The demand for pharmacist care will require a larger number of pharmacists

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Robert Ross

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Examining the Pharmacist Labor Supply in the United States: Increasing Medication Use, Aging Society, and Evolution of Pharmacy Practice.

Abstract
The increasing number of pharmacists in the US has generated concern regarding potential oversupply. A 2018 analysis from the National Center for Health Workforce Analysis (NCHWA) in the US projected a best case scenario of an oversupply of more than 18,000 pharmacists in the year 2030. In this commentary, the limitations of this general health labor force analysis by the NCHWA are described. The goal of this work was to provide a more nuanced examination of the pharmacist labor demand in the US. Data from the US Bureau of Labor Statistics (BLS) and the US Medical Expenditure Panel Survey (MEPS) were utilized to examine, annually over a ten year period ending in 2017, the number of pharmacists, the ratio of pharmacists to persons living in the US, the ratio of pharmacists to older adults living in the US, and the ratio of medications to pharmacists. The number of pharmacists grew from 266,410 in 2008 to 309,330 in 2017. As anticipated, despite a growing US population, the ratio of people living in the US per pharmacist dropped unabated from 1141 to 1053 from 2008 to 2017, respectively. However, the reverse trend was observed for the ratio of persons 65 years or older per pharmacist. This ratio increased from 146.1 older adults to each pharmacist in 2008 to 164.3 in 2017. The accelerating demographic shift to an older population is also reversing an overall trend in the number of medications to pharmacist that will continue for the foreseeable future. While the ratio of medications to pharmacist dropped overall from 2008 to 2016, it has begun to rise again from 2016 to 2017. Beyond the increasing number of medications attributable to a rapidly aging population, there is a growing demand for clinical care from pharmacists due to the maturing environment of complex, costly medications for chronic disease treatment. As the portion of total health expenditure is increasingly devoted to medications and the US health delivery system continues its movement to community-based care, the demand for pharmacist care will require a larger number of pharmacists trained for advanced-practice care.

www.ncbi.nlm.nih.gov

Examining the Pharmacist Labor Supply in the United States: Increasing Medication Use, Aging Society, and Evolution of Pharmacy Practice - PubMed

The increasing number of pharmacists in the US has generated concern regarding potential oversupply. A 2018 analysis from the National Center for Health Workforce Analysis (NCHWA) in the US projected a best case scenario of an oversupply of more than 18,000 pharmacists in the year 2030. In this...
www.ncbi.nlm.nih.gov www.ncbi.nlm.nih.gov
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The flaw in that logic is that an increase in medication usage does not equal an increase in the demand for medication management by pharmacists because there are plenty of things such as technology that can improve medication management without needing a clinician. Things like mail order (adherence) or DUR software (drug interactions/patient safety). This article is simply putting a modern spin on the same lines used by academicians for decades: “Baby boomers are aging so we need more pharmacists!” “Clinical/MTM services from pharmacists are in demand!” “Pharmacy must reach provider status!”
 
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I scanned the full article, there's nothing in there that the academic pharmacy organizations haven't been saying for at least 25 years. This line did make laugh a bit:
Given that CVS Health has acquired Aetna, one of the five largest health insurers in the US [14], it can rapidly begin to shape the health care delivery system by deciding covered services. These transformations are motivating, if not requiring, pharmacist positions to provide care.
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The only growing position of pharmacy is for pharmacy professors. They open new schools every year which means more pharmacy professor positions every year.
 
As bad as things look now, I think in the long run there will be increasing demand for more pharmacists because of provider status.
 
WVUPharm2007 said:
Probably written by some guy that's been a professor for a few decades that has never seen the bench and has no idea what the job market is like on the ground.
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No, I actually know Jon professionally. He's around my age, but I can't wrap my head around how tenuous these conclusions are drawn from what is supposed to be part of the National Health Interview Survey. For all intents and purposes, MEPS is basically a follow-on survey that follows a clustered (multiple people in the same household), stratified (uses race, gender, and some demographics) sample that attempts to get dollar amounts out of pocket for health care that a household uses. It oversamples the insured and otherwise literate population. You can't estimate provider population as it doesn't cover major sectors of the healthcare system (institutions like VA, charity care through HHS, and Medicaid proper due to reporting issues in the NHIS). This is incredibly substandard work from someone that I actually have some regard for, and there is no way that anyone from UW PORPP/HSERV especially one trained by Sullivan, Basu, and Garrison would ignorantly make this kind of overreach extrapolation mistake. As ClinX faculty, he doesn't have to publish this stuff as he has no tenure possibility, why would he do this is what is going through my mind?

