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9/19/2000

Pharmacist Shortage Causes Staffing Frustrations

Kate Traynor

Facing stiff competition from employers in community pharmacies and industry, hospital pharmacy directors are using incentives in the scramble to fill vacant pharmacist positions.

Even large hospitals in geographic areas generally considered nice places to live can have a hard time hiring pharmacists. Alan Knudsen, M.S., director of pharmacy operations for Shands Hospital at the University of Florida, Gainesville, oversees 61 pharmacists and aims to hire enough to fill 8.5 more slots. 

Before this year, "I didn't think I'd ever have a problem filling clinical specialist" positions, says Knudsen. 

Clinical specialists are in short supply elsewhere, concurs Craig Thurmond, pharmacy operations manager for Children's Mercy Hospital in Kansas City, Mo. "It's really difficult to find good, clinically involved pediatric pharmacists." 

The national shortage isn't limited to clinical specialists, either. According to a recent ASHP survey, 70 percent of pharmacy directors believe there is a severe shortage of experienced frontline practitioners. The 432 pharmacy directors who participated in the survey also saw a shortage of entry-level practitioners—87 percent of respondents called this shortfall severe. 

John P. Santell, M.S., director of the ASHP Center on Pharmacy Practice management, predicts that pharmacist positions will continue to be difficult to fill "at least for the next five years." 

For Knudsen, a frustrating effect of the pharmacist shortage is that "it keeps us from accepting some of the roles that the medical staff would like us to collaborate on." 

Hiring a pharmacist can take a long time. Thurmond estimates that when a distributive position needs to be filled "we usually find someone within two months. For clinical positions, a search of six months is probably not uncommon." At Shands, it takes six to seven months to fill staff pharmacist positions, says Knudsen, and at least six months to find clinical pharmacists. 

New career opportunities are luring pharmacists away from "the traditional practice sites of hospitals and retail and maybe home care," says ASHP's Santell. He adds that pharmacists are "seeking other opportunities that were not as prevalent five years ago." 

Knudsen has anecdotally heard from other pharmacy directors that "very good clinical specialists went to industry." Thurmond sees pharmacists heading to community pharmacies as well as industry. 

Money is an issue. "The money is better in industry—and even in retail—than in health-system settings," says Santell. 

Not by choice, Knudsen hires few new graduates, saying that they enter the workforce with "a significantly larger debt load" than in years past. "When they hit the job market and see Walgreen's paying 25 percent more than a hospital," they opt for community pharmacy jobs. 

Knudsen notes the starting pay at Shands isn't competitive with community pharmacy salaries for new graduates but says the difference fades as pharmacists gain work experience. 

Most of Thurmond's new hires are recent graduates, and most of his current staff has been on board for less than a year. He credits a recent influx of new hires to Mercy Hospital's use of signing bonuses. 

The hospital started offering the bonuses around the first of the year and now has only two vacant positions for pharmacists. In discussing vacancies, Thurmond says, "It's a relief to be down to two." For his hospital, the cost of cash incentives is "cheaper than the lengthy recruitment process." 

How prevalent are signing incentives? Seven of the 27 employment advertisements for pharmacists in the Aug. 15 issue of the American Journal of Health-System Pharmacy offered a signing bonus. At the same time last year, none of the journal's advertisements mentioned a bonus. 

Knudsen points out one exception to his hiring troubles—a recently opened ambulatory care pharmacy is fully staffed. He describes the spacious new pharmacy as "largely automated" with a "nice workflow environment" where patients can sit across a conventional desk from a pharmacist. 

It's very important to "address environment issues and quality-of-life issues" if you want to hire and retain pharmacists, adds Knudsen. 

According to ASHP's Santell, the health-system environment offers pharmacists advantages that can't be measured in dollars. "The value and enjoyment that practitioners get from working in the hospital, maybe because they're utilizing more of their clinical skills, is worth the trade-off of a higher salary in retail." 

Over half of the pharmacy managers surveyed by ASHP this year "still feel that the health system and hospital environment is actually a bonus in terms of recruiting and retaining people," says Santell. 

And the shortage's effect on the patient-pharmacist relationship? As Thurmond says, patients' "needs are being met, we just have to work a little harder."