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Pharmacists: What do we do, why we are needed, how much do we make.

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  • Jun 23rd, 2015 2:49 am
Newbie
Mar 31, 2010
66 posts
11 upvotes
Surrey

Pharmacists: What do we do, why we are needed, how much do we make.

Pharmacists: What do we do, why we are needed, how much do we make.

Dear All,
I am a UBC pharmacy student just finished my 3[SUP]rd[/SUP] year of study and going into my final year. I accidentally discovered this thread and felt the need to create this thread for pharmacists’ voices to be heard. I had worked in corporate pharmacies, franchised pharmacies, and independent pharmacies as pharmacy assistant throughout my studies. As I have some time on my hand right now, I thought I would do this instead of doing other things. Please feel free to correct me if any information written below has errors or needs clarifications. Experienced pharmacists’ opinions are also greatly appreciated.

I am not too familiar with posting on RFD, so the formatting is not the best (the "paste from Word" function does not work well). Please excuse me on this. Ctrl+F is your friend if you are looking for specific things.
Now, I felt that I am insane to spend hours putting this together. Please comment if you have further questions, things to add, or would like to start a discussion.

Index:

I. What do we do? – responsibilities, services, and challenges
a. Daily tasks and job description (with time factors)
b. Expanded scope of practice
II. Why are we needed – our place and purpose as a health care professional
a. Importance of pharmacists in patient health care
b. Health care system problems in countries without pharmacists
c. Challenges of being a pharmacist
III. For future pharmacy students – wage, requirements, future prospects
a. How much do pharmacists make on average – BC focused
b. What does it take to become a pharmacist
c. Future changes in the profession
IV. FAQ – updated as needed

I. What do we do? – responsibilities, services, and challenges
a. Daily tasks and job description (with time factors)
From outside to inside of the pharmacy:
1. OTC (over the counter) medications counseling
(1-10 minutes depends on case complexity)
– help patients choose their cold and cough medications, vitamin supplements, natural health products FREE of charge.
2. Overseeing the store
(at all times with help from staff)
- ensure no theft on pharmaceutical products or over stocking/ abusing of these products
- make sure all the customers are helped
– ex. DM (dextromethorphan, an antitussive= for cough suppression) is actually used by many drug abusers to produce addictive illegal products (if you watch Breaking Bad, you would know)
3. Take in prescriptions
(depends on the doctor ~5 minutes)
– this is actually difficult. Reading the doctors’ writing takes practice. Drug and therapeutic knowledge are essential. Digital prescription forgeries are also screened here. Prescriptions missing information such as dosages, strengths, signatures, etc. require attention of a pharmacist to contact the doctor.
4. Preliminary prescription assessment, patient counseling and interaction check
(this should take up 5 minutes if done properly, on more complicated patients needing to contact the doctor, it could take much longer)
– here is to prescribing errors by the doctor. Upon questioning the patients of their conditions, allergies, and medication uses. Pharmacists confirms the medication(s)'s necessity(required?), efficacy(works?), safety(allergies? interactions? risk>benefit?), and adherence(patient has no problem taking the medication?) before processing the prescription while counseling the patients on how to use the medications, side effects, storage, non-pharmacological recommendations, etc. With increasing use of OTC, supplements, natural health products nowadays. This check is critical to patient safety.
5. Look up resources
(5-10 minutes)
– if asked questions or there are uncertainties with the script
6. Type up prescriptions
(done with #5)
– Make sure to type the correct medication, directions, authorized quantity, quantity dispensed, doctor’s details, insurance details, etc. all with the in-store old, slow computers on a win 2000 UI.
7. Fill the prescription
(2-10 minutes depends on whether or not the insurance company needs to be contacted. Also, depend on the internet and the insurances’ servers)
– MOST annoying process, where we deal with pharmacare and your 3[SUP]rd[/SUP] party plan with or for you. If we make a wrong judgment here, we will be audited and the coverage could be reversed (and pharmacy will lose that money).
8. (NOT our main job) Drug dispensing
(5-10 minutes)
– Pulling drug off the shelf, count the pills, and put them in the bottles– this is usually done by tech if there is no rush on the item.
9. Check the prescription, sign it, and file it away
(depends on experience, <1-2minutes / drug)
– no errors in patient, drug (expiry, strength, dose, direction, auxiliary labels, refills/ authorized quantity), doctor, and if additional counseling’s are needed.
10. (NOT our main job) Medication pick up and sale
(5 min)
– usually done by assistant. Make sure the person picking up the prescription is the patient or the authorized person. Making sure the prescriptions are correct.
11. Additional counseling
(as needed, 0-5 minutes)
12. Answer phone calls
(each call takes more than 5 minutes)
– from doctors (verbal prescriptions, or verbally answering faxed questions)
- patients inquiring about their medications, refills, OTC, etc.
13. Other managerial duties
(could more than 30 minutes)
– supervise technicians, assistants, take responsibilities of errors and customer service demands.
– if you are a store manager or someone on the management team, then you take part in the store operations

