Too many pharmacists?

[az101]

“This market, the American market, is ready for another round of consolidation,” Pessina, Walgreens Acting CEO and executive vice chairman, told analysts last week on Walgreens Boots Alliance second-quarter earnings call. “Because the margins are squeezed everywhere; the government is more and more in charge for the costs of the healthcare business and so for sure they will exercise their power to squeeze the cost as much as possible, as we have seen in Europe for decades.”

http://www.forbes.com/sites/bruceja...utm_source=MEDCareerAgents&utm_medium=twitter

Interesting. Here is a CEO saying he is done competing for thinner margins and would like to limit his competition by consolidating. Doing so would be for the sole interest of his business - eliminate the competition so pricing power increases. It makes sense except why can't pharmacist do the same thing?

We are told that we can't limit the number of pharmacy schools, we need to let the free market work, colluding is illegal, etc. So why is it that capitalist can combine to increase their own pricing power but pharmacist doing the same is wrong and anti-competitive? If WBA can limit their competition, the national pharmacy organizations should do the same for pharmacy schools.

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[Lnsean]

because the bop is a joke and the pharmacist association has no backbone

 

[bacillus1]

Because Walgreens is making their own choice to consolidate; no one is really "forcing" them to, it's just in their best interest.

 

[PharFromNormal]

Simple way is to do something similar to what MD's did. Put a cap on the total number of accredited APPE rotation sites. This probably would not happen as the pharmacist associations seem to be all about expanding and growth (from scope of practice to number of schools, etc.).

 

[deleted158872]

hmm... pretty sure the MOST expensive costs of healthcare come from private insurance companies' asinine practices, not because of the government.

Simple way is to do something similar to what MD's did. Put a cap on the total number of accredited APPE rotation sites. This probably would not happen as the pharmacist associations seem to be all about expanding and growth (from scope of practice to number of schools, etc.).

what they do is put a cap on medical school entrance.

 

[PharFromNormal]

hmm... pretty sure the MOST expensive costs of healthcare come from private insurance companies' asinine practices, not because of the government.


what they do is put a cap on medical school entrance.

Well the residency cap essentially trickles down to the medical school entrance. What school would want to open a medical school or increase their enrollees if they couldn't place their graduates into residencies? Who would want to attend a school with such low placement rates?

More info for you...

https://www.aamc.org/advocacy/gme/71178/gme_gme0012.html

 

[deleted158872]

What school would want to open a medical school or increase their enrollees if they couldn't place their graduates into residencies? Who would want to attend a school with such low placement rates?

it's not A school that has high failure rate; it's the total # of enrollments that matter.
med schools certainly can act like pharm schools by opening hundreds of satellites, IF there isn't a cap on med school entrance by the AMA. For one, their criteria for accreditation are way tougher than pharm schools. http://scholarship.law.duke.edu/cgi/viewcontent.cgi?article=3288&context=lcp

 

[PharFromNormal]

it's not A school that has high failure rate; it's the total # of enrollments that matter.
same for pharm schools: people still go to "diploma mills" because in the end, the whole profession gets squeezed and not just them.
med schools certainly can act like pharm schools by opening hundreds of satellites, IF there isn't a cap on med school entrance by the AMA. For one, their criteria for accreditation are way tougher than pharm schools. http://scholarship.law.duke.edu/cgi/viewcontent.cgi?article=3288&context=lcp

Criteria is harder because the already opened schools would be threatened due to a limited number of residency positions. Medical residencies are pretty much required in all states now to get a license... not a degree. If a school has a low match rate, or in other professions a low employment rate post-grad, it doesn't look good for potential students.

In pharmacy APhA has stronger ties to academia vs. graduates, in medicine AMA is stronger with graduates vs. academia. AMA cannot enforce laws nor regulation, it, like APhA can champion, advocate, or lobby for policy, but it is not the federal or state government nor it is a medical board. I agree that AMA strongly favors a limit on med school entrance and they managed to achieve this via limiting residency positions that graduates must have in order to be licensed to practice.

 

[Lnsean]

it's not A school that has high failure rate; it's the total # of enrollments that matter.
same for pharm schools: people still go to "diploma mills" because in the end, the whole profession gets squeezed and not just them.
med schools certainly can act like pharm schools by opening hundreds of satellites, IF there isn't a cap on med school entrance by the AMA. For one, their criteria for accreditation are way tougher than pharm schools. http://scholarship.law.duke.edu/cgi/viewcontent.cgi?article=3288&context=lcp

Not really. With MDs, you have to match into a US residency in order to have any kind of credence, and these spots are always limited and not expanding even if the schools are.

 

[deleted158872]

x

 

[Lnsean]

with pharmacy, you have to find a job. Job positions are limited, too?

I don't need residency to apply to the majority of jobs out there. That's one less barrier.

