The Community Pharmacist Shortage: The Causes & Effects of Fewer Pharmacists Behind the Counter

By Alex Yampolsky, Pharm.D.

In recent months, pharmacies across the nation have had to decrease store hours, limiting access to pharmacy services for their communities. These availability changes have been in response to what is being described as a pharmacy staffing shortage.

To combat these staffing issues, established pharmacy chains have begun to offer dramatic sign-on bonuses to entice pharmacists to help fill those gaps. These staffing issues are being felt across all sectors of the community pharmacy setting as evidenced by a January 2023 NCPA report on drug shortages and staffing. That report surveyed over 8,000 pharmacy owners and managers and found that 67 percent stated they were having trouble filling open positions.

Where Have the Pharmacists Gone?

Prolonged staffing shortages could have dire implications on public health. The pharmacy profession must understand the fundamental issues driving this shortage and restore access to one of the most trusted and reliable healthcare providers in the United States.

A May 2022 report from Statista shows that pharmacist licensure has been steadily increasing over the past ten years to a peak of over 315,000 pharmacists in 2020. With a steadily increasing supply of pharmacists, why is the community care setting struggling to meet staffing demands? The answer to that question is complex and requires an understanding of the current community pharmacist work environment as well the financial incentives that led to this point.

Understanding the New State of Pharmacists' Wellbeing

Since the start of the COVID-19 pandemic, pharmacists have played an integral role in the implementation of the pandemic response. The CDC reports that pharmacists administered over 300 million doses of the COVID-19 vaccine to Americans nationwide. This dramatic increase in vaccination demand has since been fully integrated into the existing pharmacy workflow and has added to the growing list of needs that community pharmacy must meet to service the health of our population. This growing list of expectations on pharmacy staff coupled with diminishing reimbursements and the pressures of a global pandemic have culminated in a rate of healthcare burnout that has affected the ability of pharmacies to hire and fill open positions today.

To keep a close pulse on the tone of community pharmacy and develop an understanding of the experiences of pharmacy staff, the American Pharmacists Association (APhA) created the Pharmacy Workplace and Wellbeing Report. Pharmacy staff are encouraged to report both positive and negative experiences to provide APhA with a more complete picture of the community care setting and its needs.

The August 2022 report offered a total of 173 confidential reports over a 7-month period. Of those 173 reports, 159 were categorized as negative experiences. 33% consisted of verbal or emotional harassment and the remaining categories in order of prevalence were: discrimination or microaggression (based on race, ethnicity, or gender), physical harm (threatened or actual), and sexual harassment. Fourteen reports during this period were categorized as positive with common themes of psychological safety, good communication within the pharmacy team, implementation of technology to benefit quality and patient safety, and improvements in work-life balance.

What Can Be Done to Fight the Shortage?

As evidenced by multiple sources evaluating staffing shortages, pharmacy environments, and the effects and implications of a global pandemic, it is fair and appropriate to acknowledge the very real and pressing concerns pharmacy staff have over the community setting. To fail to recognize these concerns as a profession is to close our eyes to the ways that we can remedy them and uplift the profession to the position it deserves. Once acknowledged, we must step back and employ any and every tool to move the profession forward and renew confidence within the community pharmacy setting. Pharmacies large and small are currently offering higher wages — and in some cases, sign-on bonuses — to entice staff back to necessary roles, but this is just the beginnings of a first step.

Narrowing margins and opaque reimbursement structures have pushed the community market into a volume-based model. This has created an environment where staff are expected to do more but are given less. To combat this as a profession, we must embrace technologies that ease workflow bottlenecks and free staff to engage with their patients and each other on more human levels. We must all work together to lobby our state and local governments to expand the pharmacist scope of practice and instill payment parity and equitable reimbursement policies. We need to advocate for federal provider status.

The choice is easy.

If we can do these things, we can diversify the incomes available to the community setting and decouple the perception of pharmacy with the singular function of medication dispensing. This freedom will enable us to shift the profession away from a model focused on volume and toward one that uplifts patient health and ensures ongoing access to the nation’s most accessible healthcare providers.

The Time for Pharmacy Advocacy Is Now

The Ask Your Pharmacist initiative was started in January 2023 to bring awareness not only to the variety of services that pharmacists can perform for their patients, but also to the various actions needed to ensure those services continue to be readily available. The concern is real. The staffing issues present in the industry are real. But, thankfully, so is the solution.

The pharmacist shortage didn’t happen overnight, and it didn’t happen randomly. Pharmacists want to be valued for their clinical expertise. They want to be recognized for the work they do and not just the medications they sell. Above all, they want to be advocates for their patients. And until those things happen, the shortage will continue, no matter how many sign-on bonuses are thrown their way.

The pharmacist shortage won’t be solved by increasing compensation or perks. It will be solved by valuing the pharmacist’s expanding role in healthcare and giving them the support they need (both operationally and legislatively) to continue offering those services and operating at the top of their license — no substitutions.

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