Covering the Pharmacy
[Sorry, the video for this story has expired, but you can still read the transcript below. ]
TED ROBBINS: Meet your new pharmacist. It doesn’t have much personality, but it doesn’t complain about the hours either. Pharmacy robots like this one at the Phoenix Veterans Hospital are the latest alternative to human pharmacists who are in seriously short supply. Take Walgreens, the nation’s largest drugstore chain says it alone will need 3,000 new pharmacists every year for the next decade. Over the last decade, Walgreens doubled the number of its stores. In the coming ten years, it plans to double again. That means it will have to at least double or triple its pharmacists to keep offering such perks as 24-hour, drive- through windows. The law requires that every open pharmacy have at least one licensed pharmacist behind the counter.
NICHOLE LITTELL, Pharmacist: Thank you. Have a good day.
TED ROBBINS: Nicole Littell began working at Walgreens after she graduated from college. She’s now pharmacy manager at this store, and she’s seen the demand for her services explode, along with the Phoenix area population.
NICOLE LITTELL: Prescription for Jane Simmons. It does get difficult. There are a lot of times where pharmacists, you know, will work a few hours at one store and have to go to another store to help out.
TED ROBBINS: The labor shortage is causing salaries to skyrocket.
NICOLE LITTELL: I mean, I never dreamed I’d be making this much money at, you know, at this young of an age.
TED ROBBINS: 28 years old, Nicole Littell is making $79,000 a year, plus cash bonuses and company stock. Some new recruits may get even more.
NICOLE LITTELL: I’ve heard, you know, anywhere from $5,000 up to $25,000 sign-on bonuses. I’ve heard some pharmacists are being offered, you know, BMW’s — some being offered houses.
TED ROBBINS: The National Association of Chain Drugstores says retail pharmacies in the US currently have about 7,000 openings. The nation’s pharmacy schools will graduate a little more than 8,000 new pharmacists this academic year. That would solve the problem, except only 5,000 or 60 percent of those graduates will work in traditional pharmacies. University of Arizona student Nicole Povich says she can get better hours and make even more money doing research at a drug company, or managing patient benefits at a health maintenance organization.
NICOLE POVICH, Pharmacy Student: Because in a retail setting, you start real high, but you tend to sort of stay in that sort of realm. There’s not a lot of advancement unless you change your position.
TED ROBBINS: Fred Paavola is assistant surgeon general and chief pharmacist of the U.S. Public Health Service.
FRED PAAVOLA: There are so many opportunities for pharmacists today — academia, the pharmaceutical manufacturers industry, the insurance companies, the pharmacy benefit managers. It’s almost unlimited where you see pharmacists can go these days.
TED ROBBINS: The demand for pharmacists follows a vicious demographic circle created by the increased use of prescription drugs. Those drugs help people live longer and healthier lives, and the longer people live, the more drugs they take.
J. LYLE BOOTMAN, University of Arizona College of Pharmacy: The longer lasting of the disease requires us to manage it not four or five years until death, but for 20 to 25 years until death.
TED ROBBINS: J. Lyle Bootman is dean of the College of Pharmacy at the University of Arizona and former President of the American Pharmaceutical Association. This year he says doctors will write the equivalent of 12 prescriptions for every person in the United States.
J. LYLE BOOTMAN: Estimates today are 2.8 to 3 billion prescriptions annually. It’s estimated by the year 2004 or 2005 certainly in excess of four billion prescriptions. That’s a tremendous percentage increase with only probably an increase of 4 percent to 5 percent of the workforce.
TED ROBBINS: Drug companies aggressively market to doctors and to patients. In 1997, the federal government relaxed rules on marketing prescription drugs on TV. You’ve probably seen commercials like this one from Schering- Plough for the best selling allergy medicine Claritin.
COMMERCIAL: Claritin has a low occurrence of side effects, such as headaches, drowsiness, fatigue and dry mouth, similar to sugar pills. Talk to your doctor about Claritin soon.
TED ROBBINS: Americans are doing just that, asking their doctors for prescriptions and getting them. A lot of people don’t think twice, since many insurance plans pay most of the cost.
SPOKESPERSON: May I have you step over to the next window? The pharmacist will go over it with you.
TED ROBBINS: Pharmacists say their role is the same as it’s been for decades, accurately filling prescriptions and counseling patients on taking medications.
PHARMACIST: Two puffs four times a day and one of the ingredients in there can make you a little jittery.
TED ROBBINS: Today, though, many pharmacists spend just as much time, maybe even more, dealing with medical insurance companies.
J. LYLE BOOTMAN: The patient comes in with a simple prescription. For some technical reason or some error, the computer says, “well, this person’s not eligible to receive this medication.” The patient says, “well, of course I’m eligible. I just went to the doctor, I belong to my insurance plan ‘x.’ Your computer must be wrong.” And so a series of phone calls have to take place. People are estimating this is occupying the pharmacist’s time to as high as 60 percent of the day.
TED ROBBINS: Experts like Bootman worry about the toll paperwork and overwork are taking on pharmacists and potentially on patient safety. A report last year from the National Institute of Medicine estimated that mistakes are made on about 4 percent of the nation’s prescriptions. That’s 120 million mistakes a year.
FRED PAAVOLA: Right now, many places are finding that pharmacists are working under stress, and when you’re working under stress and you don’t have enough people to fill the prescriptions that are out there, it is going to be tough on them. They’re going to make mistakes and errors.
TED ROBBINS: Millions of people are also self-medicating with herbs and over-the-counter drugs. That presents additional danger to a patient and a busy pharmacist, unless the customer speaks up.
NICOLE LITTELL: So it’s a two-way street, though. The pharmacist has to be sure to ask the patient, but the patient has to let us know, also, when they’re taking something over the counter or added an herb to their medication regimen.
FRED PAAVOLA: If a pharmacist is not willing to take the time with you to explain those things, then I would go to another pharmacy and find a pharmacist that is willing to sit down and talk to you.
TED ROBBINS: The pharmacy industry is doing a number of things to alleviate the shortage. The pharmacist still has responsibility for prescription accuracy, but technicians like this woman now assist them by serving customers and making calls to doctors and insurance companies.
SPOKESPERSON: We can give them a call.
SPOKESMAN: Can you do that?
TED ROBBINS: And then there’s the robot pharmacist. This one automatically fills single-dose prescriptions for hospital patients. It cost $1 million, but Phoenix VA Hospital chief pharmacist Michael Gump says it’s worth it. The pharmacy stays open around the clock, and the robot prevents mistakes.
MICHAEL GUMP, Chief Pharmacist, Phoenix VA Hospital: Everything that leaves our inpatient pharmacy is bar-coded. So from the time a physician puts the order into the computer, till it’s filled, till it’s dispensed to the patient, it’s all bar-code driven. And the final end of that is that the nurse on the floor has a bar-code device, to be sure the patient is getting the right medication and the right dose at the right time.
TED ROBBINS: The hospital is hoping to install a robot in its out patient pharmacy next year. A number of mail-order pharmacies are using them, as well. Several new pharmacy schools are scheduled to open in the next few years, and many existing schools are expanding their enrollment. The University of Arizona, for instance, where this student is doing research, will expand from its current 60 graduates to 70 graduates next year. National polls consistently rate the pharmacy profession near the top in honesty and in ethics. To stay that way, the pharmacy industry has to creatively confront a demanding mix of aging customers, expanded benefits and more products. In the meantime, customers may just have to be patient while the industry’s solutions take effect.