Will retail be only option for pharmacist in future ???

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pharmchick21

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i am sure this question has been asked before ..

Will retail be only option for people graduating in next 3- 4 year and so on???

I have interview at pharm. school and i am scared of thought of spending my life working as retail pharmacist..

I just want know this before i commit to 200 K debt...

As of now other career paths are not option for me as i am in late twenties just want to figure out my career.

I have BS in Chemistry. but it's not even that helpful. I want to wait one year to apply to state schools but i feel

like i will be wasting my year and i am already late so ready to settle with private school..

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It depends on several things.

1. location: Are you willing to move to rural areas, where job market is better? Do you need to stay at a certain location?
2. Residency: A lot of hospitals/amb care/non-retail are now requiring a residency just to interview. To get a residency, you will need to do well in school, proly be at least in top in top 20% of your class.
3. FYI, in most classes 65-70% of the class ends up in retail, where majority of the jobs are at. If you despise retail so much, reconsider your decision to go to pharmacy bc high chance that's where you will end up and problem is retail is super saturated in most locations.
 
Retail pharmacy is what pharmacy actually is

If you can't do retail, don't get mixed up in pharmacy

Retail working conditions continue to deteriorate and degrade further and further though. Help keeps getting cut and you are forced to do more and more in less time with less help.
 
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To answer your original question,

No. In 3-4 years retail pharmacy WILL NOT be only employment area for pharmacists. However, those non-retail jobs are the most competitive jobs and they pay less than retail.
 
It depends on several things.

1. location: Are you willing to move to rural areas, where job market is better? Do you need to stay at a certain location?
2. Residency: A lot of hospitals/amb care/non-retail are now requiring a residency just to interview. To get a residency, you will need to do well in school, proly be at least in top in top 20% of your class.
3. FYI, in most classes 65-70% of the class ends up in retail, where majority of the jobs are at. If you despise retail so much, reconsider your decision to go to pharmacy bc high chance that's where you will end up and problem is retail is super saturated in most locations.

People end up in retail ... if they're lucky! People make a career out of retail ... if they're super lucky!! Maybe not much luck needed in BFE Alabama or Louisiana.
 
Retail isn't what it once was, lots of people are begging for hours and working less than 30 hours a week. The bosses see the desperation and the working conditions have suffered as a result.
 
This notion that only retail jobs are available is completely untrue. There are tons of small, rural hospitals that hire pharmacists without residency experience. If you're willing to work in the sticks, the jobs are there and there's money to be made. I'm an example. I work in no-man's-land but I make great money relative to most hospital pharmacists and I do not have residency experience.
 
I think the better question is will dispensing be the only option for pharmacists?

It seems so. Depressing because that can be automated easily.

If we can make a living from our clinical opinions, then that would be our saving grace. Too bad we give that out for free along time ago.
 
i am sure this question has been asked before ..

Will retail be only option for people graduating in next 3- 4 year and so on???

I have interview at pharm. school and i am scared of thought of spending my life working as retail pharmacist..

I just want know this before i commit to 200 K debt...

As of now other career paths are not option for me as i am in late twenties just want to figure out my career.

I have BS in Chemistry. but it's not even that helpful. I want to wait one year to apply to state schools but i feel

like i will be wasting my year and i am already late so ready to settle with private school..
What about PA school? Or AA school?
 
No one should ever pay $200k for a PharmD. Never never never. It is not, has never been and will never be worth that. Just don't do it bro.

I started pharmacy school at 30. Graduated at 34. It's not that bad.
 
I think the better question is will dispensing be the only option for pharmacists?

It seems so. Depressing because that can be automated easily.

If we can make a living from our clinical opinions, then that would be our saving grace. Too bad we give that out for free along time ago.
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Because healthcare is moving away from fee for service (FFS) and towards value-based payment/purchasing (VBP), clinical knowledge and application will be paramount. Pharmacists will be called on more than before to perform clinical duties to improve outcomes because in VBP, poor outcomes = less reimbursement, and medication-related problems are a huge issue.