 

[bacillus1]

with pharmacy, you have to find a job. Job positions are limited, too?

Jobs aren't based on CMS funding, unlike medical residencies, so it's not a set number. And the amount of people truly unemployed 6 months after graduation is still pretty low, as long as one is OK with moving wherever the job takes them. However, that may change soon as there are even more schools.

 

[knight on horse]

“This market, the American market, is ready for another round of consolidation,” Pessina, Walgreens Acting CEO and executive vice chairman, told analysts last week on Walgreens Boots Alliance second-quarter earnings call. “Because the margins are squeezed everywhere; the government is more and more in charge for the costs of the healthcare business and so for sure they will exercise their power to squeeze the cost as much as possible, as we have seen in Europe for decades.”

http://www.forbes.com/sites/bruceja...utm_source=MEDCareerAgents&utm_medium=twitter

Interesting. Here is a CEO saying he is done competing for thinner margins and would like to limit his competition by consolidating. Doing so would be for the sole interest of his business - eliminate the competition so pricing power increases. It makes sense except why can't pharmacist do the same thing?

We are told that we can't limit the number of pharmacy schools, we need to let the free market work, colluding is illegal, etc. So why is it that capitalist can combine to increase their own pricing power but pharmacist doing the same is wrong and anti-competitive? If WBA can limit their competition, the national pharmacy organizations should do the same for pharmacy schools.

It is the classic capital vs. labor, and guess what: capital won

 

[SClENCE]

So essentially, since the government is screwing pharmacies with little to no profit on Medicaid patients WAGS wants to merge with Rite-Aid to not only eliminate competition but to also have more leverage in pricing when dealing with government reimbursements? Seems like a good business plan if I am interpreting this correctly... though if a larger entity has more leverage with government reimbursements then they may have larger leverage with pharmacist salary too.

As far as the example with medical schools, I would say that licensing is certainly capped by residency positions as opposed to admission numbers. It doesn't matter how many people get a degree, only so many will become licensed. Because of this, there is no point in opening a new school of students know that they cannot get licensed. With pharmacy, there is no limit aside from the job market itself. @Maruko The whole point of limiting pharmacy schools is to improve the job market, so making the case the the job market is the limiting factor is kind of self defeating. With medical school and capped residency, the limiting factor (residency) prevents graduates from even attaining a license thus the job market is not affected. If you use the job market itself as the limiting agent than obviously the job market will be affected.

Many people simply argue that with so many schools enrollment will simply fall. I would argue that this is not the case, as lower quality applicants will just be accepted to fill these seats.

 

[BidingMyTime]

Plus, what many people don't get, the public has NO sympathy for us or anyone else earing 6 figure incomes. The public doesn't care if students go thousands or hundreds of thousands of dollars into debt. They don't care if pharmacists (or doctors, and especially not lawyers) do public good. So as long as the argument is, "we need less schools, because pharmacists will make less money if there are more schools", nobody but pharmacists will care.

 

[deleted158872]

Plus, what many people don't get, the public has NO sympathy for us or anyone else earing 6 figure incomes.

well, pharmds only get 6 figure if successfully find a job and don't get laid off before 2 years Some pharmacist jobs only go to 5 figure these days

 

[SClENCE]

Plus, what many people don't get, the public has NO sympathy for us or anyone else earing 6 figure incomes. The public doesn't care if students go thousands or hundreds of thousands of dollars into debt. They don't care if pharmacists (or doctors, and especially not lawyers) do public good. So as long as the argument is, "we need less schools, because pharmacists will make less money if there are more schools", nobody but pharmacists will care.

I agree. Many people demonize anyone who makes money and ignore the investment of time/effort/money it took to get there along with the skills and services they offer.

That being said, there's a good portion of customers that probably have no idea what a pharmacist makes. A customer last month asked me how many weeks of classes you have to take to be a pharmacist and if you can do it online. She wasn't referring to becoming a tech either.

 

[PharFromNormal]

I think the thought is if the total number of pharmacies shrinks it increases demand in the marketplace.

Pharmacies (and chains) have little leverage to push back on the real payors (insurance companies/PBMs) because the pharmacy across the street is willing to accept the contract their neighbor didn't because it means more prescriptions for them. If there wasn't 3 pharmacies at every corner the equation MIGHT shift. If wags was the only pharmacy in town and all of town had a certain insurance, that insurer has less leverage thus giving wags a stronger voice in the reimbursement discussion.

I would argue Pessina means there are too many pharmacies... Not too many pharmacists.

 

[BidingMyTime]

well, we only get 6 figure if we successfully find a job and don't get laid off before 2 years Some pharmacist jobs only go to 5 figure these days

Well, I could reword that as, the public has NO sympathy for anyone who makes more than they do. Most people have no idea how long pharmacists go to school, and the ones that do, really don't care.