"We're training our kids for jobs that won't exist."

[BackRowChi]

'We're training our kids for jobs that won't exist': Community Health Systems director of pharmacy on the industry's changing landscape

Terry Baughman, regional director of pharmacy for Franklin, Tenn.-based Community Health Systems, has 45 years of experience in the pharmacy industry. Starting his career at a pharmacy management company, he went on to spend 10 years teaching pharmacists how to become directors of pharmacy.

www.beckershospitalreview.com

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[PharmtoCS]

Most of the specialties and niches that pharmacy school promote, i.e. MTM, critical care, emergency medicine, oncology, informatics, amb care, industry, etc. make up probably less than 10% of the jobs available to pharmacist.

RETAIL still makes up the vast majority of jobs and is where most of you will end up whether you choose to or not.

 

[Gombrich12]

Things are going to change dramatically in the next 30 years. Only 20 percent of the available pharmacy jobs are in hospital settings and 60 percent are in retail settings. The dilemma is, you have students who spend six to eight years learning how to be a junior physician, and their practice comfort area is a hospital. It isn't a CVS or Walgreens or Walmart. We're training our kids for jobs that won't exist in 10 or 12 years. As a manager, I'd be looking for ways to expand services outside the four walls of the hospital pharmacy. Managers today need to train staff to do things they really didn't think they'd be doing when they came out of school.

Sounds like he expects a contraction in hospital positions that will happen fairly quickly. I wonder why he is saying this?

 

[Pharmacy is a Scam]

Sounds like he expects a contraction in hospital positions that will happen fairly quickly. I wonder why he is saying this?

Because the value proposition of a hospital pharmacist is built around “costs avoided” and many of their responsibilities can be either done by techs or automated by technology. While these are the same reasons why retail positions are contracting, the business model in retail is based off of generating profitability from dispensing/selling drugs so you can very easily calculate the ROI of a pharmacist in that setting (based on how many scripts they fill a day, etc).

This in contrast to justifying FTEs/ROIs of hospital pharmacists. For example, what is the ROI of checking INRs or vanco levels for renal dose adjustments? What is the ROI of making IV’s? What is the ROI of all the time spent pre-rounding and rounding with the team making the real medical decisions? What is the ROI of sitting around at a desk playing on your phone while serving as a concierge service for questions from nurses? What is the ROI of having a pharmacist specifically doing discharge counseling versus the status quo of a nurse or PA doing it? What is the ROI of verifying orders? I guarantee you hospitals are looking for ways to automate these responsibilities or pay someone 5x less to do it than a pharmacist if they could.

All of the above is what schools delude students into thinking they will be doing once they graduate, but none of these students understand that pharmacy is about being a business, first and foremost, and not about “helping people.” If you happen to be a unicorn where the business model in the setting you work in actually lines up to your being able to “help people,” then you are the exception rather than the norm.

I work in a non-traditional setting and interact with students from across the country regularly. What’s sad is that every student I meet has the same story: “I don’t have exposure to X because my school focuses on ‘clinical’.” To which my standard response nowadays is “well that’s no excuse because what school doesn’t focus on ‘clinical’?” The students that tend to stand out are the ones that can see beyond the fluff that schools are teaching them about “what a pharmacist does.”

 

[Hels2007]

I would take the regular retail pharmacy degree back to a bachelor's degree with more emphasis on business & law and less on therapeutics vs PharmD degrees today, plus a mandatory retail internship for three-four months. And keep mandatory IPPOs for hospital and a non-direct patient care. Then at the end of the BPharm program those who really want to go clinical, would have an option of applying to PharmD programs (2-3 years long, with far, far fewer spots than currently exist so the number of grads would actually correspond to the number of openings) where they do focus on therapeutics and literature evaluation (and I would add a couple public health/epi courses) and do several clinical and non-traditional rotations. Then PharmD grads would be eligible for residencies and fellowships. Maybe even make PGY-1 a part of the PharmD program (though I personally would have hated that). But for schools, this plan makes zero business sense, so no way they would agree to something like this.

