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PharmacyThisWeek: Guest post from Ryan Schell, PharmD Re the Pharmacist Job Crisis

July 12, 2017

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Welcome to PharmacyThisWeek!

The following is a guest post by Ryan Schell, PharmD Re the Pharmacist Job Crisis. Dr. Schell is an Emergency Medicine Clinical Pharmacist, Mount Carmel West Hospital, Columbus, OH

There has been a lot of talk the past four or five years about a looming pharmacist job crisis, and one does not have to look very hard to find articles, blog posts, and forum discussions revolving around the subject. Many pharmacists are also familiar with the study published in the American Journal of Pharmaceutical Education in 2002 that predicted a need for 417,000 pharmacists in 2020 with a shortfall of 157,0001. This study is often cited as a major reason for the rapid expansion of pharmacy education over the past decade.

However, we know that the healthcare environment has rapidly changed between then and now, and it is worth taking a look at the available jobs data and numbers to try to get some idea of our current labor market and job outlook. If you search the internet for pharmacist job outlook, one of the first few hits will be the Bureau of Labor Statistics (BLS) occupational outlook for the pharmacists. When you go to the webpage, you may notice that the job outlook between 2014 and 2024 for the pharmacist profession is only expected to grow by 3% over that 10 year period, increasing from 297,100 in 2014 to 306,200 in 2024 or 910 jobs a year2. This is an alarmingly low number given that in 2015-2016, 14,556 first professional pharmacy degrees (and 326 non-traditional post B.S. Pharm.D. degrees) were awarded according to the American Association of Colleges of Pharmacy (AACP)3, and this is a number expected to increase further. However the BLS webpage you are on does leave out a few important details.

If you dig deeper, you will see that the BLS gets their data from Projections Central, and these projections are easily accessed via their website at projectionscentral.com. Here, included with the same long term projections, you can find a number referred to as “average annual openings.” This is the sum of the number of pharmacists expected to leave the pharmacist workforce (through means like retirement, acquiring a non-pharmacist job, etc.) plus newly created jobs. Essentially it can be looked at as the number of pharmacists we would need to graduate each year if 100% of pharmacy jobs were filled to start the year. The number for the long term projection is 7,840 annually4, which if you are keeping track, is roughly half of the pharmacy graduates we expect each year, not even factoring in any further growth in pharmacy school graduation rates. Anyway you spin it, graduating around 7,000 more pharmacists than are needed to fill projected job vacancies is not a sustainable pace for our profession.

Projections central also provides a short term estimate, from 2016-20185. These numbers appear to be more accurate given their 2016 estimate for pharmacist jobs is 304,820, which is only off by 690 from the actual estimate performed that year according to the BLS Occupational Employment Statistics which was 305,5106 (for comparison, the long term projection only estimated 298,920 jobs in 2016). The short term projection estimates pharmacy job growth at 3,425 annually with average annual openings of 9,900, giving us a surplus of around 4,656 graduates using the 2015-2016 graduation number, again not factoring in any further growth of this number.

The question now becomes how many jobs are currently unfilled, and are we currently sitting on a surplus or a shortage of pharmacists? The BLS Household Data from 20157 suggests that in the year 2015, there were 282,000 practicing pharmacists. If we take our 2016 job number of 304,820 and subtract 3425 growth for that year, we get a job number for 2015 of 301,395, and then simple subtraction gives us a shortage of 19,350 practicing pharmacists for the year 2015. If the projections are accurate and we are indeed graduating 4,656 more pharmacists a year than are needed to fill newly created positions and positions vacated by other pharmacists, we could expect this gap to be closed by 2020, and if the status quo is maintained, the result afterwards would be a significant nationwide surplus of pharmacists.

Next question I had is what jobs are included in these projections, or how does the BLS define pharmacist? To quote them: “Pharmacists dispense prescription medications to patients and offer expertise in the safe use of prescriptions. They also may conduct health and wellness screenings,
provide immunizations, oversee the medications given to patients, and provide advice on healthy lifestyles.” Therefore, any pharmacist with a job falling out of this description would not be counted as a pharmacy job, which will likely include industry jobs, academia, research, and consulting/business jobs. It could also exclude by that definition community and hospital administration positions with no patient care component as well as informatics and other non-patient care oriented positions in health systems and chains. It is possible that job growth in these areas is unaccounted for in these projections and may alleviate some of the pending crisis, but it is not a large percentage of pharmacists that work in these areas and I wouldn’t count on these jobs to make up for any significant projected deficit.

It is also worth noting that these estimates also do not include self-employed workers. An article in Pharmacy Times from 2016 put the number of independent pharmacies at 20,0009, although it is unclear how many pharmacist owners this represents (one pharmacist may own multiple
pharmacies, and it only would exclude the owner, not the pharmacists that are paid employees at these independents). The debate around the feasibility of pharmacy ownership in the current healthcare climate is too long to get into for the purposes if this article, but I wouldn’t count on that either to alleviate any large jobs deficit. Because the BLS definition of employed is literally “people with jobs8“, I also assume that these jobs numbers represent full time, part time, and as needed pharmacists who work at least periodically.

I’m also not entirely certain whether pharmacy residents would be included in these numbers, but it is entirely possible they are counted considering they are licensed pharmacists working in patient care, and since they are paid would be included in the “people with jobs” definition. The AACP statistics also indicate that in 2016, 4,591 students were enrolled in Ph.D. and M.S. graduate programs in pharmaceutical sciences, but it is unclear how many of these students have a PharmD prior to enrolling, so it is hard to gauge any effect this student population would have on the pharmacy job market, but it is likely minimal if any since as stated above, positions in research and academia where these graduates will likely end up are unlikely to be counted as pharmacy jobs.

