Pharmacist Career Ladder

[Eugenepota]

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Greetings all!
I work as a clinical pharmacy coordinator at a growing health-system.
I have been tasked by my administration to develop a Pharmacist Career Ladder akin to the one laid out by the Yale team in this publication: Implementation of a pharmacist career ladder program | American Journal of Health-System Pharmacy

My questions for you:
Do you have a similar system of rank/compensation ladder at your practice site?
If so, what are the title names and differentiations between rank? (i.e. are there practice/privileging differences or simply compensatory ones?)
If you have such a career ladder in place, what are the staffs thoughts on the system?
What do they love and what do they dislike?

Many thanks for your time and have a great day!

 

[njac]

Current job labels them "pharmacist I through IV"

Previous job was "clinical pharmacist " vs "clinical pharmacist specialist "

One of my dislikes at current place is there is no mechanism to get hired at above a I, and you can't apply for II for 2 years. I was a specialist at my previous job and definitely meet the requirements to be a III and most of the requirements for a IV, but it will take 5 years to reflect that in my pay and title.


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[lord999]

Before you go too far with this idea at first:
1. Do you have to report salaries externally like the government?
2. How are labor relations with the pharmacists?
3. Do you have the funding and the grading requirements to discriminate (and I mean this in the HR sense) between different classes of pharmacists?
4. Are you an Academic Medical Center (which has implications from 1)?
5. Can management handle grade competition as cooperation in systems like this always decrease (see Organizational Behavior in the hierarchical management structure chapter for research and evidence)?
6. Is there a mechanism for demotion as well as promotion?
7. Are there objective benchmarks that really reflect what good pharmacists do? I can do all those things on a mediocre basis and still promote (and management can't stop me because I met the objective target and subjective discrimination will get contested).

Also, flat hierarchies make it much easier to obfuscate salary information and assignment information in management's favor. When you impose a ladder hierarchy, you open yourselves to being much more inflexible on pay, on assignments (the hell a II supervises a IV), and on advancement potential. That's kind of why the government has gone away from making those hierarchies strict except for clearly demarcated supervision and command responsibilities in pharmacy. It's why medicine does not do this to themselves as while there are clear gradation differences between physician, supervising physician, section chief, specialty chief...up to chief of staff, the gradations are not based on clinical authority but on bureaucratic responsibility.

You should look at police hierarchies to understand how subgrades tend to work out in practice. Now, ladder systems work until you have people progress to terminal ranks, but it creates a hell of a mess later on when those terminal staff members get complacent if you cannot reassign them lower.

Crudely said: Yale and academic medical centers have a tendency to screw their clinical staff out of higher pay for power. But once you give the people the power, it will be turned against you, and anything to disrupt a ladder system will be defeated by the rank and file as post hoc discriminatory.

VA Ranks Post Reform:

Grade 12: All standard pharmacists, clinical and operations. Assistants to technical grade pharmacists. No clinic oversight.

Grade 13: First-line supervisors, technical pharmacists (QM, informatics, pharmacoeconomics and ordering) at the hospital level. Clinic directors with or without supervision of pharmacist.

Grade 14: Second-line supervisors and small hospital chiefs (<24 hours or <100 beds). Regional and National technical pharmacists. National clinical pharmacists.

Grade 15: Chiefs and Pharmacy Regional Directors. Deputy Chief Consultants at the National level. Hospital Associate (Vice) Director for Operations.

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There's only one pharmacist that ranks a 15 normally, but there are several pharmacists at this grade who work in other fields like hospital management.

SES II: Chief Consultant (National Director) of Pharmacy (1). Rank equivalent to O-7.

 

[lord999]

And the reason why I bring all of those issues up was that VA used to have a much more hierarchical gradation between the rank and file practitioners that we found to be self-defeating. The high-graded pharmacists would then transfer to work in the easiest jobs, and the low grade pharmacists all got the worst and the most demanding jobs leading to this vicious cycle of rewarding lazy pharmacists. With the flattening, it's been much easier to take actions under the table because the clinicians are equal and honestly, should be.

What @njac said is basically what happened in VA, and where people would come in demanding higher grade placement which was unfair to the seniors or people who worked in the system hence the reform to flat grades.

 

[ChalupaBatman86]

What do you for a living?

I'm a pharmacist 3!

What the hell is that?

Oh, it's better than a pharmacist 2. But not quite as good as a pharmacist 4. And I am allowed to give wedgies to the pharmacist 1's. And I get to put a "3" in my email signature and I get an extra 0.27 per hour.


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