Pharmacists are facing competing demands on their time and an increasingly stressful work environment. Rather than submitting to these conditions, individual pharmacists must take steps to exert professional independence.
For some time I have been receiving comments about how pharmacists are being asked to shoulder increasing workloads with less help. These comments suggest that the situation may be leading to unsafe practices— and somebody needs to do something.
Here are a few comments that I have received:
“Pharmacy organizations don’t mention the ugly subjects of high script volume, inadequate support staff, lip service for counseling and patient care (wink, wink) but no time or means to administer it, and the countless other problems that demean and denigrate us as a profession of pharmacists. And that argument cuts across EVERY practice setting, some more than others.”
“I fail to understand how you can be so ignorant of the pharmacist’s abuse and plight in the retail arena (like in gladiator) where you are DANGEROUSLY short staffed, often not provided with competent help and support…”
“The fault is in the anemic reimbursements offered by the insurance companies and termed ‘professional fees’ when they are merely token gestures to a very responsible position.”
“The insurance companies must be pursued as a threat to public health and safety, which they have indeed become!”
“I am now in my 34th year of pharmacy practice and only see things going downhill from here. Adaptability is just another way of saying ‘let the corporation big boys tells us how to practice pharmacy from their cushy comfy chairs’…Oh yes, and now being forced to give flu shots and other vaccinations as well. Not what I envisioned 30 years ago.”
“There is a disturbing thing happening in pharmacy practice and it needs to be addressed… What disturbs me is the workload of the pharmacist—it’s ridiculous. I resigned my position…because I didn’t have enough help.”
I have resisted this topic because there is not a simple solution to a very complex problem. I do not believe there is a single source of the problem, nor is there a simple solution. Thus, anything I write will be subject to criticism because each situation has many facets.
A speaker I heard recently said that the top 10 jobs today did not exist in 2004. Behind that statement is the realization that there is much change occurring—and with it new opportunities. As an employee, what is my responsibility to keep growing with the development of new skills and even taking on new responsibility, a new job, or even changing careers to assure that I am in control of my own destiny and not controlled by my current employer? When I find myself unhappy in a job and at a dead end in my career, is it my fault or the employer’s fault? People can make a case for either, I guess, but unless I am willing to take responsibility for my own career, I will always be beholden to my employer and I will always feel the problem is caused by someone or something outside of my control.
The other aspect of this situation that I think about is how do I differentiate myself so that potential employers will see something different in me and want to hire me or keep me? It is my observation that too many pharmacists stop growing professionally after graduation and their careers stagnate. They then wonder why they have limited job opportunities and often want to blame someone else when it may actually be their own problem.
Becoming an employer rather than an employee puts an individual in control of their own destiny. But that requires someone to take a risk by believing in themselves, and it seems like too many in our profession are risk adverse. Demonstrating to our employers that we are depending on them (even if this is subtle) may cause our employers to take advantage of us. Again, we are inclined to put the blame somewhere else rather than accept our part in the problem.
Of course, there may be situations where employers really do take advantage of an employee. My father worked in a machine shop and was a union member. I understand a little about unions. I personally do not feel like that approach belongs in a profession, but others disagree with me. They would suggest that a solution to this workload problem is a union or a professional guild. Another approach recently announced by the California Pharmacist Association is the establishment of the first employee ombudsman program. We will be following how this program progresses to see if it could be a solution that may work in other states.
The fact that many pharmacists feel that inappropriate workloads exist in pharmacy is clear. Who is responsible for this situation is not as clear. What to do about it is even more difficult to define and many of the solutions proposed may not even be feasible. Ultimately, as I have suggested here, individual pharmacists must work out their own solutions, hopefully with help from other elements of the profession. PT
Mr. Eckel is a professor at the Eshelman School of Pharmacy, University of North Carolina at Chapel Hill. He serves as executive director of the North Carolina Association of Pharmacists.