The Changing Pharmacy Landscape and its Effects on Patient Safety 

Though the coronavirus disease 2019 (COVID-19) public health emergency declarations have officially come to an end, the effect of the pandemic and changes to professional roles and workplace standards will be felt by pharmacists and workers across many industries for years to come. 

In the post-COVID-19 context, the pharmacy landscape continues to evolve. Noteworthy demographic trends include decreasing pharmacy school applications alongside increasing opportunities for those who apply, as well as a changing job outlook for both new and seasoned pharmacists. Such trends may place additional pressure on pharmacy practices, chains, and schools to become more focused on recruiting and retaining talent in the coming years.  

Changes in the Pharmacy Workforce and the Decreasing Number of Pharmacy Students 

Following the unprecedented workplace challenges of the last three years, many experienced pharmacists of the baby boomer generation (59-77 years old) – and older members of Generation X (42-58 years old) – are deciding to either retire or seek better opportunities and work-life balance by transferring to less demanding roles in non-retail pharmacy settings. Pharmacists who are leaving the profession often say they are doing so because of professional burnout and insufficient compensation for increased hours and duties in an increasingly high-stress retail environment. 

Rather than leaving the profession altogether, some seasoned pharmacists have also been opting to step down or transition into different roles, such as working from home for pharmacy benefits managers or insurance companies. These alternative positions allow them to practice pharmacy without having to adapt to pandemic-related changes – administering COVID-19 testing and vaccinations, accepting reduced staffing and lower pay, or utilizing new technologies – at the later stages of their careers.  

Pharmacists just entering the practice would likely fill the gaps left by the loss of more seasoned practitioners, and such workers are certainly in demand in retail pharmacy settings. These newly licensed pharmacists have completed training in the latest technologies and practice models, adding to their appeal during the hiring process. 

However, as pharmacist vacancies increase, enrollment at schools and colleges of pharmacy has declined. The American Association of Colleges of Pharmacy’s (AACP’s) PharmCAS Applicant Data Report shows that even before the pandemic, the total number of PharmCAS applicants had been steadily declining, dropping from a high of 17,617 during the 2012-2013 application cycle to 15,335 applicants in the 2018-2019 cycle. Later, at the peak of the pandemic, the applicant total fell to 13,324 during the 2020-2021 applicant cycle and then decreased by an additional 15.8%, to a low of 11,219 people submitting 32,848 applications in the 2021-2022 cycle. 

Demand for Pharmacy Professionals Continues to Rise Amid Slow Job Growth 

Though the number of students pursuing careers in pharmacy is declining, the number of pharmacist job postings per year increased from 62,051 in 2021 to 68,988 in 2022, including 41,484 postings for retail pharmacists in particular, according to the AACP Pharmacy Demand Report. Job growth is expected to continue over the next decade, according to the Bureau of Labor Statistics’ Occupational Outlook Handbook, but the workforce may not grow quickly enough to meet increasing demand for pharmacy staffing. 

Despite these upward trends, both chain drugstores and independent community pharmacies reportedly have had difficulty filling open positions this year, resulting in situations such as some employers cutting back pharmacy operating hours due to a lack of qualified staff. In a recent survey of pharmacy owners and managers, 67% said they are having trouble filling open positions, according to the National Community Pharmacists Association.  

Offering a different perspective on this workplace issue,  American Pharmacists Association (APhA) issued a statement in January asserting that when pharmacies reduce their operating hours, it is not due to a pharmacist staffing shortage but rather due to “a shortage of pharmacists and technicians willing to work under the current conditions.” Such conditions include working in a more stressful environment to perform the same amount of work in a shorter period of time.  

Appropriate staffing and workplace conditions are essential for pharmacy teams to safely deliver quality patient care, said APhA, yet pandemic-era practice changes, such as increased scope of practice, may continue to affect pharmacists for the foreseeable future. 

Overworked employees are more likely to make mistakes, including medication errors, which can have life-altering consequences for patients. To address these concerns, NABP President Lenora S. Newsome, PD, announced in May that her initiative will be to provide resources in support of the mental health and well-being of pharmacists and pharmacy staff. To kick off the discussion, a task force will be held later this month to discuss this topic. 

New Challenges on the Horizon 

With members of the baby boomer generation having longer life expectancies than earlier generations, the health care industry needs to continue preparing for expected increases in patients, prescriptions, and associated expenses, or else risk being overwhelmed. 

Health systems must address the unique needs of aging populations, according to World Bank, which recently reported that by 2050, 1.5 billion people will be 65 and older. They predict that as populations age, chronic diseases will skyrocket, and seniors will face multiple barriers to care, including high costs, lack of access to medicine, and insufficient numbers of trained health care providers. 

We will be faced with new questions as this situation continues to unfold. How can pharmacies ensure safe practices with more and more demand for prescriptions to be dispensed, but fewer pharmacists to fill them? If technology is part of the answer, how will new technologies be incorporated? How can we build a pharmacy workforce that students are interested in joining? What measures do we need to take to sustain patient safety in the changing pharmacy workplace?  

NABP’s task forces will gather input and insights from pharmacists and other pharmacy professionals to develop new solutions with the goal of creating a sustainable pharmacy workforce while maintaining safety for patients.  

This blog was adapted from an article that originally appeared in the July/August 2023 issue of Innovations.