Will technology replace retail jobs? Will hospital salaries outstrip retail?

[Rybko90]

Looking for some advice and perspective.

2018 Grad.

Working CVS. $60 an hour. Overnight shift 7 days on 7 days off. Store is ten minutes from where I live. Perfect job really for me. I don't mind the CVS pace. I can't stand not being busy.

Here's the bottom line: if I knew that retail pharmacy would be around for the next 40 years, I'd stay retail. The job is easy. I'm good at it.

Here are the doubts:

A) At our chain there are now E-scribed scripts that are completely typed and verified by the computer system. I'm not talking about refills. I'm talking about first-fill. All I'm doing is verifying that the pill is the right one. I'm not exaggerating when I say that an 8-year old could verify such a script. Sure, I do have to make all the decisions on drug interactions. The computer flags these but it has no idea what's significant and what's not. I guess that's something.

B) Along with everyone else, I'm also seeing tremendous negative wage and hours pressure in retail. Walgreens is now hiring at $10 an hour less than I make, and I'm hearing that the final goal is $45 an hour. What's to stop a chain from trying to push out someone who makes $60 an hour to get a fresh new grad at $45?

C) I can honestly do my job as well as a pharmacist who has been there 10 years right now. In many cases, I can do the job faster than a pharmacist who has been there 20 years. They've burned out. I'm fresh. In 20 years, I'll be slower. Then what?

Considering reapplying for residency and going hard at it this year. Applied for residency last cycle on a whim. Last-minute application slapped together. 2 interviews, didn't match. However Studying for the NAPLEX, I actually really got interested in the clinical side of things. I could read about Infectious Diseases all day, honestly. So I'm considering going for it again. However,if I matched I'd be giving up a job in my home market at $60 an hour. All without guarantee of having a hospital job. It would be an investment solely based on the future of pharmacy for the next 40 years. Huge decision.

On top of that, I'd be giving up a job with CVS. For me, with their acquisition of Aetna and their massive overall structure including things like Omnicare, I think CVS is the place to be in retail right now. At the very least, they will be the company best prepared to tackle an entry from Amazon.

Here are the key questions:

1. How much do you think automation and technology will replace retail pharmacists in the next 10-20 years? In 20 years, does anyone see a worse-case scenario future where we have 4-5 chain pharmacies manned by technicians only, with one pharmacist doing the verification and doing counseling through video technology when necessary? Of course, this would require a change in the laws.

2. Is a clinical, hospital-based skill-set more protected from technological innovation, or will hospital pharmacists face the same barriers? Of course, a clinical skill-set is at least much more protected from influx of new grads than a retail pharmacy skill set.

3. With the current downward trend in salaries in retail pharmacy be reflected in hospital pharmacy, or will hospital pharmacists with a clinical skill set soon command a greater salary than a retail pharmacist?

Any and all input is appreciated!

---

Members don't see this ad.

 

[Rouelle]

1. There has to be a licensed individual to take the fall when something goes bad. Retail pharmacists fill that role and, thus, aren’t going anywhere.

2. I would tend to think somewhat more protected, yes. You see a larger pharmacist:tech ratio in hospital than in retail. That should tell you something.

3. More people want to work hospital than retail, and there are fewer hospital jobs. It’s not what you can do that counts, but rather what someone else will do it for.

 

[DOOM N GLOOM]

Looking for some advice and perspective.

2018 Grad.

Working CVS. $60 an hour. Overnight shift 7 days on 7 days off. Store is ten minutes from where I live. Perfect job really for me. I don't mind the CVS pace. I can't stand not being busy.

Here's the bottom line: if I knew that retail pharmacy would be around for the next 40 years, I'd stay retail. The job is easy. I'm good at it.

Here are the doubts:

A) At our chain there are now E-scribed scripts that are completely typed and verified by the computer system. I'm not talking about refills. I'm talking about first-fill. All I'm doing is verifying that the pill is the right one. I'm not exaggerating when I say that an 8-year old could verify such a script. Sure, I do have to make all the decisions on drug interactions. The computer flags these but it has no idea what's significant and what's not. I guess that's something.

B) Along with everyone else, I'm also seeing tremendous negative wage and hours pressure in retail. Walgreens is now hiring at $10 an hour less than I make, and I'm hearing that the final goal is $45 an hour. What's to stop a chain from trying to push out someone who makes $60 an hour to get a fresh new grad at $45?

C) I can honestly do my job as well as a pharmacist who has been there 10 years right now. In almost all cases, I can do the job better than a pharmacist who has been there 20 years. They've burned out. I'm fresh. In 20 years, I'll be slower. Then what?

Considering reapplying for residency and going hard at it this year. Applied for residency last cycle on a whim. Last-minute application slapped together. 2 interviews, didn't match. However Studying for the NAPLEX, I actually really got interested in the clinical side of things. I could read about Infectious Diseases all day, honestly. So I'm considering going for it again. However,if I matched I'd be giving up a job in my home market at $60 an hour. All without guarantee of having a hospital job. It would be an investment solely based on the future of pharmacy for the next 40 years. Huge decision.

Here are the key questions:

1. How much do you think automation and technology will replace retail pharmacists in the next 10-20 years? In 20 years, does anyone see a worse-case scenario future where we have 4-5 chain pharmacies manned by technicians only, with one pharmacist doing the verification and doing counseling through video technology when necessary? Of course, this would require a change in the laws.

2. Is a clinical, hospital-based skill-set more protected from technological innovation, or will hospital pharmacists face the same barriers? Of course, a clinical skill-set is at least much more protected from influx of new grads than a retail pharmacy skill set.

