Pharmacist Job Turnover, Length of Service, and Reasons for Leaving, 1983-1997

David A. Mott, Ph.D.

Disclosures

Am J Health Syst Pharm. 2000;57(10) 

In This Article

Abstract and Introduction

Pharmacist job turnover from 1983 to 1997 was studied.

Data were collected from a randomized 1997 mail survey of 1600 licensed pharmacists in four states (Ohio, Massachusetts, Oregon, and Alabama). The survey instrument included questions on pharmacist demographics, work schedules, salary, and work history.

A total of 541 pharmacists responded, yielding an adjusted response rate of 34.5%. Information was provided on a total of 1697 jobs with start dates from 1931 to 1997. Pharmacist job turnover was fairly steady across the 1983-1997 period, averaging 11% annually. The average median tenure of pharmacists who left jobs was 32 months. The percentage of pharmacists leaving jobs and ranking stress as the reason for leaving increased, and the percentage of leavers ranking salary as the reason decreased. Women had a significantly higher annual turnover rate (15%) than men (9.7%), and they stayed in jobs for significantly less time (25.2 months) than men (56.5 months). There were no differences in turnover rates across practice settings. A larger percentage of pharmacists leaving jobs in large chain and institutional settings ranked stress as a reason for leaving than pharmacists leaving independent or small chain pharmacies. A larger percentage of pharmacists leaving independent or small chain pharmacies ranked salary as a reason than pharmacists in the other two settings.

Pharmacist job turnover averaged 11% per year between 1983 and 1997. Pharmacists who left jobs typically stayed less than three years. The percentage citing stress as a reason for leaving increased, and the percentage citing salary decreased.

The expanding use of drug therapy, escalating drug costs, and a growing focus on the quality of health care have increased the demand for pharmacists and created employment opportunities for pharmacists outside traditional patient care settings.[1,2] The rising demand for medications has adversely affected pharmacists' work environments,[3,4,5] but a pharmacist shortage has increased salaries as employers compete to attract pharmacist labor.[6,7,8] The deterioration of the work environment, combined with the extra employment opportunities and increasing pay, can result in high pharmacist job turnover.[9]

Knowledge of pharmacist job turnover -- including its prevalence, the types of employees leaving, and how turnover occurs -- is important because the supply of pharmacists is limited and because job turnover is costly to health care organizations. Organizations lose the efficiency of the person leaving (the "leaver") and incur costs associated with hiring temporary employees and recruiting and training new employees.[10] Also, employees who remain have to work harder to make up for the leaver. The cost of replacing an employee has been estimated to be up to four times the employee's annual salary.[11,12] Pharmacy labor turnover costs are probably significant in this era of reduced reimbursement for pharmaceuticals -- possibly preventing the development of services and limiting the amount and quality of time pharmacists spend with patients. Also, turnover costs may contribute to the closing of pharmacies, which reduces patient access to pharmaceutical goods and services.

Turnover rates by themselves provide an understanding of how often the event of leaving occurs but do not describe the nature of job turnover.[13] Coupling tenure (the length of service) of leavers with turnover rates helps determine whether turnover involves short-service workers or whether the more stable cadre of long-service employees is affected. Much like the turnover rate, the tenure of leavers is sensitive to working conditions and the labor market. Poor working conditions typically result in high turnover rates and shorter tenures, as short-service workers are proportionately more affected.

Employees' reasons for leaving jobs are another measure of job turnover.[9] Factors can be related to aspects of work that can to some extent be changed by the employing firm (e.g., salary, benefits, and work schedule) or to aspects beyond the firm's control (e.g., desire for new challenges and relocation). Trends in the importance workers place on reasons for leaving are important, as they provide indirect evidence of changes in the work setting. In addition, they provide employers with information on how to address employees' problems and how to design strategies to prevent turnover.

Researchers have examined pharmacist turnover by calculating turn-over rates and testing behavioral models relating attitudes toward work, career, and employers with intentions to leave a job.[3,14,15,16,17,18,19,20,21,22,23,24] However, understanding trends in pharmacist turnover is difficult, since measurement of turnover rates is infrequent, limited to specific practice settings, and rarely associated with reasons for leaving. Furthermore, a review of the literature did not reveal a study calculating the tenure of pharmacists leaving jobs.

From an economic perspective, job turnover is caused by the interaction of individual choice and opportunities in the labor market.[25,26,27] Central to this interaction is the availability (i.e., number of opportunities), attractiveness (i.e., characteristics), and attainability (i.e., skills needed) of different jobs. Workers choose to leave one job for another when the benefits of the other job outweigh the cost of staying in the current job.

Previous studies have not examined or compared turnover rates, tenure of leavers, and reasons for leaving by sex or practice setting. However, pharmacist job turnover probably varies with sex and practice setting. Researchers have found that female pharmacists have less commitment to hiring organizations, experience more job stress, and have stronger intentions to leave their jobs than male pharmacists.[5,28] Also, female pharmacists are more likely than male pharmacists to leave jobs because of family responsibilities.[29] Consolidation of hospital settings may reduce turnover by limiting the number of employment opportunities in those settings. Conversely, expansion of the number of sites within the chain drugstore industry provides additional employment opportunities and may increase turnover if these new opportunities are attractive to pharmacists. Researchers have found differences in salary levels, job stress, levels of organizational commitment, job satisfaction, and job withdrawal intentions among pharmacists practicing in different settings.[4,5,14,28]

The first objective of this study was to assess pharmacist job turnover between 1983 and 1997. This was accomplished by determining annual pharmacist job turnover rates, the tenure of pharmacists who had left jobs, and the reasons pharmacists gave for leaving their jobs. The relationship between turnover rates and tenure of leavers was examined to determine the types of workers leaving jobs. Trends in the reasons for leaving jobs were examined to determine why pharmacists left jobs and to highlight possible changes in work characteristics. The second study objective was to describe pharmacist turnover by sex and practice setting and to identify any differences in turnover rates, tenure of leavers, and reasons for leaving by sex and practice setting.

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