The Paradox of Plenty: How Retail Pharmacy Chains Can Resolve Understaffing

Pharmacists are frustrated by chronic pharmacy understaffing, PMB squeeze and increasing patient risks.

Workforce shortages present serious challenges for pharmacies. Pharmacists are frustrated by expanding roles, responsibilities and how understaffing may put patients at risk. Record high sign-on bonuses and salaries are not solving the problem. And, retail pharmacy chains seem ambivalent to the issues. When will chain pharmacies begin treating staff as people and how will they leverage technology to better serve patients and staff?  Read on to learn why this is happening and when the staffing conundrum might be resolved.

Why is This Happening?
The pharmacy business model is changing.

Pharmacy retail chains are staking their future on expanding the health care services they offer. Thousands of community pharmacies are disappearing as retail chains acquire each other, close stores, reduce store hours and lay off staff.  Pharmacists and technicians are required to perform expanding duties with less support and longer hours. And prescription fill volumes are only increasing as are the services performed by retail pharmacies. Fewer pharmacies are fulfilling growing demand and pharmacy staff are getting squeezed from all directions.
It’s unsustainable. It’s dangerously irresponsible. Pharmacists and technicians are fed up.

Talent Drain
It’s getting harder to draw the next generation of pharmacists amid an industry in turmoil.
As front-line providers, pharmacists bear the harsh burden of change. Bled Tanow, a former Walgeens pharmacist agreed saying, pharmacists “carry the weight of the pharmacy on their shoulders.”
The once-revered community pharmacist role has been diluted over the years.  The perception and desirability of the profession has declined, and the talent pipeline is dwindling accordingly. Graduation rates and applications to pharmacy schools are in steady decline. There's been a steady drop in applications to pharmacy schools, falling 64% from nearly 100,000 in 2012 to about 36,000 in 2022, according to the American Association of Colleges of Pharmacy.

Breaking Point
Understaffing fuels pharmacy staff burn-out and put patients at risk. Pharmacists, administrators and advocacy groups are ringing the alarm bells.
Around the country pharmacy staff have staged walkouts to raise awareness of harsh working conditions that make it difficult to safely fill prescriptions and the danger this poses for patients. A New York Times article highlighted the pressure on pharmacy staff to do more with much less. “It was so mentally taxing,” said Dr. Poole, a Tuscaloosa retail chain pharmacist. “Every day, I was like: I hope I don’t kill anyone.”

Workload Demands
Chain pharmacies like CVS and Walgreens appear to ignore concerns, consistently slashing staffing levels while saddling front-line workers with an expanding list of additional duties. A 2022 APhA survey showed that nearly 75% of respondents felt they did not have enough time to safely perform clinical duties and patient care.
When faced with inquiries from the media or regulatory bodies, chain pharmacies often attribute their challenges to the impact of COVID-19 and assert that the data they are scrutinized for is outdated. However, this explanation falls short in addressing the persistent issue of understaffing. Despite the closure of hundreds of community pharmacies over the past decade, there remains a pool of qualified pharmacists and technicians seeking employment opportunities. The discrepancy between the available workforce and the ongoing understaffing raises pertinent questions about the dynamics within chain pharmacies.
Retail stores often operate with just one pharmacist behind the counter for a 12-hour shift. A USA TODAY investigation revealed that 10 years ago a pharmacy might have had two pharmacists and six pharmacy technicians filling an average of 500 prescriptions a day.  Today that same store may have half the staff and a higher prescription volume – plus an endless flow of vaccine appointments, rapid tests and patient consultation calls.
It’s a recipe for disaster. “Pharmacists are so overwhelmed and worried that they’re going to make a mistake. It’s so easy to make a mistake under those conditions,” said Shane Jerominski, a pharmacy labor advocate who spent a decade working at chain pharmacies including Walgreens and now manages an independent pharmacy.
Pharmacists and pharmacy technicians are often on the front lines, dealing with an ever-increasing workload. The expansion of services offered by pharmacies, such as vaccinations and patient monitoring, has not been matched with adequate pharmacy staffing, leading to burnout and publicized staff walkouts.
“The primary reason is our concern for public safety,” said Corey Schneider, one of the CVS pharmacists who participated in the Kansas City walkout. “It’s also about basic decency. Pharmacists shouldn’t have to cry at work or go home worried that they made a mistake.”
One CVS pharmacist reported that as CVS first began to cut staff, they budgeted additional staff hours. But that soon ended and the increased volume became part of the normal daily workload. She often found herself filling one prescription every minute and a half over the course of a 13-hour shift.