Hovewer, the lowering of standards for pharmacy education and increase in the number of pharmacy schools ensures that supply outpaces demand... and therefore more pharmacists than ever will be doing retail, and even then, retail is seeing such a glut of pharmacists that many new pharmacists are lucky to even have a job floating from store to store without having a stable staff position. If you want a job with a lot of clinical functions, you'd better attend an established school of pharmacy vs. these increasingly common no-standards "diploma mills", and really excel as a student (ideally, be near the top of your class, perform as a leader, impress your professors and preceptors). Expect to have to do a residency, in which you'll earn less than 50% of a full-fledged pharmacist's salary for at least another year.

It really depends on what you are trying to get out of becoming a pharmacist. But people should understand that it is not a profitable profession in most cases. 4 years of school and $200k+ in tuition. If you would have otherwise made $40,000/year with a job right out of undergraduate school, 4 years in pharmacy school comes with the opportunity cost of $160,000 in lost earnings, in addition to the $200,000 you're paying. That's about $360,000 which doesn't even include the interest on loans. If you owe $200k+, expect to start off paying $10,000 a year in interest - that will decrease over time as you pay off your principal, but over the lifetime of the loan, it will add up to become a lot. In order to even "break even" financially, it will take most new pharmacists more than 10 years (15-20, likely)....maybe 10 years to pay off the loan and another 5-10 years to make it back.

Honestly, nurses will probably make more than pharmacists for the first 15 years and be able to save quicker while they are young...by the time they are in their late 20s or early 30s, they will have less trouble affording weddings, vacations, and buying a house while most pharmacists are struggling to pay off their debt. So if you decide to do go into pharmacy, you should understand that the path will be very difficult, the competition will be stiff, and the financial payoff will not be high - you'd better have some kind of compelling non-financial payoff to justify a decision to become a pharmacist. Most prospective pharmacy students just don't have the maturity to see beyond the alluring, but deceptive $100k salary. They just do not understand the costs and difficulties of being a pharmacist.
 
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As of now other career paths are not option for me as i am in late twenties just want to figure out my career.

Not quite sure I'm understanding. Are you saying at this point, you have no choice but to become a pharmacist? If that's the case, I would highly advise you to re-think. You do not want to enter a profession because you feel that you are out of time in deciding and that you have no other options. You will not be happy. The number one reason for anyone to go into pharmacy right now is that you have a clear understanding of what pharmacists do, you truly have a desire to do that, and you are not afraid to make the sacrifices to get there. And even after you get there, you will be feeling the effects of those sacrifices for a long time. Being a pharmacist can be very rewarding, but not to everyone, and for most who do find it rewarding, those rewards will probably not be monetary/material. It's not just a temporary 4 years of pharmacy school, passing the board exams, then you're out of the woods kind of thing. You will have to predict now how you will weigh those costs against your desire to become a pharmacist.
 
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@Caffeine QAM , talk about a curve ball! After reading your first sentence, I thought to myself that Larry Brown (the dean from Chapman) hacked into your account.. That notion was quickly thrown out the window when you started describing the unpleasant outcome and reality to hit many of these grads in a few years.
 
Because healthcare is moving away from fee for service (FFS) and towards value-based payment/purchasing (VBP), clinical knowledge and application will be paramount. Pharmacists will be called on more than before to perform clinical duties to improve outcomes because in VBP, poor outcomes = less reimbursement, and medication-related problems are a huge issue.

Hovewer, the lowering of standards for pharmacy education and increase in the number of pharmacy schools ensures that supply outpaces demand... and therefore more pharmacists than ever will be doing retail, and even then, retail is seeing such a glut of pharmacists that many new pharmacists are lucky to even have a job floating from store to store without having a stable staff position. If you want a job with a lot of clinical functions, you'd better attend an established school of pharmacy vs. these increasingly common no-standards "diploma mills", and really excel as a student (ideally, be near the top of your class, perform as a leader, impress your professors and preceptors). Expect to have to do a residency, in which you'll earn less than 50% of a full-fledged pharmacist's salary for at least another year.

It really depends on what you are trying to get out of becoming a pharmacist. But people should understand that it is not a profitable profession in most cases. 4 years of school and $200k+ in tuition. If you would have otherwise made $40,000/year with a job right out of undergraduate school, 4 years in pharmacy school comes with the opportunity cost of $160,000 in lost earnings, in addition to the $200,000 you're paying. That's about $360,000 which doesn't even include the interest on loans. If you owe $200k+, expect to start off paying $10,000 a year in interest - that will decrease over time as you pay off your principal, but over the lifetime of the loan, it will add up to become a lot. In order to even "break even" financially, it will take most new pharmacists more than 10 years (15-20, likely)....maybe 10 years to pay off the loan and another 5-10 years to make it back.

