Robot Pharmacists?

Many pharmacy students or prospective pharmacy students wonder if automation or robots will replace pharmacists. This may be a concern for those who wonder if there will be enough jobs available by the time they graduate from pharmacy colleges. It’s a valid question to ask for anyone who is pursuing a career, whether it would be for nurses, security personnel, delivery workers, or even taxi drivers. In this age of highly developed technology and innovation, it is something job-seekers could probably think about and perhaps even do some more research as we see automation everyday in our daily lives around us. Technology seems to be improving each year with more efficiency, accuracy, and less technical problems. The grocery store checkout lines with more automated self-check-out areas replacing cashiers. ATMs readily available 24/7 replacing bank tellers. Amazon experimenting with drone delivery, and even some innovative companies making headlines with testing driverless vehicles. Not only do we see automation replacing workers, but we are also witnessing other types of technology replacing the traditional model of business. Plug-and-play wireless technologies implemented in the areas of home security camera installations as opposed to using traditional home security installers. Streaming wireless television replacing traditional cable television. Online shopping such as Amazon or travel websites replacing the brick-and-mortar retailers and the travel agent, respectively. Now with these great advances in practically every sector of society, how will this impact the pharmacist profession?

One way to look at this is how current pharmacy businesses and services operate today, and to identify solutions to current problems, or ways to improve the current model even if there are no issues. Some of the goals of technology are to cut down on costs, time, and inefficiencies, and provide transparent and meaningful data to allow the users and operators to detect errors or trends in order to improve a “system.” We can apply this to the pharmacy service model in retail and hospital, and suggest possible solutions, and its potential ramifications to the pharmacy workforce if such solutions are implemented. Here are a few common problems or areas that could be improved in the retail and hospital pharmacy setting:

Retail

Long Lines/Waiting: Prescription dispensing machines, similar to bank ATMs, could potentially reduce the need for a 24/7 pharmacy drive-thru or checkout counter. Mail-order, already available from many pharmacies, may also increase in wide-spread use which would limit the need for brick-and-mortar pharmacy retailers. Similar to Amazon, a customer may simply login to their account, and set up active prescriptions to be refilled and mailed on a scheduled monthly basis.

Limited Staffing: Widespread use of integrated and compatible prescription transmission from the doctor’s offices directly to the pharmacy software could reduce the need for the patient/customer to go to the pharmacy in-person, and cut-down on pharmacy personnel needed to receive the written prescription from the customer. Robotic counters, packagers, and fillers could replace the need for human pharmacists or technicians to manually fill routine or daily refilled medications for customers to pickup from the pharmacy. Mail-order pharmacies (as discussed above) may resolve the need for some staffing.

Hospital

Missing Medications: Utilization of advanced automated dispensing cabinets or machines housed in hospital units for common medications could reduce the need to deliver medications, and the time required to find missing medications or replace medications that are not found after delivery. This is a potential area needed of improvement, for which a solution may not necessarily reduce the pharmacy workforce or affect it at all.

Delayed Medication Delivery: As noted above, usage of automated dispensing cabinets or machines in hospital units may reduce the need to deliver medications, thus reducing the need for transporters to deliver medications from the pharmacy to the hospital units. However, pharmacy personnel would still be required to continually refill the automated dispensing cabinets if dispensing is highly utilized within the hospital unit.

Limited Staffing: Advanced software systems could automatically review medication appropriateness before final pharmacist sign-off. Robotic counters and fillers could replace the need for human pharmacists or technicians to manually fill routine or daily refilled medications for patients.

Cart filling medications: Robotic counters and fillers could replace the need for human pharmacists or technicians to manually fill routine or daily refilled medications for patients.

It may come as no surprise, and maybe even expected that there will probably be some usage of automation in the pharmacy practice setting in the future. Advances in technology allow companies or owners to save money, while also potentially improving patient/consumer safety; this may be due to reduced medication errors from the use of intelligent medication information systems and faster delivery times. Similar to automation in grocery store checkout lines and bank ATMs, or even customer service agents assisting with online services, we could witness a hybrid model of human/machine model where a few workers (e.g. pharmacists/technicians) would oversee and manage a mass of automated machines and/or software systems; this could have some impact on the workforce. However, this may not always be the case as improvements in information technology such as intelligent medication information systems which provides essential medication resources (drug to drug interactions, potential adverse events, allergic reactions, etc.) allows pharmacists to save time by avoiding timely research in manually trying to find important and relevant information. Integrated pharmacy software such as computerized pharmacy order entry (CPOE) software also allows pharmacists to avoid serious transcription errors, save time, and allows the pharmacist to focus more thoroughly on reviewing medication orders. On the flip-side, automation may not always have a serious impact on the workforce as it could also present more opportunities for pharmacists to expand on clinical duties, thus improving the safety and wellness of patients. Higher usage of automated and robotic systems may present new opportunities to other sectors such as engineers and technical support specialists who may be needed to develop and maintain such technologies.

