How Pharmacy Work Stopped Being So Great (Published 2022)
Two years of economic recovery brought strong gains to workers at the top and the bottom, but headwinds for those in between. Consider the pharmacist.
NYT article: How Pharmacy Work Stopped Being So Great
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Paywall. Sounds like an interesting article though.
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How Pharmacy Work Stopped Being So Great How Pharmacy Work Stopped Being So Great
Here's a gift article link: I've never tried sending one, let me know if it works
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How Pharmacy Work Stopped Being So Great
Two years of economic recovery brought strong gains to workers at the top and the bottom, but headwinds for those in between. Consider the pharmacist.If any group of workers might have expected their pay to rise last year, it would arguably have been pharmacists. With many drugstores dispensing coronavirus tests and vaccines while filling hundreds of prescriptions each day, working as a pharmacist became a sleep-deprived, lunch-skipping frenzy — one in which ornery customers did not hesitate to vent their frustrations over the inevitable backups and bottlenecks.
“I was stressed all day long about giving immunizations,” said Amanda Poole, who left her job as a pharmacist at a CVS in Tuscaloosa, Ala., in June. “I’d look at patients and say to them, ‘I’d love to fill your prescriptions today, but there’s no way I can.’”
Yet pay for pharmacists, who typically spend six or seven years after high school working toward their professional degree, fell nearly 5 percent last year after adjusting for inflation. Dr. Poole said her pay, about $65 per hour, did not increase in more than four years — first at an independent pharmacy, then at CVS.
For many Americans, one of the pandemic’s few bright spots has been wage growth, with pay rising rapidly for those near the bottom and those at the top. But a broad swath of workers in between has lagged behind.
In the two years after February 2020, income for those between the middle and the top tenth of earners grew less than half as quickly as income for those in the top 1 percent, according to data collected by a team of economists at the University of California, Berkeley.
The gap is part of a long-term trend made worse by a slowdown in pay gains for middle- and upper-middle-income workers in the 2000s. “If you’re going to a hedge fund or investment bank or a tech company, you’ve done enormously well,” said Lawrence Katz, a labor economist at Harvard. Typical college graduates, he said, “have not done that great.”
The stagnation appears to have moved up the income ladder in the last few years, even touching those in the top 10 percent.
In some cases, the explanation may be a temporary factor, like inflation. But pharmacists illustrate how slow wage growth can point to a longer-term shift that renders once sought-after jobs less rewarding financially and emotionally.
Growing Chains, Falling Wages
In 2018, Suzanne Wommack moved from western Missouri, where she had worked for several years as a pharmacist at a Hy-Vee supermarket, to the eastern part of the state, where she and her husband had relatives. The job she landed as a Walgreens pharmacy manager in Hannibal, roughly an hour-and-a-half outside St. Louis, paid her about $62 per hour — nearly $6 below her previous hourly wage, though regional pay differences helped to explain the drop.More striking was how few pharmacists Walgreens appeared to employ. At Hy-Vee, Dr. Wommack worked with one or two other pharmacists for most of the day. At Walgreens, the volume of business was similar, she said, but she was almost always the only pharmacist on duty during her shift, which often ran from 8 a.m. until the pharmacy closed at 8 p.m.
“I had to quit breastfeeding within a month of starting because I could never pump or eat enough to sustain milk,” Dr. Wommack, who had given birth to her third child a few months before taking the new job, said in an email. She said she later began taking anti-anxiety medication and antidepressants to cope with stress at work.
The job market Dr. Wommack encountered was a stark reversal from a decade earlier. In the 2000s, wages in the profession surged as the country faced a pharmacist shortage driven by an aging population and a rise in chronic conditions.
Universities ramped up enrollment in pharmacy programs, leading to a fivefold increase in graduates — to roughly 10,000 new pharmacists — in the decade that ended in 2007. (Pharmacists typically take two or three years of college-level prerequisites before earning a four-year professional degree.)
But by the 2010s, the market for pharmacists was cooling thanks to some of the same factors that have weighed on other middle-class professions. Large chains such as Walgreens and CVS were buying up competitors and adjacent businesses like health insurers.
This consolidation generated large fees for workers at the top of the income ladder — financiers and corporate lawyers — but slowed the growth of retail outlets where pharmacists could find employment. After striking a deal in 2017 to acquire roughly 2,000 Rite Aid stores, Walgreens shut down more than 500 locations. It closed a few hundred more over the next three years.