3. With the current downward trend in salaries in retail pharmacy be reflected in hospital pharmacy, or will hospital pharmacists with a clinical skill set soon command a greater salary than a retail pharmacist?

Any and all input is appreciated!

1. Yes. As a matter of fact, Florida is exploring this right now (last I’ve read, these kinds of arrangements have been brought up in legislature but haven’t officially passed yet). Retail chains have got to be licking their chops at the idea of one remote pharmacist verifying prescriptions for 4 brick-and-mortar pharmacies.

2. Artificial intelligence and machine learning are going to replace anything that can potentially be automated in the next 15-20 years. You have to be more specific when you talk about having a “clinical skill-set” as a hospital pharmacist because if by that you mean you can memorize all the side effects, DDI’s and spectrum of activity of antibiotics, then guess what? There’s a computer that can memorize 10000x more information than you with 100% accuracy.

3. My view on this is that hospital pharmacists will always make more than retail pharmacists (if you factor in number of hours you get paid for per pay period) because the money is going to be where the pharmacists who are more credentialed are at. Seeing as how hospitals require PGY1’s at a minimum and PGY2/PGY3’s for clinical positions now, I would think that your PGY3 grad would probably make more than a retail pharmacist. Granted, I think the salaries of both types of roles would be <100k in the future so job stability is probably more key here.

 

[Rybko90]

2. Artificial intelligence and machine learning are going to replace anything that can potentially be automated in the next 15-20 years. You have to be more specific when you talk about having a “clinical skill-set” as a hospital pharmacist because if by that you mean you can memorize all the side effects, DDI’s and spectrum of activity of antibiotics, then guess what? There’s a computer that can memorize 10000x more information than you with 100% accuracy.
.

Very true. I see your point. However, it's one thing to have a computer flag all the drug interactions, doses, side-effects. It's another thing to have, say, a seasoned infectious disease specialist, having seen thousands of cases, be able to assess a particular patient and what would be the best antibiotic treatment choice for a patient, while working in congruence with this technology in order to make the best decision. At least, that's what I would like to think! At the current pace of technological innovation, you never know!

 

[Gombrich12]

"A) At our chain there are now E-scribed scripts that are completely typed and verified by the computer system. I'm not talking about refills. I'm talking about first-fill. All I'm doing is verifying that the pill is the right one. I'm not exaggerating when I say that an 8-year old could verify such a script. Sure, I do have to make all the decisions on drug interactions. The computer flags these but it has no idea what's significant and what's not. I guess that's something."

That sounds quite unsafe with the frequency of input errors by prescribers and nurses using escribe. I've never heard anyone else at CVS say their system works this way, can someone confirm?

 

[Hibiclens]

Looking for some advice and perspective.

2018 Grad.

Working CVS. $60 an hour. Overnight shift 7 days on 7 days off. Store is ten minutes from where I live. Perfect job really for me. I don't mind the CVS pace. I can't stand not being busy.

Here's the bottom line: if I knew that retail pharmacy would be around for the next 40 years, I'd stay retail. The job is easy. I'm good at it.

Here are the doubts:

A) At our chain there are now E-scribed scripts that are completely typed and verified by the computer system. I'm not talking about refills. I'm talking about first-fill. All I'm doing is verifying that the pill is the right one. I'm not exaggerating when I say that an 8-year old could verify such a script. Sure, I do have to make all the decisions on drug interactions. The computer flags these but it has no idea what's significant and what's not. I guess that's something.

B) Along with everyone else, I'm also seeing tremendous negative wage and hours pressure in retail. Walgreens is now hiring at $10 an hour less than I make, and I'm hearing that the final goal is $45 an hour. What's to stop a chain from trying to push out someone who makes $60 an hour to get a fresh new grad at $45?

C) I can honestly do my job as well as a pharmacist who has been there 10 years right now. In many cases, I can do the job faster than a pharmacist who has been there 20 years. They've burned out. I'm fresh. In 20 years, I'll be slower. Then what?

Considering reapplying for residency and going hard at it this year. Applied for residency last cycle on a whim. Last-minute application slapped together. 2 interviews, didn't match. However Studying for the NAPLEX, I actually really got interested in the clinical side of things. I could read about Infectious Diseases all day, honestly. So I'm considering going for it again. However,if I matched I'd be giving up a job in my home market at $60 an hour. All without guarantee of having a hospital job. It would be an investment solely based on the future of pharmacy for the next 40 years. Huge decision.

On top of that, I'd be giving up a job with CVS. For me, with their acquisition of Aetna and their massive overall structure including things like Omnicare, I think CVS is the place to be in retail right now. At the very least, they will be the company best prepared to tackle an entry from Amazon.

Here are the key questions:

1. How much do you think automation and technology will replace retail pharmacists in the next 10-20 years? In 20 years, does anyone see a worse-case scenario future where we have 4-5 chain pharmacies manned by technicians only, with one pharmacist doing the verification and doing counseling through video technology when necessary? Of course, this would require a change in the laws.

2. Is a clinical, hospital-based skill-set more protected from technological innovation, or will hospital pharmacists face the same barriers? Of course, a clinical skill-set is at least much more protected from influx of new grads than a retail pharmacy skill set.

3. With the current downward trend in salaries in retail pharmacy be reflected in hospital pharmacy, or will hospital pharmacists with a clinical skill set soon command a greater salary than a retail pharmacist?

Any and all input is appreciated!

