Tip of the Week: Staying Ahead of Change to Maintain a Healthy Work Environment


There are a number of ways in which job design and working conditions can be improved in the community pharmacy setting, either on the store level or on an organization-wide basis.

The phone rings. “Call on line 1.”

A patient is demanding to know why their controlled medication is not ready yet.

The phone rings again. “Call on line 2.”

A technician is relaying a question from another patient. Someone is waiting for their shingles shot.

Pharmacist verification totes hang haphazardly to the side, threatening to tip over if anyone walks by. All of this requires a pharmacist’s attention, and it all adds up to create an environment that could result in a patient safety mistake. Additionally, anything less than terrific coping skills could potentiate employee stress and burnout.

There are a number of ways in which job design and working conditions can be improved in the community pharmacy setting, either on the store level or on an organization-wide basis. A recent study by Beal et al examined pharmacist perceptions of various policy solutions that could improve the work environment.

The main concerns and solutions differed depending on work setting. Those in chain stores favored limiting the number of prescriptions verified per hour or per day per pharmacist.

There is a push to change corporate policies to focus on patient care rather than on other metrics and to ensure that pharmacists are given mandatory breaks. Implementing these changes can realign the job priorities so that patient care comes first.

Expanding pharmacy roles was another area of discussion. Pharmacists with fewer than 5 years of experience were more likely to support changing pharmacy personnel roles.

Overall, pharmacists are split regarding giving technicians more responsibilities to help reduce pharmacist workload. Some pharmacists expressed that expanding the pharmacist role would help with job satisfaction, but with the caveat that this be accompanied by appropriate technician salary and reimbursement to the pharmacy for these roles.

Pharmacists were supportive of regulating pharmacy benefits managers (PBM) as well, as many viewed decreasing reimbursement as a big concern. Pharmacists who worked at independent pharmacies viewed PBM regulation as the primary concern along with getting reimbursement for non-dispensing services.

PBM regulations have been enacted in 21 states, but some view the issue as being far from fully addressed. In some states, pharmacies report closing due to falling reimbursement rates and many independent pharmacies cite similar future plans.

Change has been coming to pharmacy practice and arguably more rapid than ever before. Some of these changes are beyond the control of individual managers.

However, the sage pharmacy manager remains abreast of regulatory, political, and economic forces that are shaping practice and anticipates them in advance, and thus is ready to respond to a changing environment. Even more so, being proactive by “reading the tea leaves” suggests that managers be innovators or early adopters for such change.

Beyond the forces outside of one’s control entirely, pharmacy managers should never stop thinking about mechanisms to improve workflow, gain efficiency, and create a more positive work environment.

The value of networking, keeping up with the literature, attending conferences (both local and national) are paramount, as is listening to your staff.

Additional information about Operations Management and Organizational Structure and Behavior can be found in Pharmacy Management: Essentials for All Practice Settings, 5e.


Beal JL, Clabaugh M, Illingworth-Plake KS, Policy solutions to address community pharmacy working conditions. J Am Pharm Assoc. 2001; doi: https://doi.org/10.1016/j.japh.2021.02.011.

About the Authors

Leslie Wu, PharmD Candidate, Touro University California College of Pharmacy.

Shane Desselle, RPh, PhD, FAPhA, Professor of Social and Behavioral Pharmacy, Touro University California College of Pharmacy.

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