There hasn't been a credible estimation of actual license to employment match versus open positions since JCPP 2004, and we all know today how far off that optimism is from the reality of jobs. We can do better than this snake oil, and this article does not meaningfully contribute to the discussion. If you are actually going to estimate the need for pharmacists, we need to know the number of pharmacists not engaged in pharmacy employment who are licensed to even get a good baseline.
 
lcow2004 said:
As bad as things look now, I think in the long run there will be increasing demand for more pharmacists because of provider status.
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You have been saying that for years.

Even after you only managed to work as a tech for 6 years after graduating from pharmacy school.
 
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zelman said:
Why don’t people who make these assertions offer cash money wagers if they’re so certain?
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I did, I left $400k on the table to go to graduate school when pharmacy was popular and get myself a more boring job. I saw the writing on the wall in 2003 as I did in 1988 when my father was laid off for the first time.
 
BenJammin said:
I 100% believe in a higher demand for pharmacists in a few years but it will be for pharmacists willing to work for $40-60k a year. Are you ready?
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I'm mentally preparing myself for that day. The plan is to buy a small house in a low cost of living area and maybe just work part-time until I can figure something else out. At least at those wages I can start considering more enjoyable types of work over the drudgery of pharmacy.
 
BenJammin said:
I 100% believe in a higher demand for pharmacists in a few years but it will be for pharmacists willing to work for $40-60k a year. Are you ready?
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Just curious. What are you basing this on?
 
stoichiometrist said:
You have been saying that for years.

Even after you only managed to work as a tech for 6 years after graduating from pharmacy school.
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It doesn't mean I can't still believe that over time the field of pharmacy will pick back up. I still think pharmacy is a good profession but just different from what it used to be.
 
lcow2004 said:
It doesn't mean I can't still believe that over time the field of pharmacy will pick back up. I still think pharmacy is a good profession but just different from what it used to be.
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lmao, I thought stoichiometrist was just joking.
Its good that you believe. Most undergrad students do the same when they apply for pharm school.
 
stoichiometrist said:
I think they’re a troll.

A few years ago they kept saying how great pharmacy is and will be, yet recently they made a thread complaining how they have been working only as a tech for the last 5-6 years despite having graduated from pharmacy school.
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I'm actually not doing that anymore. I am now taking classes to complete my application for nursing school.
 
lcow2004 said:
It doesn't mean I can't still believe that over time the field of pharmacy will pick back up. I still think pharmacy is a good profession but just different from what it used to be.
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Please humor us. How will pharmacy pick back up over time? You think there will be a demand for the 15,000 new pharmDs per year and the current pharmDs who are unemployed or underemployed?
 
VictorOfHungerGames said:
Just curious. What are you basing this on?
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The direction of the profession. Dispensing is becoming less and less profitable and the CVS pharmacist down the street produces very little value. Pharmacists are losing their autonomy every day and this is what they want. We're already seeing pharmacies operating where the pharmacists only role is to manage drug therapy and optimize physician productivity. They're midlevels but bottom of the barrel midlevels. $100k a year salaries will be reserved for pharmacists who can actually demonstrate a value to the system.

Let's be honest about community pharmacy. The guys working at Walgreens and CVS only have one responsibility: to make sure the right medication goes to the right patient. What if I told you there were pharmacists out there who actually made sure the patient got the medication?
 
There will eventually be a demand for pharmacist once people decide to put pharmacist into other roles. With what pharmacist do now, there isn't a need for more than 2 of them in most stores and maybe like 6 of them per institution so demand is just not there, esp with dispensing not being profitable for stores due to PBMs and insurances making all there is to be made. When they do find more roles for pharmacist, like doing some of the stuff that nurses do (Which we sort of learn and then proceed to never use ever again in pharmacy school), our wages will inevitably drop to reflect what those roles are.
 
angelsplight said:
There will eventually be a demand for pharmacist once people decide to put pharmacist into other roles. With what pharmacist do now, there isn't a need for more than 2 of them in most stores and maybe like 6 of them per institution so demand is just not there, esp with dispensing not being profitable for stores due to PBMs and insurances making all there is to be made. When they do find more roles for pharmacist, like doing some of the stuff that nurses do (Which we sort of learn and then proceed to never use ever again in pharmacy school), our wages will inevitably drop to reflect what those roles are.
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Our roles cannot expand unless the laws first change. Like when it changed to allow pharmacists to immunize.