Automation has further reduced demand for workers — many pharmacists now spend far less time processing insurance claims because software does it for them.
Pharmacies also faced external challenges. To hold down the cost of prescription drugs, insurance companies and employers rely on so-called pharmacy benefit managers to negotiate discounts with drugmakers and pharmacies. Consolidation among benefit managers gave them more leverage over pharmacies to drive prices lower. (CVS merged with a large benefits manager in 2007.)
Big drugstore chains often responded by trying to rein in labor costs, according to William Doucette, a professor of pharmacy practice at the University of Iowa. Several pharmacists who worked at Walgreens and CVS said the formulas their companies used to allocate labor resulted in low levels of staffing that were extremely difficult to increase.
According to documents provided by a former CVS pharmacist, managers are motivated by bonuses to stay within these aggressive targets. CVS said it made staffing decisions to ensure “the safe and accurate filling of prescriptions.”
More Business, Fewer Hands
The day that Dr. Poole began seriously reconsidering her CVS job in Tuscaloosa came in May 2021 when, nearly eight months pregnant, she fainted at work.The loss of consciousness was nothing serious in itself — she and the baby were unharmed, and an adjustment to her blood-pressure medication solved the problem. Much more alarming to her was what the episode said about working conditions: Despite the additional responsibilities of the pandemic, like coronavirus vaccines and catering to Covid-19 patients, there was no co-worker around to notice that she had hit the deck.
“No one knew I was passed out until a customer, said, ‘Um, is anyone back in the pharmacy?’” Dr. Poole recalled. “They found me on the ground.”
In most cases, an industry without enough workers to meet customer demand would simply hire more, or at least raise wages to attract them.
Yet, according to the Bureau of Labor Statistics, neither of those things happened last year. The number of pharmacists employed in the United States dropped about 1 percent from 2020 to 2021. On balance, employers did not raise wages — in fact, median pay fell slightly, even without adjusting for inflation.
While this data is not yet available for 2022, a contract signed in March by a union of Chicago-area Walgreens pharmacists reflected a similar approach. It provided maximum base pay of $64.50 per hour, the same as the previous contract, but lowered the starting wage from $58 per hour to $49.55 per hour by September. (Like many retail pharmacists, the union members also receive bonuses.)
CVS and Walgreens said they had made hiring pharmacists a priority during the pandemic — CVS said it employed nearly 6 percent more pharmacists today than it did in early 2020; Walgreens declined to provide a figure. CVS said its compensation was “very competitive” for pharmacists, and Walgreens cited “ongoing phased wage increases”; both chains have offered signing bonuses to recruit pharmacists. The Chicago union said Walgreens had recently offered to raise pay for about one-quarter of its lowest-paid members.
To explain the wage stagnation of upper-middle-class workers during the pandemic, some economists have suggested that affluent workers are willing to accept lower wage growth for the ability to work from home. Dr. Katz, of Harvard, said the wages of many affluent workers might simply be slower to adjust to inflation than the wages of lower-paid workers.
But Marshall Steinbaum, an economist at the University of Utah, said the fact that upper-middle-class workers were not able to claim a larger share of last year’s exceptionally high corporate profits “speaks to the disempowerment of workers at all levels of status.”
Late last year, CVS announced that it planned to shut 900 stores, or nearly 10 percent of its locations, by 2024. Steven Valiquette, an equity analyst at Barclays, suggested the move was partly intended to hold down the wage bill for pharmacists and other personnel. “It was well timed to take labor pressure off the franchise,” Mr. Valiquette said in an interview. (CVS said it retained 95 percent of the employees from the stores it closed this year.)
When drugstores have added personnel during the pandemic, they have often added pharmacy technicians, who help fill prescriptions, instead of pharmacists, effectively replacing costly workers with less costly ones.
In late 2020, Sarah Knolhoff, then a pharmacist at a Walgreens in Rockford, Ill., received an email from management announcing that it was planning to hire several pharmacists in her area to help administer Covid vaccines. But the positions never materialized. The company later announced that a change in state regulations would allow pharmacy technicians to administer shots. “They expected the techs to transition into that role,” Dr. Knolhoff said.