Typed AND verified by a computer?

 

[Rybko90]

Yes, typed and verified by a computer.

These are a very few scripts, in which the doses are standardized and all the directions are simple and match the usual dosage for the medication. For example, Atorvastatin 20mg 1T;PO;QD. All the patient information has to match exactly between the doctor's system and our system as well. We still have the option to view the directions if we want to to check. I've been checking everything and I've never found an error.

Edit: I'm relatively new, but now that I think about it, it may also just be on scripts that were previously requested for refill from the doctor and the refill directions matched the previous directions. I'll confirm this next shift I work. If that's the case, then I guess it's not so bad. It would technically be a new script but might as well be a refill.

 

[DOOM N GLOOM]

Very true. I see your point. However, it's one thing to have a computer flag all the drug interactions, doses, side-effects. It's another thing to have, say, a seasoned infectious disease specialist, having seen thousands of cases, be able to assess a particular patient and what would be the best antibiotic treatment choice for a patient, while working in congruence with this technology in order to make the best decision. At least, that's what I would like to think! At the current pace of technological innovation, you never know!

What’s going to be important is not necessarily knowing how to assess a patient and optimal choice of pharmacotherapy but understanding how to strip down those decisions into algorithms. Once you get the algorithms down, then assessing even complex patient cases can become automated. You just need skilled people to do it but this is going to be the way of the future.

 

[pencilandpen]

you cant predict the future but you can do your best to prepare for it
if you do stick with your CVS job, best to pay off your loans ASAP if you have them and save up for a rainy day if one day your job does get replaced.
also live below your means.

 

[lord999]

I am not so sure that hospitals would be the long-term answer either. The one thing that changes the game for everyone is the postponed Medicare/Medicaid reform. If rates are cut like they should be (like under a Greenspan Commission style tasking), no one in medicine is safe. What I see in the bubble are all of those new nurses who have come from every single background and in quite a number of cases, should have never been in the health professions to begin with. Much of medicine, including the most conservative politics among the physicians, know that a reckoning to the CPT/RBRVU reimbursement would have a cascading effect on their livelihoods. That would be a hospital merger and acquisition spree that would doom all but the Certificate of Necessity and Religious Hospital chains that already have the horizontal integration to win the board (HCA's business model is to buy up every CoN and then turn around and force the insurance networks to give more favorable terms as well as do the dirty work outside regulatory supervision).

There is an incentive though for the pharmacy companies to still support pharmacists reluctantly. If pharmacy becomes purely a distributive logistics game, then the big two (UPS and XPO) decisively win the game for the non-retail segment, and the insurmountable supply chain for Walmart wins the retail segment (sure there will be small time players, but the corporate era will not last under a non-pharmacist situation). Getting paid $60 for the work today is a pay cut from me getting $41 in 2004 as my work was much less productive then than yours has to be today. Unless the money game changes drastically, I don't see any reason why you are all gone. They said that automation would eliminate us all 15-20 years ago, and yet here you all are.

Just enjoy the work for what it is. Figure out as you work to develop some sideline, but you are already too committed at this point that you should not throw away a good thing for a maybe. When it happens, you'll know. As far as jobs go, there is no long-term future in anything that provides such a return on investment like what we have right now in the health professions. If I were you though, I would be very cautious before getting into "sticky" financial arrangements unless I felt good about being able to make it work (so, I would not exactly buy a house that would financially require you to pay 30 year mortgage, only get one that you could afford in 10 years even if you term it at 30).

 

[Rybko90]

I am not so sure that hospitals would be the long-term answer either. The one thing that changes the game for everyone is the postponed Medicare/Medicaid reform. If rates are cut like they should be (like under a Greenspan Commission style tasking), no one in medicine is safe. What I see in the bubble are all of those new nurses who have come from every single background and in quite a number of cases, should have never been in the health professions to begin with. Much of medicine, including the most conservative politics among the physicians, know that a reckoning to the CPT/RBRVU reimbursement would have a cascading effect on their livelihoods. That would be a hospital merger and acquisition spree that would doom all but the Certificate of Necessity and Religious Hospital chains that already have the horizontal integration to win the board (HCA's business model is to buy up every CoN and then turn around and force the insurance networks to give more favorable terms as well as do the dirty work outside regulatory supervision).

There is an incentive though for the pharmacy companies to still support pharmacists reluctantly. If pharmacy becomes purely a distributive logistics game, then the big two (UPS and XPO) decisively win the game for the non-retail segment, and the insurmountable supply chain for Walmart wins the retail segment (sure there will be small time players, but the corporate era will not last under a non-pharmacist situation). Getting paid $60 for the work today is a pay cut from me getting $41 in 2004 as my work was much less productive then than yours has to be today. Unless the money game changes drastically, I don't see any reason why you are all gone. They said that automation would eliminate us all 15-20 years ago, and yet here you all are.

Just enjoy the work for what it is. Figure out as you work to develop some sideline, but you are already too committed at this point that you should not throw away a good thing for a maybe. When it happens, you'll know. As far as jobs go, there is no long-term future in anything that provides such a return on investment like what we have right now in the health professions. If I were you though, I would be very cautious before getting into "sticky" financial arrangements unless I felt good about being able to make it work (so, I would not exactly buy a house that would financially require you to pay 30 year mortgage, only get one that you could afford in 10 years even if you term it at 30).

Thank you for this well thought-out input. Sincerely.

 

[Modest_anteater]

Looking for some advice and perspective.

