Steph’s Note: (Bonus points if you get the Judy Blume reference!) Anyways, it’s been a while since we’ve had a good rant on tl;dr - mostly because we really try not to be ranty pharmacists but also because we’re really rather positive, happy people! That being said, sometimes things just gotta be said. So we have something of a rant for you all this week…but I still even hesitate to call it a rant. It’s really more of a call to action. A plea for change. A supportive slap on the shoulder for a large portion of our colleagues who need it.

Spearheading this call to action is Vaidehi Parekh, whom you may recognize from her previous posts about specialty pharmacy and community-based pharmacy residency programs. Vaidehi currently works as a Senior Clinical Consultant for a healthcare technology company but has years of experience in both a PBM-owned specialty pharmacy and retail pharmacy with a large chain. Needless to say, she not only talks the talk but also walks the walk!

So Vaidehi, you have the floor. What do you wish the powers that be would know about retail pharmacy in 2023?

Current Perspectives about Retail Pharmacy

Community practice gets a bad rep in pharmacy school and is often professional-shamed within our own profession. Raise your hand if you’ve heard any of the following:

“Your talents are going to be wasted in retail!”
“You’re too smart to just work retail!”
“You could do so much more with your knowledge!”
“Why would you waste your degree working in retail?”
“Oh… okay…” (Said in a disappointing tone when you tell your preceptor that you’re going to work retail after graduating.)

I’m sure there are more that I’m forgetting, but these are just some of the comments that I have heard first hand that have stuck with me throughout the years. I feel like I shouldn’t have to say this, but here we are nonetheless:

All pharmacists are clinical pharmacists.

〰️

All pharmacists are clinical pharmacists. 〰️

If this site would let me light it up like a billboard, I would. But alas, not yet an option.

I’m gonna dare to follow up this statement with this: retail pharmacists do not get enough credit.

Spongemock is being rather rude today, don’t you think? (Image)

I spent 7 years working in retail, as a tech and intern, before I graduated pharmacy school. Retail pharmacy was my first love, and breaking up with retail pharmacy was one of the hardest things I have done professionally.

WhY dId YoU lEaVe If YoU lOvEd It So MuCh?

Reason 1:

I saw working conditions worsen with my own eyes before I even graduated from pharmacy school. The chain I worked for changed pharmacy hours for all the stores surrounding us so that we were the only 24 hour pharmacy in that chain left within a large radius. This significantly increased our volume.

Despite this, my already high volume store was being drained of both pharmacist and tech hours, while simultaneously being pushed to fill more scripts and administer more vaccines. I could see the toll that the added stress was taking on the pharmacists I worked with. We were getting beaten down - and this was well before the pandemic.

Reason 2:

The chain I worked for had a formal summer internship available. If you worked for the company and were selected for the internship, they would take you out of your home store and place you into a different store for the 2 month internship period.

Luckily for me, my summer internship was at a unique location: a hospital outpatient pharmacy that also doubled as a specialty pharmacy. Conveniently, my manager/mentor for the summer was also the RPD for the community-based residency for the chain in my area. Those 2 months absolutely changed my life as I learned about community-based residency and specialty pharmacy.

So yes, I broke up with retail pharmacy. But I owe my experiences in retail pharmacy for everything that has since happened in my professional career!

(Brief sidebar and bit of advice… For those of you that work in retail pharmacy now and are not sure what you want to do after graduating, I encourage you to explore options within your chain. Like me, you might not know what even exists that could quite literally change your life. Alternatively, you could explore the options and still decide that you truly love retail and want to stay right where you are!)

With that, let’s get back to our scheduled rant.

Fast forward to post-grad. I was in the middle of my community practice residency when COVID hit in 2020. Things were calm in the retail world for a bit as the world was on lockdown, but that didn’t last for long. Retail pharmacies became the one-stop-shop for COVID testing and COVID vaccines in addition to the usual responsibilities.

