Nearly two dozen pharmacists at the nation’s largest retail pharmacy chain staged a walkout in the Kansas City metro area this week over working conditions they say put CVS Health pharmacists and patients at risk. The walkout began Thursday and continued into Friday. Organizers said they had shuttered numerous pharmacies across the metro area, which covers a portion of eastern Kansas and western Missouri. Some pharmacies outside the metro area also have joined. They estimated at least 22 locations had closed.
While the group’s specific complaints focus on store staffing and quotas, the walkout reflects a rising outcry from pharmacists at several national pharmacy chains. They say their work requirements leave them unable to safely fill and verify prescriptions, putting patients at risk of serious harm or even death.
“Pharmacists all over the nation have talked about, joked about, wanted to, wished that we could do things like this,” one of the walkout organizers told USA TODAY. “I know the pharmacists in this district – a lot of us have worked together for a long time, and we just decided we’ve had enough.”
This is an industry wide self-inflicted wound. There is a shortage of pharmacy technicians because the job is extremely high stress, under staffed and under paid, which furthers the shortage. You can walk into any medical office and see the medical assistant has a calm job for the same or more pay than a pharmacy tech who is running one hundred miles an hour with their hair on fire trying to juggle six things at once. Decades of intentional understaffing by big retail pharmacy has created an environment where no one wants to do the job anymore, which then makes it worse for those who remain. There is a hole in pharmacy’s bucket and the only way to fix the hole is to get water from the bottom of the well, which requires a bucket. Dear Liza, dear Liza, a hole.
I just love it when APhA brags they are working with big retail to improve working conditions in pharmacies, because they are certainly not working with CVS, Walmart, Walgreens, or bankrupt (again) Riteaid, and there pretty much isn’t anyone else.
A funny thing happened when Covid-19, the Wuhan virus, hit the world. America’s retail pharmacy corporations volunteered their overworked, understaffed, mentally exhausted pharmacists to take on the enormous responsibility of administering 400,000,000 vaccines in the first 12 months of the vaccination program. That represents an approximately four-fold increase in total vaccines administered by American pharmacists for the 2020-2021 cycle. With no additional staff. So do you know what happened? Every pharmacist who could find a different job or retire did just that. We saw the storm coming and we quit. By the thousands. Those poor, indentured souls who had to stay got hit by a train, swallowed up by an earthquake, and washed away in a flood. The industry is in trouble, and it is a self-inflicted wound.
Pharmacists across the state and the nation are seeing a decrease in the control of their workload and their sense of community, as well as a lot more burnout, depression, anxiety and emotional exhaustion.
Alisyn May, an assistant professor of pharmacotherapy at the University of Utah College of Pharmacy, describes the profession as “high stress with low tolerance for error” — a job that already had a large problem with burnout before the pandemic started.
She noted that pharmacy includes a wide range of practitioners, including people like Peng, in hospitals, to those in local retail pharmacies, like Vickers. But no matter where pharmacists work, the COVID-19 pandemic has drastically increased their workload and resulted in a wave of trained pharmacists and staff abandoning the profession, leaving those who remain with even more work and less support.
This is pharmacy reality – Please share it with as many potential pharmacy students as possible.
Most of you have heard of “trend colleges,” say for computer technology, medical assistants, pharmacy technicians, etc, and likely cringe at the thought of some poor kid taking out a loan for an education that is mostly worthless. These fly-by-night programs do not conform to academic rigors and standards of accredited universities and colleges. They simply part a fool from his money. This chicanery, this charlatanism, cannot possibly exist in major colleges and universities, who produce the great thinkers of our time, can it? A reputable institution of learning would never sell a student a worthless degree, would they? What about major universities offering advanced degrees in America’s most trusted profession, pharmacy? Surely, these very expensive and academically rigorous degrees will reap a financial and professional reward for their holders, right? Well, friend, sorry, they don’t. Not anymore. You did the work. You paid the bill. You earned the degree. The Uni separated you from your money, but thanks to the machinations of industry leaders like Walgreens, CVS, Walmart, and RiteAid (who control right around 30% of the job market), and pharmacy benefit managers, in league with your vine-covered institution of higher learning, the Doctor of Pharmacy degree has become an albatross of debt flailing on the back of a miserable, low paying job.
Once upon a time, pharmacy was a promising profession. The cost of education was reasonable, and the job market and pay were good. I spent six years at Oregon State University earning my pharmacy degree in the late 80s. The Grand Total – tuition, books, rent, and food – everything – came to $36,000. When I graduated I had a $42,000/year job (worth about $90,000 in today’s dollars) waiting for me. It was a good trade-off. Through the years I earned healthy raises and retired at the peak of industry wages. While Walgreens intentionally creates hostile work environments for nearly all its employees, at least the money was good, once upon a time.
