For many patients, pharmacies are the first and most accessible point of contact with healthcare, yet their competencies in Slovakia remain limited. A discussion with Jaroslav Kiper reveals that the keys to improvement are systemic funding, expansion of services, and addressing the staffing shortage. Vaccination in pharmacies could, if legislation develops favorably, start by the end of the year.
Pharmacies between healthcare and retail
During the pandemic, it became clear that pharmacies can maintain access to help even when clinics restricted their operations. Pharmacists are ready to guide and advise patients, but the Slovak environment mainly allows them to dispense medicines and provide basic consultations. Compared with several countries, we are still at the beginning when it comes to providing expanded services such as examinations or diagnostics.
The financial framework forces pharmacies to rely on over-the-counter products, which reinforces the perception of a pharmacy as a shop rather than a healthcare facility. In practice, a pharmacist’s pay is more than 50% lower than a doctor’s, even though the training is demanding and lengthy. The solution requires systemic financing of the entire healthcare system, not just raising the pay of a single profession, and recognition of pharmacies as a full-fledged part of patient care.
Who will be behind the counter: the decline of pharmacists
The situation in pharmacies is so far better than in hospitals, but the trend is worrying. The number of graduates is not increasing and interest in the field is declining; in Slovakia there is only one faculty and one department that train pharmacists. Some students are considering going abroad and several would prefer to work outside pharmacies, for example in the pharmaceutical industry or research, where positions are limited. If conditions do not improve, the availability of pharmaceutical care may decline in the future.
More services for the patient: vaccination and diagnostics
Expanding competencies could ease the burden on doctors and the budget, especially in prevention and vaccination. Parliament did allow vaccination in pharmacies a year and a half ago, but implementing regulations are missing, without which accredited education and pharmacist practice cannot begin. At a favorable pace, after theoretical preparation and practical training with doctors, they could vaccinate their first clients by the end of the year. Pharmacies today handle rapid tests, for example CRP to differentiate viral and bacterial infection, and after legislative adjustments they could cooperate with laboratories to a greater extent.
Safety is addressed through standard protocols and training to handle adverse events, including the option to use a resuscitation set and call emergency services. Digital services already allow patients to reserve prescribed medicines, but ordering and inter–pharmacy transfers run into regulations: each outlet is a separate company and transfers are limited. The sector, together with the professional chamber, is calling for the removal of these administrative barriers so that services can be provided more flexibly and conveniently for the patient.