But even with all that, the first and the most important problem is PBMs. Majority of pharmacists work in retail setting and PBMs are jacking everything up. Which is the reason why these shady pharmacies start to pop up where theyre exploiting PBM loop holes. Ive seen pharmacies where they cater to certain doctors to write prescriptions for specific topical drugs that reimburse hundreds if not thousands of dollars. These pharmacies have pre-written prescriptions and doctors just check off what ever drug they want to fill in which doctors get a portion of that money. Yes, if proven it would be considered kick back but these people are risking it all for the money.

Not sure how long this can go on but im sure it will soon all back fire.
 
angelsplight said:
There will eventually be a demand for pharmacist once people decide to put pharmacist into other roles. With what pharmacist do now, there isn't a need for more than 2 of them in most stores and maybe like 6 of them per institution so demand is just not there, esp with dispensing not being profitable for stores due to PBMs and insurances making all there is to be made. When they do find more roles for pharmacist, like doing some of the stuff that nurses do (Which we sort of learn and then proceed to never use ever again in pharmacy school), our wages will inevitably drop to reflect what those roles are.
Click to expand...
This is exactly my point. The role of pharmcist will need to expand and when it do, it will increase demand for pharmacists. This is already happening with pharmacists getting provider status so that is why in the long term there will be always be demand for more pharmcist.
 
lcow2004 said:
This is exactly my point. The role of pharmcist will need to expand and when it do, it will increase demand for pharmacists. This is already happening with pharmacists getting provider status so that is why in the long term there will be always be demand for more pharmcist.
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It's unlikely to expand. ARNPs/DNPs and PAs have been growing (growth rate >20% expected for the next decade). Pharmacists will stay in their own lane and schools will start to close down once our wages decline and become a deterrent for future student applicants.
 
lcow2004 said:
This is exactly my point. The role of pharmcist will need to expand and when it do, it will increase demand for pharmacists. This is already happening with pharmacists getting provider status so that is why in the long term there will be always be demand for more pharmcist.
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D6A6E258-D9D8-452C-A2B6-EACAF41B9E4E.jpeg

It’s not going to happen.
 
Lubeckd said:
Let me know when provider status comes and I'll look into this thread
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It was passed this year in Texas. Not sure what that means for the everyday community pharmacist. Like all things, it'll be slow to start and in the end will probably just pile more work onto my already overburdened workload.
 
rxkrafted said:
It's unlikely to expand. ARNPs/DNPs and PAs have been growing (growth rate >20% expected for the next decade). Pharmacists will stay in their own lane and schools will start to close down once our wages decline and become a deterrent for future student applicants.
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I mentioned this in another thread, but PAs have already gained greater autonomy and expanded clinical privileges in the IHS/PHS. Pharmacists could gain provider status tomorrow and it wouldn't matter. Pharmacy education and residency cannot prepare a pharmacist to do the things that a PA or NP can do. There's only so much you can do when all you do is pharmacotherapy for chronic disease management. PAs and NPs have a broader training that makes them a better fit for midlevel duties.

Given that all other healthcare field have better job outlooks, pharmacy schools are already facing a lack of quality applicants. The AACP meeting this past summer was basically a workshop for pharmacy schools designed to get applicant numbers up.

Its gotten so bad, that state schools (even prestigious schools) have begun adopting the gimmicks that the AACP have pushed including:
  • Extending their application deadline.
  • Giving in-state tuition for out-of-state students
  • Dropping the PCAT
  • Devising ways to prop up prepharmacy clubs at universities and community colleges (AKA "developing pipelines")
  • Tricking gullible high schoolers to commit to pharmacy schools (early decision)
  • Sending mailers to students who performed poorly on the MCAT (I have no idea how they get this info)
The only satisfaction I get from this mess is the knowledge that pharmacy schools are losing their prestige at an accelerating rate.
 
