A Looming Joblessness Crisis for New Pharmacy Graduates and the Implications It Holds for the Academy

Daniel L. Brown, PharmD

Disclosures

Am J Pharm Educ. 2013;77(5) 

In This Article

Trends in the Pharmacy Workforce

The Pharmacy Workforce Center (PWC), formerly known as the Pharmacy Manpower Project, Inc, tracks the pharmacist workforce for multiple pharmacy organizations.[7] The primary data element compiled by the PWC is the aggregate demand index (ADI) which is derived from feedback obtained from a nationwide panel of participants who are engaged in hiring pharmacists. Panel members report their impressions of the pharmacist job market to PWC on a monthly basis using a 5-point scale, where 5 = high demand—difficult to fill open positions; 4 = moderate demand—some difficulty filling open positions; 3 = demand in balance with supply; 2 = demand is less than the pharmacist supply available; and 1 = demand is much less than the pharmacist supply available.[9]

A national 10-year trend map of ADI shows that it remained fairly steady at a level of about 4 (moderate demand) from 2002 through early 2008, indicative of a modest but stable pharmacist shortage (Figure 1).[10] However, the ADI then began a downward trend that brought it closer to the "equilibrium point" of 3 in 2010, where it has hovered since. The drop in ADI of a full point in just a couple of years, in contrast to predictions of a persistent pharmacist shortage for many years to come, is cause for concern. The November 2012 regional ADI results shed a bit more light on the job market and might serve as a harbinger of what lies ahead. The Northeast, with several states already having demonstrated major academic growth, has seen the ADI drop to 2.85.[11] Several states in the South are about to drop below 3.0 in the not-too-distant future (Florida already has), and other regions will follow suit shortly thereafter. Furthermore, the November 2012 national ADI for community pharmacies was only 2.83, suggesting that the most prevalent pharmacy practice setting is already showing a net surplus of pharmacists nationwide.[12]

Figure 1.

Plot of monthly national averages of the Aggregate Demand Index for the 10-year period of December 2002 through November 2012.10 Note the downward trend of data points that started in June of 2008.

Institutional pharmacy shows similar trends. Pharmacy Forecast 2013–2017, a strategic planning report for institutional pharmacy, reports that the vacancy rate for pharmacists in hospital practice dropped from 7.2% in 2002 to 2.4% in 2011.[13] The report notes that although the market for staff pharmacists has leveled off, it remains difficult to fill some managerial and clinical specialist positions. This phenomenon might have been exacerbated by the rapid expansion of academia, which has created a bountiful supply of new leadership and clinical positions to be filled since 2001.

Along with an increasing rate of production of pharmacy graduates, a lower-than-expected creation of new pharmacist jobs also serves as a critical component of the pharmacy manpower equation. The projected need for pharmacy services in 2020 assumed a reduction of 36,400 pharmacist FTEs needed for dispensing and a pronounced increase of 135,000 FTEs for primary care services.[4] This role transformation is simply not happening, at least not at the rate or extent predicted. According to results from the 2009 National Pharmacist Workforce Survey, 70% of pharmacist time in the community setting is devoted to dispensing, with just 10% spent on patient care activities.[14] In hospitals and other patient care settings, 43% of pharmacist time was allocated to dispensing activities, compared to 27% allocated for direct patient care. The reasons for which medication therapy management services and primary care activities in ambulatory clinics have not dramatically impacted the pharmacist job market are beyond the scope of this commentary. However, there is no disputing that direct patient care jobs for pharmacists outside of acute care facilities have been slow to develop. Furthermore, not much has changed in community pharmacy practice to enhance the level of direct patient care services provided with every prescription. Community pharmacy jobs are still more closely linked to prescription volume than to the demand for patient care services.[15]

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