2018 Grad.

Working CVS. $60 an hour. Overnight shift 7 days on 7 days off. Store is ten minutes from where I live. Perfect job really for me. I don't mind the CVS pace. I can't stand not being busy.

Here's the bottom line: if I knew that retail pharmacy would be around for the next 40 years, I'd stay retail. The job is easy. I'm good at it.

Here are the doubts:

A) At our chain there are now E-scribed scripts that are completely typed and verified by the computer system. I'm not talking about refills. I'm talking about first-fill. All I'm doing is verifying that the pill is the right one. I'm not exaggerating when I say that an 8-year old could verify such a script. Sure, I do have to make all the decisions on drug interactions. The computer flags these but it has no idea what's significant and what's not. I guess that's something.

B) Along with everyone else, I'm also seeing tremendous negative wage and hours pressure in retail. Walgreens is now hiring at $10 an hour less than I make, and I'm hearing that the final goal is $45 an hour. What's to stop a chain from trying to push out someone who makes $60 an hour to get a fresh new grad at $45?

C) I can honestly do my job as well as a pharmacist who has been there 10 years right now. In many cases, I can do the job faster than a pharmacist who has been there 20 years. They've burned out. I'm fresh. In 20 years, I'll be slower. Then what?

Considering reapplying for residency and going hard at it this year. Applied for residency last cycle on a whim. Last-minute application slapped together. 2 interviews, didn't match. However Studying for the NAPLEX, I actually really got interested in the clinical side of things. I could read about Infectious Diseases all day, honestly. So I'm considering going for it again. However,if I matched I'd be giving up a job in my home market at $60 an hour. All without guarantee of having a hospital job. It would be an investment solely based on the future of pharmacy for the next 40 years. Huge decision.

On top of that, I'd be giving up a job with CVS. For me, with their acquisition of Aetna and their massive overall structure including things like Omnicare, I think CVS is the place to be in retail right now. At the very least, they will be the company best prepared to tackle an entry from Amazon.

Here are the key questions:

1. How much do you think automation and technology will replace retail pharmacists in the next 10-20 years? In 20 years, does anyone see a worse-case scenario future where we have 4-5 chain pharmacies manned by technicians only, with one pharmacist doing the verification and doing counseling through video technology when necessary? Of course, this would require a change in the laws.

2. Is a clinical, hospital-based skill-set more protected from technological innovation, or will hospital pharmacists face the same barriers? Of course, a clinical skill-set is at least much more protected from influx of new grads than a retail pharmacy skill set.

3. With the current downward trend in salaries in retail pharmacy be reflected in hospital pharmacy, or will hospital pharmacists with a clinical skill set soon command a greater salary than a retail pharmacist?

Any and all input is appreciated!

1. How much do you think automation and technology will replace retail pharmacists in the next 10-20 years? In 20 years, does anyone see a worse-case scenario future where we have 4-5 chain pharmacies manned by technicians only, with one pharmacist doing the verification and doing counseling through video technology when necessary? Of course, this would require a change in the laws.

I'm not even sure that it would take a change in laws. The law states a pharmacist must be in the pharmacy at all times. That could be intrepreted as the pharmacist is digitally in the pharmacy at all times? regardless techs checking techs means instead of a busy store for 4 pharmacists and 8 techs it will be 10 techs and 1 pharmacist. DOWNWARD pressure is coming to the pharmacy profession and if you are not willing to work for 30 USD an hour I would get out now. I am willing to work for 15 USD an hour. That is my bottom line. If it goes below that I will switch jobs to something like Walmart stocking cans or a valet in a wealthy area where I get to drive fancy cars. I can see the wage stablizing at 40USD an hour in 2020. I think it will stay there as inflation and CoL continue to errode the wage to a real wage of 30 USD an hour.

2. Is a clinical, hospital-based skill-set more protected from technological innovation, or will hospital pharmacists face the same barriers? Of course, a clinical skill-set is at least much more protected from influx of new grads than a retail pharmacy skill set.

The boomers have money saved up. THat is why hospital is still doing okay. Once the boomers are unable to sale their mcmansions to the debt strapped millennial there goes the majority of the boomer money. most of their money is in their houses. This will cause healthcare to "rightsize" back to within global market prices.


3. With the current downward trend in salaries in retail pharmacy be reflected in hospital pharmacy, or will hospital pharmacists with a clinical skill set soon command a greater salary than a retail pharmacist?

all pharmDs will continue to see decrease salary pressure. it's basic supply and demand man. 15,000 new grads every year. The market can't support that growth. FINITE MONEY to go around. just try to work for ten years pay off your debts then "retire" to a low strees low paying job.

I don't even feel bad for people that went into pharmacy to "get rich". that is sinful. this is healthcare your priority should be helping others not making tons of money. As i see it right now pharmacists are way over paid currently. You need enough to pay for rice/ramen and a car/tent to sleep in. that comes out to around 2,000 USD a year then maybe 40k a year for your debt so 42k a year plus taxes so 25 an hour is a good wage.

 

[Timbo]

Looking for some advice and perspective.
Here are the key questions:

1. How much do you think automation and technology will replace retail pharmacists in the next 10-20 years? In 20 years, does anyone see a worse-case scenario future where we have 4-5 chain pharmacies manned by technicians only, with one pharmacist doing the verification and doing counseling through video technology when necessary? Of course, this would require a change in the laws.

2. Is a clinical, hospital-based skill-set more protected from technological innovation, or will hospital pharmacists face the same barriers? Of course, a clinical skill-set is at least much more protected from influx of new grads than a retail pharmacy skill set.

