Life After the Last Pharmacy Gig

[Carol is Alpha]

I guess most of you realize the pharmacy job you now have will probably be the last.

What are your plans for the hereafter?

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[Niosh]

I used to drive a forklift, it was fun. Except the brakes went out and I almost hit my boss's car with it. Totally his fault, he didn't want to get the brakes fixed.

 

[BMBiology]

Come on now..most of our jobs are secure.

If something does happen, I don't want to become that middle age pharmacist who is bitter about life. I certainly don't want to turn into a gold bug and hope the world is going to collapse.


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[Carol is Alpha]

 

[lord999]

Already there in administration. It's just like being in an ADX prison, but pays better and you deal with intellectual/emotional psychopaths than physical ones.

 

[PAtoPharm]

Why is everyone's current pharmacy job likely to be their last? Because of insurance reimbursement cuts, automated vending technology, etc.?

 

[Carol is Alpha]

Why is everyone's current pharmacy job likely to be their last? Because of insurance reimbursement cuts, automated vending technology, etc.?

It doesn't take a 4th stage Guild Navigator to see where this is going.

Or even a 2nd or a 3rd stager.

A wafer thin spice mint will suffice.

 

[wagrxm2000]

Why is everyone's current pharmacy job likely to be their last? Because of insurance reimbursement cuts, automated vending technology, etc.?

Don't worry there's still a good 20 years before anything starts changing and that might even be too soon.

 

[297point1]

I do indeed expect this to be my last pharmacy job.

It's been a good run. But when this position ends (one year from now, ten years from now, whenever), I'm calling it a career for pharmacy. I've gotten more than an adequate return on my educational investment; it would be perfectly fine for me to move onto something else. And I will.

 

[gwarm01]

Why is everyone's current pharmacy job likely to be their last? Because of insurance reimbursement cuts, automated vending technology, etc.?

I think the sentiment is more along the lines of if you have something solid you should hold onto it, because the future is going to get rocky. It'll be a long time before pharmacists are completely phased out, but automation will continue to reduce the amount of people needed for all jobs. I'm expecting the trend of reduced hours to continue as it has been. Pharmacist overlap removed, 24 hour stores shut down. There are just fewer positions for an ever growing number of pharmacists.

 

[Carol is Alpha]

Don't worry there's still a good 20 years before anything starts changing and that might even be too soon.

20 years? Ahhh! Watch this vid and ponder the implications. If robots can now find blood vessels...how much of a leap is it to program one to recognize chicken scratch? The days of which are numbered as prescribers are strong-armed into the digital world. And I know abut the issues with e-rx, but those errors can easily be handled with more tech and algorithm.



And even if we still have 20 years, does it make sense for kid to take on 200k in debt for at best a 32 hour gig?

Everybody should keep an eye on the developments in the UK regarding pharmacy. They are going to ramrod the Amazon model onto the industry over there. This will be the test run.

This is where we're going.

 

[BMBiology]

20 years? Ahhh! Watch this vid and ponder the implications. If robots can now find blood vessels...how much of a leap is it to program one to recognize chicken scratch? The days of which are numbered as prescribers are strong-armed into the digital world. And I know abut the issues with e-rx, but those errors can easily be handled with more tech and algorithm.



And even if we still have 20 years, does it make sense for kid to take on 200k in debt for at best a 32 hour gig?

Everybody should keep an eye on the developments in the UK regarding pharmacy. They are going to ramrod the Amazon model onto the industry over there. This will be the test run.

This is where we're going.

So what happened to you? Are you still working as a pharmacist?


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[wagrxm2000]

Lol sometimes I can't tell if this guy is nuts or just trolling. No one working right now will still be working or even alive when "robots take over the world". Someone is just watching too much science fiction.

 

[lord999]

Lol sometimes I can't tell if this guy is nuts or just trolling. No one working right now will still be working or even alive when "robots take over the world". Someone is just watching too much science fiction.

I don't think either. I wouldn't word them as colorfully as Carol, but I held the same sentiments when I joined the profession over a decade ago (you can read some of my posts from 02-04, I was laughing at the clinical pharmacy cult then and I even laugh harder now). The only difference between then and now is that people keep reaffirming my fundamental belief in human stupidity in ways that I couldn't have imagined when I started.

The rivalry between the chains is ultimately a mutually self-destructive one.
The war against technology is ultimately a suicidal one.
The push to clinical pharmacy for trivial matters diminishes the value of all pharmacists.
The only defense in a capitalist system that a worker can have is have capital (our education, our land, and our work ethic) and to whom we choose to sell our labor.
The only race worth running is for self-satisfaction, however you choose to define what that means.

When this is all over, I'm sure ChapmanPharmacy (LB) and I will have a couple of drinks and I'll definitely ask him whether being a tool (military, academia, and now administration) was worth the hassle, and wonder if it were better in the end to read, enjoy playing with the students (both literally in class and euphemistically after class), drink good whiskey, and smoke/eat lots of high quality sinsemilla like Peter did. I'm now firmly on the side that we should have taken Peter's initial class more seriously, kicked back, and learn to stop worrying about the job and self-indulge ourselves. I know what I'm going to do the day I turn in my license, and it will be to be a hedonist about everything everyone told you was wrong. I'd probably not do cocaine or heroin because I'd like it too much, but I'd find something that would let me keep my background investigation clean enough.

My real regret (and I think some of us fall into that category) is that there is absolutely no rational reason why this could not work out for everyone in a way that we could help people out, get paid decently to do it, work humanistic hours with time enough for other matters. But being a part of this system, it turns you into a tool, and in the ways where your own sense of values are warped by the alienation away from what you really do, it's hard to reconcile why we got all this education to do such stupid work for a public that really won't change one way or another irrespective of how incompetent or negligent you do that stupid work. I don't work that job, but that's a conscious intentional series of choices I made to avoid being in that position. But for the average pharmacist, it's not a good place to be and it's going to get worse.

I'm going to now cash my bonus check (screw you Congress!) and drink a Islay hogshead to comfort myself this weekend. This is so depressing...

