Ways that hospital pharmacist pay will be reduced in the future

[MatCauthon]

Here is a blueprint on how to cut pharmacist wages far more than 10%.

1. Decrease healthcare coverage to plans with high deductibles. Drastically increase benefits costs for spouses and children
2. Reduce paid time off. Make sure that new employees don't get vacation time in their first year
3. Eliminate all differentials for night-time workers by forcing them to go on salary. Pay 7-days on, 7-days off employees only for the hours they work.
4. Eliminate all holiday pay differentials, overtime, and other differentials by forcing all employees to go on salary
5. Eliminate all pension plans and replace it will a 401k match. Gradually reduce the employee match over a period of time
6. Eliminate extraneous benefits such as tuition reimbursement, floating holidays, food discounts, free parking, etc.
7. Decrease sick-time by combining vacation time and sick time into one pool. Make sure that total days off are at least 1 week shorter when combining these pools
8. Decrease pay to all new hires drastically (100k or less). Offer no room for negotiation.
9. Freeze or greatly limit yearly pay-raises. Make yearly pay-raises merit-based so that very few employees get them
10. Force all new employees to have a PharmD and a PGY1. Use these criteria to clean out senior pharmacists that didn't do a residency or have a residency-equivalent like the BCPS.
11. Consolidate FTEs. Force managers and PICs to work more by getting rid of project days, research days, etc. Since these managers are on salary, so the hospital will not have to pay them extra for their extra hours worked.
12. Squeeze pharmacist hours so that there is minimal overlap during shifts
13. Force PICs to supervise more than one location.
14. Hire far more positions into per-diem/on-call/relief positions with no benefits.
15. Weaken pharmacy union support as much as possible. Force employees to compromise on every union negotiation so that employees are always losing, not gaining benefits. Use extra profits to lobby for anti-union legislation.
16. Use creative accounting to enforce selective layoffs that affect a higher percentage of senior employees with higher pay/greater benefits.
17. Higher management from retail companies such as CVS that are good at maximizing profit.
18. Eliminate all paid-breaks from a pharmacists work-day. Give pharmacists such little help, that it is even hard for them to take their unpaid breaks.
19. Enforce a wide-range of metrics. Use these metrics to help clean-out under-performing and senior employees
20. Create barriers to employees using sick-days such as required doctor notes, etc
21. Create barriers to using all vacation time by having rigid requirements on who can take vacation days and when. Let employees with seniority bludgeon out newer employees so that it looks like an employee issue and not a management one.
22. Above all else: Make sure that the management team does not associate too closely with staff employees. Give management huge bonuses for cutting payroll so that they have no qualms in laying off pharmacists or cutting benefits.

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[Dred Pirate]

Here is a blueprint on how to cut pharmacist wages far more than 10%.

10. Force all new employees to have a PharmD and a PGY1. Use these criteria to clean out senior pharmacists that didn't do a residency or have a residency-equivalent like the BCPS.

you will never retroactively require a residency - you may for new hires, but you will never tell somebody who has 20 years experience that they need a residency or they are fired.

 

[MatCauthon]

you will never retroactively require a residency - you may for new hires, but you will never tell somebody who has 20 years experience that they need a residency or they are fired.

I agree. However, they are starting to put pressure on our pharmacists to get a BCPS.

 

[Dred Pirate]

I agree. However, they are starting to put pressure on our pharmacists to get a BCPS.

I just hate the concept of BCPS (and I have it) -

although we have all seen some of the examples you listed - that is the way you will see pay cut more than a straight up wage reduction

 

[MatCauthon]

This post is so dramatic.

It is dramatic because some of our employers are taking dramatic actions to reduce costs. I've already seen over half the items on this list just at my hospital alone. I tried to add a little entertainment value in my post, but this post isn't based that far outside of reality. I don't think any one employer is doing all these things simultaneously, but the items on this list are certainly happening in bits and pieces.

Maybe I just happen to be at a bad place right now, but based on conversations with fellow pharmacists, this stuff isn't happening at just one hospital.