 

[Sleepingdoc]

I would take the regular retail pharmacy degree back to a bachelor's degree with more emphasis on business & law and less on therapeutics vs PharmD degrees today, plus a mandatory retail internship for three-four months. And keep mandatory IPPOs for hospital and a non-direct patient care. Then at the end of the BPharm program those who really want to go clinical, would have an option of applying to PharmD programs (2-3 years long, with far, far fewer spots than currently exist so the number of grads would actually correspond to the number of openings) where they do focus on therapeutics and literature evaluation (and I would add a couple public health/epi courses) and do several clinical and non-traditional rotations. Then PharmD grads would be eligible for residencies and fellowships. Maybe even make PGY-1 a part of the PharmD program (though I personally would have hated that). But for schools, this plan makes zero business sense, so no way they would agree to something like this.

Yes, same goes for all degrees except medicine. Why the f... is PT now requiring it to be a doctorate degree when all you do is walk old people and post surgery people around. This is rediculous that everyone wants to be a "Doctor".

 

[Hels2007]

"Doctor" is originally an academic degree and the US is about the only country in the world where "doctor" is conflated with "physician". Even in the UK I don't think it's gone that far, and it's certainly not true of other languages. There is no reason for physicians' initial degree to be a doctorate level either. It can be reserved for those who are do additional training and focus on research, while those who do direct patient care only can hold a bachelor's degree, though it would have to be a 6-year degree, can't think of fitting everything into just 4 years. Residency would still be a must on top of it. But certainly "doctor" everything is a US vanity thing, just like vanity sizing and supersized meal deals.

 

[mentos]

Yes, same goes for all degrees except medicine. Why the f... is PT now requiring it to be a doctorate degree when all you do is walk old people and post surgery people around. This is rediculous that everyone wants to be a "Doctor".

LoL when I worked in a hospital, a patient told the nurses something absurd, they asked who told him to do whatever he was doing and he said the doctor told him. It took the nurses and physicians all day to find out who this mystery doctor was. Finally they realized it was the PT, and the nurses told her "oh so you're not a real doctor".

 

[Sleepingdoc]

"Doctor" is originally an academic degree and the US is about the only country in the world where "doctor" is conflated with "physician". Even in the UK I don't think it's gone that far, and it's certainly not true of other languages. There is no reason for physicians' initial degree to be a doctorate level either. It can be reserved for those who are do additional training and focus on research, while those who do direct patient care only can hold a bachelor's degree, though it would have to be a 6-year degree, can't think of fitting everything into just 4 years. Residency would still be a must on top of it. But certainly "doctor" everything is a US vanity thing, just like vanity sizing and supersized meal deals.

Well this becomes a patient safety issue and truly misguiding people. Yes the foreign medical schools give bachelors of medicine but they are called doctors... same in US, where they are called doctors after 4 years of med school... because they are doctors.

 

[Hels2007]

 

[APN-59 rph]

Well this becomes a patient safety issue and truly misguiding people. Yes the foreign medical schools give bachelors of medicine but they are called doctors... same in US, where they are called doctors after 4 years of med school... because they are doctors.

Don't refer to yourself as a doctor in a medical setting unless you are prepared to manage advanced life support..Or..are standing next to someone who is....It's like standing in an airliner and claiming..."why yes, I'm a pilot" when you fly a bug smasher...

 

[TheDancingWriter]

Yes, same goes for all degrees except medicine. Why the f... is PT now requiring it to be a doctorate degree when all you do is walk old people and post surgery people around. This is rediculous that everyone wants to be a "Doctor".

You must never have actually shadowed PT beyond acute if you think that's all most PTs do.

 

[Sleepingdoc]

You must never have actually shadowed PT beyond acute if you think that's all most PTs do.

Sorry, do not mean to hurt feelings... In this world everyone is a doctor...