 

[PAtoPharm]

I don't think either. I wouldn't word them as colorfully as Carol, but I held the same sentiments when I joined the profession over a decade ago (you can read some of my posts from 02-04, I was laughing at the clinical pharmacy cult then and I even laugh harder now). The only difference between then and now is that people keep reaffirming my fundamental belief in human stupidity in ways that I couldn't have imagined when I started.

The rivalry between the chains is ultimately a mutually self-destructive one.
The war against technology is ultimately a suicidal one.
The push to clinical pharmacy for trivial matters diminishes the value of all pharmacists.
The only defense in a capitalist system that a worker can have is have capital (our education, our land, and our work ethic) and to whom we choose to sell our labor.
The only race worth running is for self-satisfaction, however you choose to define what that means.

When this is all over, I'm sure ChapmanPharmacy (LB) and I will have a couple of drinks and I'll definitely ask him whether being a tool (military, academia, and now administration) was worth the hassle, and wonder if it were better in the end to read, enjoy playing with the students (both literally in class and euphemistically after class), drink good whiskey, and smoke/eat lots of high quality sinsemilla like Peter did. I'm now firmly on the side that we should have taken Peter's initial class more seriously, kicked back, and learn to stop worrying about the job and self-indulge ourselves. I know what I'm going to do the day I turn in my license, and it will be to be a hedonist about everything everyone told you was wrong. I'd probably not do cocaine or heroin because I'd like it too much, but I'd find something that would let me keep my background investigation clean enough.

My real regret (and I think some of us fall into that category) is that there is absolutely no rational reason why this could not work out for everyone in a way that we could help people out, get paid decently to do it, work humanistic hours with time enough for other matters. But being a part of this system, it turns you into a tool, and in the ways where your own sense of values are warped by the alienation away from what you really do, it's hard to reconcile why we got all this education to do such stupid work for a public that really won't change one way or another irrespective of how incompetent or negligent you do that stupid work. I don't work that job, but that's a conscious intentional series of choices I made to avoid being in that position. But for the average pharmacist, it's not a good place to be and it's going to get worse.

I'm going to now cash my bonus check (screw you Congress!) and drink a Islay hogshead to comfort myself this weekend. This is so depressing...

What do you think the "breaking point" is going to be? Do you think cutbacks by the retail chains (due to budget issues, automation, etc.) will cause the initial collapse of the pharmacy field, or will it be related to the oversupply of new pharmacists? And do you think it will happen with a wave of mass firings at some point in the next few years, or on a more drawn-out timescale?

 

[lord999]

What do you think the "breaking point" is going to be? Do you think cutbacks by the retail chains (due to budget issues, automation, etc.) will cause the initial collapse of the pharmacy field, or will it be related to the oversupply of new pharmacists? And do you think it will happen with a wave of mass firings at some point in the next few years, or on a more drawn-out timescale?

Oldtimer and It's Z would probably know better (as my parents did), but the 80s just was not fun to work in. You had lots of work, your techs made 3/4's of what you did, you had little protection against misfilling, and jobs were hard to come by and paid relatively as well as absolutely less than today's world. Physicians treated you worse although insurance used to be better. Corporations went through periods of absolute sociopathy (look at the law books for example where there was a period of time where every case was "v CRW dba Walgreens" for a time when Walgreens was not as good as it is now). There's no one cataclysmic moment (Rome did not fall in a day), it's just going to be another Dark Ages period in Byzantine conditions where you have to spend more effort to get less back. That's the profession I knew going into pharmacy, and I knew what sort of timeframe but also what I wanted when going into it. I don't see a true breaking point, there is no one single element that dooms the profession immediately. I just see the ok deal that I had becoming a new deal (which was the 2008-2014 graduates) now becoming the raw deal for anyone graduating now and in the future.

In your case, that's why I actually believe that it doesn't end well for you irrespective of the professional future. If you do not really know what you want and have a plan for it, idling coasting along will not end well unlike my generation. I don't know what your way is going to be, but I know enough to believe that this is not for you due to your lack of courage to actually figure out what you want to do and do it. But, it's your life (and money).

I used to wonder if IRL, Carol, Momus, BMBiology, gwarm01 have already started the decoupling process from work to a future without stable employment. I actually assume so, because like whether you have a soul, the way to tell is whether or not you considered the matter. Anyone who bothers to think even shallow thoughts about the future knows to plan for an uncertain one. I think one of the older members, dgroulx actually did leave the profession after banking his necessary $M working double nights for a decade in anticipation of this future. I have as well, and can financially retire with an 8% inflation rate on flat no-interest accumulating assets for the rest of my actuarial life. I know Caverject and the VA Minnesotan also did start angling toward that direction when they left the boards. I worry for the new grads now, and consider those in school to need to save their energy to fight after they graduate for things that were handed on a literal $80k bonus check platter to us.

 

[PAtoPharm]

Oldtimer and It's Z would probably know better (as my parents did), but the 80s just was not fun to work in. You had lots of work, your techs made 3/4's of what you did, you had little protection against misfilling, and jobs were hard to come by and paid relatively as well as absolutely less than today's world. Physicians treated you worse although insurance used to be better. Corporations went through periods of absolute sociopathy (look at the law books for example where there was a period of time where every case was "v CRW dba Walgreens" for a time when Walgreens was not as good as it is now). There's no one cataclysmic moment (Rome did not fall in a day), it's just going to be another Dark Ages period in Byzantine conditions where you have to spend more effort to get less back. That's the profession I knew going into pharmacy, and I knew what sort of timeframe but also what I wanted when going into it. I don't see a true breaking point, there is no one single element that dooms the profession immediately. I just see the ok deal that I had becoming a new deal (which was the 2008-2014 graduates) now becoming the raw deal for anyone graduating now and in the future.

In your case, that's why I actually believe that it doesn't end well for you irrespective of the professional future. If you do not really know what you want and have a plan for it, idling coasting along will not end well unlike my generation. I don't know what your way is going to be, but I know enough to believe that this is not for you due to your lack of courage to actually figure out what you want to do and do it. But, it's your life (and money).