Today, it will cost you ten times the dollars I spent to earn your pharmacy degree. Once you add in the cost of your undergraduate degree, you can expect to drop an average of $300,000-$400,000 before you earn your first dollar as a pharmacist. The academic inflation rate for a pharmacy degree is four times the US inflation rate over the past 30-odd years, meaning you just spent $350,000 on something that cost me $86,000 of your dollars, and you are bridging that gap with student loans. For instance, if you have student loans of $200,000, the service on that 10-year debt at 5% will be $2121 per month. Cheers, you lucky devil, you are now indentured, and your future employer knows it and will enjoy keeping their foot on your neck until you break.
What awaits today’s aspiring young pharmacist in the “new grad” job market? Not the job the sell-outs at APhA or your alma mater advertised – the job where you would collect a cool $125,000 a year – the job where you could actually afford to service your debt. Due to an irresponsible increase in pharmacy programs nationwide, 140 at last count – an increase of 30 over in just the last ten years, and the subsequent glut of pharmacists graduating every year, there are more pharmacists than there are jobs. A lot more. I mean, thousands more, and it is only going to get worse. It is like a broken fire hydrant flooding the streets with pharmacists, gushing out all wet, cold and desperate, and if you cannot find a job in the industry, your $350,000 degree is not worth the paper on which it is printed. You have no other marketable skills. Walgreens can smell your desperation like the nervous stench of a thirteen-year-old boy at a school dance.
Even a 2% unemployment rate for pharmacists is catastrophic, leaving over 6,000 debt-ridden practitioners desperate for a paycheck. Not to mention the underemployed – if you add the unemployed, under-employed, and pharmacists like me who simply walked away because the job sucks, and there are a lot of us, you will easily get a number at or above 2% if anyone cared to collate the stats.
The temporary surge in hiring and retiring pharmacists due to the Covid crisis will eventually collapse. Before Covid, every new hire I talked to had taken a substantial pay cut. Walgreens has managed to replace nearly their entire veteran North Idaho pharmacist staff in the past three years with cheap, new hires. A friend still on the inside told me WAG is currently offering $60-70,000 a year to new grads in the Portland market. The current pharmacist “shortage” is a self-inflicted wound by the industry. They, Walgreens and their ilk, treated so many of us so horribly, en masse, we took early retirement when Covid hit. We were already stretched beyond the breaking point, only to have the burden of Covid thrown on our shoulders. It was a painfully funny miscalculation on the industry’s part. They believed they could abuse us forever with no repercussions.
Number of Pharmacy Graduates by Year
While the number of pharmacists grows each year by 15,000 new graduates, only 7,000-10,000 will age out of the industry once Covid fades, and the number of available jobs is expected to shrink over the next decade by about 7,000. Think about that… an extra 5,000 debt-laden licenses a year, every year, for the next two decades. Do not forget, those 15,000 annual new grads have to compete against the thousands of unemployed and under-employed pharmacists already in the market. Today’s P1 student could easily come into a job market in 2025 with an unemployment rate of 5-10%. Think about what that will do to wages and working conditions. Big Retail knows you have no choice but take their paltry offer. This is one of the ways Walgreens plans on propping up is recently sagging earnings. Every $10,000 WAG saves in pharmacist wages results in a $270,000,000 savings the company can waste on their many harebrained schemes, like turning their pharmacists into mental health crisis counselors for store customers.
What awaits you, my pharmacy friend, is a job at Walgreens earning $60-70,000 a year, a nearly 25 year rollback in wages where you get to party like its 1999. A lousy, high stress, understaffed, hell-hole job, where the first $2100 of your paltry $3300 take-home pay gets nicked to pay your debt. That is if you are lucky. You might get stuck working a mishmash of unbenefitted part-time jobs just to make ends meet. At the end of day, you will see the real earnings of a minimum wage job for your first decade of servitude, and then you will turn a bitter forty years old. So, congratulations are in order! After all of your really, really hard work earning one of your university’s most difficult and expensive degrees, you will make about the same as the general manager at your favorite Denny’s Restaurant, only the Denny’s manager is not saddled with $200,000 in student debt, so they can afford a mortgage rather than moving into their parent’s basement to save on rent. A trucker with a GED and zero student debt likely makes as much or more than you, and already has fifteen years of earnings under their belt before you save your first dollar. Hell, if you are a USC grad (at the University of Spoiled Children, one of the biggest educational ripoffs in the known world, eight years costs about $700,000) you may never actually earn back the cost of your education. You, my friend, have just been “Trend Colleged,” only you lost eight years of your life instead of one, and Joe Biden ain’t gonna be able to forgive you student debt. You ought to sue for a refund, my pharmacy friend, just sayin’.