As a disclaimer, I am not an analytics professional, just a pharmacist who heard the conversations, became interested, and had some free time to dig into these numbers. Also remember that these of course are only projections, estimates and assumptions, and that there are numerous variables that can have positive and negative influences on pharmacy job creation and the pharmacist job market. It is important to not get caught up in the exact numbers as these can fluctuate by hundreds or thousands from the projections, but instead focus on what the potential trends are and could be. Unfortunately, the current numbers indicate that we as a profession are trending on a potential course that could result in a significant jobs crisis in the near future, the result of which could be several thousand pharmacists graduating with significant debt and very poor job prospects and out of work pharmacists having an extremely difficult time finding jobs.

I haven’t mentioned the Pharmacist Demand Indicator yet, which can be found on pharmacymanpower.com. This write up has already gone on long enough, but for completion here is a screen shot the Q1, 2017 PDI. Remember it is a scale from 1 to 5, 5 being high demand for pharmacists (pharmacist shortage), 1 being low demand for pharmacist (pharmacist surplus), 3 being demand in balance with supply.

The numbers hovering just above three would indicate that we are almost in balance, but maybe there are just slightly more positions than there are pharmacists nationwide. If you look back into 2006, these numbers are above four, indicating a pharmacist shortage at that time. This downward trend from over four to three over the last decade seems to support the conclusion that we are filling up our shortfall, and can expect to hit a balance soon if our current projections are accurate.

 

Ryan Schell, PharmD
Emergency Medicine Clinical Pharmacist
Mount Carmel West Hospital
Columbus, OH

 

  1. Knapp, DA. Professionally Determined Need for Pharmacy Services in 2020. American Journal of Pharmaceutical Education; Winter 2002; 66; 421-9.
    http://www.aacp.org/resources/research/pharmacyworkforcecenter/Documents/2020NeedForServices.pdf.
  2. Occupational Outlook Handbook: Pharmacists. Bureau of Labor Statistics. Accessed July 2017.
    https://www.bls.gov/ooh/healthcare/pharmacists.htm.
  3. Academic Pharmacy's Vital Statistics. American Association of Colleges of Pharmacy. Accessed July 2017.
    http://www.aacp.org/about/Pages/Vitalstats.aspx.
  4. Long Term Occupational Projections: Pharmacists. Accessed July 2017.
    http://www.projectionscentral.com/Projections/LongTerm.
  5. Short Term Occupational Projections: Pharmacists. Accessed July 2017.
    http://www.projectionscentral.com/Projections/ShortTerm.
  6. Occupational Employment Statistics: Pharmacists. Bureau of Labor Statistics. Accessed July 2017.
    https://www.bls.gov/oes/current/oes291051.htm.
  7. Household Data Annual Averages. Bureau of Labor Statistics 2015. Accessed July 2017.
    https://www.bls.gov/cps/aa2015/cpsaat11.pdf.
  8. Labor Force Participation. Bureau of Labor Statistics. Accessed July 2017.
    https://www.bls.gov/bls/cps_fact_sheets/lfp_mock.htm.
  9. Ellis, Dave. Independent Pharmacy Ownership Provides an Attractive Career Choice. Pharmacy Times, November 29, 2016. Accessed July 2017.
    http://www.pharmacytimes.com/news/independent-pharmacy-ownership-provides-an-attractive-career-choice.

We update the following employer’s openings each week so be sure and check out their latest available positions. Unless otherwise noted these employers have openings in multiple states so be sure and search on the state and/or job title you are most interested in. If you have any questions just let me know.

AIDS Healthcare Foundation
All Children’s Hospital
Apexus
Baptist Hospital of South Florida
BizEx
Board Certification Program In Medical Affairs
Boston Medical Center
CareerStaff Rx
Central Admixture Pharmacy Services
CardinalHealth
Commonwealth Health Corporation
Comprehensive Pharmacy Services (CPS)
Confluence Health
Cox Health
CVS Health
Eastern Maine Healthcare Systems (EMHS)
Franciscan Missionaries of Our Lady Health System
Froedtert Health
Genoa, A QoL Healthcare Company
GNYHA
Greenville Health System
HCA
Intermountain Healthcare (UT and SE ID)
Jackson Pharmacy Professionals
JFK Medical Center
Johns Hopkins Home Care Group
Johns Hopkins Medicine
Lahey Health
Navitus Health Solutions
OnePoint Patient Care
Pharmacy Systems, Inc.
Pharmapreneur Academy
PHI Pharmacy
Preferred Homecare
Premier, Inc.
Providence Health & Services
RPh Professional Search
Samaritan Health Services
Script N Go
Sentara (SE VA and NE NC)
Skagit Regional Health
Soleo Health
St Helena Hospital Napa Valley
Tahoe Forest Hospital District
The Queen’s Medical Center
Triad Isotopes, Inc.
UCSF Benioff Children’s Hospital Oakland
UCLA Health
UHG/OptumRx
University of Utah
Veterans Administration
Vizient

I hope everyone has a great week! You can always reach me at my email or cell number below, thanks!!

Kevin Mero
President
kevin@pharmacyweek.com
cell: 210 872-6160

 

 

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