I used to wonder if IRL, Carol, Momus, BMBiology, gwarm01 have already started the decoupling process from work to a future without stable employment. I actually assume so, because like whether you have a soul, the way to tell is whether or not you considered the matter. Anyone who bothers to think even shallow thoughts about the future knows to plan for an uncertain one. I think one of the older members, dgroulx actually did leave the profession after banking his necessary $M working double nights for a decade in anticipation of this future. I have as well, and can financially retire with an 8% inflation rate on flat no-interest accumulating assets for the rest of my actuarial life. I know Caverject and the VA Minnesotan also did start angling toward that direction when they left the boards. I worry for the new grads now, and consider those in school to need to save their energy to fight after they graduate for things that were handed on a literal $80k bonus check platter to us.

Good post.... I have one more question for you. You say that you don't think things will end well for me because pharmacy is obviously heading down a dark road, and I don't even know what I want to get out of it. These are good points. Now, let's say that I leave pharmacy school to attend a health professions program that actually does have a bright future (in terms of job market, at least) ahead of it, such as PA school. However, the catch is that I would still be entering a program just for the sake of hopefully having a good career but without knowing what I want to get out of it. In that scenario, do you think I would also be destined for a bad ending since I would be entering the profession on similar terms that I pursued pharmacy on (dsspite the profession itself actually having a positive outlook)?

 

[CetiAlphaFive]

Why is everyone's current pharmacy job likely to be their last? Because of insurance reimbursement cuts, automated vending technology, etc.?

Because I'm not a pre-everything major that doesn't realize it's only their personal clock that's at 11:59.

 

[lord999]

Good post.... I have one more question for you. You say that you don't think things will end well for me because pharmacy is obviously heading down a dark road, and I don't even know what I want to get out of it. These are good points. Now, let's say that I leave pharmacy school to attend a health professions program that actually does have a bright future (in terms of job market, at least) ahead of it, such as PA school. However, the catch is that I would still be entering a program just for the sake of hopefully having a good career but without knowing what I want to get out of it. In that scenario, do you think I would also be destined for a bad ending since I would be entering the profession on similar terms that I pursued pharmacy on (dsspite the profession itself actually having a positive outlook)?

Pretty much. One of my official hats in the VA is dealing with burnout clinicians with the exception of nurses (the nursing services office have their own ways of dealing with them). I've seen them all: physicians, PA's, dentists, optometrists, psychologists, and the scariest ones to deal with, social workers...Many of these cases, I really would have never admitted them to professional school as they had all the psychological warning signs (substance abuse, inability to form/sustain long-term relationships, are not introspective) that should have dealt with. You don't join a profession if you don't intend on doing the actual work. The physicians and dentists make for particularly pitiful cases, because you have find reasonably well-paying alternate career placements for even pharmacists (many go into QM, IT, or oversight), but that's not easy for clinicians and there are peer penalties involved. The physicians in the VA who don't practice and are assigned to alternate positions (mostly Central Office) are paid substantially less (do not get accession pay), get the cold shoulder from their actual professional colleagues, and are eliminated the moment a RIF comes through or assigned to a position where political oversight will kick them out.

But the two career fields that historically have been the scariest second careers have been social workers, because with the traits of one but without the heart, they become the most sociopathic sorts of administrators, and pharmacists, who have the ugliest histories when in senior positions (and I am no exception to that rule). The most despised Chief of Staff we ever had in VA was a pharmacist who adopted the Randian hero archetype, and for her amusement, pitted offices against each other and causing all sorts of the sort of problems companies that do stack ranking have in terms of cliques and information hiding. A lot of the reason why VA management has these sorts of screw the field attitudes has its origins in her management. And the other reason is a social worker who everyone remembered for manipulating every director under his control and removing anyone who he even suspected of having a spine.

 

[wagrxm2000]

Do we really need to scare the children? 20 years ago you could say pharmacists will become obsolete and nothing has changed. Nothing will change in another 20 years either.

 

[PAtoPharm]

Because I'm not a pre-everything major that doesn't realize it's only their personal clock that's at 11:59.

Maybe I am just dense, but I don't get the second part about the personal clock being at 11:59.... ?

 

[quickpic007]

Retire soon....golf,travel,maybe volunteer get easy job at country club or airlines...need to finish college fund for grandchildren first

 

[lord999]

Do we really need to scare the children? 20 years ago you could say pharmacists will become obsolete and nothing has changed. Nothing will change in another 20 years either.

From the book I pulled off the shelf right now:

/quote
Here is one starting point: currently, over a third of the working-age population in the United States responds in the negative to the survey question "Will you be able to afford to retire? " Perhaps you are one of them or would consider joining them after giving the question some thought. By the way, the question is splendidly euphemistic, making it seem as if being ready for retirement is like being ready for the big weekend. The actual question
is, "Will you be able to survive once you are too old to work?" If not, then what are you planning to do about it?

Slave away until destitute old age catches up with you? Here is a bad solution: get drunk a lot. With any luck, you would not live long enough to reach retirement age and you would be too drunk to care even if you did.

//end-quote

Not trying to, but you've been around long enough to remember the time before POWER, before we scanned scripts, and possibly before we ran NT. You might even have been around long enough to remember the time before Intercom Plus (yes, I was an Option 1000, 2000, and 3000 member). Of course it's changed, and with those changes, you saw displacement of pharmacists unable or unwilling to make those changes. The pharmacists who manage to survive are exceptional, but we both know what happens to the ones who are forced out earlier. Pharmacists will never be obsolete, but that doesn't mean you or I won't be...

For us, there is no reason why pharmacy should have not been a net gain then or now. That's not the case with the new practitioners graduating last academic year onwards. They did all the right things, some even drank the Kool Aid, but it's hard now and will get harder. And you're an RXM, can you say that your store was manned at the same rate per prescription than before 2007? (If near the same rate, then your POWER calculation is wrong for your district or store.)

