There are pharm jobs, but not traditional ones
Managed care has changed roles forever
You’ve been a pharmacist at Happy Hospital for six years. Yesterday, Happy completed a merger with MegaCorp Health System. More technicians already have been hired and two pharmacists with less tenure than yours were let go in anticipation of the newly created Mega-Happy merger. You welcome the challenge of an increased clinical role, but rumor has it there may not be enough clinics or programs for all the newly combined pharmacy staffs. You really start to worry when the merged system installs two more PYXIS machines, a computerized dosing system, and an automated prescription filling system. What’s worse, Dr. So-and-so is increasingly cool to you during rounds, and you’re beginning to doubt your future is going to be "Mega-Happy." What’s a pharmacist to do?
Start checking the want ads, industry experts say. "Do you want to live in the area known as the playground of the presidents?’" asks a recent ad from the human resources department at John F. Kennedy Memorial Hospital in Indio, CA. Or, if you like the idea of no state or local income taxes, an average of 315 days of sunshine a year, and accessibility to "an abundance of both indoor and outdoor activities," then maybe one of several recent openings advertised in Las Vegas is for you.
An advertisement for a pharmacist at the Mayo Clinic in Rochester, MN, touts a package of tax deferred annuities, mutual fund options, child care, a discount travel service, and an employee fitness center. Or perhaps a job in academia appeals? This past summer, the universities of Michigan and Texas were looking for a pharmacy school dean. The job market for pharmacists is healthy, if not robust, agree a variety of professionals throughout the industry. Up to a dozen ads like those above can be found in industry trade publications or even the Sunday paper, and clinical positions are among the fastest growing.
Pharmacists who want to switch jobs in the near future, however, must be willing to adapt to a job market that reflects the needs generated by managed care, capitation, mergers, and automation. For example, one hot job for pharmacists today is called an "information services coordinator." The ideal candidate is a pharmacist with a master’s in business. This job requires savvy and experience in pharmacy systems, computers, and databases needed for pharmaceutical outcomes tracking and reporting.
Some markets are tight
Research continues to be a priority, as well. Many hospitals or provider systems need coordinators for investigational drug research, say industry professionals. "My impression is that pharmacy positions are pretty regionalized," says Joe Ness, MHA, RhP, director of pharmacy at Grays Harbor Community Hospital in Aberdeen, WA. "Ultimately, I haven’t had trouble replacing people. In the last round of hiring, I had a lot of headhunters calling me, and I was surprised at how many pharmacists are represented by headhunters. That tells me there’s not a big shortage of pharmacists, but the Northwest is pretty tight."
In the Midwest, James Toohey, director of pharmacy at Aultman Hospital in Canton, OH, has had a stable staff of pharmacists for 15 years. This year he was able to create a new position for his first clinical pharmacist, but he says, "I got almost no response from my ad. I think most pharmacists are still looking to get into educational institutions. I think they feel more comfortable there, as managed care hasn’t quite hit those areas so badly."
At Syracuse (NY) Veterans Affairs Medical Center, Kathryn Fowells, chief of pharmacy services, has replaced nine pharmacists including three in clinical positions among her total staff of 20 over the past two years. It wasn’t easy, she says. "I sent invitations to over 100 pharmacists seeking a PharmD with residency, and 75% of the responses said they didn’t want to come to this region." Relocation expenses and bonuses were part of the package.
One pharmacist left simply because her spouse was transferred away. But the turnover in the other positions had to do with the need for pharmacists to adapt. "In my recruiting, the main selling point is the clinical side. The reason I’ve had turnover is some pharmacists I had here did not want to do that. They were comfortable with the way things were done before and weren’t interested in expanding their role," Fowells explains.
"We decentralized pharmacy services and added a mobile cart system," she adds."The staff members who are still here were excited about that, and those that aren’t were not excited and had some concern about it, either with the distribution system or capability. My guess is their desire or capability to do those changes was the problem," she says. Fowells adds that those pharmacists no longer at Syracuse VA went to other local hospitals or into home health care. "But that turnover has been the tool that has enabled me to recruit more clinical pharmacists, and we are at full staff now," she says. That staff is younger and more focused on clinical pharmacy. Fowells says her new hires came from five states: Maryland, Pennsylvania, Kentucky, Texas, and Florida. VA hospitals do not require an in-state license. "That’s a big recruiting opportunity for us," she says.
For their part, industry headhunters do cite mergers, hospital closings, and budget cuts as factors affecting their clients, but they don’t agree on where pharmacists are going, or where they want to go. "A lot of pharmacists want to go into managed care and HMOs and get out of acute care and traditional hospitals," says Mary Pearson of Pearson & Associates in New Orleans.
"I think a percentage that are clinically oriented would rather be in a hospital setting vs. a managed care setting. I think managed care for most still has a bad taste," says Peter Sullivan of Sullivan & Associates, a search firm based in Hickory, North Carolina.
"The number of hospitals are shrinking," says Pearson, who noted that on the day she spoke with Drug Utilization Review, she had more openings than pharmacists to fill them. "Before, pharmacists would change jobs more frequently, but now they are more hesitant on whether a hospital would be open six months from now."
"I’ve seen hospital pharmacy departments cut back," Sullivan says. "If they need 20 but can run it with 18, they will. The majority of pharmacy positions are open in retail. That’s where the market is in the chain retail setting or private independent store." He notes that pharmacists leave their jobs for a number of reasons: to advance their careers, get into a more clinical setting, or become supervisors with an opportunity for advancement. But he cautions against trying to develop turnover trends based on the industry’s merger and managed care turmoil. "I think 60% to 70% of turnovers are still of a personal nature, that is, moving closer to family, or a divorce, or some other anecdotal reason, just like any industry."
Pearson agrees that more pharmacists are seeking clinical practice settings, but she doesn’t see an employment boom anytime soon. "Many applicants say they don’t want to do any dispensing; they just want to talk to physicians and just be clinicians, but that won’t happen any time soon. That’s like opening a restaurant and saying, I don’t want to cook.’"
The employment experts say jobs are scarce in the big cities, but openings in the suburbs remain strong. "The openings are there, but not in key metro areas, mainly in the suburbs," Pearson says.
"I get calls from pharmacists who want to go to a big city, and I can’t help them," Sullivan agrees. Regionally, the Midwest is struggling to keep and attract pharmacists, mainly because salaries are not competitive with the West Coast or Southeast, Sullivan and Pearson say.
[For more details, contact James Toohey, Director of Pharmacy, Aultman Hospital, 2600 Sixth St. SW, Canton, OH 44710. Telephone: (330) 452-9911. Peter Sullivan, Sullivan & Associates, P.O. Box 2911, Hickory, NC 28603. Telephone: (800) 951-9307. Mary Pearson, Pearson & Associates, New Orleans. Telephone: (504) 887-1832.]
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