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Pharmacists face changes as the profession continues to redefine itself, but for most, the money's still good.
While the healthcare industry is rapidly evolving, one thing remains the same: Most pharmacists are happy in their profession. Pharmacists responding to Drug Topics’ 2015 salary survey continue to report high levels of satisfaction, in part because of the low unemployment, infrequent overtime, and high salaries that are characteristic of the profession.
But the field isn't immune to the changing healthcare landscape, and as more Americans obtain healthcare coverage and pharmacists assume greater responsibilities in providing patient care, pharmacists are also finding that workload and stress levels are also on the rise.
"We're still holding onto the traditional roles of filling prescriptions and handing those to patients, and counseling and all that goes into that, but on top of that, more and more pharmacists are providing immunizations and taking blood pressures and healthcare screenings. And then, you know, we've got these MTM opportunities that we are trying to fit into the day as well," said Marvin Moore, PharmD, president and owner of The Medicine Shoppe in Two Rivers, Wisconsin.
This year's salary survey polled 1,987 pharmacists working across the country in independent, hospital, chain, retail, mail-order, and payer environments to gauge trends in satisfaction, salaries, workloads, and stress among those in the field.
Overall, nearly three-quarters of survey participants (73.2%) reported being either satisfied, very satisfied, or extremely satisfied with their jobs.
Unemployment rates also continue to remain low, with 85.4% of respondents reporting full-time employment this year. Only 1.2% of those who responded were either unemployed or a temporary employee.
Significant overtime is also not a factor for most pharmacists. According to the results, slightly more than half of the respondents - 52.3% -work between 40 and 44 hours a week, with just 8.1% reporting 50 or more work hours each week.
The financial picture for pharmacists remains relatively positive. Slightly over half of respondents (52.9%) say their earnings each year are based on an hourly wage, and that hourly wage appears to be on the rise. While in 2013 only about a third of hourly employees reported making more than $61 an hour, this year that figure has grown to 42.6%. An additional 44.1% of hourly employees report making between $50 and $60 each hour.
Compensation may also be on the rise for salaried employees. In 2013, 12% reported earning $141,000 or more each year. This year, that number has grown to 14.4%. A significantly greater percentage (42.6%) of salaried employees, however, report earning between $116,000 and $140,000 each year, with an additional 18.6% of salaried pharmacists making somewhere between $101,000 and $115,000.
Among the respondents, 45.5% believe their salaries are average compared to those of other pharmacists in their region who work in the same practice settings.
Some pharmacists were able to boost their take-home pay in 2014 through additional commissions, profit-sharing, or bonuses. This was the case for 46.9% of the respondents who received additional income last year. Of those who reported the extra earnings, 53.3% reported that the additional compensation was $3,999 or less.
Additional income wasn't the only thing increasing pharmacist's overall income in 2014. Last year, 61.9% of pharmacists reported receiving a raise. The raises have remained modest for most, however, with 65.2% of those who received a pay increase reporting raises of 2% or less.
Moore believes that the likelihood of large raises for pharmacists is a thing of the past - at least for now, as members of the profession adapt to new roles and responsibilities, and get a better sense of where future revenue streams will come from.
"We're going to see the salaries remain pretty steady. Perhaps down the road that will change, but I think right now we're seeing less revenue for dispensing and more revenue for MTM, and until that all flushes out and we know what the future looks like, I think it's going to be kind of just wait and see," said Moore, who is a member of Drug Topics’ editorial advisory board.
Nearly 60% of pharmacists, however, say that they expect a raise in 2015, although most believe it will once again be 2% or less.
Survey results suggest that most pharmacists are content with their jobs. They report high satisfaction levels and have no plans to switch jobs in the immediate future.
In this year's survey, 35% of pharmacists describe themselves as satisfied with their current positions, while 24.5% are very satisfied and another 13.7% would classify themselves as extremely satisfied. Only about a quarter are somewhat dissatisfied or extremely dissatisfied with their positions.
"I think most people are pretty happy around here with their job," said Nancy Nesser, PharmD, JD, director of pharmacy for the Oklahoma Healthcare Authority. "We tend not to get paid the same as a dispensing pharmacist, but it's gotten better."
Nesser has been with the state's Medicaid program for 13 years. As the pharmacy director, she's in charge of the pharmacy benefit and decides on restrictions and coverage for the state's Medicaid program. While the job can be challenging, she said, the advantage is that she is able to work fairly standard office hours, with no obligations to work nights, holidays, or weekends.
Moore said that his satisfaction on the job can be attributed to the expanding role he's been able to take on as a pharmacist in Wisconsin, where pharmacists can get paid for providing MTM services through the Wisconsin Pharmacy Quality Collaborative.
"Those things are exciting to me, and I think other pharmacists are seeing that we're being more integrated into the healthcare team and we're being relied upon for our skills and knowledge a little bit more. Hopefully, overall, pharmacists are excited about those sorts of things and looking forward to the future and getting even more involved with patient care," he said.
