American College of Clinical Pharmacy
      Search      Cart
         

ACCP Report - July 2020

President's Column

Today’s Pharmacists: From Dispensing to Indispensability

Written by Brian L. Erstad, Pharm.D., FCCP, BCPS


You have to know the past to understand the present.
– Carl Sagan

The future depends on what we do in the present.
– Mahatma Gandhi

The report of the 2019 National Pharmacist Workforce Study sponsored by the Pharmacy Workforce Center (formerly known as the Pharmacy Manpower Project, Inc.), of which ACCP is a member, has been released and is available on the American Association of Colleges of Pharmacy (AACP) website.1 As suggested by the title, the report focuses on demographics, work contributions, and the quality of work-life of the pharmacist workforce in 2019.

The report reminds me of a previous work published by the same group that was of a more prognostic nature. In 2001, the Pharmacy Manpower Project, Inc., held a conference to project the need for pharmacy services in 2020.2 The group’s assumptions related to these projections included factors such as future growth in size and complexity of health systems with an increasing need for care coordination; growth of individualized treatments, including specialty drugs; and increases in distance care through the use of technology such as telemedicine. Although these assumptions have come to fruition, the group’s predictions for 2020 related to the number of pharmacist jobs, schools of pharmacy, and pharmacy students were not as prescient. At the time of the 2001 conference, 196,700 full-time equivalent pharmacists were practicing in the United States. Conference attendees projected the need for 417,000 pharmacists in 2020, assuming a 20% increase in the number of graduates of existing schools and the addition of three new pharmacy schools. This was predicted to result in a shortfall of 157,000 pharmacists in 2020.

In reality, by 2017, the actual number of pharmacists in the United States was approximately 295,000,3 graduation rates according to the 2019 data listed on the AACP website increased from 7,000 in 2001 to almost 15,000 in 2018,4 and the number of pharmacy schools increased from approximately 80 in 2001 to more than 140 in 2018.5 Along these lines, the number of pharmacist jobs published by the U.S. Bureau of Labor Statistics (BLS) in 2018 was 314,300, a figure that BLS projects to remain unchanged over the next decade.6 Not surprisingly, in light of these statistics, a quick search of the Internet using the phrase “job outlook for pharmacists” reveals many more pessimistic than optimistic postings with respect to the outlook for pharmacist positions.

However, I remain optimistic and hope that younger readers, in particular, remain optimistic about their choice of pharmacy as a profession. Let me give you some of the reasons for why I see the glass as half-full rather than half-empty.

To begin, let’s revisit the 2018 BLS projections.6 On the BLS website, there is indeed a projection of no change in employment figures for pharmacists from 2018 to 2028, ostensibly because of the deployment of new technologies and the increased use of pharmacy technicians. However, the accompanying text notes, “Demand is projected to increase for pharmacists in a variety of healthcare settings, including hospitals and clinics,” as a result of factors such as an aging population with more chronic diseases and scientific advances in drug development. Furthermore, BLS specifically mentions an increased demand for clinical pharmacists “in hospitals, clinics, and other healthcare settings,” arguing that today:

[Pharmacists] spend little time dispensing prescriptions. Instead, they are involved in direct patient care.

In addition, BLS lists the 2018 median annual wage for pharmacists as $126,120,6 and at entry level, a pharmacist makes more money than any other professional.7

Now, let’s return to the 2019 data published by AACP regarding students in schools of pharmacy. Although the website shows that the number of pharmacy graduates has increased dramatically over the past 20 years and even though it is still too early to know whether the number of pharmacy schools is leveling off, enrollment figures for full-time, first-professional degree pharmacy students have steadily declined from 2014 to 2018: 63,927 in 2014, 63,460 in 2015, 63,444 in 2016, 63,087 in 2017, and 62,504 in 2018,4 Together, the BLS projections and the data published by AACP should help assuage the concerns of pharmacy students and new practitioners who worry about supply outpacing demand.