Between the stress of the pandemic and an increase in duties with no additional assistance, large numbers of pharmacists left retail in an attempt to find better working conditions. Many didn’t want to leave their patients behind but could no longer work in a stressful environment for 8 (10/12/14)+ hours a day, nearly every day of the week, with barely any time to use the restroom or eat despite being given lunch breaks.

What’s the result? Now there’s a shortage of pharmacists working retail. Read that again because it’s not a shortage of pharmacists period… It’s a shortage of those willing to work in retail with the current working conditions.

Even APhA has straight up called out the issue:

“Some are blaming reduced hours on a pharmacist shortage. It is incorrect to say that there is a shortage of pharmacists or pharmacy technicians. More accurately, there is a shortage of pharmacists and technicians willing to work under the current conditions. Pharmacy is a rewarding profession, and pharmacists are experts in medication use. We need to stop conflating and blaming the current conditions on pharmacist or technician shortages, when it’s due to short-staffing and health care system faults.” - Ilisa BG Bernstein, PharmD, JD, FAPhA, interim executive vice president and CEO of APhA

Good try, retail powers that be… but those shiny money numbers may not be sufficient anymore. (Image)

In response to the relative shortage, large chain retail pharmacies are offering huge sign-on bonuses and high salaries in an attempt to drive pharmacists back into retail.

In reality, most pharmacists don’t think it’s worth the tradeoff. We’ve found jobs that give us a better work-life balance, less stress, and maybe even the ability to work from home!

So this is my call to action for the retail powers! If the large chains want pharmacists to come back and stay, they need to make genuine changes. Here are my suggestions.

How to Improve Pharmacist and Technician Retention in Retail Pharmacies

Bring back pharmacist overlap.

For stores that are open the common 14 hours a day (8 am - 10 pm), there should be a minimum of 3 pharmacists working; 1 opener, 1 mid-shift, 1 closer. Ideally the pharmacist should only be working alone for a max of 2 hours at opening or closing. Outside of those solo hours, there should be 2 pharmacists working to keep up with prescription review, counseling, immunizations, blood pressure checks, COVID and flu testing, OTC questions, etc.

If the pharmacy is staying caught up on work, do not cut hours!

The reason the pharmacy is doing well is because they have enough manpower to keep it running smoothly. Please don’t punish the team for performing well. They likely rather enjoy fulfilling some basic human necessities, like being able to eat and go to the bathroom when necessary.

Lunch breaks should not be at shift changes.

This defeats the purpose of giving lunch breaks. Many pharmacists end up leaving at the start of their lunch break or coming in after their lunch break. The time to give a break is in the middle of the shift when they need to eat (and potty), not right as they are getting ready to start or end their shift.

Pay technicians more and remove pay caps.

These people comprise the backbone of the pharmacy, and we can’t fulfill our pharmacist responsibilities without them. We turn into techs if we don’t have techs. That’s not what we went to school for, what our patients or providers expect from us, or what you’re paying us for!

Tech retention is low in part because they can find higher paying jobs outside of retail pharmacy, especially if their pay is capped. Inflation isn’t capped, so why should their pay be?

The US Bureau of Labor Statistics estimated a mean hourly wage of $19.35 for pharmacy technicians in 2022. Fast food and counter workers had a mean hourly wage of $13.53. Now don’t get me wrong. We all love when our McDonald’s hamburger comes out correctly, but don’t you think that correct medications are higher stakes and worth more than an additional (not even) $6/hour?

The tl;dr of This Call to Action

All of this to say, please remember that our friends in retail pharmacy are overworked and undervalued. If they didn’t do it, who would? Let’s give them the respect and the kudos that they deserve for being there for patients even at the cost of their own health and well-being.

Never forget that at the end of the day, we’re all pharmacists, and we’re all clinical in our own respect. The way we practice might look different, but we all have the same goal in mind: helping patients.

End rant.

Are You There Retail Pharmacy Managers? It's Me, A (Former) Retail Pharmacist