Is There a Retail Pharmacist Shortage? Three Pharmacists Weigh In
Key takeaways:
Several chain pharmacies have begun offering large sign-on bonuses to pharmacists, citing difficulties finding pharmacists to staff their stores.
While this would typically indicate a shortage of qualified personnel, it may actually be due to pharmacist burnout amid the increased pressure from COVID, strenuous working conditions, and billing and reimbursement challenges.
Many retail pharmacists have moved on to other roles at independent community pharmacy and safety-net clinics, hospitals, industry, and non-traditional settings.
Walgreens recently announced it would offer up to $75,000 as a sign-on bonus for pharmacists. This came as a surprise to many practicing pharmacists who had been hearing about shrinking demand and increasing numbers of pharmacists.
So is there a pharmacist shortage? Here, we’ll dive into the job openings and demand situation for retail pharmacists.
To get a sense of what’s happening on the front lines, we interviewed Alex Barker, PharmD, founder of the Happy PharmD, and Ken O’Shea, PharmD, a pharmacist who has worked as a recruiter for a chain pharmacy. We also interviewed a district manager (DM) for a chain pharmacy who wished to remain anonymous.
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Many signs point to limited opportunities despite sign-on bonuses
Walgreens is not the only chain pharmacy trying to recruit pharmacists. CVS is also attempting to lure pharmacists with sign-on bonuses.
Sign-on bonuses typically mean chains are having difficulty filling positions, which happens when there’s a shortage of qualified staff. However, the fast growth of pharmacy schools combined with declining demand due to increased automation, lower reimbursement, and the rise of mail order pharmacies have recently left many pharmacists scrambling to find a job.
The prospects for new pharmacists are also unclear. According to one 2015 survey, almost 1 in 5 pharmacists did not have a job or postgraduate plans, like a residency or fellowship, at the time of graduation. Another survey found that between 2013 and 2017, around 1 in 7 pharmacists did not have postgraduate plans.
While this is similar to the rates of nursing graduates, it does seem to be getting more difficult for pharmacy school graduates. The University of California-San Francisco found that more of their pharmacy school graduates’ plans are “to be determined” than ever before, while rates of employment in community pharmacies have plummeted.
Finally, the Bureau of Labor Statistics projects pharmacy jobs to grow at 2%. That’s significantly lower than the national average of 5%. And most of the job openings will be due to pharmacists either switching professions or retiring.
Is there actually a pharmacist shortage?
According to the pharmacists we interviewed, the mismatch between job trends and the current sign-on bonuses is rooted in multiple factors.
Burnout and working conditions
All three pharmacists we interviewed said working conditions are primarily driving a shortage of retail pharmacists.
Problems include staffing shortages, stressful labor metrics, productivity metrics, and the expansion of practice, leading to additional responsibilities that fall on the same pharmacy team. Pharmacist burnout is so widespread that the American Pharmacists Association released a statement saying it has reached a “breaking point.”
“Few pharmacists want to expose themselves to these working conditions, regardless of pay, and I’m glad few pharmacists take that offer,” said Dr. Barker.
The DM we interviewed also felt like this was part of a long trend. “Community pharmacy [work] over the past many years has increased in stress and expectations, with the addition of immunizations, adherence programs companies have set up, and now being able to prescribe Paxlovid.”
These are important milestones for the advancement of pharmacy and for allowing pharmacists to play a larger role in public health. But without adequate staffing, the piling on of responsibility adds stress to an already overwhelmed pharmacy team.
Dr. O’Shea spoke of pharmacists working the entire day alone. Even at a low-volume store, that can be stressful. For example, if the phone rings, someone comes to the register, and someone pulls up to the drive through at the same time, the pharmacist can get overwhelmed in a matter of minutes.
COVID has exacerbated the stress pharmacists are under. “The pandemic brought many people to the conclusion that the stress and work they were putting in was not worth it. And they took jobs in other areas of healthcare. Quality of life became more important, and retail pharmacy did not take steps to reduce stress and add staff so they could entice people back into the profession.”
Patient safety
In addition to the stress and burnout caused from the working conditions, pharmacists are concerned about patient safety.
“It comes to a point where we are concerned about patient care, we recognize we are putting our patients at risk working like this. So it’s a responsible decision [leaving community pharmacy] at this point, for both patient and pharmacist health,” Dr. O’Shea asserted.
The DM we interviewed also notes that most companies will only train a pharmacist for around a week, which is not enough. “Many DMs end up placing new hires in difficult situations out of desperation, and the pharmacist quits,” he said.
Billing and reimbursement
Pharmacists on the front lines also must handle the challenges with billing and reimbursement. Two main ways billing adds pressure are prior authorizations that cause delays in care and angry patients verbally abusing staff due to things beyond their control, says Dr. O’Shea.
The DM we interviewed agreed. “While I understand a patient’s frustration if the pharmacy makes a mistake, or a prescription is not ready when promised, there are many issues out of our control where the patient places blame on the pharmacy staff, which adds to the stress.”
Finding alternative paths
Dr. Barker’s company helps pharmacists clarify their goals and find a career path that best fits those goals. He has seen many pharmacist career-changes through his work.
According to their latest Success Report, the pharmacists they coach have moved into industry (14.8%), entrepreneurship (10.7%), hospitals (10.7%), community pharmacy (8.2%), and medical writing (5.7%). This report also found that only 5% of pharmacists moved out of pharmacy entirely.
Dr. O’Shea says that many new graduates never even practice pharmacy in a traditional setting and instead forge a different path for themselves. “Some of my peers in industry never bothered taking the NAPLEX. They saw what pharmacy was becoming, and nothing any company could say would change their mind.”
Lastly, the DM we interviewed felt that the growth of the cannabis industry has contributed to the exodus of retail pharmacists. As of February 2022, 37 states, 3 territories, and Washington, D.C. allow the use of medical cannabis. And in many states, like Connecticut, pharmacists are legally required to be involved in cannabis dispensaries. That creates a lot of new jobs for pharmacists looking for a career transition.
The bottom line
Pharmacists are among numerous healthcare professionals experiencing high levels of burnout, and many are leaving the profession. While the situation began long before COVID, the pressures pharmacists faced during the height of the pandemic only exacerbated the situation.
To prevent a shortage of community pharmacists, it will be important for the industry to address the concerns leading to burnout, like working conditions, staffing, and productivity metrics.
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