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Published on Friday, December 17, 2021

APhA: Pharmacist burnout hits breaking point, impacting patient safety

WASHINGTON, DC -  The Board of Trustees of the American Pharmacists Association issued the following statement today:

We have heard loud concerns of overwhelmed pharmacists in busy pharmacies. We have also heard of potential pharmacist protests to their employers in the form of a sickout.

Pharmacy workforce issues that lead to frustration and burnout are very real. They have been building for some time, but they have become more acute with the stressors brought on by the COVID-19 pandemic. Workplace conditions have pushed many pharmacists and pharmacy teams to the brink of despair. Pharmacy burnout is a significant patient safety issue. It is impacting patients today with delayed prescription fulfillment, unacceptable waits for vaccines and testing, and potential errors due to high volume, long hours and pressure to meet performance metrics.

Well-being

APhA and the National Alliance of State Pharmacy Associations developed the Pharmacy Workplace and Well-being Reporting (PWWR), a safe, confidential, and anonymous space for pharmacy personnel to report positive and negative workplace experiences. PWWR reports create a pool of aggregated data that will be used to influence and educate our pharmacy community and leaders—including those who can do something about it – on meaningful and actionable changes. The experiences and situations submitted via PWWR help tell a collective, powerful story that can spark change and improvement in well-being, delivery of care, and patient safety in pharmacies.

APhA unwaveringly supports our pharmacists and the work of pharmacy teams as they seek overdue action from employers to improve eroding workplace conditions. However, we strongly believe that actions such as a sickout where pharmacists would walk away from direct patient care is not an appropriate action. A profession that is rightly demanding action to keep themselves and their patients safe should not compromise public welfare by abandoning patients who rely on them. Serving patients and ensuring patient safety is core to the profession of pharmacy.

Pharmacists are caregivers, and we must address the fundamental issues causing burnout and frustration. The public, decision-makers, and regulators must be educated about, and recognize, the seriousness of our pharmacy teams’ negative well-being and the need for both additional resources and realistic expectations to safely provide patient care services. The value within our practices are the individuals who serve the health care needs of their patients and communities. Pharmacists are committed to serving these needs and have demonstrated this commitment throughout the pandemic. However, they cannot sustain this commitment without immediate changes.

Employers across the health care system must have meaningful dialogue with their teams that result in realistic expectations that are supported by appropriate staffing levels and procedures. These employers have an obligation to increase staffing in their pharmacies to promote safety and access for patients and improve well-being for their pharmacists and pharmacy technicians. 

Boards of pharmacy, who are tasked with protecting public safety and public health, including timely access for patients to needed medications and services, must also examine current experiences and regulations contributing to this issue, and take appropriate action.

Root causes

A significant contributing factor that causes understaffing and unrealistic performance metrics is a misaligned payment system that rewards volume and not value. Pharmacists and pharmacies are primarily reimbursed for dispensing a product, not for addressing the clinical needs of the patient. The payment system for pharmacy services is fundamentally flawed.

PBM issues

Pharmacy benefit managers (PBMs) are intermediaries who have siphoned tremendous profits from the prescription drug system, leaving pharmacies to depend upon unrealistically high transaction volumes with minimally viable staffing to stay in business. Pharmacy teams have been meeting a significant need within their communities during the pandemic through the provision of acute and chronic medications and associated services, including testing, vaccination, and treatments. These services are provided on top of a model that was stretched to its limit prior to COVID-19, due to the misaligned payment model.

Provider status

Pharmacists strive to optimize medication use and ensure that medications are taken correctly, but coverage is lacking for these clinical services. Pharmacists are health care professionals with training, experience, and knowledge as medication experts, and they provide clinical care related to those medications and the conditions they treat.

Pharmacists are not able to bill Medicare for their clinical services because they are not recognized as eligible providers under the Social Security Act. Other health care professions – including physicians, nurse practitioners, physician assistants, audiologists, and nurse-midwives – are all eligible providers who can bill for their services.

Solutions

There are both short-term and long-term remedies.

First: Employers must immediately address working conditions. Signing bonuses and free pizza aren’t enough. Pharmacies must be staffed appropriately so that pharmacists and pharmacy technicians have dedicated time for the safe dispensing of medication, safe delivery of clinical services such as COVID-19 vaccine administration, and adequate time to talk with and counsel patients about their medications.

Second: APhA is engaging in direct conversations with chain pharmacy leadership and other influencers to address the issues related to workload and well-being.

Third: Boards of pharmacy must engage in conversation with pharmacy team members, pharmacy management and organization executives to examine the following:

  • Staffing levels needed to safely provide care and sustain timely public access to needed medications and patient care;
  • Performance measures that jeopardize care delivery;
  • Use of technology;
  • Administrative policies and procedures that distract pharmacy teams from the delivery of patient care

Fourth: The underlying payment issues must be rectified. This includes reining in adverse PBM business practices and recognizing pharmacists as patient care providers in Medicare as well as Medicaid and private insurance plans. Until then, pharmacists will continue to run on fumes with high burnout and inadequate support.

APhA calls on anyone who can impact our pharmacy teams’ well-being and the safe delivery of patient care to address these issues now with their teams and those who can make a difference – employers, boards of pharmacy, and payers. In order to sustain public access to pharmacy services, relief is needed now. We stand with our pharmacy teams in making the case for timely change.

About the American Pharmacists Association

The American Pharmacists Association is the only organization advancing the entire pharmacy profession. Our expert staff, and strong volunteer leadership, including many experienced pharmacists, allow us to deliver vital leadership to help pharmacists, pharmaceutical scientists, student pharmacists and pharmacy technicians find success and satisfaction in their work, while advocating for changes that benefit them, their patients and their communities. For more information, please visit www.pharmacist.com.

Contact: APhA Media Relations; media@aphanet.org

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