b. Expanded scope of practice
1. Immunization
– it is now a requirement to be certified for injections. Flu shot services are very important to the employers (aka pharmacy managers/ owners/ corporations).
2. Emergency supplies and adaptations
– pharmacists are allowed to prescribe medications or change medications with very specific restrictions
3. Medication Reviews
– for eligible patients on multiple medications, we provide a comprehensive review for their medications. Make sure they understand their meds and the health management is appropriate.
4. Future possibility to have more prescribing rights
– as medication experts, this will primarily serve the purpose to eliminate time and resources wasted in trying to wait for the doctors to correct their own medication related errors. We can help the patients right away if there are problems with their prescriptions (then notify the doctor).
– It will likely require extra certification.
– we are trained with a focus on medication knowledge. Many times, we know which medications are best for a patients better than unexperienced physicians
5. Pharmacists’ general attitude towards the expanded services
– positive: pharmacists can help our patients right away without having to wait for the doctors
– positive: lowering the healthcare cost by lowering the physician office visits/ billings to help more patients in the long run
– negative: All extra services we provide are unremunerated to the pharmacist, they go to the store/corporation. They are adding work load for the pharmacists to perform these services while many patients to serve and are already fully loaded with the tasks discussed in section I. Pharmacists are being pressured and exploited by our employers to perform medication reviews or do flu shots.
– negative: when patients come into the pharmacy for these services they demand to have it done right away because they do not want to wait to get an appointment with the doctors. These services then negatively affects the pharmacist’s ability to deal with prescriptions in the line-up.
– negative: adapting the medications sometimes offend the doctors and the pharmacists are not going to risk their license for some service that provides no incentives


II. Why are we needed – our place and purpose as a health care professional
a. Importance of pharmacists in patient health care
1. pharmacists protect the patients
- double checking doctors’ prescriptions for necessity, effectiveness, safety (allergy, interactions, side effects), and adherence (ease for the patient to take the medication).
- pharmacists prevent medication/ substance abuses, we can flag and inform prescribers of drug abusers who tries to poly doctor and poly pharmacy on addictive substances
- prevent over prescribing of medications
- pharmacists are the most accessible health care professionals (just walk into a pharmacy) providing first line of care to the patients
- pharmacists are drug experts relied on by many physicians and nurses for therapeutic questions and dosage adjustments
- Proper counseling and timely help would decrease patients’ mortality and complications when there are drug reactions (such as allergies or side effects).
2. pharmacists decrease health care systems’ burdens
- by decreasing physician office visits. If a condition is treatable with OTC or non-pharmacological measures, we save the patients time to visit the physician’s office and healthcare money billed by the doctors.
- Less drug related problems (side effects, allergies, etc) alleviating stress on health care system by lowering ER and physicians visits.