Pharm.C. said:
Same old garbage flame war. Pharmacists can provide value. The problem is we live in an inefficient world that doesn't give a damn. We still have freaking real estate agents making thousands because they get to hide listings from you and fill out some forms. Zillow could put them all out on the street overnight. We send people to school for 11 years and spend $600k+ so they can glue wires to teeth as an orthodontist. The world is in a constant state of everyone trying to screw everyone else out of their money. Will the healthcare system of the future actually be incentivized to care about outcomes? Will pharmacists be part of the equation? Whos knows. There's inherent randomness in the universe (see quantum physics). Only time will tell.
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Caring about outcomes will include personal responsibility on patients part...
 
Pharmd = Phake Doctor said:
I mentioned this in another thread, but PAs have already gained greater autonomy and expanded clinical privileges in the IHS/PHS. Pharmacists could gain provider status tomorrow and it wouldn't matter. Pharmacy education and residency cannot prepare a pharmacist to do the things that a PA or NP can do. There's only so much you can do when all you do is pharmacotherapy for chronic disease management. PAs and NPs have a broader training that makes them a better fit for midlevel duties.

Given that all other healthcare field have better job outlooks, pharmacy schools are already facing a lack of quality applicants. The AACP meeting this past summer was basically a workshop for pharmacy schools designed to get applicant numbers up.

Its gotten so bad, that state schools (even prestigious schools) have begun adopting the gimmicks that the AACP have pushed including:
  • Extending their application deadline.
  • Giving in-state tuition for out-of-state students
  • Dropping the PCAT
  • Devising ways to prop up prepharmacy clubs at universities and community colleges (AKA "developing pipelines")
  • Tricking gullible high schoolers to commit to pharmacy schools (early decision)
  • Sending mailers to students who performed poorly on the MCAT (I have no idea how they get this info)
The only satisfaction I get from this mess is the knowledge that pharmacy schools are losing their prestige at an accelerating rate.
Click to expand...
Maybe Aamcas and MCAT sell these lists
 
TikiTorches said:
Psychologists have lobbied for prescribing status in a few states. They have to go thru pa school to get it
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Depends on the state in Illinois it's essentially a PA school curriculum. I know one guy is licensed already in the state there are like 17+ I don't know how many people are actually seeking these credentials. I remember reading a post where you stated Ilinois will never have any RxP psychologists.You underestimated the PsyD's with 300k+ debt who will do anything to pay off those loans. https://alexianfoundation15508.thankyou4caring.org/file/100851_Alexian_Vision_Rev4.1.19-FINAL.pdf According to this in the next 10 years the number of prescribing psychologists will match the number of psychiatrists. I don't know if this statement is necessarily true.
 
BorderlineQueen said:
Depends on the state in Illinois it's essentially a PA school curriculum. I know one guy is licensed already in the state there are like 17+ I don't know how many people are actually seeking these credentials. I remember reading a post where you stated Ilinois will never have any RxP psychologists.You underestimated the PsyD's with 300k+ debt who will do anything to pay off those loans. https://alexianfoundation15508.thankyou4caring.org/file/100851_Alexian_Vision_Rev4.1.19-FINAL.pdf According to this in the next 10 years the number of prescribing psychologists will match the number of psychiatrists. I don't know if this statement is necessarily true.
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Psychologists and the schools, much like nursing, has very effective lobbies with lots of money to get what they want passed.
It took years and years for them to get rxp in Illinois.
 
BorderlineQueen said:
Depends on the state in Illinois it's essentially a PA school curriculum. I know one guy is licensed already in the state there are like 17+ I don't know how many people are actually seeking these credentials. I remember reading a post where you stated Ilinois will never have any RxP psychologists.You underestimated the PsyD's with 300k+ debt who will do anything to pay off those loans. https://alexianfoundation15508.thankyou4caring.org/file/100851_Alexian_Vision_Rev4.1.19-FINAL.pdf According to this in the next 10 years the number of prescribing psychologists will match the number of psychiatrists. I don't know if this statement is necessarily true.
Click to expand...
And I don't consider them Rxp psychologists.
They are doing PA training, so it's like being a PA
 
lcow2004 said:
I heard of this is happening only in some areas too

OHHHMAHHGODD!!! I LOVE this movie but I don't remember Regina George mentioning anything about Provider Status
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There was a whole subplot where she talked to Liz Lemon about how tech-check-tech will free up pharmacist time to perform MTMs.
 
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