 

[Dred Pirate]

No one is going to implement all of these at once - and I don't think that is what matcauthon is saying - but examples I have seen at my hospital and/or other hospitals nearby include:
1. freezing pension
2. eliminating matching funds to your 403b (was temporary 4 years ago and still have not resumed)
3. Eliminated a week of PDO for those that have 13+ weeks seniority
4. Eliminate the work 70 get paid for 80 night shift
5. expanding residency program which could be construed as using residents to avoid hiring more FTE Rph's - this is debatable
6. Pay raises are decreasing
7. Not sure if this saves money or not, but they have instituted a High deductible health insurance plan - but there are contributions to the HSA

 

[MatCauthon]

No one is going to implement all of these at once - and I don't think that is what matcauthon is saying - but examples I have seen at my hospital and/or other hospitals nearby include:
1. freezing pension
2. eliminating matching funds to your 403b (was temporary 4 years ago and still have not resumed)
3. Eliminated a week of PDO for those that have 13+ weeks seniority
4. Eliminate the work 70 get paid for 80 night shift
5. expanding residency program which could be construed as using residents to avoid hiring more FTE Rph's - this is debatable
6. Pay raises are decreasing
7. Not sure if this saves money or not, but they have instituted a High deductible health insurance plan - but there are contributions to the HSA

Your hospital has no pension plan and no 403b match? What retirement options do you have?

 

[Dred Pirate]

Your hospital has no pension plan and no 403b match? What retirement options do you have?

Not both things at my hospital - just things I have seen at mine or the surrounding hospitals

 

[confettiflyer]

Here is a blueprint on how to cut pharmacist wages far more than 10%.

1. Decrease healthcare coverage to plans with high deductibles. Drastically increase benefits costs for spouses and children
2. Reduce paid time off. Make sure that new employees don't get vacation time in their first year

Realistically, you'd likely have to do this across all employees in an institution. Except for c-suite/upper management, I've never seen split benefit structures that specifically single-out a particular job code.

3. Eliminate all differentials for night-time workers by forcing them to go on salary. Pay 7-days on, 7-days off employees only for the hours they work.
4. Eliminate all holiday pay differentials, overtime, and other differentials by forcing all employees to go on salary

California only - non-management pharmacists by law are hourly and a change to salary requires legislative changes

5. Eliminate all pension plans and replace it will a 401k match. Gradually reduce the employee match over a period of time

There are still pensions? And same with benefit policy, I'm not sure it's even legal under ERISA to have different match levels for different employees (that might disqualify the plan for the institution, but double check me on that).

6. Eliminate extraneous benefits such as tuition reimbursement, floating holidays, food discounts, free parking, etc.
7. Decrease sick-time by combining vacation time and sick time into one pool. Make sure that total days off are at least 1 week shorter when combining these pools

#6 is feasible, #7 is subject to institution-wide policy as described above.

8. Decrease pay to all new hires drastically (100k or less). Offer no room for negotiation.

It's possible, but you'd have to deal with the turnover consequences or rapidly raise pay as your staff becomes experienced.

9. Freeze or greatly limit yearly pay-raises. Make yearly pay-raises merit-based so that very few employees get them

This is also feasible.

10. Force all new employees to have a PharmD and a PGY1. Use these criteria to clean out senior pharmacists that didn't do a residency or have a residency-equivalent like the BCPS.

I don't see how this would decrease salaries...if anything, it's justification for a department to maintain higher than average salaries because the labor pool from which to draw from has shrunk.

11. Consolidate FTEs. Force managers to work more OT by getting rid of project days, research days, etc.

OT is expensive.

12. Squeeze pharmacist hours so that there is minimal overlap during shifts

I thought this happened at most places 10+ years ago?

13. Force PICs to supervise more than one location.

Retail thing I think.

14. Hire far more positions into per-diem/on-call/relief positions with no benefits.

Feasible, but pay compensates for lack of benefits, savings are on the back end, lots of my per diem pharmacists are doing well financially, but not working FT can be considered a pay drop if such a person desires FT employment.

15. Weaken pharmacy union support as much as possible. Force employees to compromise on every union negotiation so that employees are always losing, not gaining benefits. Use extra profits to lobby for anti-union legislation.

F*ck unions.

16. Use creative accounting to enforce selective layoffs that affect a higher percentage of senior employees with higher pay/greater benefits.

Feasible, and it's not really accounting, but you'd have to weigh the risk of litigation for age discrimination vs. benefits to axing high cost employees.

17. Higher management from retail companies such as CVS that are good at maximizing profit.

This makes me lol.

18. Eliminate all paid-breaks from a pharmacists work-day. Give pharmacists such little help, that it is even hard for them to take their unpaid breaks.

Not legal.

19. Enforce a wide-range of metrics. Use these metrics to help clean-out under-performing and senior employees
20. Create barriers to employees using sick-days such as required doctor notes, etc
21. Create barriers to using all vacation time by having rigid requirements on who can take vacation days and when. Let employees with seniority bludgeon out newer employees so that it looks like an employee issue and not a management one.
22. Above all else: Make sure that the management team does not associate too closely with staff employees. Give management huge bonuses for cutting payroll so that they have no qualms in laying off pharmacists or cutting benefits.

