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.