3. With the current downward trend in salaries in retail pharmacy be reflected in hospital pharmacy, or will hospital pharmacists with a clinical skill set soon command a greater salary than a retail pharmacist?

Any and all input is appreciated!

1. Very possible. Right now there are still a lot of elderly people who aren’t tech savvy and prefer the face-to-face interaction you get at a retail pharmacy. But I see a growing number of 50+ who own the latest smart phones and know who to use it. Pretty soon we’ll have an entire generation of retired people who are glued to their phones and prefer the convience of ordering their meds online for same day delivery. They won’t need any counseling either, they’ll just google webmd. I feel pharmacy in particular is more susceptible to tech replacement compared to other healthcare professions. Physicians, nurses, PAs, dentists, ODs all have valuable procedural skills. Pharmacists? We just serve as drug encylopedias. Anybody with a computer and internet access has no use for us
2. Clinical/hospital is more protected but still susceptible. Remote verification is a thing in hospital systems too. And as EHRs become more efficient, the need for pharmacists will drop. I have heard stories of mass hospital layoffs after EPIC rollout because it made ordering and verification less labor intensive.
3. Both salaries will drop. I think more and more people in retail will try to jump to hospital as they realize retail is a sinking ship. As everybody else said, with 15,000 new grads a year, salaries will just spiral downward because supply >>> demand

 

[Rybko90]

Got it. Well, these last two replies just want to make me reach for a bottle of gin

 

[Thoughtfulsinner]

Pharmacists are definitely overpaid. 35-45 per hour makes a lot more sense.

 

[pharmd 08902]

There are government, construction jobs that pay somewhere around $30-45 range. Pharmacists are definately worth more than that, especially if my decision could cost someone their life, and I am liable for it.

 

[Sparda29]

Pharmacists are definitely overpaid. 35-45 per hour makes a lot more sense.

NYPD detectives make $90k+ a year, most of them are near $200k because of overtime. I'm pretty sure I should be making a lot more than a fkin detective.

 

[lord999]

NYPD detectives make $90k+ a year, most of them are near $200k because of overtime. I'm pretty sure I should be making a lot more than a fkin detective.

If you want the crazy hours, the bureaucracy, the soul-destroying corruption, and the TOTAL ABSTINENCE FROM ILLICIT SCHEDULE I SUBSTANCES, I think you'd be fine. I think you could deal with the first three, but weed is a hell of a drug to give up...

 

[arresteddev]

If you want the crazy hours, the bureaucracy, the soul-destroying corruption, and the TOTAL ABSTINENCE FROM ILLICIT SCHEDULE I SUBSTANCES, I think you'd be fine. I think you could deal with the first three, but weed is a hell of a drug to give up...

How different is this from retail pharmacy?

 

[wagrxm2000]

Just to clarify the OPs misinterpretation. The e-scribe auto-entering is dependent on the information being sent correctly. As long as Mds can add directions to the comments section, this can't be trusted. Most mds at least in my area use the comments a lot for what they want on the script.

When that is fixed, well, a big percentage of our job is now completely automated. Time will tell when that finally happens.

 

[owlegrad]

We just launched an update at my work where if the computer doesn't detect any errors in an e-script it automatically processes it for the pharmacist to check without any technician input. So far we have not had a single e-script processed this way. I guess we will see if we ever get this elusive perfect e-script that requires no input from an order entry tech.

 

[wagrxm2000]

We just launched an update at my work where if the computer doesn't detect any errors in an e-script it automatically processes it for the pharmacist to check without any technician input. So far we have not had a single e-script processed this way. I guess we will see if we ever get this elusive perfect e-script that requires no input from an order entry tech.

It's pretty much what I was just saying, until mds aren't allowed to change anything and can only pick prepopulated directions, it won't work.

 

[Sparda29]

How different is this from retail pharmacy?

You don't have to be abstinent from weed to work as a pharmacist.

Quick Fix Urine

That's what I use to get through pre-employment drug screens. I've used it 3 times so far, each time worked perfectly. Warm it up in the microwave for 15 seconds, strap the bottle onto your inner thigh or keep it in your boxers near your scrotum. Get to the urine test site as fast as possible and get the test done as fast as possible. You don't want to be waiting around while the synthetic urine falls out of the normal urine temperature range.

 

[AlwaysContrary]

SDN has literally turned into a meme with some of the posters now lol

 

[gwarm01]

You don't have to be abstinent from weed to work as a pharmacist.

Quick Fix Urine

That's what I use to get through pre-employment drug screens. I've used it 3 times so far, each time worked perfectly. Warm it up in the microwave for 15 seconds, strap the bottle onto your inner thigh or keep it in your boxers near your scrotum. Get to the urine test site as fast as possible and get the test done as fast as possible. You don't want to be waiting around while the synthetic urine falls out of the normal urine temperature range.

I don't know if I could do this. The risk of catching myself in the mirror and seeing what I've become is just too great.

It'll probably be federally legal soon anyway.

 

[projektreverb]

You don't have to be abstinent from weed to work as a pharmacist.

Quick Fix Urine

That's what I use to get through pre-employment drug screens. I've used it 3 times so far, each time worked perfectly. Warm it up in the microwave for 15 seconds, strap the bottle onto your inner thigh or keep it in your boxers near your scrotum. Get to the urine test site as fast as possible and get the test done as fast as possible. You don't want to be waiting around while the synthetic urine falls out of the normal urine temperature range.