Great Pharmacy Schools For Adventurous Students

Who enjoys the great outdoors? Exploring the vast wonders of America by hiking, canoeing, or even enjoying fun activities like skiing, snowboarding, or surfing. Here in this post, we look at three pharmacy schools that may not receive as much press, but are located in areas not far from places that may provide the adventurous student several options to enjoy their time in pharmacy school. It could also provide a great balance to offset the potentially grueling four to six years of intense pharmacy school studies. Who said you can’t have any fun during pharmacy school?

For the hikers: Roseman University of Health Sciences College of Pharmacy

Roseman University of Health Sciences is located in Henderson, Nevada outside of Las Vegas. Although Las Vegas may be known for casinos, entertainment, clubs, fine dining, MMA fights, and dry hot weather, it also provides a lot of outdoor activities for those who want to “get away” from it all every now and then. Red Rock Canyon is only around forty minutes by car and provide many hiking trails, scenic drives, picnic areas, and other other activities.

For those willing to drive further to see even more of what the area has to offer, Zion National Park is around two hours and forty-five minutes away in Utah by car. Zion National Park offers bicycling, backpacking, climbing, stargazing, and hiking with breath-taking views. Some of the trails and climbs are not for the faint-of-heart however.

For the skiers and snowboarders: University of Colorado Anschutz Medical Campus School of Pharmacy

University of Colorado School of Pharmacy is located in Denver, CO. Denver is known as the “mile high city” because it is situated around one mile above sea level. It is also the home to the Denver Broncos, Denver Nuggets, Colorado Rockies, and Colorado Avalanche if you enjoy watching professional sports. Colorado is also known to have many amazing ski resorts in Aspen, Vail, Breckenridge, Telluride, and Steamboat Springs. What is not as well known are the smaller ski resorts that are not as crowded and closer to Denver. One ski resort is located just around an hour away in Loveland, CO. Loveland Skiing receives plenty of snow and opens many trails for all levels of skiers.

For those who are willing to drive a little further for a bigger ski/snowboarding resort, Keystone offers a resort with around 120 trails, and a summit elevation of 12,408 feet. Located around under an hour and forty minutes, Keystone is an excellent place to ski and snowboard with plenty of options, entertainment, and excitement.

For the beach bums, sun lovers, and aquamen: West Coast University School Of Pharmacy

West Coast University School of Pharmacy is located in Los Angelos, and less than thirty minutes by car to both Venice Beach and Santa Monica Beach, two of the more famous beaches in California. If you love swimming, surfing, rollerblading, skateboarding, playing beach volleyball, or enjoy many other beach-related activities, this area might be a great location for you. Los Angeles also is also the home to the world famous Los Angeles Lakers (think Kobe, Shaq, and Magic) and many other great sports teams (e.g. Dodgers, Chargers, Galaxy). You may even run into some Hollywood stars if you’re lucky.

And there you have it. Just a few schools located in areas not far from areas that could offer the adventurous pharmacy school student some excitement. It may even be a great place to decompress from the long hours of studying, or after a grueling exam week. There are many other schools with great locations with similar activities or even more. Just check out our pharmacy school directory and map the school addresses to your places of interest.

The Regrets of Pharmacy Students

During my pharmacy school days and years after, I’ve talked to many pharmacy school students at my program, and from many others at other schools I met from clerkship rotations or conferences about their pharmacy school experience.  One theme I recall were the regrets that some students expressed after coming to pharmacy school.  These regrets vary based on their interest, background, and the pharmacy school they chose.  Some of these issues may be of use to future pharmacy school students to consider so that those pursuing this career could view all of the angles and possibilities when making the best decision possible.

Many pharmacy school students in their senior years expressed some uncertainty about their job prospects.  According to an article in PharmacyTimes, there were 72 pharmacy schools in 1987.  In 2014, 130 pharmacy schools were accredited according to the American Association of Colleges of Pharmacy (AACP).  The rise in pharmacy schools and graduates will mean more competition for limited job openings, unless the number of vacancies available due to retirements or new opportunities match the number of job seekers year after year.

