THE GOOD, THE BAD & THE INCOMPETENT

My last blog addressed the issue of the apparent oversupply of pharmacists and the recent Workopolis Report indicating that pharmacists can look forward to generally full employment for the foreseeable future.  My point was/is that there is a big difference between having a full time job and being fully employed.

Too many pharmacists are engaged doing menial tasks which draw very little from the many years of university education required to graduate and then to become licensed to practice…especially those employed in grocery stores and big box merchandisers.  This is because it is the pharmacist’s license more than the pharmacist herself which is important to the non pharmacist owner.  The pharmacy license allows the merchant to sell a whole bunch of stuff which is restricted to sale in pharmacies only and to create the food drug combo platform.  These drug store type products are supported by billions in advertising dollars which create a powerful pull effect, even though most of the products have little or no efficacy.  It’s all about creating customer traffic and exposing consumers to more and more merchandise.  One of the main reasons that Loblaw purchased Shoppers Drug Mart (now known as SHOBLAWS) is to expose the Weston Group of companies to more markets in urban centres and smaller niche markets.

In a normal supply demand marketplace, it is demand that drives supply.  The supply/demand curve remains relatively symmetrical fluctuating a little but maintaining its own balance.

The unfortunate situation we witness today with pharmacy is that this curve is greatly distorted by artificial demand; demand which is created by Big Retail in its endless pursuit of greater sales volumes.  This is how we get 10 pharmacies in one intersection, all within a few hundred yards of each other.

Clearly there never was a demand for that level of pharmaceutical services at this one intersection.  Most of the pharmacists within this geographical area are not practicing pharmacy, but they are employed as ‘pharmacists’.

A perfect in vivo example of this artificial demand phenomenon was the recent entry of TARGET Stores into the Canadian marketplace.  This successful US based company entered the Canadian market like an invading army, opening 122 stores in the space of about two years.  In the space of this short period of time Target created a corporate demand for over 200 pharmacists…pretty close to half an entire pharmacy graduating class.  Target is now struggling, having lost over a billion dollars in its first full year of operation.  There is some speculation by analysts (though denied) that if things don’t improve Target may eventually retreat out of Canada.  What will happen to those 200 pharmacists if they spill back out into the general pharmacist population?

These types of huge swings in artificial demand distort the supply side of the curve and this has a major impact on remuneration and working conditions, as we woefully witness today.

The further reality is that the universities, the pharmacy regulatory bodies and the pharmacy associations all become quickly addicted to these high pharmacist numbers.  All of these institutions thrive and profit from the bigger numbers and the revenues (tuition fees, annual licensing fees, and association fees) which these big numbers create.

Hence back to the title of this blog.  There are no real good guys or bad guys in this story (well, maybe a couple of bad guys).  Mostly there are a lot of incompetents whose self serving interests drive their motivations and actions.

Today’s cohort of pharmacy graduates is proving daily that they will not accept this paradigm.  More and more of them are creating new value propositions and creating the pharmacy of tomorrow. These graduates are not afraid of the future; they are seizing it and bending it to their will.  These graduates are clearly competent to practice as real pharmacists employed doing what they were educated to do…serve patient needs.  As for all those box store pharmacists, isn’t it time you evaluated your life and your career?  Is the 20% staff discount really worth it?

 

Pharmacy Today and Professional Satisfaction

The recent Workopolis Report on “job prospects” for various professions appears to point towards a generally rosy picture when it comes to prospects for new pharmacy graduates.  Over 95% of pharmacy graduates eventually end up working in their chosen field, as opposed to making cappuccinos at Starbucks.

The only “downside”, as suggested by a U of T pharmacy professor, is that pharmacists may no longer get to work in one place for 40 hours, and that they may not get employee benefits.  What a sad perspective this is…that it should be a primary career goal…to get a good job working 40 hours a week for the same employer and getting good employee benefits.

What happened to trying to change the world, to innovation and reaching for new horizons?  What about “taking the fork in the road less travelled”?  What a bleak outlook…working 40 hours a week at Super Duper Drugs, getting your eyeglasses paid for and a 20% staff discount.

The Workopolis Report also indicates that 56% of all university graduates believe that they are over educated for the actual job function they are performing.  I speculate that if this same question was posed to many pharmacy graduates a few years into their working careers, the percentage would be much higher…likely north of 75%.

The big pitfall in looking at statistics on a quantitative analysis basis is that it gives a false impression.  A better indicator of the level of professional satisfaction would be a qualitative analysis of what many employed pharmacists actually do on a day to day basis, especially those that work for Big Pharmacy.

If we were to compare pharmacists, to say nurses (also 95% employed as nurses), we would likely find that 99% of nurses are actually very busy performing the duties of a nurse; most nurses would claim that they are overworked and that hospitals are understaffed. The world appears to need even more nurses.

The same is not true for pharmacy.  In every urban centre across the country (and many rural ones as well) there are many instances where there are way too many pharmacies.  Every box store, every grocery store, every mass merchandiser on top of all the chains and the independents all competing for a finite number of patients/customers and often for different reasons, least of which is the provision of health care,

Visit many of these food/drug combos and you will often see one pharmacist working alone in a 10 by 20 foot cubicle…not enough prescriptions to hire even one pharmacy assistant so the “performance metrics” dictate.

The pharmacist is staring at a computer screen, often looking a bit awkward while the smell of barbequed chicken wafts through the air and we are reminded yet again that this is Senior’s Day over the sound system.

If an analysis was done of the actual activities that many of these pharmacists perform in an 8 hour period, it might be surprising to discover how much time they spend ringing in and bagging merchandise, entering data into a computer, counting pills, checking inventory, answering questions as to where the toys are etc., all of which could easily be done by a high school kid with a couple of months training.  Often only a minority of the time that the pharmacist is in situ, is spent counseling patients or doing anything close to what she was highly educated to do.  Everyone knows this reality, but everyone chooses to ignore it.

Why has this happened? How did this happen?  How is it that so many pharmacists are underutilized, and yet, hundreds of international pharmacy graduates were encouraged to immigrate to Canada to fill a false shortage created by Big Retail Pharmacy?

How did Ontario end up with a second Faculty of Pharmacy at the same time all this was happening and at a cost of hundreds of millions of dollars?

Very simple answer: the number of pharmacists in the work place has little to do with the actual need for pharmaceutical services required by the patient population; there is no direct ratio between the two.

The number of pharmacists in the workplace is directly related to the number of ‘pharmacy outlets’ that Big Pharmacy chooses to open.  This is how we end up with 10 pharmacies all within 200 yards of each other.  It has nothing to do with need for pharmaceutical services, but everything to do with selling more and more stuff, some of which may be health related, but most of which is the antithesis of health and well being. (Pizzas, decadent chocolate chip cookies, soft drinks, chips, Fat Flushes, Cold FX etc).

The sooner we begin to tackle pharmacy’s biggest challenge…i.e. the dominance of commercial interests over the profession of pharmacy, the sooner we can claim once again to be a profession which has patient care as a central focus of our activities, and the sooner there is a real match between demand and supply.

Until we do this, all the ‘job prospect’ numbers are driven by retail imperatives, share of market, basket size, etc. etc.

At the end of the day, the Workopolis Report as it pertains to “pharmacy jobs” makes very little sense if it is viewed from an actual pharmaceutical services delivery perspective.

Too bad that the universities, pharmacy regulatory bodies and pharmacy associations continue to bury their heads in the sand on this critical issue.