Was too lazy to write the quote /quote code, but there are risks to introducing strife within your department.

 

[OmiPharmD]

Our health system has done 7 1/2 items on your list (the half is from decreasing how much vacation time you can accrue but you still start earning it immediately and can use it as soon as you have it) but these were not pharmacy specific.

 

[Its Z]

Realistically, you'd likely have to do this across all employees in an institution. Except for c-suite/upper management, I've never seen split benefit structures that specifically single-out a particular job code.



California only - non-management pharmacists by law are hourly and a change to salary requires legislative changes



There are still pensions? And same with benefit policy, I'm not sure it's even legal under ERISA to have different match levels for different employees (that might disqualify the plan for the institution, but double check me on that).



#6 is feasible, #7 is subject to institution-wide policy as described above.



It's possible, but you'd have to deal with the turnover consequences or rapidly raise pay as your staff becomes experienced.



This is also feasible.



I don't see how this would decrease salaries...if anything, it's justification for a department to maintain higher than average salaries because the labor pool from which to draw from has shrunk.



OT is expensive.



I thought this happened at most places 10+ years ago?



Retail thing I think.



Feasible, but pay compensates for lack of benefits, savings are on the back end, lots of my per diem pharmacists are doing well financially, but not working FT can be considered a pay drop if such a person desires FT employment.



F*ck unions.



Feasible, and it's not really accounting, but you'd have to weigh the risk of litigation for age discrimination vs. benefits to axing high cost employees.



This makes me lol.



Not legal.



Was too lazy to write the quote /quote code, but there are risks to introducing strife within your department.

LOL, strong work!

 

[confettiflyer]

LOL, strong work!

Not my best! Haha...and I think half the stuff in there actually increases the total amount of money a pharmacist would take home, either through lawsuits, OT, or other compensation.

I'm thinking of #18, failure to go on a lunch = 1hr of overtime pay in CA.

 

[Its Z]

Not my best! Haha...and I think half the stuff in there actually increases the total amount of money a pharmacist would take home, either through lawsuits, OT, or other compensation.

I'm thinking of #18, failure to go on a lunch = 1hr of overtime pay in CA.

People are so gung ho about the sky falling...they fail to realize it only takes a few leaders in pharmacy to improve the work environment for his/her people..and reverse every possible "falling sky" scenario.

 

[MatCauthon]

Not my best! Haha...and I think half the stuff in there actually increases the total amount of money a pharmacist would take home, either through lawsuits, OT, or other compensation.

I'm thinking of #18, failure to go on a lunch = 1hr of overtime pay in CA.

California is its own place. Most of the big retail chains have eliminated paid breaks a long time ago. Usually employees get a 30-minute unpaid lunch time, but they commonly don't get to take it because the pharmacy is too busy. I see this happen in the hospital I work at as well.

Half this stuff does not increase compensation. OT is a California thing, but it is being phased out virtually everywhere else. Starting wages are starting to go down-- and staff cannot easily jump to other jobs when the job market is stagnant.

Also, in my state, on-call workers are not usually paid more. That might be another California thing? They are paid the same rate as everyone else, but they just don't get benefits. Hospitals love this. They even keep some employees in on-call positions for several years It doesn't seem fair, but it is definitely happening. I've worked 3 different on-call positions and never gotten paid more than other staff pharmacists. Hospitals can get away with a lot more now that they have so many job candidates.

Many of the changes in benefits such as frozen pension plans and increased healthcare costs are a system-wide hospital agenda to decrease costs. Those changes don't just apply to pharmacists.

I know of several hospital pharmacists, especially infusion pharmacists, that are forced to be the PIC of multiple sites. This helps keeps costs down for the hospital, but it greatly increases the workload for the PIC.

Also, you must understand what I meant about managers working more OT. These managers are salaried. They are being forced to work more hours for no extra compensation. That is why the hospitals have been so big about forcing all their pharmacists to be salaried. Once they get them salaried, they start taking away project days so that almost have no choice but to work free hours past their allotted 40-hour schedule. There is also no compensation structure in place to to pay them for the extra hours worked. You are probably unaware of this trend since you live in California.

 

[confettiflyer]

You are probably unaware of this trend since you live in California.