Maybe I'm just at a point in my career that I have enough disenfranchised pharmacists to know that unless I am extraordinarily lucky, no matter how good I am, that day when I become obsolete will come. And when that does happen, do I need to consider that question above? We're too old to be worried about pharmacy as a profession, but we are getting old enough to worry about whether we can sustain ourselves as pharmacists in this environment. I have my happy answer, and I think you do too (although you do get some grief for being a more straightforward CRW RxM), but that professional grace did not come without some reflection.

 

[peachcreamsicle]

Even though the original post was being facetious, I think it begs a very interesting question. Many of my close pharmacist friends and I are actively looking towards life after retail pharmacy. The tech cuts have been so extreme in my area that it makes it almost impossible to do my job.

I've been an avid saver since starting work (2009 grad) and worked as many relief shifts has I could for the first few years. I have a few rental properties, about $600k in liquid investments and although it won't be enough to outright retire, I am trying to pad my nest egg a little more before leaving FT retail for good.

Any thoughts / input from people who've done something similar? Anyone care to share their FI numbers / post-pharmacy work plans?

 

[297point1]

The Dos Equis commercials are wrong.

@lord999 is the Most Interesting Man in the World.

 

[gwarm01]

I used to wonder if IRL, Carol, Momus, BMBiology, gwarm01 have already started the decoupling process from work to a future without stable employment.

I'm definitely trying to diversify my skill set as much as possible. I'm also doing my best to avoid anything that would tie me down to any particular area. The wife and I have happily avoided having children, and I didn't fall into the trap of buying the absolute largest house I could get a loan for after graduation. We are still living in the 1200 sqft house we bought when I was still in undegrad and the wife had just graduated. We rented it out for three years while working out of state, and will probably do so again in the future.

I grew up in a small town where the entire economy was based on the local factories. My mom was a COBOL programmer and my dad a factory worker. Both of their jobs got shipped overseas and it was pretty devastating. They had no backup plan, no other skills, and the thought of moving to another city to find work never even entered their minds. What's scary is that I know plenty of pharmacists who are living like this. They went to the local college, then the local pharmacy school. Got a job at the Walgreens in their hometown and bought a big house. They are only one corporate restructuring away from having their entire lives taken away and they seem to be oblivious.

Now, let's say that I leave pharmacy school to attend a health professions program that actually does have a bright future (in terms of job market, at least) ahead of it, such as PA school.

The PA market of today reminds me a lot of the pharmacist market of the 2000's. It's a hot field and everyone is interested. You can make 100k and the program is only 2 years long! Unfortunately, you cannot operate independently so your livelihood is limited by your potentially employers. I wouldn't be surprised to see that profession follow a similar boom-->bust cycle as pharmacy.

Do we really need to scare the children? 20 years ago you could say pharmacists will become obsolete and nothing has changed. Nothing will change in another 20 years either.

I'd rather be a little shaken than have my head in the sand. If someone is going to spend over 100k and 4+ years of their life to become a pharmacist, they should be aware of the changing market and the potential pitfalls that may away them. The 10-year trend data on pharmacymanpower.com continues marching towards oversupply. Retail chains are buying each other, consolidating, closing locations. There might be a time very soon where you realistically only have one or two options for employment. Better hope they treat you well, or you aren't marked non-eligible for rehire. Some people are fighting tooth and nail to land a 32-hour "fulltime" float position. Others are doing 2 years of residency, maybe 3 in the near future, just to get the same job their preceptor was considered qualified for right out of school.

I'm not saying this profession isn't worth it or that you cannot succeed. You just need to know what you are up against so you can plan accordingly.

Here is a bad solution: get drunk a lot. With any luck, you would not live long enough to reach retirement age and you would be too drunk to care even if you did.

Bad solution? Hell, it's been working just fine for me.

 

[Pharmd = Phake Doctor]

No offense to anybody, but does every thread on SDN forum have to end up becoming a PA-to-Pharm Life Decisions Discussion thread by the end?

Every thread I've read on these forums has gone through a life cycle of:

Discussions about the thread topic → Derailment/off-topic banter ⇌ Lord999 talks about the ole' times/tells a story without context or exposition, so 99% of the people can't follow what he's talking about ⇌ PA-to-Pharm brings ups his worries → Thread death!!!

P.S. Just so no one gets the wrong idea, I actually like reading Lord999's posts. But sometimes I find myself wondering what he's talking about, especially when it comes to stuff about his experience in school or some obscure topic from 20 years ago.

 

[Pharmd = Phake Doctor]

Good post.... I have one more question for you. You say that you don't think things will end well for me because pharmacy is obviously heading down a dark road, and I don't even know what I want to get out of it. These are good points. Now, let's say that I leave pharmacy school to attend a health professions program that actually does have a bright future (in terms of job market, at least) ahead of it, such as PA school. However, the catch is that I would still be entering a program just for the sake of hopefully having a good career but without knowing what I want to get out of it. In that scenario, do you think I would also be destined for a bad ending since I would be entering the profession on similar terms that I pursued pharmacy on (dsspite the profession itself actually having a positive outlook)?

There is only one health professions program that is a sure safe bet in the future. And that is to become a surgeon. Otherwise don't depend on PA, NP, CRNA, or PharmD to be safe for employments sake. Even primary care as an MD is suspect. Surgeons require 6+ years of residency and fellowship before they can be fully independent. With the medical schools bone-headed push to increase family medicine residents instead of surgeons, they are dooming this country to a shortage of surgeons and specialists.

On the other hand, NP schools are graduating 20K students a year and PA schools are headed towards graduating 10K students yearly. That's 3oK mid-level/primary care practitioners graduating each year for the foreseeable future. Even if the USA is facing some 90K shortage of physicians by 2025, I don't see how this volume of mid-level providers is not going to negatively affect the professions involved.

This "shortage" rhetoric happened 16 years ago with pharmacists. I believe we are seeing the same thing happening again with PAs, NPs, Dentists, and (possibly) MDs at this moment.

