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Medical Forum / General / Pharmacy / October 2003

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pharmacist shortage

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Paul Trusten - 06 Oct 2003 02:18 GMT
A brief item in the latest issue of "Pharmacy Times" said that the
pharmacist shortage continues unabated. The article estimated that, for
example, the US chain drug industry is short 5500 pharmacists. The cause, it
was suggested, is the lenghtening of the pharmacy program by one academic
year to make the Pharm.D. degree.

What else is contributing to the shortage, and to what degree do you think
it is? Lack of secondary school training, interest, and/or ability in
science? Tuition costs? I know that there was a Congressional study on the
issue in the late 1990s, but I'd like to hear from the field. What do you
think?

Paul Trusten, R.Ph.
3609 Caldera Boulevard Apartment 122
Midland TX 79707-2872 USA
432-694-6208
ptrusten@cox.net

"There are two cardinal sins, from which
all the others spring: impatience and laziness."

                                         ---Franz Kafka
David St. - 06 Oct 2003 03:30 GMT
>A brief item in the latest issue of "Pharmacy Times" said that the
>pharmacist shortage continues unabated. The article estimated that, for
[quoted text clipped - 18 lines]
>
>                                          ---Franz Kafka

Pau

Almost 2/3 of current graduates are female. The majority of
Pharmacists work in retail, they don't seem to care for it very much.
I have noticed that women who dislike their field of endeavor often
choose to retire or work part time when and if they have children.
There is the possiblity that this could be a major factor in the
Pharmacist shortage.

Dave
Randy Rostie - 06 Oct 2003 13:39 GMT
I respectfully disagree. If almost 2/3 of the pharmacy graduates were NOT
women we would have an even greater shortage of pharmacists. It seems that
more men are being counseled to go into other fields. The pharmacist
shortage is due to several factors: (1) lack of pharmacy school space (2)
burn-out of current pharmacists
(3) poor working conditions - no breaks or lunch most places (4) too much
job stress (5) too heavy an RX load due to pharmacist shortage, etc.

How many of you REALLY recommend pharmacy as a career choice today with all
that is going on in the industry?

> >A brief item in the latest issue of "Pharmacy Times" said that the
> >pharmacist shortage continues unabated. The article estimated that, for
[quoted text clipped - 29 lines]
>
> Dave
James Pinkerton - 06 Oct 2003 15:41 GMT
> I respectfully disagree. If almost 2/3 of the pharmacy graduates were NOT
> women we would have an even greater shortage of pharmacists. It seems that
[quoted text clipped - 3 lines]
> (3) poor working conditions - no breaks or lunch most places (4) too much
> job stress (5) too heavy an RX load due to pharmacist shortage, etc.

Compare pharmacy to other professions.  Yes you can always get a job
(somewhere that is) and pharmacy is well suited as a part-time job.
I worked both retail and hospital pharmacy.  I worked eighteen years in a
hospital.  As far as retail pharmacy goes the working conditions are bad.
First unless the store is real busy they will not hire you anyway.  Any
place that I worked in retail I was always constantly busy and I was darn
lucky to get caught up.  There was no scheduled lunch time or breaks.
Usually there was no time off from work.  If you missed a day due to
sickness, you had to make up the hours.

Then the pharmacy schools go about creating two classes of pharmacists.  The
regular working all hours and weekends pill counting guys and a clinical
pharmacist who only wants to do "professional work" like advising
physicians.

I read that today the average pharmacist spends one-third of his/her time
just doing paperwork and calling insurance companies.  In a profession like
medicine or law clerks are hired to do the paperwork.  When lunch time
arrives, the doctor or lawyer just takes off and goes out to eat.  That is
really a lot better than trying to count pills with one hand and handle
greasy chicken with the other!  There should not be a lot of job stress in
pharmacy but there is because of the lack of help and organization.  Its not
like we are actors in the TV show ER where we are busy doing CPR.  We are
basically taking the medicine out of stock bottles and putting them into
smaller labeled containers. The counseling part of our job isn't done very
well as we are too busy doing all the manual dispensing ourselves and don't
have time to spend with our patients.
jdarph - 06 Oct 2003 13:34 GMT
>A brief item in the latest issue of "Pharmacy Times" said that the
>pharmacist shortage continues unabated. The article estimated that, for
>example, the US chain drug industry is short 5500 pharmacists. The cause, it
>was suggested, is the lenghtening of the pharmacy program by one academic
>year to make the Pharm.D. degree.

The Pharm D. requirement has lengthened the program by a minimum of
one year--in some cases by as many as three years.

