Blog July 18, 2013

The Changing Pharmacist Workforce

Healthcare reform, shifting standards in education, and a more complex patient population are changing the role of pharmacists in today’s healthcare system. Employers and pharmacists alike are adapting to these industry trends and preparing for more integrated care models, the influx of more insured patients, and other changes ahead.

New pressures on pharmacy employers

While the severe national shortage of pharmacists from a decade ago has been reduced, there are new pressures on hospitals and other pharmacy employers, noted Lucinda Maine, PhD, RPh, executive vice president and chief executive officer of the American Association of Colleges of Pharmacy (AACP).

“There are regional differences, but in general it appears we are much more balanced now between supply and demand,” she added. “Right now, the biggest issue, especially for hospital pharmacies, is that the acuity of care of the typical hospitalized patient has increased so terrifically with a lot of different factors going on, that it’s really putting pressure on hospitals to increase the level of clinical ability of their pharmacists and pharmacist technicians.”

Drug shortages from various manufacturers have added to the difficulties by occupying a disproportionately large amount of the time and talent of institutional pharmacists.

Education and residency

This need for a higher level of competence and specialized skills is driving the demand for residency-trained pharmacists.

“Because the demand for residency-trained pharmacists is going up, more and more of our graduates are seeking residency training,” Maine explained. “A relatively small percentage of our graduates, somewhere around 15 percent, enter residencies right now.”

Heather Stamps, director of pharmacy staffing at Rx Pro Health, an AMN Healthcare company, said that Rx Pro Health has also seen the need for more pharmacists to come out of residency programs and have a focus in a specialty, such as oncology or pediatrics. While demand for the company’s consulting and staffing services has remained strong across the board, the requests for pharmacists with a specialty focus appear to be growing.

“Where we are seeing shortages is in the number of pharmacists who are working in a specialized field or have specialty skills; that is where we are seeing a lot of vacancies and a greater need for staffing services like ours,” Stamps said.

The demand for residency-trained pharmacists demonstrates a shift in education and required skills sets, and pharmacists and pharmacy technicians who are looking to expand their skills without years of additional training and education can look to continuing education, like the courses offered by RxSchool, an e-learning company that provides ACPE-accredited continuing education and review courses.

“Drug information and the types of prescriptions that are out there change so rapidly, and with the expanding role of the pharmacist being more consultative and needing to understand different disease states, it is absolutely imperative that pharmacists keep themselves well-versed in all of these components,” Stamps said. “Education will always be important.”

Changes coming for the pharmacist workforce

Due in part to the expected increase in demand from newly insured patients under healthcare reform, Stamps anticipates that the number of pharmacist jobs is going to increase along with other healthcare specialties over the next 10 years. More retirements may also play a part.

“We’ve seen pharmacists holding off on retiring during the recession, so we should see some of those people leaving the workforce,” she said.

Meanwhile, pharmacy schools are working to fill the pipeline with highly-educated pharmacists who can contribute their skills.

According to data from the AACP, as of fall 2012 there were 61,275 students enrolled in the first professional PharmD program,* and there is at least one pharmacy school in every state but two--Alaska and Delaware. There are currently 130 accredited pharmacy schools in the country, up from 120 in 2010.

The increase in the number of pharmacy schools should help overall provider supply as more pharmacists’ services are needed to accommodate for more patients and increased acuity.

“Increased patient volume and the changes to healthcare reform that will allow a greater portion of the population access to prescription coverage will facilitate the need for more providers,” Stamps said.

Pharmacists’ expanding role in the care team

These industry changes have also caused the role of the pharmacist to evolve and expand over time, calling for the pharmacists, doctors, nurses and other healthcare professionals to work as a team in the new patient care models.

“We spend a lot of the time at the AACP working with our colleagues across the other disciplines on the design and delivery of inter-professional education and team-based care models,” Maine said. “We have to create an expectation among our learners that this is the way that care is going to be designed and delivered.”

Stamps echoed that the role of the pharmacist is expanding and taking more of a holistic focus. “We are seeing the need for pharmacists to act as a consultant to understand things like immunizations, screenings and act more in a role where they are providing total patient care and assisting with medication therapy management.”

Beyond the traditional careers in retail and hospital pharmacies, there has also been an increase in different types of pharmacy jobs.

“We are seeing different types of pharmacy positions,” Stamps said. “Pharmacists play a role in mail-order pharmacy, long-term care, hospital administration, managerial positions, compliance and regulations, managed care, drug information and medical writing, and acting as pharmacy educators in clinical roles.”

Permanent and temporary staffing trends

Stamps reported that the demand for temporary pharmacy staffing has remained consistent in recent years, with the biggest needs being reported due to short-term staff vacancies, periods of leave, temporary census or volume increases, and technology conversion projects.

As more hospitals push to achieve the federally defined “meaningful use” of electronic health records (EHRs)--including computerized provider order entry (CPOE) that links to prescription orders--these implementation projects are expected to continue to drive demand for temporary pharmacy staffing.

“On the permanent placement side, we see a lot of demand for specialty positions. We also see increased demand in rural markets where the candidate pools are smaller and in locations where the pharmacy does not have the resources to bring in the type of quality staff they are looking for.”

As patient care models evolve and the insured population grows and puts increasing demand on the healthcare system, the need for both permanent and temporary pharmacy staffing services are likely to remain on an upward trend.

*A doctor of pharmacy (PharmD) degree is awarded after completion of a four-year professional degree program following a minimum of two years of collegiate pre-professional study. Accreditation of bachelor of science degree programs (BS Pharmacy), requiring a minimum of five years of college study, ended in 2004, according to the AACP.