Future of Retail Pharmacy and Saturation

[Guest guest]

So we all heard that Pharmacy is saturated, and perhaps technology and central

fill/mail order will replace majority of retail pharmacies in 10-15 years.

What is your opinion on that?

Also, allow me to introduce myself. I am a former pharmacy technician and now in

my 4th year at a pharmacy school in CA. Some background information, prior to

2004 there were only 4 pharmacy schools in CA, UCSF, UOP, USC, and WesternU. Now

there are 8 with plans to open 8 more. The 1990's and 2000 saw a huge demand for

pharmacists, while right now half of my graduating class doesn't have a job

offer. Getting a retail job in OC and most of LA is darn right impossible... As

a result of the surplus, working conditions have declined and now a days people

are hired part time and perdm... Even intern jobs are hard to come by. How is

the job market for pharm techs right now?

Here is a link from a dean talking about this crisis for those interested

http://pharmacy.uconn.edu/index.php?option=com_content & task=view & id=509

http://www.pe.com/localnews/stories/PE_News_Local_D_pharmschool22.3f1de68.html

[Guest guest]

Dearest Yuriy,

It seems only yesterday that you and I were discussing your teching at Rite aid

and your intent to become a pharmacist. Congrats on your 4th year.

Preface: I did not go to the links that you provided yet.

About Techs:

My students mainly find jobs at their site of externship/internship.

Most are usually hired right after completion in hospital as per diem and after

proving themselves with good work ethics (on time and attendance etc) which may

'change' from what it is like during externship and being hired, most are put on

a full time or part-time basis within 90 to 180 days. However that being said

we had less hired during the last 2 years than ever due to the economy.

Across the nation I hear of many techs not finding work. On the other hand there

seems to be more job openings for techs in the last year than the last two

years.

About Pharmacists:

I cannot and will not speak for pharmacists and that areana. I can not pretend

to know. But I can say that I am in education and I DO know that many pharmacy

(for Pharm D) schools are opening up than ever before due to the response to

comments of shortage of Pharm D. over the last 10-15 years.

One of the main reason for the shortage has been that baby boomers would be

living longer and needing more meds.

Well I think we are seeing only the tip of that iceberg if it is really to

become one. Why? because we have seniors living longer and also working longer,

and more medications to treat illnesses that traditionally t staying in hal

It is possible that Health Care Reform may play a part in whether there is

really a shortage now or going to be one or not in near future. That is

something I really can not speculate upon. But definitely mail order, something

which was not foreseen 10-15 yrs ago as becomming such a big hit, has played a

huge part in the decline for the need for more pharmacists and to some degree

technicians.

I do see however more mail order pharmacies opening in the near future, but not

enough to say that there is a shortage of Pharm D's.

I have been told about 5 yrs ago that there is or was an incentive program for

pharmacist students to get loans or grants for pharm school IF they signed on to

work in rural and other areas of the US for at least 2 yrs after graduation.

These " other areas " are areas that do not attract most people graduating with

Pharm D's: small rual towns, cities with high crime rate, poor weather etc.

All that being said, no one foresaw the changes in the Global and US economy

and " market " when the need for pharmacists was being tauted more than 3 years

ago. We have not heard much about the need for more pharmacists in the last 3

yrs.*** Further, opening a school of pharmacy does NOT happen overnight. I can

assure you of this! I am involved in such a task at this moment in time. We

began our journey to open a school of pharmacy more than 8 yrs ago, gathering

information, statistics, self-assessments and plan of action etc etc.

simultaneously with the feat of opening a school of nursing for BSN. We placed

the pharm school on the back burner for about 2 yrs while the attention went to

our newly opened our school of nursing one year before the economical turn. [as

a side note we graduated cohort 4 and 5 last night! ] It takes TIME and MONEY to

open up such a school of nursing or PHARM school. We returned our focus once

again to the school of pharmacy last year - EVEN though the economy had taken a

turn for the worse 3 years ago just when our school of nursing opened! So I will

put my word and life on it, that at least 6 of the 8 schools [that you refer

to]which MAY or MAY NOT open up and become accredited etc., have been working on

their individual plans to respond to the need for more pharmacists for OVER

THREE YEARS and I would say more than likely OVER FIVE YEARS ago. But YOU and

the public may JUST now be hearing about their plans!!! And further there may be

a cap### on opening more until these open and ACPE sees if there is a need for

more.