b. Health care system problems in countries without pharmacists
In some countries where doctors can prescribe and dispense the medications in their clinic (AKA no one financially unrelated from the doctor checks over the medication), what can happen? **I do believe majority of doctors are capable and good. However, as humans, we have flaws. These are what ACTUALLY are happening, I have seen these things happened**
1. Over prescribing
- doctors could abuse the system by over-prescribing medications. That way they can earn profit on the extra medications.
- patients receiving too many medications takes them could have additional side effects, which the doctor then prescribed another medication to suppress the side effects resulting in possible addition to other side effects, etc.
2. No prescription error prevention or immoral behavior screening
- No one checks the doctors’ work. Medication prescribing errors can occur.
- drug abusers can just find an “easy” doctor who would keep “selling” the controlled/abusive substance to them for profit.
- all these increase the health care systems’ burden as the patients’ safety are more at risk.

c. Challenges of being a pharmacist
1. Sandwiched between different health care professionals, insurance companies, patients, and their families.
– pharmacy at its core has 2 aspects: patient care and business. The patients care about their care and the employers about their business. We have to please both sides. Therefore, pharmacists often has to make sacrifices for customer service.
– many times when the doctors failed to communicate details to their patients, pharmacists became the first ones to receive the blame: price of the medication are one of the most common ones.
– some doctors are difficult to deal with and have “god” complexes, their condescending attitudes are pharmacists’ nightmares. Refusing to modify therapy without valid reasons or unacceptable telephone manners are not unheard of.
– patients gets upset by their insurance coverage, and they let their anger out on the pharmacists
– insurance companies (including pharmacare) are quite strict. When they audit prescriptions and decided to reverse their coverage, the pharmacy often has to absorb the loss.
- we have to protect patients confidentiality, even when the patients’ parents or family comes asking for the patient’s medication, we will need written consent.

2. Patients do not understand pharmacists’ duties
– they believe it only takes 5 minutes to fill up a bottle of medication.
– we are expected to provide services right on the spot, customers do not like to wait to have their OTC questions answered or their flu shots administered.
3. Lowered pharmacist to pharmacy assistant ratio
– if you are the only pharmacist in the pharmacy, you have very little time to go to the washroom or take a break until your shift ends.
- This is common with the corporations cutting down the cost and customers expecting services without breaks during the operational hours.
4. Community pharmacists has no union
– we have very little resistant to employers when our wages are lowered or our workloads are increased.


III. For future pharmacy students – wage, requirements, future prospects
a. How much do pharmacists make on average – BC focused
I am pretty sure the document I got from BCPhA for the BC pharmacists was supposed to be confidential (plus, the sample size was less than 100…), so I would just quickly point out a few things
- a google search would’ve led you to some websites with the numbers. These numbers are NOT accurate reflections of what you are likely to get when you start practicing as a pharmacist. I am going to list them here.
1. Supply and demand
– the pharmacists practicing now do get decent pay, before the corporation took over the pharmacy market in BC and the saturation happening now, they had much better wages
- the demand is quite low in Vancouver or even lower mainland in BC.
- class size of UBC pharmacy graduates had doubled starting last year with ~200 grads/ year
2. Hourly wage and bonuses
– almost everyone is paid on hourly basis
– the lowest wage I’ve heard of people being offered had dipped into $29/hour. (note: regulated techs do 2 years of college and majority of them earn >$20/hr). Even though our peers tried to resist this, it is obviously not effective as some new grads or even foreign pharmacists are willing to work for less.
– a recruiter I’ve spoken to considered his offer of $37/hr to be higher than other chains and he was right, I am starting to hear more and more low 30s offer.
– more than half of working pharmacists (in the survey) do not get bonuses or profit sharing. If they do, the percentage/ salary is negligible.
– majority of pharmacy chains provides no pension plan
– all of these accounted, we still make pretty decent amount as new graduate then we slowly lose to other graduates as our pay are usually increased by $1/ hr / year.
3. Locations
– most of the grads who wishes to start in the lower mainland will have to float (go to different stores) to get enough hours. The only way to avoid this is to sign up for outside of lower mainland. My friend decided to sign for 2 years at Fort Nelson to avoid floating and for higher pay. Depend on different chains, people usually float or work outside of lower mainland for 2-5 years before they are able to get a full time set position in metro Vancouver. Some students who is lucky (or had worked for a store for a long time) are hired by a store manager, but that is uncommon now.