Pharmacy schools have evolved to incorporate clinical decision making into their curriculum.  This is evidenced by the trend from a Bachelor’s of Science in Pharmacy towards the Doctor of Pharmacy as the standard in today’s pharmacy schools to become a pharmacist; this may be due to the complexities found in drugs, diseases, and different aging populations to manage.  Additionally, the availability of opting for further board certifications in various specialties administered by the the Board of Pharmacy Specialities (BPS) allows pharmacists to attain further recognition in patient care.  However, pharmacists are not trained to diagnose patients in the same way as medical doctors, physician assistants, and nurse practitioners are.  They are trained as dispensers of prescriptions for the most part as opposed to prescribers (although some states allow clinical pharmacists some prescribing authority with limited scope under the supervision of a license patient care provider).  Therefore, for pharmacists interested in the clinical aspects of patient care such as diagnosing and treating patients, many pharmacy students have expressed frustration in the limited scope of their clinical involvement; they are being confined to reviewing or advising on medication regimens for complex patients such as vancomycin dosing for renally impaired patients, or managing nausea and vomiting for chemotherapy patients, and checking INR levels for anticoagulation patients.  Some students believe from their clerkship experiences that clinical pharmacists are not generally thought as being part of the essential “core” of a patient care team, and will always need to fight and earn their place in the team to be respected.  And they’ll have to  earn their place again each time a new team or leader is implemented which makes things even more difficult.   Therefore, many pharmacy students and graduates believe that pursuing a degree as an MD, physician assistant, or nurse practitioner as opposed to a PharmD  is a more preferred route for those interested solely in patient clinical care.

One last example expressed by pharmacy students include being “stuck” in the traditional retail pharmacy setting.  Because a lot of pharmacy students take on much debt to finance their education, they are also quick to accept a position in a traditional retail pharmacy immediately after graduation, and forego a chance at furthering their knowledge in other areas of pharmacy.  Such opportunities would be available in a paid post-graduate residency or fellowship program which could open doors to other opportunities beyond a job in a retail pharmacy.  A lot of hospitals look for residency experience for those who lack any type of hospital experience on their resume, especially for limited and competitive positions.  This may also be the best time to pursue a residency immediately after pharmacy school as their knowledge of pharmacy will be very fresh on their minds as opposed to someone who took a position in retail after graduation, and decided to pursue a residency and enter a new industry after many years in the retail setting.

 

Dual Degree Program: MD and PharmD

 

 

 

 

 

The Rutgers Ernest Mario School of Pharmacy currently offers a dual degree program for both the Doctor of Medicine (MD) and Doctor of Pharmacy (PharmD) in addition to several other dual degree programs such as PharmD / PhD, PharmD / MPH and PharmD / MBA.  Although, many pharmacy schools offer dual degree programs, this may be one of the first to offer some sort of pathway for an MD in addition to a PharmD.  According to the website’s current description for the program, only “enrolled” PharmD students are eligible to apply; they may apply during the Fall of their second or third professional years (P2/P3).  Once accepted, they may enter medical school after successfully finishing their PharmD program.  This is important to note because one feature many people may look for in a dual degree program is the reduced time it would take to receive both degrees at once as opposed to applying and obtaining each degree separately.  As a result, there appears to be no advantage in saving time;  it seems one would have to finish both the MD and PharmD programs in the same length of time as it would have taken to finish the MD and PharmD separately assuming the applicant enrolls into the programs sequentially.

Now let’s review the time required to be a full-fledged MD/PharmD with a few examples:

Applicant A:  Two years of pre-professional studies + four years of professional PharmD program + four years of MD program + three to fives years of residency + year(s) fellowship (depending on specialty).

Total aggregate time spent obtaining both degrees and finishing residency after a high school diploma:  At least 13 years to 15 years or more (depending on fellowship/specialty).

Applicant B:  The second type of applicant would already have a bachelor’s degree which would have taken around four years to complete, and would have to apply to pharmacy school which would generally take another four years…plus four more years of medical school.  Applying to the MD / PharmD dual degree program would mean they would have to commit to at least 15 to 17 or more years of school and training after a high school  diploma before finishing residency, and even more if pursuing a fellowship/specialty.

Assuming the average age of a high school graduate is eighteen years of age, a person finishing a MD / PharmD program and residency would probably be around 31 to 33 years of age assuming no entry into a fellowship.

Such a person finishing years of rigorous schooling should be congratulated; it is a difficult task to accomplish even one professional degree.  But before one can bask in the glory of their dual titles, with the benefit of adding extra letters on their resumes and business cards along with their names, it would be prudent to review the pro’s and con’s of such a program, as each person’s life situation will vary.  Here are some factors to consider:

Pros:

Opportunities:  The dual title will surely grant more job opportunities…more so in leadership roles which may garner higher incomes.

Knowledge:  Someone with both an MD and PharmD would surely know a good deal about pharmacology and its applications in the clinical settings.

Prestige:  Having both degrees will draw prestige…as you may be part of a very limited pool of specialists holding both degrees.

