Too many pharmacists? No. Greater need to use them wisely? Yes!

April 10, 2015

The probable is not pharmacist glut. The problem is underused pharmacists.

Ken BakerTwo subjects are being widely discussed in the world of pharmacy. The first is whether there is a surplus of pharmacists. While a few years ago pharmacy school graduates were able to choose from a selection of good jobs in exactly the locations they wanted to practice, today new graduates must compete for available positions. Pharmacists can still find jobs, but they must look further from home, and sometimes the jobs are less than the ideal versions the students had in mind.

There are, as the argument goes, too many pharmacists for the number of positions available. At least at this time, that is probably not true. It is true that some students do not have jobs waiting when they walk out of the university, diplomas in hand. It is also true that competition for choice positions is getting tougher and tougher.

See also: Duty to warn: The importance of the pharmacist in everyday practice

Out of the basement

The second topic under discussion in pharmacy today is the growing recognition of the value of pharmacists’ training and skills. Pharmacists are no longer confined to the basement of the hospital or to an area behind the counter at the community pharmacy. As the shortage of pharmacists has evaporated, more pharmacists are being employed in clinical positions.

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A study in the Archives of Internal Medicine compared the numbers of preventable adverse drug events (ADEs) when pharmacists were or were not involved in discharge counseling of hospital patients. The results were dramatic. Thirty days after discharge, preventable ADEs were detected in 11% of patients in a control group compared with 1% of patients in the pharmacist intervention group.1

At a time when “adverse drug events [ADEs] result in more than 700,000 Emergency Department [ED] visits yearly,”2 it has been proven that pharmacists added to the ED staff can result in increased patient care and decreased overall costs.3

In 2010 the Office of Inspector General for Health and Human Services estimated that 180,000 annual Medicare patient deaths were due to what was characterized as “bad care.”3 The fact that pharmacists can improve these numbers has drawn increasing recognition.

 

Greater numbers, more need

These two topics may have a symbiotic relationship. The dark clouds surrounding the problems associated with pharmacists’ growing numbers and resulting competition may have a silver lining.

Pharmacists are needed in more areas now, and now there will be enough pharmacists to begin to fill these needs.

Today’s pharmacists must prove their worth with more than a piece of paper bearing a license to practice in the state. While high grades are still important, other skills are necessary.

Pharmacists who can speak a second language, who have a demonstrated work ethic, who have a proven record of customer care, who can get along with coworkers, and who can communicate with physicians, colleagues, and patients are the ones who will be placed first. More and more, the pharmacist who is recognized as having superior knowledge in either general pharmacy or in a specialty practice will be seen as having higher value.

Legal and ethical duty

Pharmacists and students would no doubt rather return to the days of shortage, when jobs were easy to find and bonuses were abundant. Pharmacists, however, have a legal and ethical duty to serve the best interests of their patients. When we did not need to prove our worth, but merely relied upon the paper license to make us valuable, we were not forced to constantly improve.

Some pharmacists believe it was enough to be able to put the right tablets in the bottle with the right label. That is not enough for the patient or for healthcare in general.

Pharmacists can improve healthcare and improve patients’ lives. Pharmacists can reduce the number of people entering the emergence department and the number having to come back.

Good pharmacist communication saves lives and improves health, but only if there are enough pharmacists to fill all the jobs that pharmacists can do.

References

1. Schnipper JL1, Kirwin JL, Cotugno MC, Wahlstrom SA, Brown BA, Tarvin E, Kachalia A, Horng M, Roy CL, McKean SC, Bates DW; Role of pharmacist counseling in preventing adverse drug events after hospitalization; Arch Intern Med., 2006 Mar 13;166(5):565-71

2.  Medication Reconciliation in a Hospital Setting, Sara Asif, PharmD, RPh, Masters Candidate, Research Paper for PHA 5271 Health Care Risk Management, University of Florida;  citing:  Budnitz, D. S., D. A. Pollock, K. N. Weidenbach, A. B. Mendelsohn, T. J. Schroeder, and J. L. Annest. "Result Filters." National Center for Biotechnology Information. U.S. National Library of Medicine, 18 Oct. 2006. Web. 12 Feb. 2015;  Hauck, K., and X. Zhao. "Result Filters." National Center for Biotechnology Information. U.S. National Library of Medicine, Dec. 2011. Web. 12 Feb. 2015.;  Cornish PL, Knowles SR, Marchesano R, et al. "Unintended Medication Discrepancies at the Time of Hospital Admission." JAMA Network. N.p., Feb. 2005. Web. 12 Feb. 2015.

2.  Improving Healthcare: A Data-Driven Approach, Robynn Wolfschlag, Masters Candidate, Research Paper for PHA 5271 Health Care Risk Management, University of Florida, Citing:  http://healthmatters4.blogspot.com/2011/06/iom-six-aims-of-quality-health-care.html/

https://docs.google.com/viewer?a=v&pid=sites&srcid=ZGVmYXVsdGRvbWFpbnxrc2VsdmE3NnxneDo1NDQzNGM1NjFjNzJmYWI2; http://www.propublica.org/article/how-many-die-from-medical-mistakes-in-us-hospital; http://journals.lww.com/journalpatientsafety/Fulltext/2013/09000/A_New,_Evidence_based_Estimate_of_Patient_Harms.2.aspx;  http://www.nap.edu/openbook.php?record_id=10027&page=5