>What else is contributing to the shortage, and to what degree do you think
>it is? Lack of secondary school training, interest, and/or ability in
>science? Tuition costs? I know that there was a Congressional study on the
>issue in the late 1990s, but I'd like to hear from the field. What do you
>think?

I doubt tuition costs are a major factor. ONU, for instance, is costly
at around $40k/year. But the bulk of that $40k can be offset by grants
and scholarships.

The sorry state of our public school systems is no doubt a part of the
problem. For those grads who are truly college material, there are too
many other professions that offer far more money than pharmacy--and
offer far better working conditions. The long-term future of pharmacy
is questionable, while certain opportunity exists in other areas of
health care. I find it hard to believe that recent grad with a
potential 30+ year career ahead of him or her would even consider
pharmacy over other professions such as traditional medicine or
podiatry, just to mention a couple of examples. The exception being
the female student. Pharmacy is a great career for women with an
interest in health care. As we all know, part-time opportunities are
available virtually everywhere. These part-time positions mesh well
with the female pharmacist's need to devote much of her life to
raising a family.

The mandatory Pharm D. requirement is absolutely asinine, and is
directly responsible for the worsening of the pharmacist shortage.
There is simply an overabundance of high-paying and highly respected
career choices for the qualified young grad who is willing to study
their way through a 6-8 year professional program.

> Paul Trusten, R.Ph.
>3609 Caldera Boulevard Apartment 122
[quoted text clipped - 6 lines]
>
>                                          ---Franz Kafka
T.  Blando - 15 Oct 2003 05:05 GMT
Yes, I just started University of Florida PharmD and it's a whooozie.. Is
that a word?I could see even some people dropping out secondary to the
coursework. This should also keep the shortage going also.I'm an older guy
who got his Respiratory Therapist thingy, then his Biology thingy... But I
do believe, if I get through this PharmD thingy I'm done with education, at
least formal academics. Surely I'll get CEU's.   Has anyone seen my life?
Where did it go??    It was here a couple of months ago......?

Tullio Blando BS, RRT, PharmD Candidate (hopefully)

Florida

> >A brief item in the latest issue of "Pharmacy Times" said that the
> >pharmacist shortage continues unabated. The article estimated that, for
[quoted text clipped - 46 lines]
> >
> >                                          ---Franz Kafka
P T - 15 Oct 2003 15:43 GMT
net.man@verizon.net (T. Blando) wrote

>Yes, I just started University of Florida
>PharmD and it's a whooozie...

>>"jdarph" <jdarph@operamail.com> wrote
>>in message ...

>>>"Paul Trusten" <ptrusten@cox.net> wrote:

>>>A brief item in the latest issue of
>>>"Pharmacy Times" said that the
>>>pharmacist shortage continues unabated.
>>>The article estimated that, for ...
  
>>>Paul Trusten, R.Ph.

>>>ptrusten@cox.net

>>>"There are two cardinal sins, from which
>>>all the others spring: top posting and
>>>laziness."

>>>          ---Franz Kafka

Yeah, I guess you're right.
>Top posting can make things confusing.
>>What's wrong with top posting?
Timbo of Rohan - 16 Oct 2003 22:59 GMT
**snip**

>   Has anyone seen my life?
> Where did it go??    It was here a couple of months ago......?
> Tullio Blando BS, RRT, PharmD Candidate (hopefully)
> Florida

Good Luck, Man.  I hope that your program treats you well and you graduate
on time.
Best Wishes!
Dan W - 17 Oct 2003 03:22 GMT
>**snip**
>
[quoted text clipped - 6 lines]
>on time.
>Best Wishes!

And what will it get you?

          _
         (_)  Daniel Warren, RPh        
  _______//    Marion NY
 (________)    Clinical Pharmacist
  \      /     dwarren2@rochester.rr.com
   | Rx |        
  /______\          
 (________)
T.  Blando - 20 Oct 2003 00:09 GMT
Thanks, should I ask "what is treating me well" mean. I'm affraid to ask....

> **snip**
>
[quoted text clipped - 6 lines]
> on time.
> Best Wishes!
Timbo of Rohan - 20 Oct 2003 23:11 GMT
> Thanks, should I ask "what is treating me well" mean. I'm affraid to ask....

May you get MORE out of pharmacy school than you put into it...
May you be blessed with professors who are more than teachers....
May you be study with fellow students who challenge you and are challenged
by you....

...etc.

It was more of a general statement of encouragement than anything else.

I was at Butler University (BSPharm '92) and Purdue (PharmD '95) for all too
short of a time.

