Automation, artificial intelligence, robotics, are all coming at once.  The speed is overwhelming and threatens to alter society in ways not yet fully predicted.  How will this affect pharmacy? … But more importantly, how will it affect individual pharmacists?  And a corollary question might be…What is Academia telling pharmacists re this very different fast changing world and the impact it will have on them?

In a recent piece in the Globe and Mail (from which I am borrowing heavily) on the subject of robotics in the work place, a striking example is given of London’s taxis, of which there are 20,000 weaving through the city daily. Getting a licence means passing the ‘Knowledge Test’ which involves memorizing thousands of street names, landmarks and routes. Passing the Knowledge Test is difficult & key to becoming a licensed cab driver.

And then along comes Uber.

No Uber driver ever takes the Knowledge Test because Uber’s mobile app is displayed on a driver’s smartphone which provides turn-by-turn instructions on where to pick riders up and where to drop them off. Street names, landmarks and routes are all laid out in detail, and the driver simply follows the instructions.

So when it comes to driving riders around, the app – not the driver, does the heavy work.

Therein lies the challenge. The app circumvents the need for knowledge of London’s streets: knowledge that riders historically paid a premium for. The result is a lower qualification standard for would-be taxi drivers; one that ultimately drives down wages, because as the job becomes more simple, it means that anyone can do it, so why should anyone incur the cost of a higher paid individual when this is unnecessary.

Anyone who performs tasks which are considered repetitive, routine and predictable is vulnerable to being replaced by a machine. The Industrial Revolution déjà vu all over again.  This is the type of work machines do well without tiring or faltering and more importantly, they do not demand any compensation or lunch breaks.  No washroom breaks either.  Sound familiar?

Many venerable professions, once thought to be untouchable, are at risk for the same reasons.  Dermatology and radiology are prime targets.  A computer can memorize millions of images of moles or MRIs and recall them in a nano-second and compare these to the image at the moment.  Plus the computer can be anywhere in the world including a low cost country like India.  Ever wonder why there are so many cosmetic skin therapy shops popping up all over?  The new market is more cosmetology and less skin disease.

Any activity which is based on accumulated data, or an activity which is repetitive and subject to an algorithmic formula is vulnerable to digital technology applications and artificial intelligence… which means the machines can actually learn from the experience they gain.

Now go back to the London taxi drivers and substitute ‘pharmacists’ into the example in place of ‘drivers’, and ‘pharmacy’ instead of ‘London’ and ‘drugs’ instead of ‘streets”.  Are we not seeing the effects of technology?  Script filling machines, computers which identify interactions and contraindications instantaneously, face recognition technology, e-prescribing etc.

Pharmacy education continues to produce graduates who in 85% of cases enter what is referred to as ‘community pharmacy’, meaning they end up working for Big Pharmacy Retail (BPR) and stand all day in a 10’ by 20’ cubicle staring into space or checking prescriptions till they get cross eyed.  A good deal of time is also spent bagging pizzas and toilet tissue, as the customer does not want to check out at the front cash where the lines are long.  The customer is always right.

How many times can you say, ‘Take with food’, or repeat instructions already printed on the label, or recommend a useless cough syrup, before delusion and apathy set in?  About 6 months after graduation, on average.

We are already witnessing Big Pharmacy Business (BPR) instituting two policies which are having a direct effect on employee pharmacists.  BPR is replacing more mature experienced pharmacists with freshly minted graduates (or IPGs) at significantly lower pay scales (so much for appreciation for loyalty and years of dedication).  Secondly the use of more pharmacy assistants (maybe also some so called pharmacy technicians) is becoming more prevalent.  Anything to save a buck in a razor thin margin business activity, namely dispensing drugs.  Still lots of money still to be made selling all the other stuff of course: cough syrups, fat flushes, homeopathy, useless vitamins etc. and we must not forget the pizzas, candy and pop.

So what has pharmacy Academia done in the face of this reality?  First Academia ignores reality, and then, if all that data isn’t enough, it pours on more data and forces all pharmacists to become PharmDs.  So now we are seeing PharmDs sitting in those 10’ by 20’ cubicles making $38.00 an hour, agonizing about how they are ever going to pay that 120K (or more) student loan, and wondering where it all went so wrong.

A Pharmacy Degree does not have to be a life sentence.  Change is happening quickly.  Pharmacists are already getting caught in the cross fire.  Plunging compensation, under employment, and even unemployment are now becoming the norm.  Meanwhile hungry governments keep picking away at pharmacy’s flesh.

The answers are: not clear.  But we can start with: adapt, innovate and be prepared to take risks & to change one’s personal environment.   If pharmacists continue to hope for the best and to rely on so called ‘pharmacy leaders’ to lead them out of the desert, doom is the inevitable conclusion.  If pharmacists leave their fate in the hands of others, the future is predictable.  Not good.

Every pharmacist must take a hold of his/her own destiny and shape his/her future with hope, job satisfaction and future security, and this just might be outside fast disappearing  traditional retail pharmacy.

It’s never too late to reach out for what you want in life, and a pharmacy degree does not have to anchor you to the sea floor.

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