b. What does it take to become a pharmacist

***if you skipped the previous sections right to section III, then you REALLY need to rethink about this profession. It’s stable, yes. It’s got a decent start off pay, yes. BUT these two things means the job is repetitive, and there are not much increase in the pay throughout your career. Please go back and see what the job really is about before you even consider the profession.

1. Please review your desired university’s requirements
- They change every year.
- 3 components: pre-requisites (your grades), application (your all around wellness), and the interview (your people/ social/ life skills).
2. People skills
- You will be the health care professional who needs this the most! Like I mentioned in section IIc, you WILL have to deal with A LOT of different people. Without good interpersonal skills, you will be miserable.
3. Hard working yet laid back
- Pharmacy school is tough. Med students gets 2 years of classes and 2 years of practicum, we get 3.5 years in school + 0.5 years practicum training us to be medication experts. At graduation, the pharmacy students will know more about medications than the newly graduated med students (on average). This is set that way, because the doctors are more focused on clinical skills and proper diagnosis while the pharmacists assist them on their medication use.
- You need to be laid back, because if you are too intense, it is hard for you to form positive relationships between people (refer to the previous point).
4. Good grades
- This is to show your ability to learn the foundation of being a health professional and your dedication to your studies. in highschool, I had 90+ average. That is now the norm for UBC science entrance. I actually would recommend a college route for the pre-pharmacy to give yourself more flexibility (and maybe get a diploma first), if the new entry to PharmD program starting next year still allows you to do that.
- UBC pharmacy’s admission average is not as strict as many thought. Many factors are considered. If you have the bare minimum 65% average, then other aspects of your portfolio has to be impressive. Normally, high 70s and decent supplements can gain you an interview.
- They eliminated PCAT (a standardized exam for pharmacy admission) starting this year, I believe (double check).
5. The interview process
- MMI format
- test out your people skills
- how you handle situations, how you answer questions. They want to know if you are suitable for the job.
- questions are quite creative. You can search up questions for med school interviews to practice if you wish.
- leave a good impression by being professional, positive, and calm. How you answer the questions are as important as your answers.

c. Why do I want to be a pharmacist
1. I love talking
2. I love science and think I am good at it
3. I care about people and love helping them
4. Unemployment rate is low
5. Do not usually need to bring work home
6. Flexibility on scheduling
7. Flexibility on job location (when have experience)
8. Stable
9. Trusted and respected profession
10. Good work environment