It's hard to believe that I've been a practicing pharmacist for more than 10
years.

It's amazing how some of the seemingly minor factoids from school come back
and help me at times.

I was "treated well" by both schools, although I didn't realize it at the
time.

Best wishes.
Mark Triboletti - 21 Oct 2003 15:29 GMT
I'm at Purdue now!  I'm in my 2nd year pre-pharm.  I was accepted to
Purdue's school of pharmacy last week and I start next fall.  Any
recommendations/pointers?

> > Thanks, should I ask "what is treating me well" mean. I'm affraid to
> ask....
[quoted text clipped - 21 lines]
>
> Best wishes.
Timbo of Rohan - 21 Oct 2003 21:58 GMT
> I'm at Purdue now!  I'm in my 2nd year pre-pharm.  I was accepted to
> Purdue's school of pharmacy last week and I start next fall.  Any
> recommendations/pointers?

**snip**
Congrats!

Follow the good general college advice you get from your school, eg get to
know your professors, study 2-3 hours for every hour in class, etc.

Pharmacy school specific advice:

Get some on-the-job experience while you are in school.  During the summer,
during school itself, whatever.  Once you are done with school, you will not
believe how valuable this experience is.  There are many programs run by
hospitals, chains, industry, and the Federal Government that are designed to
recruit students while giving them experience.  Ask your advisor about
this - make some plans to do this, and you won't regret it.  I worked for a
large hospital in Indiana, as well as a small hospital in New Mexico - these
jobs were over the summers.  It is amazing how much these helped me then and
now.

Go to ASHP MidYear at least once.  The closest the meeting usually gets to
Purdue is usually Atlanta.  If not ASHP, attend SOME large meeting to help
make contacts/get a better idea of pharmacy issues, etc.  You won't regret
it.

Consider doing a residency.  These are one year intensive experiences,
either general or specific.  Again, ask your advisor about one.  You won't
regret the asking, but you are the one who can decide if a residency is for
you.

Did I mention get to know your advisor?  They really will look out for you
(ymmv).

Best Wishes....
Aimee G - 06 Oct 2003 14:22 GMT
I am a retail pharmacist. It allows me to get full-time hours in the space
of 3 days, so I can spent the majority of time home with my 2 kids (and
wishing I were at work). I have a clinical degree and can easily slip into a
position at the husband's place of work (big East Coast manufacturer). As
tempting as it would be to have a pretty desk job with a huge salary
and --get this-- a LUNCH BREAK! SICK DAYS!! (gasp!)... I love retail.

I love my customers. I love being right there when they need me for all
their big and bitty questions and concerns. I get to see bellies grow big
with new babies, and I get to see age erased from faces when a patient
finally gets pain relief, and I get to hold hands with my customers when all
that's needed to brighten someone's day is a simple human touch. I am
fulfilled by my role as a retail pharmacist. I try hard to be a good person,
and this is the place I get my best practice. I can see why some people
don't last in retail-- if your heart isn't in it, if you aren't a people
person, if you just don't give a rat's a.s for a stranger's problem, then
you are going to be annoyed when customers come to you for compassionate
care.

Ok, so it's not glamorous. The stuff I actually get paid to do-- repetitive
counting, regulations out the wahzoo, calling petty third parties,
explaining copays to pissy people, trying to explain that "Yes, there is an
Aisle 6, it's right next to Aisle 5 but there is no sign"...the real work
stinks sometimes. We are horribly understaffed-- I guess they budget their
tech hours to the point when there are none on duty at some point every day
and from 3-9 on Saturdays because it MAKES SENSE to some dope who probably
has never even been in my store...ah, the Corporation Mentality...and
sometimes I can't get to the other phone in time.  But I have a great
partner (still don't know how I got so lucky to work with her) and I like
the front store staff and I have great customers. The mall has pretty good
food and when I actually have a tech working with me, I get to eat. I go
home some nights dog tired, and some hours are so busy that I pray out loud
not to screw up something. But I love my job because the good outweighs the
bad and that's why I am in retail for life.

Aimee

> A brief item in the latest issue of "Pharmacy Times" said that the
> pharmacist shortage continues unabated. The article estimated that, for
[quoted text clipped - 18 lines]
>
>                                           ---Franz Kafka
P T - 06 Oct 2003 15:41 GMT
Viva la shortage. I prefer to think of it as a healthy market.

I suppose there are not enough pharmacists for the chains to build a
pharmacy on every block. Oh well, too bad for the chains.

