Fit to practise? Processes for dealing with misconduct among pharmacists in Australia, Canada, the UK and US

In many countries with legal systems based on English common law, pharmacy regulators have a responsibility to protect, promote and maintain the health and safety of patients. Where there is a potential risk to patient safety, or where the public's confidence in pharmacy could be adversely affected by the actions of a pharmacist, these regulators have a statutory duty to investigate concerns. The legal provisions underpinning each jurisdiction's disciplinary processes depict distinctive outlooks from the different authorities, as each works towards the same goal. Legal statues, regulations, rules, and guidance affecting the disciplinary process in Great Britain, Australia, New York and New Brunswick were collated, and the processes they describe were attached to a common process flow diagram for step-by-step evaluation of their respective legal provisions. The initial stages of the respective investigation process are broadly similar in all the jurisdictions examined; however, each process has subtle differences that afford some level of advantage or disadvantage over its comparators. Factors including: how matters of discipline are framed; the existence of a separate process for minor and uncontested violations; the ability to effect an interim suspension of a practitioner's license; threshold criteria for escalation of complaints; the membership of disciplinary panels; and the perceived independence of these panels all philosophically affect the public safety remit of each regulator. This work constitutes the first comparison of international regulatory frameworks for the profession of pharmacy. Of the four jurisdictions examined, Great Britain most clearly acts in the interest of the public and the profession - rather than the respondent pharmacist - at every step of its process.