Across Ontario, a quiet but consequential restructuring of primary care is underway — not in hospitals or policy chambers, but behind pharmacy counters in communities where family doctors are scarce and emergency rooms are strained. Since 2023, pharmacists have been granted steadily expanding authority to assess, treat, and vaccinate, completing more than 2.4 million patient encounters for conditions once reserved for physicians. The July 2026 expansion, adding nine ailments and six vaccines to their scope, reflects a broader reckoning with how health systems must adapt when the traditional ar