Overall, the industry added more than 20,000 technicians — an increase of about 5 percent — from 2020 to 2021. In that time, prescription volume increased roughly the same percentage, according to data from Barclays.
The effective replacement of higher-paid workers with lower-paid workers has also occurred in other sectors, such as higher education. But at drugstores, where pharmacists must sign off on every prescription, this shift has left little margin for error.
In August 2020, Dr. Wommack, the Walgreens pharmacist in Missouri, got Covid. A colleague covered her first two days out but couldn’t cover the third, at which point the store simply closed because there was no backup plan.
Pharmacists “carry the weight of the pharmacy on their shoulders,” said Bled Tanoe, a former Walgreens pharmacist who has created an online platform for colleagues to advocate better working conditions.
Several pharmacists said they were especially concerned that understaffing had put patients at risk, given the potentially deadly consequences of mix-ups. “It was so mentally taxing,” said Dr. Poole, the Tuscaloosa pharmacist. “Every day, I was like: I hope I don’t kill anyone.”
Asked about safety and staffing, CVS and Walgreens said they had made changes, like automating routine tasks, to help pharmacists focus on the most important aspects of their jobs.
Many pharmacists contacted for this article quit rather than face this persistent dread, often taking lower-paying positions.
Still, none had regrets about the decision to leave. “I was 4,000 pounds lighter the moment I sent my resignation email in,” said Dr. Wommack, who left the company in May 2021 and now works at a small community hospital.
As for the medication she had taken for depression and anxiety while at Walgreens, she said, “Shortly after I stopped working there, I stopped taking those pills.”
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Yea, we've been talking about this for 10+ years on here. Whenever I see a new grad at work I just shrug. I'm only working 2 days a week these days and it seems like everytime I come in for work they've added on some new responsibility. You would think they would try to lighten the workload with so many stores being closed because of a lack of pharmacists.
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It really is time to unionize
Really the only way for things to change
Really the only way for things to change
It was around this time that I made the decision to become a pharmacist, because it had such a great outlook at the time. I feel I've been duped, lol
Now I'm skeptical about jumping ship to any other profession knowing it could turn to sh** just as easily.
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That will never happen.
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I actually tried to get union reps out before I quit my last job. Figured if I was leaving anyway I might as well try to help out my coworkers on the way out. Couldn't get anyone to even return my calls.
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People have also been saying this for 10+ years.
This article should be a sticky in the prepharm forum.
Make pharmacy great again.
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The article seems to be focused on pregnant (female) pharmacist with 3 to 5 kids! Why this slant, are they the only ones that suffer? Maybe hormones? Post Partem Depression? Very odd to go around the country and focus on three female pharmacist and their plight!How Pharmacy Work Stopped Being So Great (Published 2022)
Two years of economic recovery brought strong gains to workers at the top and the bottom, but headwinds for those in between. Consider the pharmacist.www.nytimes.com
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Agree but.. no backbone and everything.
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Indeed, you were rick rolled.
However, the projection and word around pharmacy getting to where it is today were out there, many just didn’t want to believe it because they were blinded by the $$. The next 10 year projections are even worse, anyone considering it for the last 5 years should seriously question their ability to make adult decisions because the facts are there and it’s not an”ignorance is bliss” kind of situation.
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Agree with what you’re saying, just to clarify on the last part for any potential student readers who may misinterpret, there is no shortage/lack of pharmacists and hasn’t been for 5-7 years or so. There has currently been a shortage of pharmacists “willing to work” due to poor conditions/pay, which was also aided by student loan pauses as many took lower paying jobs (even outside pharmacy/healthcare) because they could afford to due to no loans and were tired of the bs. This will regulate and surely be back back to pre COVID times where PGYs couldn’t even get positions and even PRN/28-32 hours was difficult to get.
Yeah, I remember coming to these boards around 2011-2012 and seeing the doom and gloom messages. Unfortunately, I was already in my mid 20s, needed to get a career started, and already completed pre-pharm and was accepted to pharmacy school...so I just went through with it.
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Given that the profession is majority female, I don't think it is really surprising. I also don't think it is surprising that women may have had more difficultly "just dealing with" the difficult working conditions that can arise in retail. It says they contacted many pharmacists. Maybe these were the most compelling stories. Maybe they were the only ones willing to share their names.
