What do you see the Pharmacy profession looking like in 10 years?
Started by Gnostic.Spirit
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I'd be hopefully out of pharmacy by then and working for Blizzard Entertainment or something
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Follow the money.
Obamacare: pharmacy professors and students thought Obamacare would create jobs. I had said Obamacare will cost jobs because the purpose of Obamacare is about doing more with less. It is about cutting the extra fat and there is a lot of waste in healthcare (good for us, bad for the taxpayers). So what happened? Companies merged and consolidated. Here's a perfect example:
Generic manufacturers merged so they would have more negotiation power. As a result, companies that have used a pharmacy to draw customers into their stores suffered since they don't have as much negotation power as CVS. Companies like Target, Walmart. Target sold all of their pharmacies to CVS. CVS will then "cut the extra fat" by closing down some stores, cutting hours and getting rid of people at Target pharmacy corporate office. This is not exclusive to just retail. Hospitals are doing the same thing too.
Obamacare: pharmacy professors and students thought Obamacare would create jobs. I had said Obamacare will cost jobs because the purpose of Obamacare is about doing more with less. It is about cutting the extra fat and there is a lot of waste in healthcare (good for us, bad for the taxpayers). So what happened? Companies merged and consolidated. Here's a perfect example:
Generic manufacturers merged so they would have more negotiation power. As a result, companies that have used a pharmacy to draw customers into their stores suffered since they don't have as much negotation power as CVS. Companies like Target, Walmart. Target sold all of their pharmacies to CVS. CVS will then "cut the extra fat" by closing down some stores, cutting hours and getting rid of people at Target pharmacy corporate office. This is not exclusive to just retail. Hospitals are doing the same thing too.
What I wish would happen:
Pharmacists get full provider status and can practice state-wide at the top of their abilities. They'll be managing chronic conditions, billing for office visits, running pharmacotherapy clinics in their area of specialty, working alongside physicians and others on a healthcare-team and provide billable clinical services for patients. New jobs are made, retail pays more to keep up, pharmacists get to actually use their PharmD.
Through legislation, PBMs will stop their abusive practices of underpaying pharmacies, having them operate at losses and fiddling with drug pricing to benefit them, hurt the patient, and hurt the pharmacy. Quality measures will be enacted as forms of payment as those pharmacists that counsel appropriately and provide community health services are reimbursed at higher rates, similar to how hospitals are tending. This would put more focus on providing care, cognitive abilities, and less on the act of dispensing.
Retail pharmacies will have incentive to staff to ethical levels instead of under-staffing and demanding more from what you have. Patient care will be the focus, as providing superior care is what is going to bring in more money instead of it being tied directly the amount of product sold.
What will probably actually happen:
Schools will push more for residencies and clinical practice, pharmacists still won't be able to bill insurance and thus payment for these jobs will not exist. You'll be employed by a hospital to do medical gruntwork for less pay than retail counterparts all the while institutions get "residents" to work 65+ hours a week for 1/3 the pay. State laws won't change to expand scopes of practice but schools will still sell the idea of clinical pharmacy and diminish community practice (similar to how some MD schools treat primary care and want everyone into specialties). You'll be prepared to manage your patients Hypertension, diabetes, CHF, and asthma as well as do complex MTM and CMR, but you won't know how to practically handle verifying, answering 2 phone calls and managing drug seekers all at the same time.
As PBMs continue their abuse, retail pharmacies will buy out more feeding into the problem while demanding more work with less help.
Pharmacy organizations will pander to chain interests, do nothing about saturation, wages, working conditions, ethical practices and push a continual message of "it's going to get better" and dangle the pipe-dream of pharmacist clinicians in healthcare settings with pharmacists doing more for public health in retail settings.
Realistically provider status may pass.... but only for medically undeserved areas at this moment in time. Some states are expanding scopes like California which recently took a big leap but they have yet to implement ways to pay for these expanded scopes to make it practical. The current provider status bill is not enough, if you are competent and valuable in undeserved areas you should be able to bill fairly everywhere. If you argue you provide superior care and save money that should be available to all people, not just as a band-aid in areas where their aren't enough physicians or mid-levels.
Pharmacists get full provider status and can practice state-wide at the top of their abilities. They'll be managing chronic conditions, billing for office visits, running pharmacotherapy clinics in their area of specialty, working alongside physicians and others on a healthcare-team and provide billable clinical services for patients. New jobs are made, retail pays more to keep up, pharmacists get to actually use their PharmD.
