In 2024, 34,665 B.C. residents who accessed the Minor Ailments and Contraception Services (MACS) program were invited by the B.C. government to participate in a survey about their use of the service over 10 two-week cycles. In total, 2,825 clients completed the survey for an overall response rate of eight per cent.
The following are some of the survey findings, along with comments received from our members from all over B.C. on their thoughts about the survey.
“Many patients mention that we are open earlier and later than GPs, other walk-in clinics, and they appreciate that no appointment is necessary, allowing them to be seen quickly. Additionally, tourists often choose to use our services due to the lower cost compared to visiting a GP (our fee is $20 while doctor will charge $150-240 depending on location. They also find community pharmacies easier to access without the need for registering or navigating the complexities of the local health care system.”
– Bryan Rizzardo, pharmacist in Vancouver
“Most of them could not get a timely appointment to see any health-care practitioner. On non-stat-holiday, non-emergency, routine days, the wait time at a walk-in clinic is about 6 hours, not including commute time.”
– Trent Tschirgi, pharmacist in Sorrento
“For most encounters, I find my patients come to the pharmacy because they’re unable to see their primary care provider in a timely manner. In some cases, they’ve even been referred to the pharmacy by the clinics when no appointments were available. Although, as our expanded scope has become more known amongst the general public, I find more and more patients are seeking us out as a first option.”
– Erica Webb, pharmacist in Vancouver
“Patients presenting to the pharmacy often mention the long wait times at local walk-in clinics as well as urgent care. Being accessible on short notice is valuable for patients. Many are in this position because they lack a GP as well as referencing pharmacists knowledge on particular subjects like hormonal contraception and UTIs.”
– Nick Fleming, pharmacist in Kelowna
“I work in South Delta and sadly our ER closed many times. There are few doctors too. The closest alternative care is bit of a drive for some. It’s a big issue for seniors who live on their own. MACS is crucial for them.”
– Hani Moukhachen, pharmacist in Delta
“While the Urgent and Primary Care Centre is located nearby, it often experiences long wait times and a high patient volume. This leaves some patients either being turned away or left waiting a significant time for a condition a pharmacist may be able to assist with.”
– Graham Foster, pharmacist in Kelowna
“With difficulty. The ER is the only in-person option as there are no walk-in clinics. We do give out the number for virtual clinics but I am often disappointed in the care provided.”
– Lori Bonertz, pharmacist in Fort St. John
“Hard to say as the times that they weren’t able to find any help stick out in my mind far more than when they have. I’ve gone so far as to make a handout listing all the local walk-ins, a link to see their wait times and if they’re at capacity, a list and instructions on how to access all the major virtual clinics available, but people still struggle to get care. Some of the virtual clinics are amazing but have also found some I wouldn’t consider a ‘reasonable alternative’.”
– Ian McDiarmid, pharmacist in Sooke
“I say that most patients would not have access to alternative care in a timely manner. Again, most people come see me because they do not have a practitioner or good access to one.”
– Robert Moore, pharmacist in Enderby
“Patient would not have REASONABLE access to alternative care. The next ‘reasonable’ option is to wait 8+ hours to be seen by someone.”
– Fairuz Siraj, pharmacist in Victoria
“In my experience, if MACS services had not been available through the pharmacy, many patients would have faced limited or less accessible alternatives. While some might have been able to book an appointment with their family doctor or nurse practitioner, timely access is often a significant barrier. Many patients share that wait times for primary care appointments can extend for several days or even weeks, particularly for non-urgent issues such as urinary tract infections, minor skin conditions, or contraception consultations.”
– Zaman Pirouzmand, pharmacist in North Vancouver
“Giving patients all their available options and reviewing the cost associated with them; this allows patients to make an informed decision and be part of their treatment. Ultimately, educating the patients on why or why not a prescription is needed helps provide the patient with a good experience.”
– Fairuz Siraj, pharmacist in Victoria
“We have built out two private consultation rooms and hired an extra part-time pharmacist to allow for more access and more uninterrupted time for clients. Our manager is great. She leads by example, and makes sure everyone has a follow-up plan which usually includes a follow-up phone call. We prioritize certain MACS, like UTI and shingles. I would say the single best reason for our pharmacy’s success in this area is that we have a manager who believes in and promotes the program, and regularly reviews implementation so that we can tweak what the team is doing ( and it really is a team effort involving the front line staff and messaging) and pivot from time to time based on pharmacy workflow.”
– Carolyn Scarfe, pharmacist in Victoria
“Take your time and don’t rush your MACS appointments. Try to give these patients your 100% focus. This is very difficult if you are the only pharmacist on the floor but much more manageable when you have overlapping pharmacists.”
– Peter Lin, pharmacist in Burnaby
“We preplan which pharmacist will respond to minor ailments. Note when there was only one pharmacist on minor ailments are rarely done. We use a private booth separate from the intake and pick up areas for confidentiality and comfort, and we try to attend to the patient’s need as soon as possible.”