Do you feel like that some specific struggle was overlooked by not including a male pharmacist among the interviewed? Or maybe there is some unrelated thought you have about female pharmacists that would cause you to focus on this specific detail instead of the overall message of the article?
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WHOA! Let's not go there, I am a card carrying feminist. But don't you see the article as very exclusionary. Says they interviewed pharmacist far and wide but the only examples of "struggle" is female, large chain retail, motherhood, child care problems. Don't you think this simplifies and excludes a whole lot of other issues that we all face?
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Let's look at the actual complaints
This doesn't seem like a gender specific or parent specific complaint
While the breastfeeding issue is woman specific, the experience of being a solo pharmacist, who doesn't have time to eat enough for good health, and has to deal with work caused anxiety and depression is not.
Again the pregnant thing isn't something we all experience, I think the lack of safety in being completely alone is.
Absolutely nothing about that situation is gender specific
Nope. Nothing gender specific about being without a backup while sick.
I am sure that absolutely no male has ever had that experience.
I think you are reading something into this that isn't there and that it isn't exclusionary at all. What issues faced by retail pharmacists do you think would have been better covered if they had interviewed a man?
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Sorry, anything over 4 lines, you have lost me. Damn this ADHD. You win!
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With so many women, you have to deal with endless maternity breaks and FMLA. I get that men can do this, too, but let's be real, women are the primary culprits. This wouldn't be an issue in most cases, but retail pharmacies are run on skeleton crews because they beat their employees like rented miles. So it winds up causing those left at the pharmacy feeling with endless stress and the desire to stab someone.
In fact, if I could only employ gay men, I would. They are the group least likely to have children. And, thus, the least likely to call up at 7am and tell me they can't come in because little Xander or whatever stupid name they are using these days has a fever. Leaving me without labor required to get the job done. Again.
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The stores I worked in had lifers with BS degrees in their 40s-50s. So I never experienced any of that.
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I work with 4 gay men pharmacists, three of them have kids, and all of them took their entire 12 week FMLA off when their child came- just saying...
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Yea, what he said!
Boy, I wish I could string together 3 sentences that made sense! Damn this ESL!
If you are not careful, KidPharmD will throw an essay at you!
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I've never seen so many people salty about maternity leave as I've seen in pharmacy. Y'all act like there aren't females in other professions that have kids too. If you had kids then I'm sure you'd want your wife to be at home with her newborn instead of at work.
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Pharmacy pay has not kept up with inflation. Starting pay in 2007 was $55-60/hr That would be $80-87/hr today.
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Agreed. It’s 45-50/hr these days, will likely remain there/decrease once/if loans resume since many pharmacists left to take 20-30/hr jobs in leu of happiness and not having payments
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I am a big fan of maternity, motherhood and newborns! I have three kids/adults now! I know how important baby/mother time is. We made a huge sacrifice to forgo my wife's considerable salary, for her to stay home and raise the babies. I had to work two jobs to support the family.
The villains in this story are large hospital systems and chains. They can't AND won't replace or provide adequate relief for the pharmacy when an FTE pharmacist is out on maternity leave, so everyone suffers. That's when the "salt" enters the picture!
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My current place has 2 people out on FMLA for personal injuries and one person out for parental leave. They won't hire a temp full-timer or increase the part-timers hours and always claim the per diems aren't able to cover it.
I still have a couple of weeks of paternity time left for this year. They'll go bat**** if I decide to use it.
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I am sorry but this generation is too marshmallow soft! My firstborn (31 years ago) was a scheduled c-section. At the time I was manager at a Home Infusion Pharmacy. We scheduled the c-section for Friday afternoon 2pm. I only missed half a day of work. I was back to work Monday morning, bright and early! Never even imagined having something called paternity leave.
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Lol, sucks to be your wife.
It was ****ing ******ed that it was never offered back then. Why shouldn't the dad get to spend time with the newborn and get paid time away from work? The only problem with the system that they are offering for parental leave is that the state puts a cap on the pay out. It's 66% of your average weekly wage up to a max payout of $1100 a week. So since, I make $3k a week, 66% would be about $2k. Meanwhile if someone normally makes $1666 a week, they would be the ones to get the actual max 66%.
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Other than having to put up with me, my wife has had a pretty awesome life, no need to feel sorry for her. Had her mom move in, help with the first two babies. She lives in a $1.4Mill, 6900sq home, drives a luxury SUV, works 1-2 days a week. She got to spend quality time with her 3 babies, didn't have to dump them at daycare at 6mos old.