Moreover, apart from the supply/demand considerations – which are ideally addressed through a multifaceted approach involving academia, the health professions, the private sector, and governmental groups – recent papers addressing pharmacy workforce issues have come to the same general conclusion: quality didactic and experiential pharmacy education and training are needed to develop a pharmacist workforce that can adapt to the new, advanced practice models needed in a changing health care environment.8-10 ACCP has a long history of developing, advancing, and positioning pharmacists, as exemplified by a 2000 white paper, which included recommendations for the entire profession as well as for ACCP and its membership.11 These recommendations remain applicable today. Indeed, ACCP has worked diligently over the past 2 decades to realize the paper’s recommendations, including intra- and interprofessional collaborations, advancement of community pharmacists and community practice, and advocacy of appropriate credentialing and certification.

My initial education and practice took place when dispensing was the prevalent practice model. However, I learned early on that I would have to adapt in order to engage in more fulfilling pharmacy positions. Initially, I returned to academia to advance my career through formal educational and postgraduate training. And as a clinician and faculty member, I continued to take advantage of other learning opportunities. In addition to being intellectually stimulating, such learning opportunities helped me secure more challenging and professionally satisfying employment. Today, as an academic department head, I encourage newer faculty members to make themselves crucial to the department’s success. I often remark that my theoretical list of most-needed faculty members is not a function of job descriptions, such as clinical versus non-clinical or tenure track versus non-tenure track, but is instead a function of how integrated and valuable a faculty member has become within our department and college. In particular, I encourage students, residents, and new practitioners to make themselves indispensable as pharmacists and our profession enter the final stages of transitioning from dispensing to advanced practice.

References:

  1. American Association of Colleges of Pharmacy (AACP). 2019 National Pharmacist Workforce Study. Available at https://www.aacp.org/article/2019-national-pharmacist-workforce-study. Accessed June 15, 2020.
  2. Knapp DA. Professionally determined need for pharmacy services in 2020. Am J Pharm Educ 2002;66:421-9.
  3. Data USA. Pharmacists. Available at https://datausa.io/profile/soc/pharmacists. Accessed July 9, 2020.
  4. American Association of Colleges of Pharmacy (AACP). Student Applications, Enrollments and Degrees Conferred Reports. Available at https://www.aacp.org/research/institutional-research/student-applications-enrollments-and-degrees-conferred. Accessed November 27, 2019.
  5. Grabenstein JD. Trends in the number of US colleges of pharmacy and their graduates, 1900 to 2014. Am J Pharm Educ 2016;80:Article 25.
  6. U.S. Department of Labor, Bureau of Labor Statistics. Occupational Outlook Handbook: Healthcare: Pharmacists. Available at https://www.bls.gov/ooh/healthcare/pharmacists.htm. Accessed July 9, 2020.
  7. Anderson M. Pharmacists Make More Money in Entry-level Jobs than Any Other Profession, Analysis Finds. November 15, 2019. Becker’s Hospital Review. Available at https://www.beckershospitalreview.com/pharmacy/pharmacists-make-more-money-in-entry-level-jobs-than-any-other-profession-analysis-finds.html. Accessed July 9, 2020.
  8. Covey JR, Cohron PP, Mullen AB. Examining pharmacy workforce issues in the United States and the United Kingdom. Am J Pharm Educ 2015;79:Article 17.
  9. Lebovitz L, Eddington ND. Trends in the pharmacist workforce and pharmacy education. Am J Pharm Educ 2019;83:Article 7051.
  10. Watanabe JH. Examining the pharmacist labor supply in the United States: increasing medication use, aging society, and evolution of pharmacy practice. Pharmacy 2019;7:137.
  11. American College of Clinical Pharmacy (ACCP). A vision of pharmacy’s future roles, responsibilities, and manpower needs in the United States. Pharmacotherapy 2000;20:991-1020.