists in residential aged care homes and hospitals has reduced avoidable hospital admissions by more than 30%.

Reality:Resistance to multidisciplinary collaboration stems from outdated hierarchies, not from the actual roles or impact of consultant pharmacists.

Claim 4: The Policy Is a Threat to the Sanctity of Healthcare Delivery

Debunked: What truly threatens the sanctity of healthcare is inefficient systems, high medical errors, and resistance to progressive innovation. The WHO estimates that medication-related harm is a leading cause of death globally, and consultant pharmacists are trained to address this.

A 2019 WHO report on medication safety suggests that optimizing the role of pharmacists could save millions of lives annually.

The Lancet Global Health Commission on High-Quality Health Systems (2018) concluded that improving team-based care, not defending professional silos, is the way forward.

Reality: Embracing consultant pharmacists isn’t a threat it’s a solution to global health challenges like antimicrobial resistance, polypharmacy, and chronic disease management.

Conclusion

Nigeria Should Lead, Not Linger. Healthcare is evolving rapidly. Nigeria has an opportunity to align with international standards and strengthen health outcomes by integrating consultant pharmacists into clinical teams. We urge the NMA and all stakeholders to adopt a progressive, evidence-based approach rather than resist innovation that ultimately benefits the patient.

Let us prioritize collaboration over confrontation, and progress over protectionism.

Nr. Reuben Zirahgi Markus

#Nurse_Activist