I do not propose to have any or all of the answers as to why more schools are

opening as you and your constituents believe there is no need and competition

for jobs. BUT I do BELIEVE that most of these schools have had plans in the

works LONG before the economical downturn and the choices before them are to

ride out the wave and hope that changes in economy long term will pay off in the

time it takes to graduate their first class RATHER than scrap their ideas and

chance missing the wave and finding themselves on the wrong side of the

'cap'###.

*** Refering to articles that say/said there is a Pharm D shortage:

1. Most articles published within the first year after the economical crunch had

been waiting to be published, but written before the crunch.

2. Most articles published after the first year of the economical crunch but

written during it have been mainly parrots of previous articles with nothing new

and no mention of the economy.

3. Articles writtn in the last year stating that the shortage is not really a

shortage may be and most likely are reflecting the effects of the economical

crunch and this is new information. IF they are true, then the competition for

you and your graduating class 'is on'.

### cap: there may be or may not be now or in the near future a cap on the

amount and location of pharm d schools that can open by ACPE or ???? the reason

is that ACPE wants to be sure that each school has enough MONEY to sustain so

that students are not left in the cold like what happened in Hawaii several

years ago. So if there are too many schools in one location or too many all

together this could happen and if you add any possibility that there are little

to no jobs after graduation the cap will be needed. There had been informal

'talks' of a cap and what I would call speculation only, by non ACPE people, but

no official word from ACPE that I know of.

" The future is ours to see, what will be, WILL be " --- we can not predict what

new machines, robotics, automation, procedures etc will affect the future of

pharmacy any more than man could predict in 1928 stock market crash of 1929 or

the landing of man on the moon in 1969.

I believe that YOU will find work as a pharmacist. I believe it may be per diem

or part time at first but by proving yourself you will be perm full time. This

is because I 'KNOW ' you AND because you have shown consistent desire to STAY in

pharmacy since you began teching.

With that I WILL go to the links ( " the matresses " ) and check them out!

Love ya and stay in touch,

Keep informing us of any changes or trends in pharmacy/Pharm D's and techs as

you learn of them.

Thank you for sharing and opening our eyes....

Jeanetta Mastron CPhT BS

Pharmacy Technician Educator

Founder/Owner of this site

These words are meant for THIS site only and may not be placed on any other site

or blog or copied and pasted else where including books or newsletters or

magazines with out my expressed written consent. The above is my own personal

opinion based upon my professional interactions with other pharmacy

professionals, pharmacy as a whole, work with technicians and my own

gut/intuition. No facts are implied or stated. They are copyrighted as of June

18, 2011.

>

> So we all heard that Pharmacy is saturated, and perhaps technology and central

fill/mail order will replace majority of retail pharmacies in 10-15 years.

>

> What is your opinion on that?

>

> Also, allow me to introduce myself. I am a former pharmacy technician and now

in my 4th year at a pharmacy school in CA. Some background information, prior to

2004 there were only 4 pharmacy schools in CA, UCSF, UOP, USC, and WesternU. Now

there are 8 with plans to open 8 more. The 1990's and 2000 saw a huge demand for

pharmacists, while right now half of my graduating class doesn't have a job

offer. Getting a retail job in OC and most of LA is darn right impossible... As

a result of the surplus, working conditions have declined and now a days people

are hired part time and perdm... Even intern jobs are hard to come by. How is

the job market for pharm techs right now?

>

> Here is a link from a dean talking about this crisis for those interested

> http://pharmacy.uconn.edu/index.php?option=com_content & task=view & id=509

>

> http://www.pe.com/localnews/stories/PE_News_Local_D_pharmschool22.3f1de68.html

>

[Guest guest]

Hi Jeanetta,

Thanks for the thoughtful response. Very insightful indeed.

I am very happy that your students are finding jobs because it's a testament of

the quality of the education that they are receiving

I am curious about what you think about those articles since you're an educator

and these articles provide the perspectives of deans of established schools and

practitioners about this crisis.

Here is another article from the American Journal of Pharmacy Education that I

highly recommend reading

http://www.ajpe.org/view.asp?art=aj7410185 & pdf=yes

I believe the dean of UCON said this is the biggest crisis that he has ever

seen. I will summarize why he feels that way for the readers of this board who

may not have time to read it. Here are also my observations with the increase of

schools.

1. you're putting out classes of pharmacists with debts of nearly 200K (40K a

year tuition in cali) who are desperate and will agree to work in unsafe

conditions. I've already seen pharmacists do 400 rx a day with just one tech,

where they compromise patient care by not checking prescriptions as thoroughly

as needed. I don't want to even think about other unethical things that

pharmacists may have to revert to doing to make ends meet. I have even seen

hospitals hire pharmacists without experience and residencies just to save money

(they agreed to work for 25% of what a CVS pharmacist makes). Ultimately, i see

an increase in errors made.