Honestly, nurses will probably make more than pharmacists for the first 15 years and be able to save quicker while they are young...by the time they are in their late 20s or early 30s, they will have less trouble affording weddings, vacations, and buying a house while most pharmacists are struggling to pay off their debt. So if you decide to do go into pharmacy, you should understand that the path will be very difficult, the competition will be stiff, and the financial payoff will not be high - you'd better have some kind of compelling non-financial payoff to justify a decision to become a pharmacist. Most prospective pharmacy students just don't have the maturity to see beyond the alluring, but deceptive $100k salary. They just do not understand the costs and difficulties of being a pharmacist.

Correction on the opportunity cost: the 200k includes living expenses, the 160k you added does not.
 
@Caffeine QAM , talk about a curve ball! After reading your first sentence, I thought to myself that Larry Brown (the dean from Chapman) hacked into your account.. That notion was quickly thrown out the window when you started describing the unpleasant outcome and reality to hit many of these grads in a few years.

Hah. Well, I would fully expect a pharmacy school dean to explain the first part but conveniently leave out the second.
 
Because healthcare is moving away from fee for service (FFS) and towards value-based payment/purchasing (VBP), clinical knowledge and application will be paramount. Pharmacists will be called on more than before to perform clinical duties to improve outcomes because in VBP, poor outcomes = less reimbursement, and medication-related problems are a huge issue.

Hovewer, the lowering of standards for pharmacy education and increase in the number of pharmacy schools ensures that supply outpaces demand... and therefore more pharmacists than ever will be doing retail, and even then, retail is seeing such a glut of pharmacists that many new pharmacists are lucky to even have a job floating from store to store without having a stable staff position. If you want a job with a lot of clinical functions, you'd better attend an established school of pharmacy vs. these increasingly common no-standards "diploma mills", and really excel as a student (ideally, be near the top of your class, perform as a leader, impress your professors and preceptors). Expect to have to do a residency, in which you'll earn less than 50% of a full-fledged pharmacist's salary for at least another year.

It really depends on what you are trying to get out of becoming a pharmacist. But people should understand that it is not a profitable profession in most cases. 4 years of school and $200k+ in tuition. If you would have otherwise made $40,000/year with a job right out of undergraduate school, 4 years in pharmacy school comes with the opportunity cost of $160,000 in lost earnings, in addition to the $200,000 you're paying. That's about $360,000 which doesn't even include the interest on loans. If you owe $200k+, expect to start off paying $10,000 a year in interest - that will decrease over time as you pay off your principal, but over the lifetime of the loan, it will add up to become a lot. In order to even "break even" financially, it will take most new pharmacists more than 10 years (15-20, likely)....maybe 10 years to pay off the loan and another 5-10 years to make it back.

Honestly, nurses will probably make more than pharmacists for the first 15 years and be able to save quicker while they are young...by the time they are in their late 20s or early 30s, they will have less trouble affording weddings, vacations, and buying a house while most pharmacists are struggling to pay off their debt. So if you decide to do go into pharmacy, you should understand that the path will be very difficult, the competition will be stiff, and the financial payoff will not be high - you'd better have some kind of compelling non-financial payoff to justify a decision to become a pharmacist. Most prospective pharmacy students just don't have the maturity to see beyond the alluring, but deceptive $100k salary. They just do not understand the costs and difficulties of being a pharmacist.

Great post, in addition, students (even current practitioners) do not put enough emphasis on how liable we are to getting sued.
 
I disagree with some of the posts. I actually think a retail job in a major city will be very difficult to get. Here are some reasons why:

- retail salary continues to grow while hospital salary has not. In some cases, it even dropped.

- don't need to do a residency, fellowship or all of this crap academia throw at you

- there is already a gut of rural pharmacists waiting to transfer

- high demand means more competition which means some people are going to be laid off if they don't keep up. Retail is also cutting which also means more competition.