At my employer, a ~400 bed hospital, since the start of the year, at
least 7 pharmacists have been hired, (including me :-) but only about 3
have left. (The imbalance was to fill a need left by an expansion of RPh
duties.) Anyway if we could hire a net of 4 RPh, maybe the shortage is
not too severe.

I first became interested in pharmacy ~1992, and since than salaries
have increased >100%. Nice.
I was in retail, and couldn't handle it. I took several months off, and
had no trouble finding employment when I was ready, and I'm 48. Nice.
The next guy we hired had an identical story. Nice. Give me a shortage
anyday.

There is one thing that worries me. My brother faced a larger shortage
in his line of work in the late 90s. He was a main frame programmer.
There was a mass influx of labor from overseas, and now, it's difficult
at best for an "American" to find work in that field. But of course,
that could never happen to us . . .

Shortages come and go. Say a prayer tonight to thank God for the
shortage.
rxempress - 06 Oct 2003 18:04 GMT
Pharmacy is a calling.

A lot of people begin pharmacy school to make a lot of money once they are
out of school. However once they experience the retail world experience a
lot of them decide that this is not for them.

Pharmacy has certainly gone downhill in the past 25 years.  When I was doing
my internship there were hardly any 3rd party payers.  Patients submitted
their receipts to the insurance company and they were reimbursed.  It meant
some extra work on the pharmacists' parts because we had to help them
complete their forms (i.e. NDC numbers... name of manufacturer... price paid
etc).

We actually loved 3rd party cards because in the end there was a lot less
work for us.  We could set the paper claims aside and fill them in during
"downtimes" .  Usually all the medications were covered.  Reimbursement
rates were profitable. The problem was that there was no way of telling if
the patient really had coverage.  We got stuck on a lot of those.

When the"black box" version of pharmacy billing came into effected (late
80's early 90s) that risk was removed.  You filled the prescription... the
insurance information went into a "black box"  (usually a phone line) ...
the patients' coverage was verified and a copay popped out.  Wow... what a
improvement.  Our job suddenly got easier.

Then one day the insurance companies started to play doctor.  Formularies,
tier level copays, and prior authorizations took hold and suddenly we were
begging some little high school graduate employee for permission for a
patient to get a script filled multiple times daily.

Additionally competition heated up amongst the chains and the insurance
companies took advantage of this.  They reduced our reimbursement rates to
levels which cut profit margins and in fact sometimes caused a net loss per
prescription.  The chains faced the possibility of not getting patients in
the door if they did not accept the contracts.

Now chain stores know how much money a person walking around the store
spends per minute of walking around.  They  accepted the lower payments in
the hope that the patients would come into the store and buy impulse items.
Of course they still wanted to maximize profit. The chain stores handled
this by decreasing the fixed cost of filling prescriptions... mainly cutting
staff hours (especially technicians).

The net result pharmacists are much busier... with less help.  Stress levels
are intense.  We cannot do our jobs up to our own professional standards
because you cannot talk to doctors about changing medications to formulary
products and counsel patients at the same time.

I see this and I still feel the calling.  I'm still here.. however my
respect for my employers has certainly lessened and my feelings toward  3rd
party payers cannot be expressed in a public forum.  However a lot of people
considering pharmacy as a career see it and change their majors... or work
for a few years and then get out it all together.

And Pharmacy times wants to know why there is a shortage?
James Pinkerton - 07 Oct 2003 17:09 GMT
> Viva la shortage. I prefer to think of it as a healthy market.
>
> I suppose there are not enough pharmacists for the chains to build a
pharmacy on every block. Oh well, too bad for the chains.
<snip>
> Shortages come and go. Say a prayer tonight to thank God for the shortage.

Its the only job security you have, the pharmacists shortage.

I wonder when some mail order outfit is going to start shipping Rxs overseas
to have them filled at lower cost and then sending them back to the States.
Could they import Pharmacists and get them licensed in the USA?  Hospitals
have been recruiting nurses from overseas for quite a while.  Too bad with
the pharmacists shortage that we don't start demanding a 40 hour work week,
better working conditions, closing for lunch,  and a quota of Rxs for a
pharmacist to fill in an eight hour shift.
skipperdogs - 06 Oct 2003 18:44 GMT
When I don't fill in part time at the RiteAid down the street, they close
the pharmacy for the day.  400scripts average per day.
The area is saturated with pharmacies.  All of them open 14 to 16 hour days.
All of them have drive thrus.  All of them have inadequate tech help.
I used to be able to work 60hr weeks.
f.ck that.
It's too hard anymore.
They want help, they can help themselves by shortning their hours to free up
RPh time and providing an environment that would enable pharmacists to work
overtime.
They've made it so difficult I don't have the strength to work extra.
I used to.
If they would make some small changes, I'd bet they'd see a 30% increase in
their work force.
But then they're MBA's arent they.
From experience I can say they couldn't find their a.s at high noon with
both hands and a guide dog.
So f.ck them.
Let them whine about their shortage.