Why would you admit this on a public forum? Even though we’re “anonymous”, why? Lol

 

[johnpharm01]

Yes, typed and verified by a computer.

These are a very few scripts, in which the doses are standardized and all the directions are simple and match the usual dosage for the medication. For example, Atorvastatin 20mg 1T;PO;QD. All the patient information has to match exactly between the doctor's system and our system as well. We still have the option to view the directions if we want to to check. I've been checking everything and I've never found an error.

Edit: I'm relatively new, but now that I think about it, it may also just be on scripts that were previously requested for refill from the doctor and the refill directions matched the previous directions. I'll confirm this next shift I work. If that's the case, then I guess it's not so bad. It would technically be a new script but might as well be a refill.

Check your board regulations for your state. Does it allow the computer to verify rxs? Almost certainly no. Likely a pharmacist or intern under the supervision of a pharmacist has to do final verification. Problem with computer software and automation is that it can make errors. Lots of errors.

 

[Chrish]

Some of the mail order facilities like ESI fill over 100K rxs per day. Several of those rxs are filled by robots and directly shipped to the patients (without being touched by the pharmacists). And if you think about it, it makes perfect sense. If the pt is taking Atorvastatin 40 #90 pills, the robot can scan the stock bottle of 90 or 3 bottles of 30 count with 100% accuracy; why would you need a tech to fill or rph to verify?

And I can also attest to the point OP is making; several of e-rxs are typed exactly the way intended for pt to take the med. Several chains are experimenting with this, not just CVS.

 

[Sine Cura]

Technically at least 30% of prescriptions I see a day are wrong or have significant omissions (but 90% of them you just do "blah blah per prescriber" or similar). This doesn't include the ones where you contact the clinic about a quantity limit restriction and the MA has no clue what the difference is between "PA not required for drug" ("but the PA was approooooved!") and "PA required to override quantity limit restriction." Some of these bitches are rude as hell too when you explain the difference.

And these are the clinics where you actually get someone on the phone in less than one minute, not ratchet-ass community health clinics

 

[CountByFives]

I read through this thread yesterday before I started a 12 hour day, so I thought it would be fun to keep track of escripts that could be considered “perfect.”

In a day where I, as the lone pharmacist, checked about 250 scripts, there were about 3 NEW escripts that I would’ve considered perfect.

Until a time where doctors have no control in adjusting prescriptions in any way, there is no way to automate the process... not to mention the 70 year old doctors who have the same chicken scratch they did 40 years ago and refuse to escribe.

 

[wagrxm2000]

Technically at least 30% of prescriptions I see a day are wrong or have significant omissions (but 90% of them you just do "blah blah per prescriber" or similar). This doesn't include the ones where you contact the clinic about a quantity limit restriction and the MA has no clue what the difference is between "PA not required for drug" ("but the PA was approooooved!") and "PA required to override quantity limit restriction." Some of these bitches are rude as hell too when you explain the difference.

And these are the clinics where you actually get someone on the phone in less than one minute, not ratchet-ass community health clinics

30%!!!!!

I only change around 3-5% of scripts entered. At least that's what Walgreens shows.

Or are you saying 30% of what the doctor sends isn't correct? Still is way too high but that could add up like wrong covered inhaler, mls instead of vials, capsules over tablets, etc.

 

[wagrxm2000]

You don't have to be abstinent from weed to work as a pharmacist.

Quick Fix Urine

That's what I use to get through pre-employment drug screens. I've used it 3 times so far, each time worked perfectly. Warm it up in the microwave for 15 seconds, strap the bottle onto your inner thigh or keep it in your boxers near your scrotum. Get to the urine test site as fast as possible and get the test done as fast as possible. You don't want to be waiting around while the synthetic urine falls out of the normal urine temperature range.

Everything you post saddens me. It's a shame some people think nothing applies to them.

 

[sakigt]

I would attempt to network yourself into a hospital PRN gig. Your 7 on 7 off schedule is perfect because everyone knows youre available. Show up, read a lot, be available, learn. Going and doing a residency would require a huge investment with an uncertain payoff. Offer to shadow the clinical positions so they can have someone cover you. This may not work in every hospital pharmacy culture but it sure would work in a lot of them.

Theres huge opportunity for pharmacists willing to learn new scary stuff and work evenings and weekends.

 

[Sine Cura]

30%!!!!!

I only change around 3-5% of scripts entered. At least that's what Walgreens shows.

Or are you saying 30% of what the doctor sends isn't correct? Still is way too high but that could add up like wrong covered inhaler, mls instead of vials, capsules over tablets, etc.

There are technical omissions like morphine sulfate ER 60 mg (which one?) but these are all common:

- Quantity errors are by far the most common (1 inhaler, 1 vial, 1 spray... requested qty does not match any pack size or even the formulation)
- Prescriptions non-compliant with state/federal regs are also very common (basically all ED scripts from one health system in my area) or 99% of faxes for controls
- Wrong clinic/facility information (relevant for controls and refill requests and actually reaching the hospitalist's correct office # so they can do PAs for patients being discharged)
- Sliding scale with no dosing information (so where's the sliding scale?)
- original sig doesn't match the one they put in "notes" but they could easily put it in as a sig
- duration of therapy does not match quantity (1 po bid 10 days quantity 14)

This doesn't include non-formulary rejections or common dosage form substitutions and Rx that present potentially significant drug-drug interactions or drug-disease interactions (like some guy started on gemfibrozil and simvastatin 40 mg and you have no prior history of anything) or back-to-back scripts where it's uncertain whether they're meant to be dispensed together like fluoxetine TDD 30 mg or the second one is the one that is supposed to be filled (no prior info)