- if you are good at what you do and do what the company say, a retail job offers a lot of stability with good benefits

I am not optimistic about clinical jobs. First, there is still no way to bill for it. Second, nurse practitioners are already a mile ahead of pharmacists. They can do more like prescribe and they make less money.

The troubling part is competitive undergrads are no longer considering pharmacy as a good career. New grads are graduating with just the minimum work experience. They don't know what is important and what is not important. All they know is what their iPhone tells them which is everything and anything. Low admission standards will lead to a group of subpar new graduates.
 
I disagree with some of the posts. I actually think a retail job in a major city will be very difficult to get. Here are some reasons why:

- retail salary continues to grow while hospital salary has not. In some cases, it even dropped.

- don't need to do a residency, fellowship or all of this crap academia throw at you

- there is already a gut of rural pharmacists waiting to transfer

- high demand means more competition which means some people are going to be laid off if they don't keep up. Retail is also cutting which also means more competition.

- if you are good at what you do and do what the company say, a retail job offers a lot of stability with good benefits

I am not optimistic about clinical jobs. First, there is still no way to bill for it. Second, nurse practitioners are already a mile ahead of pharmacists. They can do more like prescribe and they make less money.

The troubling part is competitive undergrads are no longer considering pharmacy as a good career. New grads are graduating with just the minimum work experience. They don't know what is important and what is not important. All they know is what their iPhone tells them which is everything and anything. Low admission standards will lead to a group of subpar new graduates.


1. I’m not sure anyone is saying that retail jobs will be easy to obtain, but rather, that the majority of pharmacists will only be able to get retail jobs. The question OP asked was “will retail be the only option in the future?” Someone did point out that retail is not necessarily the only option for one willing to compromise on location, e.g. hospital jobs are more likely to be available in rural areas, which is a pretty valid point.


2. Inpatient salaries are definitely lower. Combined with the fact that most inpatient jobs will be difficult to acquire without a residency, more people will be pushed towards retail.


3. There are a lot of people who love their stable retail job. Or they don’t care enough about the downsides for it to outweigh the decent compensation (compensation that far exceeds that of pharmacists in more clinical roles)


4. Agreed...a lot of chains are cutting hours and expecting pharmacists and technicians to get even more work done with less hours.


5. There are ways to bill for clinical services though it depends on the setting. Just have the pharmacists operate under physician protocol – that’s the simplest way and how most ambulatory care clinics and inpatient services that employ pharmacist services work. Also, there are 3rd party administrators that insurance contract with, and who in turn contract with pharmacists to provide medication-related services in outpatient settings. Insurance willingly pay for these services because they recognize that preventative measures cost them much less than what it would for acute care services. In fact, I think one of the quality measures for insurances are that medication management services be provided for patients that meet specific criteria. I can tell you that the reimbursement is not great, but it’s a move in the right direction. One of the major barriers is how to incorporate clinical services in practice – this seems to work very well in integrated healthcare settings that provide well-coordinated care. Not your standard retail pharmacy.


More importantly, the emphasis is for reimbursement to not be on services provided, but the quality of the services and the outcomes. The economic value of pharmacists and basically any other healthcare provider will be seen more and more not as income-generating, as cost-savings in that respect. Therefore, I do not think that clinical roles for pharmacists are diminishing. I see the issue more as clinical positions are becoming harder and harder to obtain because the growing number of pharmacy graduates. ASHP statistics show the number of residency programs growing, but that growth is far exceeded by the number of new schools and students flooding the market.
 
1. I’m not sure anyone is saying that retail jobs will be easy to obtain, but rather, that the majority of pharmacists will only be able to get retail jobs. The question OP asked was “will retail be the only option in the future?” Someone did point out that retail is not necessarily the only option for one willing to compromise on location, e.g. hospital jobs are more likely to be available in rural areas, which is a pretty valid point.


2. Inpatient salaries are definitely lower. Combined with the fact that most inpatient jobs will be difficult to acquire without a residency, more people will be pushed towards retail.


3. There are a lot of people who love their stable retail job. Or they don’t care enough about the downsides for it to outweigh the decent compensation (compensation that far exceeds that of pharmacists in more clinical roles)


4. Agreed...a lot of chains are cutting hours and expecting pharmacists and technicians to get even more work done with less hours.


