Once I interviewed a pharmacist and had a conversation kind of like this: “I work at [insert pharmacy here] right now but it is just a meat grinder. It feels like an assembly line. I don’t get do anything clinical (my least favorite word, by the way).”
When I heard that, I pressed her to go a little further: “Have you talked to your boss about doing any new projects? Starting any new services for patients?”
She replied, “No ... [insert pharmacy name here] would never do that. All they care about is profit.”
I said, “I’ve actually worked for a couple chains before, and I was able to do [X] and [Y] project.”
She responded, “Wow, they let you do that? I don’t think my company would do that. I want something with more opportunity.”
I, of course, was not planning to hire her at this point but was curious to see how she would respond.
Unfortunately, this attitude is all-too common. I want to start by saying that I understand that pharmacies are busy, and chain pharmacies are no exception. I have worked for 2 different chains, Safeway and Walgreens, and both were hectic. My current job at an outpatient pharmacy in a hospital is busy, too, by the way. It is also true that for-profit companies must be concerned about their bottom lines or they will cease to exist. But guess what: I work for a non-profit that is just as concerned about profit. Does that make these places horrible? Unfortunately, even if a non-profit wants to stay in existence and continue to help people, it must pay its bills, and if it wants to have money to reinvest in expanding services it must be profitable. So, moving to a non-profit, an independent, or anywhere else is not going to remove the pressure to make money.
The key to success in any position is outlook and creating opportunity within the current role. Those who do so can accomplish several things: they will be more satisfied, regardless of the job they have; they will put themselves in a position to move up within their current company (eg, Safeway and other chains have "clinical pharmacy managers" who are responsible for implementing new programs within their pharmacies; those who have already been doing these things would be attractive candidates for the job); and they will have more to brag about if they decide to go elsewhere. These things will make candidates more attractive.
So, what type of projects am I talking about? I was not at Walgreens long, and it was my first job out of school (I left to move to Hawaii, by the way, not to leave Walgreens), but I remember a woman asking me questions about her mom, who was in a nursing home. I had been on a geriatrics rotation in school and felt pretty comfortable discussing it with her, even though I was a new graduate, and in the end, she told me that she did not want to talk to any other pharmacist but me, which, of course, felt great. I suggested a comprehensive medication review (CMR) and told her that her insurance company would cover it (medication therapy management [MTM] was a big project at the time at Walgreens). I found out later from our district office that this insurance company would not cover MTM. However, my boss told me to go ahead and do the CMR, and he would pay me for the time it took. In other words, Walgreens agreed to eat the cost. So, there I was a new grad, licensed a few months, and I had already created a position with the "direct patient care" that so many pharmacists say they want more of. Walgreens won, too, as a loyal customer is worth an extra hour of a pharmacist's time. If I had been there longer, I would have talked to my boss about going out and doing MTM in high-risk populations, partnering with local hospitals to help follow-up after discharge, or any other number of things that would improve care and still help make Walgreens money.
I was with Safeway longer and did a few different things there. One of the projects I really enjoyed was partnering with the Hawaii Public Health Association on smoking cessation initiatives. Safeway implemented smoking cessation across all its stores while I was there, so this was a natural extension of that rollout. We held a smoking cessation event at the store, and public health professionals came to help discuss their public initiatives while I counseled on smoking cessation and recommended vaccines. I was selected as the media contact for the state of Hawaii to represent Safeway. I had also been working on a sharps takeback initiative that, had I been able to stay longer, I think I would have been able to fully implement. I was going to fund it by applying for a grant from the Safeway Foundation, which is the chain's non-profit to fund community health projects in the communities they work in. I had already emailed the Safeway Foundation and they thought it was a great idea. Again, I would have created an opportunity in a chain pharmacy role to be the lead author on a grant proposal for a community health initiative.
In both these roles I chose not to just "be in the meatgrinder," while still accepting that any community pharmacy role can be extremely busy. The Safeway I worked at was the store that many new floats struggled with the most, so I was not in an easy store. I had to create the opportunities to lead the career I want to lead. I also take satisfaction in the day-to-day interaction with patients, but these unique projects keep me excited about pharmacy.
Pharmacists should think about the projects that they can develop that will help their employer, help them feel more fulfilled, improve their communities, and put them in a better position to move up later. Those who feel stuck in their jobs may find that this is the best place to start, even if they do decide to move on to bigger and better things later.
Alex Evans, PharmD
Alex Evans, PharmD, BCGP is a pharmacist and medical writer based out of Jacksonville, FL. He is the founder of Pharmacy Compliance Specialists, LLC (www.pharmcompliance.com), a company dedicated to the success of community pharmacists. He can be reached at firstname.lastname@example.org.