Through legislation, PBMs will stop their abusive practices of underpaying pharmacies, having them operate at losses and fiddling with drug pricing to benefit them, hurt the patient, and hurt the pharmacy. Quality measures will be enacted as forms of payment as those pharmacists that counsel appropriately and provide community health services are reimbursed at higher rates, similar to how hospitals are tending. This would put more focus on providing care, cognitive abilities, and less on the act of dispensing.
Retail pharmacies will have incentive to staff to ethical levels instead of under-staffing and demanding more from what you have. Patient care will be the focus, as providing superior care is what is going to bring in more money instead of it being tied directly the amount of product sold.
What will probably actually happen:
Schools will push more for residencies and clinical practice, pharmacists still won't be able to bill insurance and thus payment for these jobs will not exist. You'll be employed by a hospital to do medical gruntwork for less pay than retail counterparts all the while institutions get "residents" to work 65+ hours a week for 1/3 the pay. State laws won't change to expand scopes of practice but schools will still sell the idea of clinical pharmacy and diminish community practice (similar to how some MD schools treat primary care and want everyone into specialties). You'll be prepared to manage your patients Hypertension, diabetes, CHF, and asthma as well as do complex MTM and CMR, but you won't know how to practically handle verifying, answering 2 phone calls and managing drug seekers all at the same time.
As PBMs continue their abuse, retail pharmacies will buy out more feeding into the problem while demanding more work with less help.
Pharmacy organizations will pander to chain interests, do nothing about saturation, wages, working conditions, ethical practices and push a continual message of "it's going to get better" and dangle the pipe-dream of pharmacist clinicians in healthcare settings with pharmacists doing more for public health in retail settings.
Realistically provider status may pass.... but only for medically undeserved areas at this moment in time. Some states are expanding scopes like California which recently took a big leap but they have yet to implement ways to pay for these expanded scopes to make it practical. The current provider status bill is not enough, if you are competent and valuable in undeserved areas you should be able to bill fairly everywhere. If you argue you provide superior care and save money that should be available to all people, not just as a band-aid in areas where their aren't enough physicians or mid-levels.
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Anybody who is selling this provider status crap is just selling false hope. The bill that was passed in CA is limited in its scope of practice. Smoking cessation? Ordering lab test? Pharmacists are already doing that. The only difference is they are working under a protocol. It does nothing about reimbursement. You cant force medicare or the insurance companies to pay you.
Who in the hell is going to do 2-4 years undergrad + 4 years pharmacy + 1-2 years residency so he can work as a "pharmacy provider" in some rural part of the country and make less than a retail pharmacist? Do you want to spend the rest of your youth on an indian reservation?
The big elephant in the room is nurse practitioner. Not only can they prescribe and do things pharmacists cant do like diagnose, they also makes less money. Provider status is the new buzz word pharmacy school is using to get gullible students to enroll in their 250 k program.
I think as things trend they may make more money in the future. Some fields like CRNA make more, and right now they are approaching the 100k mark (along with PA) while pharmacist wages remain stagnant in growth as it seems. I think NPs are also pushing for independent practice (something PA's aren't) and in some states they don't even need a supervising physician anymore to contract under in order to provide their services. Sometimes I regret not going into nursing and going for NP, I'd already be done with school by now and could function as a clinician with less debt making roughly 90k a year.
Almost out of pharmacy school I do feel like we are a duped. We get sold on clinical pharmacy, provider stats, team based care, pharmacotherapy clinics and other stuff thrown at us and we are educated to do that yet it isn't practical. You learn so much only to realize it's not legal for you to use your knowledge. At least ACPE seems to try to do things by making employment stats a requirements for accreditation, but schools can just make their own residencies and count that as "employment" if they fall behind.
I think pharmacy is still a good field, but our schools aren't realistic regarding actual pharmacy practice and it leaves a bitter taste in students mouths (at least mine) to realize these clinical jobs you are trained to do either don't exist or are illegal and if you wanted to do these things you should have gone to med school or NP/PA school. I started off wanting retail, fell in love with clinical, and will probably settle in retail for a while. If I can make 120k a year at a decent retail gig in a city I won't be too upset. I'm willing to move (and will likely have to move as my city is extremely saturated).
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Salaries decrease to $40/hour. Pharmacy schools closing down due to being unable to fill up enough seats. Unemployment in the 20% figures.
Some pot dispensary pharmacy becomes a fortune 500 company. Also, vertically stacked drive-thru lanes to accommodate the flying cars.
