Q&A: Factors Influencing Perception of Pharmacy as a Career

The 2024 National Pharmacist Workforce Study reveals a profession under pressure.¹ Pharmacists report increasing dissatisfaction tied to workplace stress, corporatization, and a lack of flexibility. At the same time, rising education costs and stagnant wages are prompting concerns about long-term career value—raising urgent questions about how the profession must adapt.

Factors Influencing Perception of Pharmacy as a Career / Ivan - stock.adobe.com

Drug Topics® recently sat down with Brianne Bakken, PharmD, MHA, associate professor at the University of Iowa College of Nursing and an author on the National Pharmacist Workforce Study, to discuss how perceptions of pharmacy as a long-term career have evolved in recent years.

Drug Topics: How have perceptions of pharmacy as a long-term career evolved in recent years?

Brianne Bakken, PharmD, MHA: This is probably the question that I struggled with the most in trying to encapsulate something that is, at least to me, very multifactorial. As I thought about this question, I immediately went back a little bit further. I know this is not recent years, but I think we're seeing the impact, or the influence, of the shift to the all PharmD back in the late 90s, early 2000s. The reason I went back that far is thinking about the impact that's had on the profession, which I think has been great. Pharmacy is, and continues to be, a great profession and a great career. But the shift to all PharmD really elevated pharmacists’ roles in the healthcare team. It also really started to shift the focus away from dispensing, which is still foundational to pharmacy practice, to clinical pharmacy and the delivery of clinical services, which I think is good.

One of the things we're starting to see is a failed or missing expectation. If you think about a new graduate coming out of pharmacy school since 2000, they have this idea in their mind that they're going to come out and provide direct patient care, clinical services, and all these really great things they learned in pharmacy school. The reality is, depending on where they end up, they might find themselves in an organization or an employer or position that's still really focused on dispensing, which is necessary, medications are still foundational to pharmacy, but if you come in with this expectation, and you find yourself in an organization that's focused on dispensing and number of scripts you can fill in an hour in a day, you might feel like you're not doing what you thought you were going to be doing, or maybe not doing what you desired. I think that's creating a rub for some pharmacists in what they thought they'd be doing. Overall, I think that shift to PharmD, the all PharmD, really did expand opportunities for pharmacists to provide clinical services and to have more opportunities overall.

One of the things I continue to think about for pharmacists as a career and a profession, is, yes, they have incredible clinical knowledge, but I think something that sets pharmacists apart or is unique, is that they also have this incredible understanding of healthcare as a system and this underlying business savvy and entrepreneurial spirit that maybe isn't always there in other health professions. That really allows pharmacists to do so many different things. It's not uncommon for pharmacists to have multiple mini careers within a career. I still think that that's there.

Some of the factors that have shifted the perception a little bit. Number one is definitely the cost, I think, tuition—this is not strictly a pharmacy thing, this is true of all graduate related programs and other health professions—has just risen exponentially. Unfortunately, pharmacist salaries, yes, they're increasing, but they really haven't kept up to that same degree. Over time, the return on investment is just slowly diminishing compared to some other health professions. Now you have an all PharmD, multiple years of school, cost of tuition, it's causing some new folks that are thinking about a career in health care to say, “Well, if I'm going to do 6, 7, 8 years, why not become a physician?” There's some things we've got to look at and think about there.

I think the other aspect or factor that continues to come up is just the overall corporatization of pharmacy. This is especially prevalent in the community setting. We saw a huge shift from independent community pharmacies. Our data from the National Pharmacist Workforce Study and others have shown that that environment is different than, say, a large chain. The flexibility, the involvement in decision making, there's just less hierarchy. You probably are friends with the owner, and you can say, “Hey, this is going on. Can we change this? Can we work to implement this new service?” If you're in a large chain, the hierarchy to be able to implement a change or take action or change something is just different. Those are some of the factors in my mind that have really shifted the perception.

Of course, COVID-19—again, this is not specific to pharmacists, it's true of healthcare and just of all humans that went through the pandemic—really changed the way we think about our personal lives, our work life, what we want for wellbeing, and how we want to handle that dynamic more personal and work at home. I think COVID-19 in particular really highlighted the stress and what's going on if you are in healthcare. You're coming in during the pandemic, even though it’s maybe not safe all the time, you're dealing with difficult patients. After that, I think we started to see a lot in the news media about work environments for pharmacists, and rightfully so. The rest of the general public saw that as well. It's shifted how we're thinking about pharmacy as a career.

READ MORE: Why More Pharmacists Are Exploring Nontraditional Roles

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References

1. Mott DA, Bakken BK, Nadi S, et al. Final Report of The 2024 National Pharmacist Workforce Survey. Pharmacy Workforce Center; Washington, DC, USA: 2024. Available online: https://www.aacp.org/article/national-pharmacist-workforce-studies