5. There are ways to bill for clinical services though it depends on the setting. Just have the pharmacists operate under physician protocol – that’s the simplest way and how most ambulatory care clinics and inpatient services that employ pharmacist services work. Also, there are 3rd party administrators that insurance contract with, and who in turn contract with pharmacists to provide medication-related services in outpatient settings. Insurance willingly pay for these services because they recognize that preventative measures cost them much less than what it would for acute care services. In fact, I think one of the quality measures for insurances are that medication management services be provided for patients that meet specific criteria. I can tell you that the reimbursement is not great, but it’s a move in the right direction. One of the major barriers is how to incorporate clinical services in practice – this seems to work very well in integrated healthcare settings that provide well-coordinated care. Not your standard retail pharmacy.


More importantly, the emphasis is for reimbursement to not be on services provided, but the quality of the services and the outcomes. The economic value of pharmacists and basically any other healthcare provider will be seen more and more not as income-generating, as cost-savings in that respect. Therefore, I do not think that clinical roles for pharmacists are diminishing. I see the issue more as clinical positions are becoming harder and harder to obtain because the growing number of pharmacy graduates. ASHP statistics show the number of residency programs growing, but that growth is far exceeded by the number of new schools and students flooding the market.

If all you have to do is work under a physician's protocol, then why are we fighting for provider status? I know a pharmacist who tried to do this and the insurance company just rejected it.

I only see ambulatory care pharmacists working for the VA, Kaiser where they don't have to bill a third party for clinical services. Everything is done in house.
 
If all you have to do is work under a physician's protocol, then why are we fighting for provider status? I know a pharmacist who tried to do this and the insurance company just rejected it.

I only see ambulatory care pharmacists working for the VA, Kaiser where they don't have to bill a third party for clinical services. Everything is done in house.

We have amb care pharmacists in FL, even in my little rinky dink hometown. Not nearly as many as retail or inpatient pharmacists of course, but to say only VA or Kaiser is grossly inaccurate.
 

Hah! I'm so glad you posted this. I was going to do something similar earlier today but I got distracted.

Pharmacists as providers is probably not going to happen. PAs and NPs are skyrocketing. They fulfill the mid-level, primary scare need and do it for less money than a pharmacist would. It's not going to happen for us, just forget about it. Besides, while I'm confident my knowledge of pharmacotherapy is superior to that of your average PA or NP, I know for a fact that I am completely useless for any actual physical examination or any other physical or non-pharmaceutical therapy.
 
I only see ambulatory care pharmacists working for the VA, Kaiser where they don't have to bill a third party for clinical services. Everything is done in house.
Really? A lot of larger hospitals are trying to provide comprehensive care across the continuum because they realize that when they discharge patients who don't get good follow-up care, the patients end up back in the hospital, and this time, the hospital is not being paid. Also, it doesn't look good on their scores. They have their own clinics. It definitely is much more common in integrated systems like the VA and Kaiser who place so much emphasis on preventative care - they have much more of a stake because they are paying for it, so they must recognize the value in it. As mentioned, care provided is much better in these integrated settings. They have better communication and coordination vs if some outpatient pharmacy like CVS, Rite Aid, or WAGs just tried to perform medication management in coordination with the patients' acute care and primary care providers.

Provider status is helpful because you wouldn't need to be under protocol. For those places that already are under protocol, I don't see it as a huge issue, but for institutions that do not have protocol, it provider status would just make it more convincing to provide medication management services. Things don't happen overnight. In California, pharmacists already have provider status, but how long it will take to see the effects of that remains to be seen. But it seems things are heading in that direction. Chances of being reimbursed right now are not that great, unless you work with a 3rd party administrator that knows what they're doing and has already done the work for you and contracted with insurance plans.
 
Because healthcare is moving away from fee for service (FFS) and towards value-based payment/purchasing (VBP), clinical knowledge and application will be paramount. Pharmacists will be called on more than before to perform clinical duties to improve outcomes because in VBP, poor outcomes = less reimbursement, and medication-related problems are a huge issue.