Skip the MCATs:  No need to study for this tough exam if admitted into the program.  However, your grades, extra-curricular activities, leadership qualities, and other accomplishments and experience will probably be more scrutinized.

Cons:

Time horizon:  Having back-to-back degrees and training will require more time, which could affect your social life.  An eighteen year old will probably be in their mid-thirties before they can capture their full income potential.

Finances:  Staying in school longer while being financed by high interest loans could lead to an enormous amount of debt which may take years to pay back unless you come from wealth.  One would have to obtain a job after residency (or fellowship) that pays well enough to justify the time expended to earn both degrees.  Adding to these expenses for a typical mid-thirty year old something:  compounding interests on the loan, family expenses (e.g. wedding, children, mortgage, cars, etc).

Job placement:  A dual MD / PharmD graduate should probably pursue something related to both where both knowledge and skills could be best utilized…otherwise what would be the point in wasting all the time and money? This may narrow the job searches to teaching professions or medical research and drug companies.  Also, if accepting a position that could have been obtained with only one degree or the other (e.g. MD or PharmD), such as a pharmacist or as a general doctor, or even a doctor specializing in gastroenterology who may not need a PharmD, the cost-benefit for pursuing a dual-degree program with respect to time and money may not be worth it.  Why go to medical school if you’re going to end up working in a hospital as a pharmacist?  Or why pursue a fellowship in transplant surgery when you could without having a PharmD?

The above are only a few factors to consider for the future applicant.  Of course to each their own, as one’s preferences and dreams are different from the next.  Each person will need to evaluate in their own way on whether such a program with its costs and benefits fit their goals in life.

Measuring Demand for Pharmacists

It is not uncommon these days to hear from pharmacy students or pharmacists about the pharmacist job market:  that the supply of pharmacists have risen, probably exceeding the demand for them.  If this imbalance occurs, the competitiveness with which a newly minted pharmacist could vie for a limited position rises, which could lead to the lowering of income earnings, reduced benefits, and maybe disagreeable shift assignments (e.g. night shift, weekends, holidays, etc) assigned to new hires .  Some point to the high volume of pharmacy schools that have been forming in the past decade, and the increase in class sizes observed at already established schools.  It is commonly known in the pharmacist job market that the majority of pharmacist positions are held in the retail and hospital setting.  Therefore, the demand for pharmacists may depend on the openings available in existing and new retailers and hospitals.  Job openings will post when pharmacists retire, when employees transfer or leave the position, or when new growth opportunities occur such as opening new retail stores and hospitals, as well as expansion seen in established retailers and hospitals.  In any case, a prudent pharmacy school candidate should perform thorough research to view the outlook of pharmacists’ demand and future job outlook, pay, benefits, and growth opportunities that are projected from the time they graduate and up until they retire.    Although such projections may not come to fruition in the future, it is a good idea to be informed of the economic landscape surrounding the pharmacist job market.

There are a few tips to gauge interest and demand for pharmacists which include but are not limited to job searches in your local area, and reviewing job statistics available from the Labor Department.  There are also searches that can be performed on the Internet, or information that may be of use from websites that offer some opinion or projected measures of such job demand. 

Here are a few of such resources:

Using a job search engines such as indeed.com will return available results within a locale.  For example, typing in the keyword, “pharmacist” in the “New York, NY” area generates 411 job results (see below) as of the time this search was performed.  Of course these results may change on a daily basis.  Using different job search engines may return similar and overlapping results, but some sites may return different information.

 

 

 

The same search performed on the same day returns 615 results in a different job search engine, simplyhired.com:

 

 

 

Therefore, it may be a good idea to use multiple job search engines when measuring openings in a specific city or area.  Using other keywords such as “pharmd” or “pharmacy” may generate a different set of results.

Another source of information is the United States Bureau of Labor Statistics.  Using the “Job Outlook” tab on their website will provide some information on the job prospects for pharmacists based on their data.  According to their page, the current information seems to be consistent with the perception of the rising competitiveness seen in this industry:

 

 

 

Finally, one interesting website (pharmacymanpower.com) measures the demand for pharmacists using a numbered scaled from 1 – 5:

 

 

 

 

 

 

 

 

The meanings of “unweighted”, “population adjusted”, and “response weighted” can be found on their website.  A further look in their site will show more information based on state, region, and job setting.

Viewing their map, the darker regions indicate higher demand, and lighter regions noting lower demand according to their website:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

However, it is important to note their disclaimer:

 

 

As all things, it is important to do your due diligence, and perform thorough research before committing to a decision.  Using a myriad and diversity of resources could provide a better picture about the market landscape, as well as seeking information from job search experts.