There isn’t a month that goes by where some well-meaning grandparent, parent, uncle, or aunt doesn’t ask me about pharmacy as a career for their loved one. What are the salaries like? Are there jobs? What are the best schools? How long does it take to become a licensed pharmacist?

Recently, my quick-and-dirty reply goes like this, “DON’T DO IT.” Almost any job is better than what I’m seeing in pharmacy today – especially those jobs that don’t require advanced education. Good wages are more than just the amount on the paycheck.

Much of my concern about pharmacists, and the pharmacy profession itself, also applies to other healthcare professionals. The medical industry consumes well over 15% of the Gross Domestic Product in the United States and it’s big business, very big business. The basic desire to help others might be the spark that causes a person to lean toward work in the medical fields, such as a pharmacist, but those ideas and hopes can easily be extinguished within weeks of receiving that prized license to practice.

Professionalism is replaced with demands for productivity and profits for the industry of hospitals, drug companies, and big box pharmacies. Workers are of little concern and often take a back seat to the goals of sales and profits. The patient remains a primary concern, not because the prevailing system itself cares about better health but because a happy patient will continue to consume every level of product prescribed to them. There’s been a meme circulating in recent years, which tells the depressing story of modern health care in a few short words: “A Patient Cured is a Customer Lost”, which is more true than any of us would like.

There’s evidence for this gloomy commentary. Here are but a few examples about pharmacy and they are similar in practically every professional health care role.

• Rules and regulations increase daily and the pressure is on the individual pharmacist more than on anyone else. Pharmacy law at every level of government places 100% of the responsibility for providing good patient care rests squarely on the backs of the pharmacist, yet a modern pharmacist has minimal influence on their work environment. Professional responsibility was a key component for pharmacists in days past when there was time to talk to patients and counsel them through every prescription dispensed. When a busy pharmacy dispensed 100 prescriptions each day there was usually time to counsel the patient. Today, pharmacies fill a thousand or more orders daily with little to no additional licensed staff. Registered Pharmacy Technicians may fill prescriptions, but the final checks and responsibility for counseling rest solely with the pharmacist. Back then there was a tight ratio between pharmacist and technician – approximately one-to-one. Today a single pharmacist may be working with as many as a dozen support staff, yet remains alone with the final responsibility for assuring patient safety and compliance.
• A shortage of pharmacists was developing twenty years ago which has been met with more schools and more licenses. A good pharmacist must produce to standards set by management or risk the loss of a job – which is particularly devastating when said pharmacist is strapped with six figures of student loan debt. Because of the growing glut of available pharmacists there are at least three more standing in line for every one that is cut away for failure to produce.
• That fear for job security causes many to ignore their health in favor of staying “at the counter” regardless of their hunger or their legitimate need for bathroom breaks. Yes, it’s true that some pharmacists believe they are forced to painfully “hold it” until the last possible moment. Some develop excruciating urinary tract infections and it isn’t uncommon to hear how some turn to illicit drugs to handle their situation.
• While there are several professional organizations for pharmacists, none of them work on behalf of the members in ways we’d expect of a union. Actually, like many boards of pharmacy, leadership in those organizations are often heavily influenced by the very companies that inflict the sad conditions on the pharmacy professional. Individual pharmacists work on behalf of management and there’s nobody to intervene.

The traditional local independent pharmacy is dying quickly. The remaining jobs are behind the counters of big box stores. Reimbursement programs dramatically harm the profitability of the small stores and they go under. Customers are funneled to the giant places where they buy their prescription drugs plus thousands of additional items – further supporting the business focus in health care..

There’s more, much more, but this should give you an idea of why I warn, “DON’T DO IT”, when asked about becoming a pharmacist.