Empowering community pharmacists in Saudi Arabia: physicians’ perspectives on competence, confidence, and independent prescribing

Background: This study examined physicians’ perceptions of community pharmacists’ (CPs) competence and confidence in prescribing for minor conditions and identified factors influencing their willingness to support community pharmacists’ independent prescribing (CPIP). Methods: A cross-sectional survey was conducted among 357 registered physicians across Saudi Arabia. The questionnaire was developed from literature, validated by physicians, and refined after pilot testing. Participants were recruited using convenience sampling. Data were analyzed in IBM SPSS Statistics version 28 using descriptive and inferential statistics, including regression. Results: Physicians expressed greater confidence in CPs’ medication management roles, particularly in prescription renewal/refill (59.9%), and red-flag identification (59.9%). Confidence was lower for more clinically complex responsibilities, including diagnosing conditions (32.5%) and selecting appropriate treatments (34.5%). Logistic regression models for perceived competence domains were significant (p < 0.05), indicating that physician characteristics were associated with perceptions of pharmacist competence. Prior exposure to pharmacist prescribing was reported by 34.2% of respondents and was associated with a healthcare setting (p = 0.010). Physicians recognized CPIP benefits, including strengthening pharmacists’ roles within healthcare teams (67.2%) and improving patient access to care (54.9%). However, key concerns remained regarding pharmacists’ clinical decision-making (81.5%) and access to patient medical records (79.8%). Conclusions: Physicians demonstrated cautious yet conditional support for CPIP, recognizing pharmacists’ strengths in medication management while expressing reservations about diagnostic and treatment responsibilities. A phased model supported by postgraduate training, shared medical record access, referral pathways, and regulatory governance may improve access, reduce physician pressure, enhance efficiency, and support a safer workforce use in Saudi Arabia.