Hovewer, the lowering of standards for pharmacy education and increase in the number of pharmacy schools ensures that supply outpaces demand... and therefore more pharmacists than ever will be doing retail, and even then, retail is seeing such a glut of pharmacists that many new pharmacists are lucky to even have a job floating from store to store without having a stable staff position. If you want a job with a lot of clinical functions, you'd better attend an established school of pharmacy vs. these increasingly common no-standards "diploma mills", and really excel as a student (ideally, be near the top of your class, perform as a leader, impress your professors and preceptors). Expect to have to do a residency, in which you'll earn less than 50% of a full-fledged pharmacist's salary for at least another year.

It really depends on what you are trying to get out of becoming a pharmacist. But people should understand that it is not a profitable profession in most cases. 4 years of school and $200k+ in tuition. If you would have otherwise made $40,000/year with a job right out of undergraduate school, 4 years in pharmacy school comes with the opportunity cost of $160,000 in lost earnings, in addition to the $200,000 you're paying. That's about $360,000 which doesn't even include the interest on loans. If you owe $200k+, expect to start off paying $10,000 a year in interest - that will decrease over time as you pay off your principal, but over the lifetime of the loan, it will add up to become a lot. In order to even "break even" financially, it will take most new pharmacists more than 10 years (15-20, likely)....maybe 10 years to pay off the loan and another 5-10 years to make it back.

Honestly, nurses will probably make more than pharmacists for the first 15 years and be able to save quicker while they are young...by the time they are in their late 20s or early 30s, they will have less trouble affording weddings, vacations, and buying a house while most pharmacists are struggling to pay off their debt. So if you decide to do go into pharmacy, you should understand that the path will be very difficult, the competition will be stiff, and the financial payoff will not be high - you'd better have some kind of compelling non-financial payoff to justify a decision to become a pharmacist. Most prospective pharmacy students just don't have the maturity to see beyond the alluring, but deceptive $100k salary. They just do not understand the costs and difficulties of being a pharmacist.

the post of the century, 100% agree
 
primary scare

LOL

A question for the OP: Have you ever worked in a pharmacy? DO THAT before you make a decision one way or another. Have some vague idea what you're getting into beforehand. People telling you about it is not the same as experiencing it.
 
Really? A lot of larger hospitals are trying to provide comprehensive care across the continuum because they realize that when they discharge patients who don't get good follow-up care, the patients end up back in the hospital, and this time, the hospital is not being paid. Also, it doesn't look good on their scores. They have their own clinics. It definitely is much more common in integrated systems like the VA and Kaiser who place so much emphasis on preventative care - they have much more of a stake because they are paying for it, so they must recognize the value in it. As mentioned, care provided is much better in these integrated settings. They have better communication and coordination vs if some outpatient pharmacy like CVS, Rite Aid, or WAGs just tried to perform medication management in coordination with the patients' acute care and primary care providers.

To me you're not describing an ambulatory care pharmacist in the traditional/academic sense... you're describing the the transition of care pharmacist, as it's called sometimes.

I think that's a much bigger/better role that suits pharmacy. Sure, big systems will have pharmacist run clinics (HTN, Coumadin, Lipid, etc...), but the economics still favor NP's for that role (I think we've hired like 6 NP's over the past year, vs. 1 FTE for RPh role in the same period).

From a deployment standpoint, when you consider the ACO model and how much hinges on preventing readmissions, you can carve out time with your existing clinical pharmacist staff to spend some clinic time, mimicking what some of our physicians do (clinic hours, etc...) No need to mess with bringing in new staff and you can help capture low hanging fruit that way.
 
LOL

A question for the OP: Have you ever worked in a pharmacy? DO THAT before you make a decision one way or another. Have some vague idea what you're getting into beforehand. People telling you about it is not the same as experiencing it.
Yes
 
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Because healthcare is moving away from fee for service (FFS) and towards value-based payment/purchasing (VBP), clinical knowledge and application will be paramount. Pharmacists will be called on more than before to perform clinical duties to improve outcomes because in VBP, poor outcomes = less reimbursement, and medication-related problems are a huge issue.