 

[wagrxm2000]

There are technical omissions like morphine sulfate ER 60 mg (which one?) but these are all common:

- Quantity errors are by far the most common (1 inhaler, 1 vial, 1 spray... requested qty does not match any pack size or even the formulation)
- Prescriptions non-compliant with state/federal regs are also very common (basically all ED scripts from one health system in my area) or 99% of faxes for controls
- Wrong clinic/facility information (relevant for controls and refill requests and actually reaching the hospitalist's correct office # so they can do PAs for patients being discharged)
- Sliding scale with no dosing information (so where's the sliding scale?)
- original sig doesn't match the one they put in "notes" but they could easily put it in as a sig
- duration of therapy does not match quantity (1 po bid 10 days quantity 14)

This doesn't include non-formulary rejections or common dosage form substitutions and Rx that present potentially significant drug-drug interactions or drug-disease interactions (like some guy started on gemfibrozil and simvastatin 40 mg and you have no prior history of anything) or back-to-back scripts where it's uncertain whether they're meant to be dispensed together like fluoxetine TDD 30 mg or the second one is the one that is supposed to be filled (no prior info)

Still seems high especially when you get those 90 day fills for 10 maintenance meds all for one a day.

 

[Sparda29]

Everything you post saddens me. It's a shame some people think nothing applies to them.

You're a fool if you think cannabis should be illegal.

Just because something is illegal doesn't make it wrong.

 

[wagrxm2000]

You're a fool if you think cannabis should be illegal.

Just because something is illegal doesn't make it wrong.

So you agree nothing applies to you.

 

[radio frequency]

These forums have become pretty dark and depressing. It's tough to read all these sad threads now; makes me want to hole up in an underground bunker and horde my money.

 

[899424]

I think you should do what you love to do! Stop thinking about money so much! I also think it'll be really hard to do a residency after working, but it's never too late to change. How come you didn't figure it out during rotations while in school?

I'm told by my professors and friends to be open minded about what I want to do with pharmacy. Last weekend, I was partying with a pharmacist that loves and works as an ambulatory pharmacist. She told me that she likes it because that's where she makes the most impact. I like the way she thinks, but it's completely different than me. She also mentioned that she didn't like retail because all you do is dispense. lol

I want to know why do you say the your job is easy? Do you work at a low volume store? Last week, I also saw a pharmacist crying at work (retail pharmacy chain). We are considered a high volume store, but I think it could do better.

Looking for some advice and perspective.

2018 Grad.

Working CVS. $60 an hour. Overnight shift 7 days on 7 days off. Store is ten minutes from where I live. Perfect job really for me. I don't mind the CVS pace. I can't stand not being busy.

Here's the bottom line: if I knew that retail pharmacy would be around for the next 40 years, I'd stay retail. The job is easy. I'm good at it.

Here are the doubts:

A) At our chain there are now E-scribed scripts that are completely typed and verified by the computer system. I'm not talking about refills. I'm talking about first-fill. All I'm doing is verifying that the pill is the right one. I'm not exaggerating when I say that an 8-year old could verify such a script. Sure, I do have to make all the decisions on drug interactions. The computer flags these but it has no idea what's significant and what's not. I guess that's something.

B) Along with everyone else, I'm also seeing tremendous negative wage and hours pressure in retail. Walgreens is now hiring at $10 an hour less than I make, and I'm hearing that the final goal is $45 an hour. What's to stop a chain from trying to push out someone who makes $60 an hour to get a fresh new grad at $45?

C) I can honestly do my job as well as a pharmacist who has been there 10 years right now. In many cases, I can do the job faster than a pharmacist who has been there 20 years. They've burned out. I'm fresh. In 20 years, I'll be slower. Then what?

Considering reapplying for residency and going hard at it this year. Applied for residency last cycle on a whim. Last-minute application slapped together. 2 interviews, didn't match. However Studying for the NAPLEX, I actually really got interested in the clinical side of things. I could read about Infectious Diseases all day, honestly. So I'm considering going for it again. However,if I matched I'd be giving up a job in my home market at $60 an hour. All without guarantee of having a hospital job. It would be an investment solely based on the future of pharmacy for the next 40 years. Huge decision.

On top of that, I'd be giving up a job with CVS. For me, with their acquisition of Aetna and their massive overall structure including things like Omnicare, I think CVS is the place to be in retail right now. At the very least, they will be the company best prepared to tackle an entry from Amazon.

Here are the key questions:

1. How much do you think automation and technology will replace retail pharmacists in the next 10-20 years? In 20 years, does anyone see a worse-case scenario future where we have 4-5 chain pharmacies manned by technicians only, with one pharmacist doing the verification and doing counseling through video technology when necessary? Of course, this would require a change in the laws.

2. Is a clinical, hospital-based skill-set more protected from technological innovation, or will hospital pharmacists face the same barriers? Of course, a clinical skill-set is at least much more protected from influx of new grads than a retail pharmacy skill set.

3. With the current downward trend in salaries in retail pharmacy be reflected in hospital pharmacy, or will hospital pharmacists with a clinical skill set soon command a greater salary than a retail pharmacist?

Any and all input is appreciated!

 

[spacecowgirl]

Some days I worry about robots. Other days I see my robotic vacuum get stuck in the legs of a chair and then I don't worry so much.

 

[Sine Cura]

Still seems high especially when you get those 90 day fills for 10 maintenance meds all for one a day.