2. He feels that there is a shortage of qualified instructors with clinical

knowledge and the quality of pharmacy instruction has suffered immensely.

3. Shortage of experiential sites.

4. Quality of students accepted is not what it used to be.

One person who I spoke to has told that legally ACPE can not institute a cap

because as long as the schools meets it's accrediting criteria they can not deny

accreditation. The way dental schools and med schools have limited new schools

from opening is having very strict requirements of having hospital affiliation.

I believe there has been 50 new schools who opened in the last decade, only one

has not gotten accrediting. That school failed to try to get accredited in the

first two years from what I remember.

[Guest guest]

Dear Yuriy,

I think these three articles and part of my own reply to you are saying the same

thing about WHY there are so many Pharm D programs now and why 10 more in the

near future.

My reason as to why we got or how we got here is more for the person who was NOT

in pharmacy 10-15 yrs ago to understand the basics of what was happening in

order to understand what is happening now. These articles leave out that

foundation of information as they are geared to those already somehow connected

to pharmacy and would know.

I wrote it so that others on this site who are reading it would have enough

information to follow along should they so choose.

I go into a bit more detail about the rural pharmacy healthare, while your last

link mentions it slightly, the other two do not. That my dear friend is where

the jobs are if any. I do not suggest that three is a surplus of rural jobs. But

I can say there was at one time. I can say that is where most jobs today will be

found. [again for those reading we are talking about Pharm D and I not wish to

confuse the pharm tech].

What is not said is that we see an increase in pharmacists working out of their

homes in telepharmacy in rural areas. This home does not have to be in a rural

area!

I like the arguments made in the last link you sent, and I agree we must all

take responsibility.

Our school also had to do a self-assessment and needs assessment in order to get

as far as we have in the process. We are in the process, and I am not able to

speak further per ACPE guidelines.

Since this topic is mainly for those who wish to become pharmacists and not for

tech study, but is a topic for pharmacy which may impact technicians I am

allowing these posts. On that note I wish to say this:

Techs can not work where there is no pharmacist supervision (including

telepharmacy).

The current number of pharmacist jobs do not seem to be varying greatly from in

the past, but there are not enough new pharmacist job openings to meet the needs

of the many Pharm D graduates, as was expected years ago when the new programs

were granted accreditation.

While some techs complain that they can not find work, again this has to do with

the current economy, many techs are finding work in mail order where the ratio

is more like 1 Pharm D to 3 Techs, which is generally greater than in

community/retail pharmacy which has been 1 to 1 o r 1 to 2. Mail order locations

were once few and far between. BUT Today I say that is where most hiring of

Pharm D's is going on in non-rural ares. It is not discussed enough in schools

of pharmacy (Pharm D). Everyone sees and knows the community pharmacist, so when

they think of becomming one that is what they think of. But pharmacy is not your

father's pharmacy any more!

LOOK at ANY medical insurance company online, what do they all have in common?

ONLINE Pharmacy or MAIL ORDER PHARMACY.

Read this UCLA article:

Buying medicine by mail may encourage patients to stick to their

doctor-prescribed medication regimen, new research suggests.

" In a first-of-its-kind study, researchers from UCLA and Kaiser Permanente's

Division of Research in Oakland, Calif., found that patients with diabetes, high

blood pressure and high cholesterol who ordered their medications by mail were

more likely to take them as prescribed by their physicians than patients who

obtained medications from a local pharmacy. "

http://newsroom.ucla.edu/portal/ucla/mail-order-pharmacy-use-could-150115.aspx

or this WEB MD

http://www.webmd.com/a-to-z-guides/features/beyond-the-pharmacy-online-and-mail-\

order-prescription-drugs

You can search all you want to find out about a medical insurance program and

you will find8 out of 10 offer mail order ormention it online. Here are a

couple:

http://www.uaskpup.com/Members/pharmacy-information.aspx

http://www.express-scripts.com/services/

http://www.healthcenter.caltech.edu/pharmacy.html

The Mere fact that the following site exists tells us that people are using

online and mail order pharmacies, tells us that it is a trend and most likely

will not end, but grow:

http://www.pharmacychecker.com/

I have a friend who has an insurance coverage and she is diabetic and the

insurnace will only cover mail order pharmacy except for first time meds. So if

she is given a new script for a maintenance med she will be allowed to use a

community pharmacy for the first fill and after that she must use mail order. I

could not believe it! But guess what that is not the kicker! The kicker is this

was told to me by her over 4 years ago! I forgot the name of the insurance

company but it is not one of the big ones.