Larry

> A brief item in the latest issue of "Pharmacy Times" said that the
> pharmacist shortage continues unabated. The article estimated that, for
[quoted text clipped - 18 lines]
>
>                                           ---Franz Kafka
Brad - 06 Oct 2003 22:13 GMT
> When I don't fill in part time at the RiteAid down the street, they close
> the pharmacy for the day.  400scripts average per day.
[quoted text clipped - 15 lines]
> So f.ck them.
> Let them whine about their shortage.

Man I don't see why or how y'all put up with that - or actually I guess the
plural would be "all y'all"
Anyway, I know I wouldn't.
I work retail - independent - about 150 a day - 10 compounds a day - 1
pharmacist 3 techs - M-F 8-6 Sat 9-1 and closed on Sunday.
I find time to counsel 100% of the new prescriptions and monitor compliance
on the refills somewhat.
And give immunizations - although I've cut down on that but will crank up
for flu season.
A lot of my patients know me personally (yet they still keep coming back).
Some days are really tough but I know they'll be over at 6pm well sometimes
a little later.
And I'm sure I get my share of pissy people - heck its a retail bidness.
But I am very fortunate to have the worlds best techs that insulate me from
most of the crap and free me up to talk and work with the patients.
I don't count and pour much anymore and I can't say I miss it.
We eat lunch on the go most of the time but will close for lunch if we need
to.

Maybe its good that I don't like working for someone other that me.

Brad
J. Alan Septimus (Shalom) - 08 Oct 2003 07:08 GMT
>When I don't fill in part time at the RiteAid down the street, they close
>the pharmacy for the day.  400scripts average per day.

Sounds like 4258. Been there, done that.

>The area is saturated with pharmacies.  All of them open 14 to 16 hour days.
>All of them have drive thrus.  All of them have inadequate tech help.
>I used to be able to work 60hr weeks.

But not all in a row... remember RXPVSM?

He was a legend in Market 10. He'd work 9am to 6pm at 4258, then over to
Jersey to take the overnight shift at 1542, 8pm to 8am... then back to
4258, for three days and three nights running. God knows how he did
that, but I wouldn't want to be the one whose rx he filled at 7:00 on
Thursday morning...

Alan (formerly RXPJAS5)
Aimee G - 08 Oct 2003 13:51 GMT
> >When I don't fill in part time at the RiteAid down the street, they close
> >the pharmacy for the day.  400scripts average per day.
[quoted text clipped - 14 lines]
>
> Alan (formerly RXPJAS5)

No wonder you guys were named after robots!!!

Oi.

Aimee
skipperdogs - 08 Oct 2003 20:54 GMT
wow, what an insightful observation.
good one.

Larry
(formerly RXPLDS)

> > >When I don't fill in part time at the RiteAid down the street, they close
> > >the pharmacy for the day.  400scripts average per day.
[quoted text clipped - 21 lines]
>
> Aimee
Ftino - 17 Oct 2003 17:00 GMT
There is no pharmacist shortage. There are alot of "vacant job positions"
because working conditions are terrible. Many rph's wont work more hours or
have cut back hours because they hate the job.  CVS lost over a dozen rph's
in my area.  Not because they died or retired but because they QUIT. Now
they are "short".  Thats not a shortage.  I think its hard to find coal
miners and high wire trapeze artists also.

:')

> A brief item in the latest issue of "Pharmacy Times" said that the
> pharmacist shortage continues unabated. The article estimated that, for
[quoted text clipped - 18 lines]
>
>                                           ---Franz Kafka
Aimee G - 17 Oct 2003 17:08 GMT
> There is no pharmacist shortage. There are alot of "vacant job positions"
> because working conditions are terrible. Many rph's wont work more hours or
> have cut back hours because they hate the job.  CVS lost over a dozen rph's
> in my area.  Not because they died or retired but because they QUIT. Now
> they are "short".  Thats not a shortage.  I think its hard to find coal
> miners and high wire trapeze artists also.

Lots of coal miners around here.

Aimee
rxempress - 17 Oct 2003 22:38 GMT
I think coal miners are unionized. Do they get lunch breaks?
Ftino - 17 Oct 2003 23:39 GMT
Everybody is a comedian these days :')

> I think coal miners are unionized. Do they get lunch breaks?
 
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