We don't get those easy set of maintenance meds that often since high Medicaid %

Half a shift so far and literally 20 e-scripts with a quantity error or uncertainty and the rest are things like wrong sig, unclear formulation, prescriber forgot to send pen needles order to go along with pens. This doesn't include "opioid stewardship" activities

 

[wagrxm2000]

We don't get those easy set of maintenance meds that often since high Medicaid %

Half a shift so far and literally 20 e-scripts with a quantity error or uncertainty and the rest are things like wrong sig, unclear formulation, prescriber forgot to send pen needles order to go along with pens. This doesn't include "opioid stewardship" activities

I guess your job is safe for now

 

[BidingMyTime]

3. With the current downward trend in salaries in retail pharmacy be reflected in hospital pharmacy, or will hospital pharmacists with a clinical skill set soon command a greater salary than a retail pharmacist? Any and all input is appreciated!

Nope, it's fairly common for clinical pharmacists to actually get paid less than hospital staffing. There are more residency trained clinical pharmacists than there are jobs for, many clinical pharmacists are working as hospital staff, or even in retail.

3. My view on this is that hospital pharmacists will always make more than retail pharmacists (if you factor in number of hours you get paid for per pay period

Except, outside of CA, this is not true. Retail pharmacists have always made substantially more (ie $10,000 - $15,000 per year more) than hospital pharmacists, and there is every reason to think this will always be true. People become hospital pharmacists because it offers lifestyle benefits, not for the pay. The only reason hospital salaries are as high as they are, is because hospitals were forced to raise their salaries during the 2000's shortage of pharmacists, because retail was taking all the pharmacists. As retail salaries are falling, and as more people are wanting to leave retail for hospital for the lifestyle benefits, hospital salaries will also fall, and I predict they will fall far faster than retail salaries (because more pharmacists are wanting hospital jobs, and there are fewer hospital jobs than retail.)

OP, if salary is your concern, absolutely stay with retail.
If stability is your concern, I think it's a wash (that technology will affect both hospital and retail jobs, not to mention hospitals already like to use tech checking tech.) Personally, if I were you, I would stay with the job I have and like, rather than give that up (knowing that you won't ever be hired back at the salary you are now making), for a potential future hospital job that will be hard to get even once you are have a residency.

 

[BidingMyTime]

The boomers have money saved up. THat is why hospital is still doing okay. Once the boomers are unable to sale their mcmansions to the debt strapped millennial there goes the majority of the boomer money. most of their money is in their houses. This will cause healthcare to "rightsize" back to within global market prices.

Maybe this is a CA thing? Since when do baby boomers have money, many of them are still working, because they have no money for retirement. Many of them are still paying on their mortgages, and some even student loans. They expect their children and the government to pay for all their retirement expenses.

Baby Boomers Face a Shocking Retirement Savings Shortfall "The average retirement portfolio, however, has just $136,200 in it, which would provide an average estimated income of $9,129."

Retirement Living: Debt holds many Boomers back
"Even more troubling: Nearly a third of the NFCC clients who file for bankruptcy are 50 and older. "In their golden years they are filing for bankruptcy," Cunningham says. "That is very disturbing."
American Consumer Credit Counseling, which says 25% of its clients are 55 and older, paints a similar picture. Seniors are going into retirement still carrying debt, including mortgages, credit card debt and student loan debt. They are depleting their savings and retirement accounts just to make ends meet."

 

[Deja]

Pharmacists are definitely overpaid. 35-45 per hour makes a lot more sense.

you think you should be paid $35 an hour? what are you smoking? no wonder pharmacists are viewed as push overs

 

[greenteapanacea]

1. How much do you think automation and technology will replace retail pharmacists in the next 10-20 years? In 20 years, does anyone see a worse-case scenario future where we have 4-5 chain pharmacies manned by technicians only, with one pharmacist doing the verification and doing counseling through video technology when necessary? Of course, this would require a change in the laws.

I've attended rounds at a hospital that included an off-site physician using a robot and computer screen/webcam. While I don't see pharmacies operating without a physical RPh within the next 10 years, it can possibly happen in > 20 if state laws are amended. It won't happen very easily, because the drug chains and patients need someone to easily place legal responsibility on if something goes wrong.

2. Is a clinical, hospital-based skill-set more protected from technological innovation, or will hospital pharmacists face the same barriers? Of course, a clinical skill-set is at least much more protected from influx of new grads than a retail pharmacy skill set.

I'd agree with you that clinical skills may be more difficult for a computer to emulate. However, I would not go so far as to say that your skillset is protected from the influx of new grads. There are increasing numbers of students applying to PGY1 (regardless of quality), and healthcare is a profession that looks at certifications/education. If you want a truly clinical job, do a PGY2. Many PGY1's end up staffing at hospitals in saturated areas.

3. With the current downward trend in salaries in retail pharmacy be reflected in hospital pharmacy, or will hospital pharmacists with a clinical skill set soon command a greater salary than a retail pharmacist?

Hospital pharmacy wages still trail retail wages, at least here in the northeast. To give you an idea, I am a new pharmacist at a local community hospital and my hourly wages are in the 40's. Many of my classmates have received offers in the high 50's for chain pharmacy positions. I don't see clinical pharmacists ever gaining much of a pay bump over their staff counterparts because of simple economics: while retail RPh's create income, hospital clinical RPh's do not.

 

[Sine Cura]

I would expect more retail consolidation as marginal players bow out (not the most radical prediction) without need to adopt or ramp up remote verification and counseling.