 

[PAtoPharm]

No offense to anybody, but does every thread on SDN forum have to end up becoming a PA-to-Pharm Life Decisions Discussion thread by the end?

Every thread I've read on these forums has gone through a life cycle of:

Discussions about the thread topic → Derailment/off-topic banter ⇌ Lord999 talks about the ole' times/tells a story without context or exposition, so 99% of the people can't follow what he's talking about ⇌ PA-to-Pharm brings ups his worries → Thread death!!!

P.S. Just so no one gets the wrong idea, I actually like reading Lord999's posts. But sometimes I find myself wondering what he's talking about, especially when it comes to stuff about his experience in school or some obscure topic from 20 years ago.

Hey, in case you haven't noticed, the way the flowchart usually works is more like this: A pharmacy veteran like lord999 makes a post that talks about the past/present/abysmal future of pharmacy --> I ask them a general, not-specific-to-me question regarding a specific statement in his post (or whoever's post I'm replying to) --> The person responds to my general question by specifically referencing my situation --> It goes from there.

 

[PAtoPharm]

There is only one health professions program that is a sure safe bet in the future. And that is to become a surgeon. Otherwise don't depend on PA, NP, CRNA, or PharmD to be safe for employments sake. Even primary care as an MD is suspect. Surgeons require 6+ years of residency and fellowship before they can be fully independent. With the medical schools bone-headed push to increase family medicine residents instead of surgeons, they are dooming this country to a shortage of surgeons and specialists.

On the other hand, NP schools are graduating 20K students a year and PA schools are headed towards graduating 10K students yearly. That's 3oK mid-level/primary care practitioners graduating each year for the foreseeable future. Even if the USA is facing some 90K shortage of physicians by 2025, I don't see how this volume of mid-level providers is not going to negatively affect the professions involved.

This "shortage" rhetoric happened 16 years ago with pharmacists. I believe we are seeing the same thing happening again with PAs, NPs, Dentists, and (possibly) MDs at this moment.

Good points (and glad you linked to some stats), but I think dentists are safe for now. Back when I was wistfully considering applying to dental schools back during the summer/fall, I did a lot of research on the job market, and according to the BLS and one other gov't.-sponsored job market projection study (I forget the name of it), all the dental schools in the country are only graduating enough dentists to meet HALF the predicted demand for dentists over the next 10 years. In other words, even after every dentist graduating over the next 10 years gets employed, there will still be twice as many openings that go unfilled. Pharmacy could've been there (maybe not in quite the same situation, but it could've been close) if they hadn't gotten so carried away with opening school after school.

I agree that eventually, the supply of PAs/NPs is going to have to meet (and then exceed) the demand for them... UNLESS the PA/NP programs out there reduce their enrollment numbers accordingly as supply begins meeting demand. However, as @gwarm01 said, I think the PA/NP fields are "hot" enough right now that nobody's bothering to ask any of the same questions or crunch any of the same kinds of numbers that people started investigating as they related to pharmacy beginning in 2012/2013.

Still, for a single piece of anecdotal evidence that the PA/NP job market is still doing well, I live in a medium-sized city in the southeast that is routinely ranked as one of the "Top 3" worst medium-sized cities in the country to live in. There are currently over 6 pages of FT/PT jobs for PAs/NPs currently posted to the well-known jobs websites (Glassdoor.com, Indeed.com, etc.), and most of these jobs are offering $100k or close to it, along with 3-4 weeks of PTO to start and good benefits/retirement plans. On the other hand, there is a grand total of TWO pharmacist job postings on the same job websites for my area, and they were both posted by CVS. So what does that tell you? It shows that even though nobody actually wants to live in my city, pharmacy school graduates are absolutely taking jobs and living here, because they simply have no choice but to do so because of how bad the job market is pretty much everywhere except the po-dunk towns in NM, AZ, etc.

On the other hand, with over 6 pages of jobs for PAs/NPs posted for my city, that shows you that nobody in those fields is choosing to take a job here, simply because they have options to live in better places. So for now, it looks the PA/NP job market as a whole is doing pretty well, but in 3, 4, or 5 years, who knows....

 

[PAtoPharm]

BTW, there are also thousands of jobs posted throughout the year for CRNAs, despite the fact that for at least 3-5 years, there have been over 120 CRNA programs pumping out graduates in the US. So it looks like there really are professions out there with job markets that can sustain thousands and thousands of new entrants every year, but maybe the party will come to an end for CRNAs as well.

 

[PAtoPharm]

The PA market of today reminds me a lot of the pharmacist market of the 2000's. It's a hot field and everyone is interested. You can make 100k and the program is only 2 years long! Unfortunately, you cannot operate independently so your livelihood is limited by your potentially employers. I wouldn't be surprised to see that profession follow a similar boom-->bust cycle as pharmacy.


I'd rather be a little shaken than have my head in the sand. If someone is going to spend over 100k and 4+ years of their life to become a pharmacist, they should be aware of the changing market and the potential pitfalls that may away them. The 10-year trend data on pharmacymanpower.com continues marching towards oversupply. Retail chains are buying each other, consolidating, closing locations. There might be a time very soon where you realistically only have one or two options for employment. Better hope they treat you well, or you aren't marked non-eligible for rehire. Some people are fighting tooth and nail to land a 32-hour "fulltime" float position. Others are doing 2 years of residency, maybe 3 in the near future, just to get the same job their preceptor was considered qualified for right out of school.

I'm not saying this profession isn't worth it or that you cannot succeed. You just need to know what you are up against so you can plan accordingly.

Bad solution? Hell, it's been working just fine for me.

As I stated in my response to someone else above, I think (just my opinion here) that the future viability of the NP/PA job market will depend on whether or not schools reduce their classes in response to future job market trends. My armchair statistical analysis is to look at the job market for any particular healthcare profession here in my home city. Since my city is consistently ranked as one of the worst medium-sized cities to live in, you know that a bad job market here means that people are taking jobs here simply because they can't find them in better places. The fact that there are now only two open pharmacist job listings in my city (both for CVS) is an indicator (at least to me) that the pharmacist job market really is hitting the bottom of the barrel, while the fact that there are still more than 6 pages of job listings for PAs/NPs is an indicator that overall, the job market for PAs/NPs is doing well overall. It's one of those N=1 things, but whatever.