I just wrapped up my thirty-year pharmacy career a few weeks ago. It is not that I did not have a little juice left in the tank to carry on a few more years, it is that working conditions in retail community pharmacy have become unbearable. I spent my last thirteen years working for Walgreens. In that time, they gradually cut pharmacy staff in half per prescription. The company stopped raises five years ago, and all newly hired pharmacists are taking substantial pay cuts. Benefits are a shell of what they were when I started with the company in 2007 and the demands the company makes on its pharmacists have become impossible to meet… even for the best of teams. It used to be hard work, and I sometimes enjoyed it. Today it is just an abusive relationship where pharmacists are treated like indentured servants. Do you recall the old saying, “The beatings will continue until morale improves!”? At Walgreens, it is just, “The beatings will continue.”
Why are they doing this, you ask? Simple answer, because they can. Here is pharmacy history 101.
Thirty years ago, as I was about to graduate, America had a lot of regional drug chains competing for new grads. Most of these chains were bent on organic growth, expanding operations to accommodate an aging population. Insurance plans still paid relatively well, and the work environment was relatively healthy. Then the industry had a convergence that created a shortage of pharmacists. At the same time when small and mid-sized chains were rapidly expanding, the industry lost an entire graduation class of pharmacists nationwide. Thousands. Before the 1990s, the standard pharmacy degree was a bachelor of science. In the early 1990s, every school across the nation began converting to doctoral programs producing the PharmD degree. This added an additional year to each program, thus the equivalent of losing an entire class.
The basic rules of supply and demand are, if something is in short supply, the price goes up. If the market has a glut, the price goes down. Easy idea, right? Well, from the early 1990s through about 2010, there was a relative shortage of pharmacists. Pharmacy chains were forced to do three unspeakable things.
Treat their pharmacists with a modicum of respect.
Give them regular raises to retain them as employees.
Pay sign-on bonus’s to steal them from competitors.
You can imagine the amount of corporate resentment that built up over these years.
Nature abhors a vacuum. As a response to the shortage, universities all across the country began opening schools of pharmacy. I suspect major pharmacy chains, like Walgreens and CVS, donated significant funds to get these schools opened as a matter of self-interest. Students flooded these new schools, lured in by pharmacy’s reputation for high wages and job security. By the early 2010s pharmacy reached equilibrium, and since then there has been a growing glut of pharmacists to the tune of tens of thousands.
By 2015 a second convergence occurred. Chain pharmacy over-expanded in the 1990s. Organic growth, building shops from the ground up, is expensive. Add in the rising cost of hiring and retaining pharmacists, and it was a formula for financial trouble. Financial trouble is the root of mergers, acquisitions, and store closures. Out of school, I worked for Fred Meyer, a company involved in five mergers and acquisitions since 1980, ultimately becoming part of Kroger in 1998. I did not like Fred Meyer, so I signed on with an up-and-coming chain called Drug Emporium, who was then swallowed up by Longs Drugs, who was then swallowed up by CVS, who closed my store. I signed on with Walgreens, a company that gave up on organic growth a decade ago. Their expansion over the last ten years has been through mergers and acquisitions while closing underperforming locations.
The overall net result has been a contraction in community pharmacy by about two thousand shops nationwide over the past five years. Add to that the growing glut of new graduates, and job scarcity with lower wages are the results. All those students who took on enormous debt, hundreds of thousands of dollars for some, on the promise of good, stable, high wage jobs, are now scrambling to find any sort of work at all. They scour the nation for job openings and end relocating to Podunk, USA for a mercilessly high stress job at 70 cents on the dollar. For twenty-five years pharmacist wages beat the pants off of inflation. $20/hour in 1990, a typical pharmacist wage, adjusted for inflation, is $40/hour today. Pharmacy wages peaked in the $60/hour range in 2014. The industry, nationwide, plans on rolling all that back. By 2025 wages will likely drop to $35 to $40 per hour simply because of supply and demand. New grads need to readjust their expectations.
There are some healthcare careers worthy of passionate practitioners. Pharmacy is not one of them. Sure, there are a few clinical jobs where the pharmacist plays a key role in patient care, but the vast majority of jobs are retail jobs that combine elements of urgent care and fast food operations. Today’s pharmacists are the equivalent of the finest chefs from Europe stooping to manage a Denny’s to make ends meet. If you are thinking of applying to pharmacy school, don’t do it. Your student debt will effectively make you an indentured servant and you will be miserable.
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