Hovewer, the lowering of standards for pharmacy education and increase in the number of pharmacy schools ensures that supply outpaces demand... and therefore more pharmacists than ever will be doing retail, and even then, retail is seeing such a glut of pharmacists that many new pharmacists are lucky to even have a job floating from store to store without having a stable staff position. If you want a job with a lot of clinical functions, you'd better attend an established school of pharmacy vs. these increasingly common no-standards "diploma mills", and really excel as a student (ideally, be near the top of your class, perform as a leader, impress your professors and preceptors). Expect to have to do a residency, in which you'll earn less than 50% of a full-fledged pharmacist's salary for at least another year.

It really depends on what you are trying to get out of becoming a pharmacist. But people should understand that it is not a profitable profession in most cases. 4 years of school and $200k+ in tuition. If you would have otherwise made $40,000/year with a job right out of undergraduate school, 4 years in pharmacy school comes with the opportunity cost of $160,000 in lost earnings, in addition to the $200,000 you're paying. That's about $360,000 which doesn't even include the interest on loans. If you owe $200k+, expect to start off paying $10,000 a year in interest - that will decrease over time as you pay off your principal, but over the lifetime of the loan, it will add up to become a lot. In order to even "break even" financially, it will take most new pharmacists more than 10 years (15-20, likely)....maybe 10 years to pay off the loan and another 5-10 years to make it back.

Honestly, nurses will probably make more than pharmacists for the first 15 years and be able to save quicker while they are young...by the time they are in their late 20s or early 30s, they will have less trouble affording weddings, vacations, and buying a house while most pharmacists are struggling to pay off their debt. So if you decide to do go into pharmacy, you should understand that the path will be very difficult, the competition will be stiff, and the financial payoff will not be high - you'd better have some kind of compelling non-financial payoff to justify a decision to become a pharmacist. Most prospective pharmacy students just don't have the maturity to see beyond the alluring, but deceptive $100k salary. They just do not understand the costs and difficulties of being a pharmacist.

I really don't see this happening unless we get reimbursed for better outcomes and that isn't going to happen without prescriptive authority. It's good to be optimistic though and I do hope the profession progress as you have imagined in your post but that is far from the reality or even a trending reality.

The residency requirement is just a consequence of the excess labor market.
 
To me you're not describing an ambulatory care pharmacist in the traditional/academic sense... you're describing the the transition of care pharmacist, as it's called sometimes.

I think that's a much bigger/better role that suits pharmacy. Sure, big systems will have pharmacist run clinics (HTN, Coumadin, Lipid, etc...), but the economics still favor NP's for that role (I think we've hired like 6 NP's over the past year, vs. 1 FTE for RPh role in the same period).

From a deployment standpoint, when you consider the ACO model and how much hinges on preventing readmissions, you can carve out time with your existing clinical pharmacist staff to spend some clinic time, mimicking what some of our physicians do (clinic hours, etc...) No need to mess with bringing in new staff and you can help capture low hanging fruit that way.

I actually had both TOC and ambulatory care pharmacists in mind (TOCs on the acute care end and ambulatory care on the receiving follow-up end). I was talking about clinical services in general, but someone just mentioned ambulatory care. I don't think it's that uncommon for healthcare systems other than VA and Kaiser that provide across a continum to employ ambulatory care pharmacists. I don't know much about how NPs are doing in that role, but imagine that what you say is probably true in terms of economics. I feel pharmacists are better suited for the role because of the pervasiveness of medication-related issues in high risk patients ( transplant, COPD, heart failure)... NPs are not as well-versed in detecting or resolving those problems. Not to say that they cannot. We probably don't know what the difference in impact would be, and I imagine much of it would have to do with the overall quality of the program and how well it's administered rather than whether the clinicians responsible for the care provided were primarily pharmacists or NPs. It would be interesting if there were some studies on that area though.
 
I really don't see this happening unless we get reimbursed for better outcomes and that isn't going to happen without prescriptive authority. It's good to be optimistic though and I do hope the profession progress as you have imagined in your post but that is far from the reality or even a trending reality.

The residency requirement is just a consequence of the excess labor market.

By "we", I'm assuming you are referring to pharmacists? It really depends on what setting you're talking about. Sure, pharmacists may not be directly reimbursed as in a medical office that sees patients and receives reimbursement for every patient they see. But other providers provide the same services and they do get reimbursed. For this reason, pharmacists cannot run their own clinic (no prescriptive authority, as you mention, is the other half of it) - however this it not really an issue for pharmacists under protocol. Many settings that employ pharmacists for clinical services already are being reinbursed for better outcomes - or rather, a more accurate way of stating it is that reimbursement is being withheld for poorer outcomes. In the context of healthcare institutions that this does occur, outcome based goals justify the need for clinical services that may be provided by pharmacists, and in some cases, best provided by pharmacists.