BTW, based on browsing some of those PA/NP job listings, I would say that the only downside to being an NP/PA is that the vast majority of employers seem to want their midlevels to take call one night per week, work a couple extra shifts (e.g., a few Saturdays) per month, etc. For the most part, at least, it seems like most pharmacy positions don't involve working more than 40 hours/week (or I guess it's now 32 hours/week?).

 

[Pharmd = Phake Doctor]

Good points (and glad you linked to some stats), but I think dentists are safe for now. Back when I was wistfully considering applying to dental schools back during the summer/fall, I did a lot of research on the job market, and according to the BLS and one other gov't.-sponsored job market projection study (I forget the name of it), all the dental schools in the country are only graduating enough dentists to meet HALF the predicted demand for dentists over the next 10 years. In other words, even after every dentist graduating over the next 10 years gets employed, there will still be twice as many openings that go unfilled. Pharmacy could've been there (maybe not in quite the same situation, but it could've been close) if they hadn't gotten so carried away with opening school after school.

I will have to disagree with you on the dentist part. Unlike medical practitioners, dentists are not covered by most health insurances (if any). Unless your workplace pays for it, most people have to buy a separate dental insurance on top of their health insurance. The BLS probably did a simplistic estimation of how many dentists the country would need if all people had dental insurance and got proper dental treatment. They never took into account how socioeconomic status plays into dentistry.

Most dental insurances only cover up to 2K-3K in treatments. If you need serious dental treatment, you're gonna have to pay a lot out-of-pocket. Cavity treatments can cost $500-1000, a root canal can go for $1500-2000, and a new crown can cost another $1000-2000. Those three treatment alone maxes out your limit, and you're still on the hook for $1000-2000 of cash.

Guess what happens to Joe Schmoe if he gets a really bad cavity?
He's getting his teeth pulled, because its a lot cheaper to do that. (FYI medicaid doesn't pay for these treatments, so poor people get the honor of losing their teeth).

In this country, getting dental treatment is a luxury while getting medical treatment is a necessity. It doesn't matter if a patient is wealthy or poor, or if the economy is good or bad, people will eventually seek medical treatment when they are sick. However, if a patient is poor, or if the economy crashes, they will not seek out dental treatment. They'll let their teeth rot out.

Rich people get to keep their teeth, while poor people eventually get dentures.

There was a really interesting thread on the SDN Dentistry forums by a guy who was disillusioned by the dental profession. He mentioned that dentistry was saturated in metropolitan areas, that student debt was astronomical (easily 300K-500K for the majority of dental schools), and that the biggest dental insurance (Delta Dental) paid crummy reimbursements. What stuck out the most was his mention that only people who could afford dental treatment would visit the dentist. While a primary care/family physician would expect to see a patient 2-3 times a year, a dentist could expect to see a patient either twice yearly (rich patients) or whenever the patient got a cavity (poor patients).

The guy even mentioned that his brother was an EM physician who made 300K yearly while he was barely making 150K.

If anyone finds the above thread, I'd love to reread it. It really opened my eyes to the drawbacks in that field.

I would take a 100K base salary job as a pharmacists with minimal (70-80K) debt than 150K base salary as a dentist with astronomical debt (300K-1M for both student and practice debt). I remember you mentioned that the state dental school in Georgia was cheap, but that sounds like an anomaly in this day and age.

 

[gwarm01]

As I stated in my response to someone else above, I think (just my opinion here) that the future viability of the NP/PA job market will depend on whether or not schools reduce their classes in response to future job market trends. My armchair statistical analysis is to look at the job market for any particular healthcare profession here in my home city. Since my city is consistently ranked as one of the worst medium-sized cities to live in, you know that a bad job market here means that people are taking jobs here simply because they can't find them in better places. The fact that there are now only two open pharmacist job listings in my city (both for CVS) is an indicator (at least to me) that the pharmacist job market really is hitting the bottom of the barrel, while the fact that there are still more than 6 pages of job listings for PAs/NPs is an indicator that overall, the job market for PAs/NPs is doing well overall. It's one of those N=1 things, but whatever.

BTW, based on browsing some of those PA/NP job listings, I would say that the only downside to being an NP/PA is that the vast majority of employers seem to want their midlevels to take call one night per week, work a couple extra shifts (e.g., a few Saturdays) per month, etc. For the most part, at least, it seems like most pharmacy positions don't involve working more than 40 hours/week (or I guess it's now 32 hours/week?).

That's why I said it reminds me of the pharmacy job market in the early 2000's. Pharmacy was able to absorb those graduates for a solid decade before things got dire. This is probably the fate of any job that becomes the hot new thing.

 

[lord999]

No offense to anybody, but does every thread on SDN forum have to end up becoming a PA-to-Pharm Life Decisions Discussion thread by the end?

Every thread I've read on these forums has gone through a life cycle of:

Discussions about the thread topic → Derailment/off-topic banter ⇌ Lord999 talks about the ole' times/tells a story without context or exposition, so 99% of the people can't follow what he's talking about ⇌ PA-to-Pharm brings ups his worries → Thread death!!!

P.S. Just so no one gets the wrong idea, I actually like reading Lord999's posts. But sometimes I find myself wondering what he's talking about, especially when it comes to stuff about his experience in school or some obscure topic from 20 years ago.

Fair criticism taken. In defense though, I normally use studentdoctor as more an informal way to communicate with certain people off the record, and just write these things on a whim. Also, I learned very early in both academia and civil service to be elliptical in writing patterns such that only a certain directed group would understand while the rest would dismiss it as boring and harmless. It's to the point that my wife knows I screwed up something royally if I ever told her directly that I loved her, simply because what started as an affection became the norm. I have to do all sorts of indirect things to let her know that. (Reminded about that yesterday...)