But not all pharmacists are finding happiness in their current surroundings. As one veteran hospital pharmacist told Drug Topics, he's not overly optimistic about the years ahead.
"I don't really see pay raises going up. I kind of see an overabundance of pharmacists, which is going to suppress the pay scale. And then there’s what’s going on with politics at the federal level. I know healthcare does not like change, so typically when that happens, I am used to seeing hiring freezes, no expansions, no this and no that," he said.
Regardless of their satisfaction levels, most pharmacists aren't planning to make a job change in the year ahead. While 73.4% of respondents said they do not plan to leave their present circumstances this year, David Stanley, RPh, a regular columnist for Drug Topics, pointed out that it is also important to note that more than one-fourth of pharmacists do plan to leave their positions.
"If you're at a busy pharmacy with four pharmacists, one of them is looking to get out of there. I suspect that ratio is even higher among retail pharmacists working for the big chains," he said.
Stanley himself bought an independent drugstore in 2013 after 21 years spent practicing in major chains.
"I love my current position," he said. "Being my own boss means I have the tools to practice my profession that I was never given while working for the chains, mainly adequate staffing, reference materials - even a speedy internet connection can make a big difference."
Those who do plan to make a job change listed professional advancement, income, job security, and geographic location as some of the reasons that they plan to leave their current positions.
While job satisfaction remains high for most, most pharmacists say they've seen an increase in their workload during the last year. According to the survey, 71.7% say their workload has increased in 2014, while 23.4% say that it has remained about the same. Only 3.6% saw a decrease in their workload.
"Our prescription count and sales are up consistently by double digits over last year," said Stanley. "Some of that is due to implementation of an automatic refill program, but the single biggest factor driving growth is the beginning of Obamacare. I have a lot of regular customers getting prescriptions now who lacked coverage and couldn't afford it before the ACA."
Moore said that in the midst of tighter margins for filling prescriptions and increased responsibilities, more pharmacy owners are trying to find ways to become more efficient, instead of hiring more staff and raising the pharmacy's expenses.
"It' a little tough to do that sometimes, but I think that's what we are all trying to figure out," he said.
Even those who aren't in the business of dispensing are seeing an increase in their daily workload.
"For us it's driven by different things. There are a lot of new drugs coming out and that impacts our workload, because we have to evaluate all the new drugs and then set coverage," Nesser said.
With reports of an increasing workload for most pharmacists, it isn't surprising to find that stress levels are also on the rise. Among respondents, 64.5% believe that, over the past year, their stress levels have increased, primarily because of increased work volume, inadequate staffing, and increased paperwork.
Moore said he thinks one factor in rising stress levels involves the additional responsibilities and services pharmacists across the country are now performing, such as medication therapy management services. He hopes that as pharmacies revamp their workflow process to accommodate these new types of services over the next few years, stress levels will also decrease for those behind the counter.
But regardless of how the demands of the job change in the years ahead, Stanley said, pharmacists need to find ways to manage stress and prevent it from affecting their health.
"You have to make an active effort to fight being dragged down by the working environment in most modern pharmacies," he said.
One important aspect of that, he said, is leaving work-related stress at work.
"Develop an identity unrelated to your work, where you can go to decompress - a hobby, volunteer work, even just giving yourself an hour of solitude each day," he said. "Anything that will let you get away from the problems of your work life."
The profession of pharmacy is evolving. One place where that is most evident is in the classroom, where a new generation of pharmacists prepares to step behind the counter.
Nesser, who teaches a pharmacy law class, said that she thinks new graduates will enter an industry full of opportunity and potential.
"I think that they will end up actually being more of a true healthcare practitioner and less of a dispenser," she said. "The students are getting a totally different kind of education now than we were getting in the ’80s and even in the ’90s."
Stanley believes that the industry's future success and ability to become a more valuable partner in healthcare will depend on whether pharmacy can find a way to provide services at a lower price point than others in the healthcare industry are able to do.
"You can easily imagine a future where a patient comes in and has his blood pressure checked at the pharmacy when he is due for a prescription renewal, or when a pharmacist can issue an order for a thyroid level to be emailed to the store and then issue a levothyroxine renewal, and if there are any problems, have the ability to schedule an appointment for the patient with the appropriate doctor through a direct connection to the physician's office computer," he said. "This would save the health system money by working these services into regular pharmacy visits that are already happening, while saving the time of the physician to diagnose and solve problems."
While some may be apprehensive about the changes ahead, Moore said, he is looking forward to the next decade.
"I think it's an exciting time to be a pharmacist. I think our role is evolving - not that we won't hold onto some of the traditional roles. But I think it's exciting to become more involved with the healthcare team and have collaboration with other practitioners," he said.
Jill Sederstrom is a freelance writer in Kansas City.