d. Future changes in the profession
1. Lower wage
2. Lower numbers of job openings in the lower mainland
3. Pharmacists are shifting to serve a clinical role, leaving medication dispensing to techs and machines
4. More services provided by the pharmacy as we expand our scope of practice
5. More and newer computer software
6. Pharmacists and future students needs to advocate for our profession
3 replies
Newbie
Mar 31, 2010
66 posts
11 upvotes
Surrey
IV. FAQ – updated as needed
1. I would like to be a hospital pharmacist
- You need to have good grades in pharmacy schools. There are only about 10 openings in total per year
- You will get a chance to shadow a hospital pharmacist in first year. Pay close attention, be prepared, and gather as much information as you could then decide.
2. I want to work for the pharmaceutical companies (industry)
- I once spoke to a Pfizer regional recruiter, he flat out told me that they are a business and would like a person with a business degree.
- All positions for pharmacists are generally in the Eastern Canada
- Pharmacists are only hired in call and help centers. PharmD’s (ones with research backgrounds) are hired in R&D, but those are REALLY rare in BC now (our entry to pharmD are not starting till next year).
3. Do pharmacists gets audited or checked for competency?
- Pharmacists do have to do licensing exam every 10 years.
- FYI. Doctors do not. It is actually quite scary.
4. What about moving to other provinces? Other countries?
- In Canada, there is a national wide board exam + a provincial (more of a health care system rule) exam. When moving to other provinces, just makes sure to do the additional licensing exams.
Newbie
Jun 14, 2015
90 posts
38 upvotes
New Westminster, BC
Good summary of the profession. For a 3rd year student, you seem to have a pretty good grasp of the realities of the profession. You're probably head and shoulders ahead of your colleagues who buy into the idealized version of pharmacy practice fed to you by the professors who haven't worked a day of retail pharmacy in their lives. Anyway, we're entering a time where pharmacists really need to prove their value to the health care system or we'll be viewed as a commodity forever. Most days, I feel like pharmacy is more of a customer service/retail job than a health profession. We're our own biggest weakness. The apathy of pharmacists never ceases to amaze me. Pharmacists can provide tremendous value to the health care system and I'm confident that we often do. However, we don't do a good enough job of increasing awareness to authorities and to the general public.

On another note, the relationship between our College and Pharmacare is an interesting one. Our College really doesn't have much power or influence over the big chains. We can't get tobacco out of pharmacies. We can't get loyalty points out of pharmacies which is a testament to how much people perceive pharmacy to be a product-oriented business rather than service-oriented. The Provincial Government actually has more influence over our profession than we do.
Newbie
Mar 31, 2010
66 posts
11 upvotes
Surrey
vanpharm wrote: Good summary of the profession. For a 3rd year student, you seem to have a pretty good grasp of the realities of the profession. You're probably head and shoulders ahead of your colleagues who buy into the idealized version of pharmacy practice fed to you by the professors who haven't worked a day of retail pharmacy in their lives.
Thank you for your kind words.
The issues of pharmacy practice are becoming more and more obvious to students. I did make efforts to talk to pharmacy professionals through various school events, and was able to ask questions related to employment and BCPhA. I was lucky to have worked with pharmacists who sees these problems and talk with friends who are in the job searching process.
vanpharm wrote: we're entering a time where pharmacists really need to prove their value to the health care system or we'll be viewed as a commodity forever. Most days, I feel like pharmacy is more of a customer service/retail job than a health profession. We're our own biggest weakness. The apathy of pharmacists never ceases to amaze me. Pharmacists can provide tremendous value to the health care system and I'm confident that we often do. However, we don't do a good enough job of increasing awareness to authorities and to the general public.
I do agree it is up to the pharmacists to prove that we are not just drug salesmen, but valuable health care providers. I do know that BCPhA do have MLA outreach programs to increase the governments' awareness in terms of what pharmacists do and will need to be able to do to help patients better. The outcome is not significant, though. BCPhA has the most potential to come up with strategies (like media coverage, provincial wide ad campaign) and asks all pharmacists in the province to make an effort. Initiating the program requires a lot of efforts.

vanpharm wrote: On another note, the relationship between our College and Pharmacare is an interesting one. Our College really doesn't have much power or influence over the big chains. We can't get tobacco out of pharmacies. We can't get loyalty points out of pharmacies which is a testament to how much people perceive pharmacy to be a product-oriented business rather than service-oriented. The Provincial Government actually has more influence over our profession than we do.
We have a College and an Association (BCPhA)- I know the college is more of a regulating body. I was confused about what BCPhA could actually do for the longest time, but now, I really feel that its major function is practice insurance.
When the corporate chains and big food stores decided to venture into this market, we are forced to do more "business" than "health care". The nature of pharmacy operation has shifted this way due to the competition. At this point in time, knowing the huge gap in resources and even consumer preference, it is impossible to resist the shift.

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