The other assumption specifically with the Walgreens and the local audience is that they have worked for a while and understand how that company's corporate politics work (and you will even as an RxM). While it is trivial to identify me, I need enough of a plausible deniability to not get sued for libel. Don't have that problem with VA or civil service though, because it's legally impossible for me to libel another civil servant over professional matters. But with pharmacy history, it's a real pity that not enough of us know it, because it'd be easier to understand why things are the way they are now if you understood that pharmacy has been in this Groundhog Day loop since the 70s.

 

[gwarm01]

pharmacy has been in this Groundhog Day loop since the 70s.

For you students out there, that means we have just finished the scene where Bill Murray perfectly steals the money from the armored car and are about to transition into bathing with the toaster. Now might be a good time to learn the piano or how to make ice sculptures.

 

[kidsaremypassion]

I will have to disagree with you on the dentist part. Unlike medical practitioners, dentists are not covered by most health insurances (if any). Unless your workplace pays for it, most people have to buy a separate dental insurance on top of their health insurance. The BLS probably did a simplistic estimation of how many dentists the country would need if all people had dental insurance and got proper dental treatment. They never took into account how socioeconomic status plays into dentistry.

Most dental insurances only cover up to 2K-3K in treatments. If you need serious dental treatment, you're gonna have to pay a lot out-of-pocket. Cavity treatments can cost $500-1000, a root canal can go for $1500-2000, and a new crown can cost another $1000-2000. Those three treatment alone maxes out your limit, and you're still on the hook for $1000-2000 of cash.

Guess what happens to Joe Schmoe if he gets a really bad cavity?
He's getting his teeth pulled, because its a lot cheaper to do that. (FYI medicaid doesn't pay for these treatments, so poor people get the honor of losing their teeth).

In this country, getting dental treatment is a luxury while getting medical treatment is a necessity. It doesn't matter if a patient is wealthy or poor, or if the economy is good or bad, people will eventually seek medical treatment when they are sick. However, if a patient is poor, or if the economy crashes, they will not seek out dental treatment. They'll let their teeth rot out.

Rich people get to keep their teeth, while poor people eventually get dentures.

There was a really interesting thread on the SDN Dentistry forums by a guy who was disillusioned by the dental profession. He mentioned that dentistry was saturated in metropolitan areas, that student debt was astronomical (easily 300K-500K for the majority of dental schools), and that the biggest dental insurance (Delta Dental) paid crummy reimbursements. What stuck out the most was his mention that only people who could afford dental treatment would visit the dentist. While a primary care/family physician would expect to see a patient 2-3 times a year, a dentist could expect to see a patient either twice yearly (rich patients) or whenever the patient got a cavity (poor patients).

The guy even mentioned that his brother was an EM physician who made 300K yearly while he was barely making 150K.

If anyone finds the above thread, I'd love to reread it. It really opened my eyes to the drawbacks in that field.

I would take a 100K base salary job as a pharmacists with minimal (70-80K) debt than 150K base salary as a dentist with astronomical debt (300K-1M for both student and practice debt). I remember you mentioned that the state dental school in Georgia was cheap, but that sounds like an anomaly in this day and age.

I wish when people made these income comparisons, they would compare apples to apples. A GP DDS's salary/income is more comparable to that of a FM/IM physician. Similarly, I'm more apt to compare EM/Derm/Anesthesiology to OMFS, Ortho, Peds specialists in Dentistry.
I do however, agree that the increasing debt across the board, especially in dentistry is problematic, and is actually increasing the competition within dental classes-as the top students begin to fiercely pursue stipended specialty residences-as those will ultimately result in higher incomes over the course of one's career. But something must be done to tame the increasing tuition.I feel very lucky to have been a Texas resident, but if I wasn't, I surely would've thought twice before signing up for 300k in debt-no matter the field of healthcare-med, dental, etc.

 

[PAtoPharm]

I wish when people made these income comparisons, they would compare apples to apples. A GP DDS's salary/income is more comparable to that of a FM/IM physician. Similarly, I'm more apt to compare EM/Derm/Anesthesiology to OMFS, Ortho, Peds specialists in Dentistry.
I do however, agree that the increasing debt across the board, especially in dentistry is problematic, and is actually increasing the competition within dental classes-as the top students begin to fiercely pursue stipended specialty residences-as those will ultimately result in higher incomes over the course of one's career. But something must be done to tame the increasing tuition.I feel very lucky to have been a Texas resident, but if I wasn't, I surely would've thought twice before signing up for 300k in debt-no matter the field of healthcare-med, dental, etc.

I see that you'll be graduating soon from a pediatric dentistry residency. In my area, Kool Smiles and Aspen Dental start off pediatric dentists at over $250k (or so I was told). There is only one dental school in GA, and I live in a medium-sized GA city that is regarded as being one of the most unpopular places to live (in fact, the only healthcare profession that doesn't have a good job market in my city is pharmacy), so maybe my area is an exception, but even with $300k in debt (the example you gave), isn't it a relatively safe gamble to make, considering that the median income for peds dentists is that much or more? In other words, in terms of proportions, isn't it riskier to borrow $140k to make $90k as a hospital pharmacist?

 

[kidsaremypassion]

I see that you'll be graduating soon from a pediatric dentistry residency. In my area, Kool Smiles and Aspen Dental start off pediatric dentists at over $250k (or so I was told). There is only one dental school in GA, and I live in a medium-sized GA city that is regarded as being one of the most unpopular places to live (in fact, the only healthcare profession that doesn't have a good job market in my city is pharmacy), so maybe my area is an exception, but even with $300k in debt (the example you gave), isn't it a relatively safe gamble to make, considering that the median income for peds dentists is that much or more? In other words, in terms of proportions, isn't it riskier to borrow $140k to make $90k as a hospital pharmacist?