Yeah this post is why I started the other thread/discussion about me being in a bubble vs. reality, I was not aware that other states do not have laws in place requiring excess pay for OT in excess of hours.

Also, managers in California who are salaried are still due overtime pay if they exceed hours based on their job duty, so one can't hire a manager and then have them work as a manager for 32 hours, but then require them to work "non-managerial" duties for 16 hours and not pay OT.

 

[MatCauthon]

People are so gung ho about the sky falling...they fail to realize it only takes a few leaders in pharmacy to improve the work environment for his/her people..and reverse every possible "falling sky" scenario.

I'm working very hard on reversing these scenarios where I work. It is very difficult to do, especially since the majority of pharmacists are too afraid to go on strike. We got raked through the coals on last negotiation with management. Now they want to take even more from us. They have used very creative accounting to show that we have a budget shortfall so that they can try to rake us again. Many of you hospital pharmacists have not worked for retail, but these kind of changes have been happening in retail for years.

This post isn't a sky-is-falling thread, it is a post about how many health systems are finding ways to cut employee compensation. I welcome leaders trying to change this situation, but we have lost a lot of leverage with the oversupply of pharmacists coming out.

 

[confettiflyer]

I'm working very hard on reversing these scenarios where I work. It is very difficult to do, especially since the majority of pharmacists are too afraid to go on strike. We got raked through the coals on last negotiation with management. Now they want to take even more from us. They have used very creative accounting to show that we have a budget shortfall so that they can try to rake us again. Many of you hospital pharmacists have not worked for retail, but these kind of changes have been happening in retail for years.

This post isn't a sky-is-falling thread, it is a post about how many health systems are finding ways to cut employee compensation. I welcome leaders trying to change this situation, but we have lost a lot of leverage with the oversupply of pharmacists coming out.

Too bad you can't quantify the errors that substandard/cut rate pharmacists would create (and subsequently quantify the errors prevented by good ones) and then assign a value based on liability and financial claims incurred/prevented upon the health system.

We're capped at $250,000 here for punitive damage claims, not sure about your state.

 

[BidingMyTime]

I lot of this stuff happened during hospital mergers/closers during the 1990's. Has any job since, I don't know, say 1985, actually given a pension? Holiday pay is another thing I've never seen in a hospital--it's always been rolled in with ET/PTO/whatever you call it, from what I've seen. Pharmacy unions, outside of NY or CA, I don't think they exist. Food discounts, free parking, floating holidays.....I have never heard of this anywhere.

As other's have mentioned, much of this stuff would have to be done hospital-wide, and the nurses will make it impossible for some of it to happen (like doing away with shift differential, forcing employees to have a note from the dr for 1 day sick....not to mention I'm pretty sure JCHO frowns on forcing sick, highly contagious employees to work)

How is forcing PIC's to supervise more than one location legal? Maybe its a state thing, that would be illegal in IL Pretty sure a majority of state laws (possibly not all) make it illegal to refuse to give breaks.

From what I've seen, the opposite of #22 is the truth. Management is encouraged to be best friends with their employees, so their employees will feel more loyalty and be willing to do more and more for less and less.

 

[bacillus1]

There are still pensions?

Yes, there are, and they have been getting worse. Employees that work for the federal government that started around 2007 paid 0.8% of their salary into their pension. For me (started in 2013), it's 3.1%, and it's about 4% for new hires now, so the "amazing federal pension" is getting worse and worse, not such a great incentive to work for the government now, considering salaries are often lower than in the private sector. Loan repayment is also getting cut at many hospitals.

 

[BenJammin]

Or we could just fire the worthless clinical pharmacists who show up to work at 8, drink coffee until 10, go on rounds at 11, make a recommendation that gets rejected, go to a meeting at 12, eat lunch, then waste time with the students. Those are the pharmacists that we need to cut loose.

 

[awval999]

Or we could just fire the worthless clinical pharmacists who show up to work at 8, drink coffee until 10, go on rounds at 11, make a recommendation that gets rejected, go to a meeting at 12, eat lunch, then waste time with the students. Those are the pharmacists that we need to cut loose.

LOL. Partially true IMO.

 

[PharFromNormal]

Or we could just fire the worthless clinical pharmacists who show up to work at 8, drink coffee until 10, go on rounds at 11, make a recommendation that gets rejected, go to a meeting at 12, eat lunch, then waste time with the students. Those are the pharmacists that we need to cut loose.