Real-Life Consequences
Perils linked to understaffing are undeniable. Persistent understaffing and mandated quotas in pharmacies jeopardize patients and staff. Hazardous working conditions lead to burnout and exacerbate the risk of serious errors. The dangers are real. The consequences can be grave.
A 2022 survey conducted by the National Pharmacy Technician Association (NPTA) showed that 91.4 per cent of pharmacy staff experienced burnout because of understaffing, high workloads, high expectations, low wages, and productivity quotas. In the long run, understaffing can negatively impact the health and well-being of pharmacy staff.
The results of staff shortages can range from mild patient inconveniences to harmful medication incidents. In many cases, pharmacy errors due to unsustainable workloads have had significant consequences. A Virginia Beach a customer ended up in the ER after receiving an antibiotic despite a known history of not tolerating the drug. “The pharmacists cannot properly concentrate because they have so much to do,” said Kristopher Ratliff, a member of Virginia’s Board of Pharmacy. In Florida, an 85-year-old died after a Publix pharmacy dispensed a chemotherapy drug instead of the antidepressant she was prescribed.
Health dangers aren’t limited to patients. Ashleigh Anderson suffered a heart attack while working a shift at a CVS store in Seymour, Indiana, in September 2021. Anderson was the only pharmacist on duty the day she died. Direct statistics are murky at best but a recent study reveals that pharmacists are at higher risk of suicide - at an approximate rate of 20 per 100,000 pharmacists compared to 12 per 100,000 in the general population.

What’s the Pharmacy Staffing Solution?
Chain pharmacies initially responded with financial incentives. It hasn’t worked. While financial incentives like sign-on bonuses are attractive, they fail to address deeper retail pharmacy issues such as job satisfaction, work-life balance, and long-term career prospects. Bonuses can create a culture of transience, where individuals hop from job to job in pursuit of the next bonus, rather than committing to a particular employer or community. And, they fail to provide long-term solution.

Critial Thinking
To address these challenges, pharmacy chains must rethink their approach to staffing. Young people have to see pharmacy as a viable career path. This includes creating a more sustainable work environment, offering better support and career development opportunities, and re-establishing the role of the pharmacist as a respected and integral part of the healthcare system.
A holistic approach that addresses the root causes of dissatisfaction and burnout is essential for attracting and retaining the dedicated professionals needed to keep our communities healthy.

Pharmacists are People Too
Pharmacy staff gets yelled at. A lot. Pharmacies are usually the last stop for weary, frustrated and overwhelmed patients. Often staff literally feel patients’ pain.
Most patients don’t really understand what goes in to filling a prescription. It’s more than taking pills from a big bottle and putting them into a smaller bottle. Pharmacists are charged with assessing what medications a customer is taking, ensuring that there will be no adverse interactions and advise them about side effects and best practices.
Retail chains must establish an environment where pharmacists and technicians:

• Are set-up for positive patient interactions.
• Work in fully staffed and supported environments.
• Have safe and quota-free workloads.
• Feel confident they are providing quality patient care with every script filled.
• Feel heard and are encouraged to discuss and solve workplace issues with management.

 
Technology Solutions
With pharmacy-school applicants shrinking and the current workforce pool drying up, retail chains see a future filled with automation and remote processing. The sad reality is that the workforce shortage is likely to worsen. Technology can help retail pharmacies weather the talent shortage today while improving safety, efficiency and patient interactions moving forward.
Retail pharmacies can improve pharmacy working conditions and customer experiences through a variety of systems designed to:

• Reduce fulfillment time.
• Eliminate dispensing errors.
• Improve inventory visibility.
• Eliminate human monitoring.
• Streamline clerical tasks.

Virtual verification technologies can help reduce prescription fulfillment delays. Prescriptions can be verified by a remote pharmacist working miles away. The highly secure technology solution complies with state laws and is a game changer for retail stores, helping prevent delays and reduce the workload for on-site staff.
An estimated 68% of medication errors occur during administration. Digital drug dispensing systems (DDS) are capable of nearly eliminating errors while simultaneously accelerating prescription processing. And these systems reduce pharmacists’ stress while freeing them up to spend more time on tasks that require human interaction such as patient consultations.
Automating medication inventory management directly impacts patient safety, satisfaction, and outcomes. And reduces pharmacy staff workload by virtually eliminating manual, error-prone methods, such as “eyeballing the bottle,” to capture inventory levels.  Automated systems accurately and efficiently support chain-wide inventory counts, forecasting, and replenishment.

Conclusion
Healthcare industry stakeholders must address the critical issue of pharmacy understaffing before more lives are put at risk. The time to act is now.
It is imperative that we heed the warnings of pharmacists, administrators, and advocacy groups to prevent burnout and protect patients. Only through concerted efforts and systemic changes can we ensure the safe dispensing of medications and the well-being of pharmacy staff.

About Ridgemont ResourcesRidgemont Resources is the leading national search and recruitment firm dedicated exclusively to the pharmacy profession. Since 1998, we have been committed to finding and securing the best candidates in the United States for our clients in the Hospital, Specialty Pharmacy, Long Term Care Pharmacy, Pharmaceutical Science, and Clinical Research industries.