– Robert Moore, pharmacist in Enderby
“I always make sure that I give the patient a chance to describe the symptoms the way they want to, and then ask them questions to assess the condition. I also explain how long of a time-frame they can expect the treatment to work within, and then mention the best way to manage any potential side effects from the medication.”
– Dona Sharma, pharmacist in Kelowna
“I ensure patients feel safe and respected by maintaining privacy, using clear and supportive communication, and being mindful of cultural or language needs. I prioritize timely care by acknowledging patients quickly and starting assessments as soon as possible. I explain conditions and treatment plans in simple terms, confirm understanding, and provide clear follow-up instructions. Using the Vigilance platform helps streamline documentation so I can focus more on patient interaction and education.”
– Meiling Liu, pharmacist in Burnaby
“We try to meet people where they're at with a low-threshold, culturally-safe approach. Our non-judgemental team offers MACS on an ad-hoc, walk-in basis (no appointments). We use plain language consent and education, brief post-visit check-ins to follow up and close gaps or capture feedback. As a result, most clients report positive experiences.”
– Justin Dovale, pharmacist in Kelowna
“Providing NRT has not changed significantly since 2023 with addition of MACS. However, having more options (Champix) is valuable for many patients.”
– Nick Fleming, pharmacist in Kelowna
“The number of cases is similar to before MACS. The difference is we can recommend Zyban and Champix as well. However, I had couple of cases cancelled by their doctor even though risk was low.”
– Jin Lee, pharmacist in Surrey
“I appreciate having options apart from nicotine replacement therapy (NRT) to offer individuals who smoke. Because I have a lot of experience and training in the area of smoking cessation, I am confident I am providing a valuable service and I gain a lot of professional satisfaction from this.”
– Lori Bonertz, pharmacist in Fort St. John
“Before MACS, most NRT-related interactions were informal and brief, often limited to product recommendations or basic guidance when patients inquired about quitting. Discussions tended to focus on product selection and dosing, with limited time for in-depth assessment or behavioral support due to workflow constraints or the absence of a formal consultation model. After MACS implementation, the service has become more comprehensive, patient-centred, and clinically focused. The ability to conduct a formal assessment, document care, and follow up has allowed me to tailor NRT plans more precisely to each patient’s needs. Patients now receive more detailed counselling on treatment options, quit strategies, potential side effects, and proper product use.”
– Zaman Pirouzmand, pharmacist in North Vancouver
“Yes. I also push quit-smoking programs in October: if patients start in October, they can get 3 months of supplies for Oct-Nov-Dec, and 3 more if needed in Jan-Feb-Mar. With 6 months in a row, they have a GREAT chance of quitting! MACS indirectly helps because the public perceives that pharmacists can prescribe, so they are more likely to ask.”
– Trent Tschirgi, pharmacist in Sorrento
“No, the clients I've encountered all knew what they wanted, which is birth control. They are younger in age and already feel shy about coming in for birth control and do not want linger for longer to listen to anything else except that I could provide them with birth control with as little talk as possible so they can get out the pharmacy quickly.”
– pharmacist in Prince George
“It’s super situational. For someone who’s been on oral contraceptive products (OCP) for many years I’ll ask about their last PAP and when they’re planning on getting their next. For someone newer to OCP I’ll ask how is it working for them, any complaints or interest in other options and discuss if there’s interest. Someone brand new to OCP I’ll be going over everything whether prompted or not. Often use the opportunity when someone switches their OCP to review other health topics as part of ‘my spiel’ which O ask them to indulge. Being in a smaller town and knowing most patients, I can touch on one thing per visit and then follow up if there’s any interest. To hit every topic every time would be difficult for all parties involved.”
– Ian McDiarmid, pharmacist in Sooke
“Patients often thank me for following up with them and appreciate how quickly I’m able to assess and provide treatment. Many comment on how convenient and efficient the service is compared to waiting for a doctor’s appointment. Yes, I would fully support expanding the types of minor ailments pharmacists can prescribe for, as it improves access to timely care and enhances patient satisfaction.”
– Meiling Liu, pharmacist in Burnaby
“I’m against expanding it to other conditions unless a payment mechanism is developed to compensate pharmacists and not pharmacies, just like doctors get paid, pharmacists need to be paid for their service, expertise, and execution of their authority.”
– Shadi Tanash, pharmacist in Surrey
“Absolutely in support of more advanced prescribing scope. We get a lot of feedback about chronic medication renewals where because they don’t have B.C. fill data we can’t support. We also get a lot of strep testing requests and subsequently would need prescribing auth to treat positive result. We also get a lot of travel health consults which require prescriptions after the consult that we can’t prescribe, which would be great if we could.”
– Bryan Rizzardo, pharmacist in Vancouver
“I am in support of expansion of assessment scope. Additional resources and training is always appreciated. I use Medsask regularly for assessments. It would be useful to have an updated list of non-Rx options, and Rx options that fall within our scope and whether they are covered benefits or not (e.g. contraceptive patch).”
– Carolyn Scarfe, pharmacist in Victoria