I was under an assumption the strong majority of these are funded by colleges to lock up rotation sites for their students

 

[rxdawg21]

Yes, there are, and they have been getting worse. Employees that work for the federal government that started around 2007 paid 0.8% of their salary into their pension. For me (started in 2013), it's 3.1%, and it's about 4% for new hires now, so the "amazing federal pension" is getting worse and worse, not such a great incentive to work for the government now, considering salaries are often lower than in the private sector. Loan repayment is also getting cut at many hospitals.

Actually it was 0.8% until 2013 then 3.1% for 2013 and is now 4.4%. The increases are due to republicans budget cuts...you know apparently all the easy stuff to cut is overlooked (see bogus research etc) and they like to attack the taxpayer by increasing their costs instead of reducing frivolous spending or simplifying the departments that tend to overlap on the job duties

 

[Carboxide]

I was under an assumption the strong majority of these are funded by colleges to lock up rotation sites for their students

You are incorrect.

 

[PharFromNormal]

You are incorrect.

Hmm well I know atleast a few but I guess my perception is warped. Thanks for the info, I now see the draw of "clinical" pharmacy.

 

[BMBiology]

Actually it was 0.8% until 2013 then 3.1% for 2013 and is now 4.4%. The increases are due to republicans budget cuts...you know apparently all the easy stuff to cut is overlooked (see bogus research etc) and they like to attack the taxpayer by increasing their costs instead of reducing frivolous spending or simplifying the departments that tend to overlap on the job duties

Can I trade my 401 k for your pension?

 

[PumpkinSmasher]

Yes, there are, and they have been getting worse. Employees that work for the federal government that started around 2007 paid 0.8% of their salary into their pension. For me (started in 2013), it's 3.1%, and it's about 4% for new hires now, so the "amazing federal pension" is getting worse and worse, not such a great incentive to work for the government now, considering salaries are often lower than in the private sector. Loan repayment is also getting cut at many hospitals.

I imagine our guaranteed pension program has to change before I retire if my employer wants to stay financially solvent, but as of right now it is still employer funded.

 

[BMBiology]

Don't you guys skip social security tax? That is 6%

 

[bacillus1]

Don't you guys skip social security tax? That is 6%

Nope, we still pay social security under the FERS system.

 

[rph3664]

you will never retroactively require a residency - you may for new hires, but you will never tell somebody who has 20 years experience that they need a residency or they are fired.

In the late 1990s, some employers talked about requiring people to get Pharm.Ds. That didn't last very long.

However, there are enough new graduates nowadays that it's essentially the same thing.

 

[rph3664]

I agree there are cuts at a lot of hospitals. I don't think that when a hospital does some of these (high deductible insurance, cut match for 403B) thY it is pharmacy specific.

It's not even hospital-specific. Lots of non-health care companies are doing all the things mentioned in the OP.

 

[rxdawg21]

Don't you guys skip social security tax? That is 6%

Bmb like another poster stated we pay into ss. The pension sounds great on paper but when my starting salary is 95900 it is kinda suppose to make up for the significant pay cut I am taking (30k) yet when having to contribute 4.4% to gain 1% per year (1.1% if you stay until 62) its not the deal it was just two years ago. Definitely still a good benefit.

 

[BMBiology]

Bmb like another poster stated we pay into ss. The pension sounds great on paper but when my starting salary is 95900 it is kinda suppose to make up for the significant pay cut I am taking (30k) yet when having to contribute 4.4% to gain 1% per year (1.1% if you stay until 62) its not the deal it was just two years ago. Definitely still a good benefit.

Fair enough but if you don't think it is worth it, then why dont you find work somewhere else?

 

[rxdawg21]

I was just disappointed and frustrated realizing those that were hired two years ago are getting the same benefit for less than 1/5 the cost. I definitely enjoy never having to stay past 6 and no weekends except for being on call once every 9 weeks. Sometimes pay is sacrificed for quality of life.

 

[confettiflyer]

I was just disappointed and frustrated realizing those that were hired two years ago are getting the same benefit for less than 1/5 the cost. I definitely enjoy never having to stay past 6 and no weekends except for being on call once every 9 weeks. Sometimes pay is sacrificed for quality of life.

Haha, welcome to America, where the next generation is screwed for everything and the mantra is "sucks to be you!"

 

[bacillus1]

Fair enough but if you don't think it is worth it, then why dont you find work somewhere else?

I think it's not better or worse. When you factor in all the benefits (including loan repayment, which not everyone has), I think it roughly evens out when comparing to private sector salaries. And "going somewhere else" is easier said than done, I've been trying for a few months now and the only position that wanted to hire me was basically a staff position that was still a government job.