Married for 37 years!
Just got back from her third vacation since June (Spain, Seaside, Fl., and Mexico). Life is good!
Wow, missing out on Paternity Leave SUCKS big time.
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Ah so she was lucky to have her mom help with the babies.
You don't think you missed out by not being around the newborns 24/7 for the first few months?
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Yeah now imagine if your wife didn't have her mom's help after the C section. Would you have returned to work right away? It's not just bonding time. The new mom needs to recover from surgery, needs help with meals and chores etc.
I've had single coworkers take full FMLA for surgery or other medical reasons and no one complains. But for some reason pharmacists like to complain about maternity leave.
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I don't get why people get upset when people take their time- I have never seen anyone (openly) say a woman shouldn't get the time - and even nobody says things when men take their time - I took 8 weeks of FMLA when my daughter was born (6 weeks at birth and 2 weeks when my wife went back to work)- I saved the other 4 in case something came came up in that first year we weren't expecting.
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use it - just to make a point. I would **** them if they can't staff the place
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Y'all gonna get salty, but that is being a crappy husband and father - do you seriously not want to spend time with your new child? That is the defnition of toxic masculinity,
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Seriously, family comes first. Who cares about work for a few months? You have the rest of your life to work. Everyone should take all the time they are eligible for.
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there are too many people in this world that are either too gullible and think their employer gives a rat's ass about them, or think by putting in "extra" work they are going to get further ahead- screw that- in in the past 4 years I have literally stayed late (more than 5 minutes) once- and that was due to a code. I usually bug out 10-15 minutes early every single day, and an hour on the weekend, and I got my annual eval in the top 10% of the department, yet some of these fools consitently give an extra hour or two all the time and work from home off the clock.
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Ehhh, not always. I was in solo practice primary care when my kids were born. Taking 1-2 months off would likely have caused the practice to go under.
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Well since this is a pharmacy forum, I assume we are talking about pharmacy. The pharmacy will survive if someone goes on leave.
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that is different that working for a large employer who can cover your hours- if one of your med assistants needed the time off, you could cover, it would suck, but that is life. As the provider - literally no money is coming in without you- then you have to balance life and work - if you worked as a hospitalist, you would take the time off and not bat an eye (at least around here that happens)
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Sure, my wife took a full 3 months post-partum from her large hospitalist job plus 1 month pre-delivery on bed rest.
But there are also 3 solo practice pharmacies in my town...
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Guys, I don't get all the venom and vitriol, different strokes for different folks! I have absolutely nothing against FMLA, maternity, paternity or any
-ternity that helps moms and dads spend time with their babies. I shared how I did it and what worked for me! And no I didn't sleep at the pharmacy, I put in my 8 hours, and went home and spent time with the babies. There was no such thing as paternity leave. Also as management, at a home infusion company, there was no way a "floater" could step in and cover for a few months. I could have taken 3 months off, but would be looking for a job at Eckerds after that. And no my three kids are not abused, or neglected. They are well adjusted adults, with absolutely no student loans, a good education and a good head start on life. I stayed married, stayed in their lives and tried to be a good role model. Well maybe I missed the 3-month paternity bonding time, but I think I have more than made up for that.
In four weeks I will be on a cruise with just my two sons, age 31 and 26. How many young people would pay their own way to cruise with their old dad, going on 3 years (COVID Excepted).
Peace and Love. Peace and Love.
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As in how many people 26-31 could afford a cruise? Not being sarcastic but aren’t cruises like $500? I would imagine most 26-31 could easily afford it, much less ones with half a decent job.
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New grad salaries = 45-50/hr and everything has gone up exponentially since then in cost, housing has become out of reach of most even in many LCOL with 80k+ salaries.
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I'm night shift so it really shouldn't affect them other than they won't have a pharmacist overlapping with the day shift in the AM.
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The issue is that the way you say it is like you think it's a virtue or a good thing that you didn't take paid time away from work. I mean, it sucks that it wasn't an option back then. I mean it's still not an option in some states where the law sides with employers/owners instead of the workers.
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Depends on the cruise. Currently a transatlantic from New York to Rome costs about $1400 a person.
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How much were houses and stocks in 1982?