It is possible that many graduates are not willing to accept a mail order

pharmacist job because their rotations did not include such. They may fell like

a ship out of water/without experience. I don't know perhaps Pharm D programs

need to take a hard look at this.

Who knew that mail order meds would become what it is today with such traffic?

Just as we could not predict the economic crunch!

Again there are so many areas of pharmacy that I believe graduates are not aware

of or not willing to consider or their professors know nothing about and

therefore did not introduce them to. In addition with New HEALTH CARE REFORM

MANY of the the older pharmacists are just now trying to get a handle on it and

understaand it all themselves so how can they explain it to newbie pharmacists?.

Once HCR gets to be old news and settled in I think we shall see more hiring of

pharmacists. Will if fill the need of surplus pharm D grads? that is yet to be

seen.

Do not forget that HCR is in flux with many debates and many wanting it

recalled.

NOTE: For those who are here to study to become a pharm tech and find these

posts not what you are interested in, then do not feel compelled to read them.

On the other hand if you feel the fate of pharmacists/pharmacy may have

something to do with your fate as a newbie tech then I suggest that you read

them.

Do not go through studying for the PTCB exam with rose colored glasses, as any

of this may affect you in the future. HOW? your guess is as good as mine.

Respectfully,

Jeanetta Mastron CPhT BS

Pharm Tech Educator

Founder/Owner of this site

>

> Hi Jeanetta,

> Thanks for the thoughtful response. Very insightful indeed.

>

>

> I am very happy that your students are finding jobs because it's a testament

of the quality of the education that they are receiving

>

> I am curious about what you think about those articles since you're an

educator and these articles provide the perspectives of deans of established

schools and practitioners about this crisis.

>

> Here is another article from the American Journal of Pharmacy Education that I

highly recommend reading

>

> http://www.ajpe.org/view.asp?art=aj7410185 & pdf=yes

>

> I believe the dean of UCON said this is the biggest crisis that he has ever

seen. I will summarize why he feels that way for the readers of this board who

may not have time to read it. Here are also my observations with the increase of

schools.

>

> 1. you're putting out classes of pharmacists with debts of nearly 200K (40K a

year tuition in cali) who are desperate and will agree to work in unsafe

conditions. I've already seen pharmacists do 400 rx a day with just one tech,

where they compromise patient care by not checking prescriptions as thoroughly

as needed. I don't want to even think about other unethical things that

pharmacists may have to revert to doing to make ends meet. I have even seen

hospitals hire pharmacists without experience and residencies just to save money

(they agreed to work for 25% of what a CVS pharmacist makes). Ultimately, i see

an increase in errors made.

> 2. He feels that there is a shortage of qualified instructors with clinical

knowledge and the quality of pharmacy instruction has suffered immensely.

> 3. Shortage of experiential sites.

> 4. Quality of students accepted is not what it used to be.

>

> One person who I spoke to has told that legally ACPE can not institute a cap

because as long as the schools meets it's accrediting criteria they can not deny

accreditation. The way dental schools and med schools have limited new schools

from opening is having very strict requirements of having hospital affiliation.

I believe there has been 50 new schools who opened in the last decade, only one

has not gotten accrediting. That school failed to try to get accredited in the

first two years from what I remember.

>

[Guest guest]

It is a similar situation here in Florida. They now have 6 pharmacy schools and

very few job postings. Most of this year's graduating students are excited to

get part-time jobs or residencies (1/3 to 1/2 pharmacist salary).

I keep saying, for pharmacy to grow in this economy, we need to do more than

fill and bill - a computer/robot can do this. We must make an impact on the

millions/billions spent on adverse drug reactions and noncompliance and use the

money saved to pay for the services. Pharmacists must step up and use the

knowledge they've been given and participate in MTM like services. Pharmacists

and techs must start informing people of the services they can access and highly

recommending patients use these services. To just hand people drugs and let

them sign away their right to speak to the pharmacist is ridiculous.

However, in Florida right now there does seem to be many pharmacy tech position

postings (in comparison to very few pharmacist postings) as we recently required

state registration for techs which is causing a shortage of qualified,

registered technicians. If someone leaves the state/profession, there is no one

coming in behind qualified to take the position. I am sure it is also

regionalized even here that areas where there is a pharmacy school they may hire

interns instead but the last time I checked www.pharmacyonesource.com there were

several hospital and retail tech jobs posted in Florida. The majority of the

pharmacist jobs were for management - another area that pharmacists don't

typically feel confident in - perhaps the schools can add more business courses

to help fill those jobs.

Joy