The residency requirement is in part due to the increasingly competitive nature of the market, but the other half of that is the competency. Honestly, seeing many of the new pharmacy student graduates, I would not trust most of them to provide clinical services at the level that we need straight out of school. The fact that they could pass the board exam does not make them competent to practice at that level. It doesn't mean that straight of school pharmacists are not competent - some may very well be, but really most of them are not, and even so, I would rather take a pharmacist battle-hardened by 1 year of experience under the guidance of an established residency program over a highly competent new graduate. Part of it could be the failure of pharmacy schools to actually train students up to that level. I really do not trust many pharmacy schools nowadays...the standards are kind of blown.
 
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What about PA school? Or AA school?
I would love to be PA but i heard its super difficult to get in this days since everyone is trying to go there. I would need 2-3 years of MA or CRNA or EMT experience.. Even after that its not possible.. I heard people applying for 2-3 cycles waiting to get in..
 
I would love to be PA but i heard its super difficult to get in this days since everyone is trying to go there. I would need 2-3 years of MA or CRNA or EMT experience.. Even after that its not possible.. I heard people applying for 2-3 cycles waiting to get in..

And, as we all know, these days, literally anyone, can get into pharmacy school.
 
We have amb care pharmacists in FL, even in my little rinky dink hometown. Not nearly as many as retail or inpatient pharmacists of course, but to say only VA or Kaiser is grossly inaccurate.

Only amb care pharmacists I've seen in GA, other than VA/Kaiser, are pharmacy school faculty who have an agreement with the hospital. And they usually only work there a few times a month. I've been to most of the major hospitals in the state, so maybe it's different in FL, but it's not that inaccurate for my state.
 
This notion that only retail jobs are available is completely untrue. There are tons of small, rural hospitals that hire pharmacists without residency experience. If you're willing to work in the sticks, the jobs are there and there's money to be made. I'm an example. I work in no-man's-land but I make great money relative to most hospital pharmacists and I do not have residency experience.
Can you tell me where these rural hospitals are? I would love to apply
 
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Can you tell where these rural hospitals are? I would love to apply

Google "cities with populations below 500k", pick one you like, go to Google maps and type in that city name + hospitals and start looking. That's basically how I got my first gig.
 
And, as we all know, these days, literally anyone, can get into pharmacy school.

All i was saying that is its very competitive to get in to PA program, My GPA might meet the requirement for PA but i simply don't have time and patience for that experience.. Yes, thats true its easy to get in to pharm school these days specially newly opened schools.. But I am not going for "new" schools...
 
All i was saying that is its very competitive to get in to PA program, My GPA might meet the requirement for PA but i simply don't have time and patience for that experience.. Yes, thats true its easy to get in to pharm school these days specially newly opened schools.. But I am not going for "new" schools...

There is nothing wrong with what you said. You stated accurate facts. When I was applying to school, my school has 13 apps per spot, now it's more in the 7 to 10 range. Some schools I heard there is literally about 3 applicants per spot. It's just the landscape of pharmacy in 2016.

For goodness sake my Facebook adds are advertising earn your pharmd in just 34 month in Massachusetts. What that tell you?
 
There is nothing wrong with what you said. You stated accurate facts. When I was applying to school, my school has 13 apps per spot, now it's more in the 7 to 10 range. Some schools I heard there is literally about 3 applicants per spot. It's just the landscape of pharmacy in 2016.

For goodness sake my Facebook adds are advertising earn your pharmd in just 34 month in Massachusetts. What that tell you?
It's turning into a joke, what else is new?
 
There is nothing wrong with what you said. You stated accurate facts. When I was applying to school, my school has 13 apps per spot, now it's more in the 7 to 10 range. Some schools I heard there is literally about 3 applicants per spot. It's just the landscape of pharmacy in 2016.

For goodness sake my Facebook adds are advertising earn your pharmd in just 34 month in Massachusetts. What that tell you?

Can I ask what school you attended?
 
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