The Struggle for Professional Identity in Pharmacy: A Crisis in the Making

Pharmacists possess a unique and specialized set of skills that allow them to provide essential services to their communities. They are often considered the first line of defense regarding health care and medications and play a critical role in providing patient care. As the job market evolves, it is becoming increasingly important for pharmacists to understand how their professional identity can be satisfied by the job roles and opportunities available to them.

As the COVID pandemic approaches its third year, there is a noticeable and troubling trend in the pharmacy profession. According to a recent LinkedIn survey, there are indications of a mass exodus from the community sector of pharmacy practice. Between 2019 and 2021, there was an increase of 47.3 percent in pharmacists either changing their job role or seeking to make a career change, the greatest noted from the chain retail pharmacy. According to USDL statistics, an estimated fifty-eight percent of US pharmacists are in a retail setting. A great majority in this sector report that they regret their career choice due to the increasing deterioration of working conditions, metrics-driven prioritization, and increasing abuse from the public post-COVID.

But is the exodus solely due to the pandemic? Evidence would suggest this phenomenon has been years in the making, but the pandemic certainly accelerated the evolution. The community setting, especially the big box chain pharmacy’s working environment, is not conducive to pharmacists fulfilling their professional identity. Community pharmacists should be viewed as the most accessible healthcare providers in the nation, optimally placed for improving the health and wellness of the communities they serve. However, the reality is that they are overworked and understaffed, with little to no time for meaningful interactions with the community. This misalignment of their professional identity from being learned professionals integral to patients’ pharmaceutical care to the reality of mechanical prescription dispensers leads to dissatisfaction with their role in the healthcare spectrum.

Community pharmacists are not the only group struggling with professional identity. Hospital pharmacists are also developing their own crisis. Health system finances are likely to remain unstable for the next year as inconsistent patient volume recovery, and inflationary pressures in the labor and supplies market continue to disrupt our core business. Across the nation, hospital closures, reductions in services, and layoffs have shown that even healthcare is not recession-proof. These challenges apply to our profession as well. Expansion of clinical services in the hospital setting remains challenging, with a greater emphasis on providing a clear financial return on investment. Pharmacists have always been successful in impacting patient outcomes and experience; however, our inability to be reimbursed for our services remains a barrier.

We develop our professional identity during pharmacy school education and training. Once we start practicing pharmacy in our respective fields, those in an environment that allows them to practice within their professional identity are more confident and self-aware. Equipped with advanced clinical knowledge, the pharmacists entering the workforce over the past two decades were taught that there should be a shift in their roles from being an expert in medication to applying that unique expertise as healthcare providers. 

A promise that at best has only been partially delivered, at best, and to only a select sector of our profession.

To compound the issue, pursuing pharmacy as a career is waning in the public’s eye. The American Association of Colleges of Pharmacy recorded an all-time low enrollment cycle in 2021 to 2022 with 11,219 applicants. It is the lowest enrollment in 20 years, a 36 percent decrease from the peak approximately ten years ago. There also has been an explosion in the number of pharmacy schools. The US had 72 accredited pharmacy schools in 1987, but that number exploded to 141 in 2022. With the increase in graduates, the market for pharmacists became highly saturated.

Before the pandemic, it was not uncommon to hear beginning salaries below a six-figure, even in the community setting. A career in the pharmacy was once considered to have a great ROI, but in the past decade, with rising tuition, residency requirements, and board certification becoming increasingly necessary, all without an increase in reward, monetary, or job satisfaction, the prospect is shifting. For example, the US Bureau of Labor Statistics reports that the mean annual salary for pharmacists is $125,690. In comparison, the mean annual salary for physician assistants is $119,460. PharmD is a doctorate, but PA needs a master’s, which means it takes less time and student loans to become a PA with relatively similar compensation. Furthermore, the US Bureau of Labor Statistics (BLS) projects a 31 percent increase in job opportunities for PAs, while pharmacists are projected to grow by 2 percent in the next ten years. With dwindling job growth forecasts and undesirable working conditions with narrow ROI, the future generation of healthcare workers may avoid a career in pharmacy.

The future of pharmacists will depend on how we choose to change our profession and what we want it to look like. Pharmacists must maintain the role of patient advocates and safe, quality patient care providers to maintain the public’s trust. The world has changed, and so must pharmacy. The COVID pandemic is the best and worst thing ever happening to the pharmacy profession. It is brought the profession to its knees, but there is hope for the future. The success of our profession depends partly on how our professional identity is respected and valued in the job market. Pharmacists can reinvent our profession and reignite the public’s trust with continued progress. Pharmacists must continue to develop and maintain a strong professional identity and take advantage of the opportunities in health care delivery. We must also actively advocate for ourselves, our profession, and our community.