I think the risk in taking out that amount of debt for the DDS lies in the fact that you are not guaranteed to match into a specialty post dental school. This is why programs like Penn and Harvard push so many of their graduates into specialties like OMFS, Ortho, etc. Because at those levels of tuition, a new grad Dr, needs to be making a certain level of income for debt payment to even be somewhat viable, without automatically defaulting to REPAYE, etc.So assuming I had decided not to pursue a specialty, and I took out significantly large loans, I would've probably been dealing with a not so great debt to income ratio for a few years, till I got faster/more efficient, etc.
That's why I'm so irked by the rising cost of education-not everyone can or should specialize, and it doesn't make sense to have that be the only path to financial stability. The job market plays a huge role as well, demand is key.And not just current demand, but long term-general trends. Location is key-not everyone can work right in the middle of the city, and have a ten minute commute. I personally think, ideally, the debt to income ratio should be at 1 or below, if one can manage it. I needed to know that even with my starting salary, first year out of school/residency that making those loan payments would not be an issue, and I could live comfortably while paying them off in 4-5 yrs. Personally, that was the measuring stick I used to decide what path to pursue career wise. Now, I'd rather borrow funds to pursue a path with a guaranteed full time position at the conclusion of my education, but I'm not taking out 300k to make 140k, even starting. The debt simply has to make sense. Everyone's comfort level is different, but I've always been more conservative than anything, so take it for what it's worth.

 

[gwarm01]

New plan: buy old 1-bedroom in Orlando, retire early. There are plenty for less than $50,000. I should be able to survive by panhandling on International Drive.

 

[Carol is Alpha]

New plan: buy old 1-bedroom in Orlando, retire early. There are plenty for less than $50,000. I should be able to survive by panhandling on International Drive.

Be wary of any locale's pension liabilities. Here's a sobering assessment by Amin Rajan.


http://www.taxpayersunitedofamerica...ng-government-pension-payments-from-taxpayers

http://www.orlandosentinel.com/news...ee-health-benefits-report-20150224-story.html

Check out the rate of change in the liabilities.
http://www.cityoforlando.net/pensio....-112.664-Compliance-Orlando-General-2015.pdf

I'm considering living in a van by the river. Not so bad with the right frame of mind.

 

[Carol is Alpha]

Maybe surgeons aren't even safe.

 

[gwarm01]

Okay, new plan: live off of the land in the jungles of Costa Rica.

 

[rxdawg21]

Taking out debt at significantly more then a 1:1 ratio is risky. After taxes you simply have to hope to be able to qualify for PSLF to get you financial house in order. In my area if you took out about 130k in loans (150k by the time you graduate due to interest) and make around 110k you are looking at a monthly payment of $1707 with a interest rate of 6.55% (after the 0.25% auto deduction for auto pay). If your refinanced to a 10 year 5% interest plan you are looking at $1590. So at a 110k salary, if you max out your 401k and don't have other deductions it looks like you are making about 4500 a month take home. after you take out roughly $1600 for loans you are living off a $35k a year to cover all other expenses (besides health insurance). Not exactly a lucrative first 10 years. Granted most people don't max out their 401k and most in retail make >110k a year. Your milage may vary

 

[Pharmd = Phake Doctor]

I wish when people made these income comparisons, they would compare apples to apples. A GP DDS's salary/income is more comparable to that of a FM/IM physician. Similarly, I'm more apt to compare EM/Derm/Anesthesiology to OMFS, Ortho, Peds specialists in Dentistry.

To be fair, I wasn't making this comparison. It was the poster of that thread who made that comparison. I may be wrong, but I've heard its easier to specialize in Medicine than it is to do so in Dentistry.

 

[Michael_Scott]

Come on now..most of our jobs are secure.

If something does happen, I don't want to become that middle age pharmacist who is bitter about life. I certainly don't want to turn into a gold bug and hope the world is going to collapse.


Sent from my iPhone using SDN mobile app

oh ...you wait and see sir...the nursing over-saturation has not taught us anything.

 

[Michael_Scott]

What do you think the "breaking point" is going to be? Do you think cutbacks by the retail chains (due to budget issues, automation, etc.) will cause the initial collapse of the pharmacy field, or will it be related to the oversupply of new pharmacists? And do you think it will happen with a wave of mass firings at some point in the next few years, or on a more drawn-out timescale?

so...did you or will you apply to dental school ?

 

[BidingMyTime]

so...did you or will you apply to dental school ?

He's started pharmacy school. I don't think dental school is in the cards for him.

 

[Michael_Scott]

He's started pharmacy school. I don't think dental school is in the cards for him.

he or she has been extensively talking about wanting to switch to dental school. Now, I am curious if they made the jump.

 

[PAtoPharm]

so...did you or will you apply to dental school ?

I never got around to applying to dental school. Believe me, I wish I had ended up going to dental school, but I kept dragging my feet when it came to turning down my acceptance to pharmacy school, and once I actually matriculated as a pharmacy student and started a pharmacy school transcript, that instantly made my chances of getting accepted to dental school even less likely than they already were. During a meeting I had with the admissions director of the only dental school in my state, she made it clear that I would be an uncompetitive applicant to their program and that it would take at least a year or two of improving my application package (taking more graduate-level classes, taking the DAT and scoring really highly, etc.) for me to have a shot at getting accepted. She also said that there are applicants who are more competitive than me in terms of the numbers (e.g., GPA) and who don't carry the "red flag" on their application of having been dismissed from a previous health professions program, and some of those applicants are having to apply 3 cycles in a row before they get accepted. So in all honesty, by the time I would actually be likely to get accepted to dental school, I could have finished pharmacy school.

At this point, if I wanted to do something else, it would probably make more sense to either go back to AA school or apply to general PA programs. Still thinking about re-applying to AA school (but at a different program -- not the same one I was enrolled in before). The PD at my former school said he would give me a positive LOR for whatever programs I want to apply to. When I decided to apply to pharmacy school last year, the job market in my area for pharmacists was actually really strong, but now it's just as bad as it is everywhere else (only 2 open positions in a city of 200k+, and they're both for CVS). Following through with pharmacy school might be as much of a waste of time as applying to dental school.