I’ve been giving some thought to the future of community pharmacy. There are around 180,000 pharmacists and 260,000 pharmacy technicians working in community (retail) pharmacies in this country. That is a lot of manpower, and so, significant potential power. Here in Arizona the numbers are about 6,000 and 9,000, respectively, according to the US Bureau of Labor Statistics as of May 2015. Imagine the powerful impact on the practice of pharmacy, healthcare and our communities if there was a concerted effort to bring positive changes to our workplaces, our best practices, and in our patients’ lives.

Involvement
Many pharmacists expect change to happen through action of their state associations, yet participation in these organizations is almost universally dismal. In states where membership is not mandatory, the percentage of member pharmacists barely reaches double digits and technician enrollment is usually less than 10%. Our state association has evolved over the years, combining the original health system pharmacists’ organization with the more general pharmacy association. The Arizona Pharmacy Association has a mission to serve and represent all pharmacy professionals in all practice settings. One of the challenges facing pharmacy is how to leverage our collective power to effect positive change. Is it through our professional association, our elected representatives (changing regulations), a pharmacy union (as some suggest), or do we just grab our paychecks and look forward to our next vacation?

I believe that no matter what steps our association, and its sub-committees (or “academies” in Arizona) take to promote change there must be an ongoing drive to grow membership and participation.
The active members currently involved should be taking a close look at issues that directly affect their work environment. Membership and participation will grow when there is evidence of specific support for changes that improve our daily lives. Some of the things to consider are already ripe for change, while others are approaching as technology and market forces drive the evolution of our practice.

Work Environment
Many community pharmacists that I talk to feel that although they are well compensated monetarily, they are not treated as professionals. Many cite the lack of breaks and meal times, long hours, and dehumanizing metrics. Chain drug stores like CVS, Wal-Mart, and Walgreens have been sued and settled a variety of lawsuits from unhappy pharmacists, whether for unpaid overtime, lack of breaks, age discrimination via metrics, racial discrimination, and other issues regarding personal beliefs. Clearly, pharmacists deserve to be treated like professionals, with decent work hours, appropriate compensation for overtime using labor laws as a guide, reasonable work breaks, proper appreciation and utilization of more seasoned (older) pharmacists, and reasonable metrics that are used as tools for improvement (as promised) and not cudgels to drive profits. I believe broad based representation of retail pharmacists and pharmacy technicians within the state association could allow meaningful discussions resulting in useful ideas to improve the workplace environment.

More
Automation is inevitable in retail pharmacies. Many already have dispensing robots, counting machines, and other time-saving devices. How this balances against the duties and responsibilities of pharmacists and technicians is a process that we must be involved with if we expect results that do not further diminish the importance of the human roles in the practice of pharmacy.

New educational standards for pharmacy technician training programs were put forth by ASHP and APCE effective January 1, 2016. These new standards include requirements for a minimum of 600 clock hours of health-related education and training, extending over a period of 15 weeks or longer. Those 600 hours must include 160 hours of didactic learning, 80 hours of simulated activity, and 160 experiential hours. As new technicians are asked to achieve this new standard, their expectations will rise accordingly as will wage pressure. Again, state associations should be developing objective transition models that consider existing conditions and new demands.

The pharmacy that I manage generates roughly 40 cubic feet and waste every day, most of it paper and plastic. With over 67,000 pharmacies in the U.S., there is a huge opportunity here. There are only a handful of retail pharmacies attempting a recycling program. Sure, there are challenges, but by recycling empty stock bottles pharmacy waste could be reduced by 50% or more. These folks have taken a good look at the problem and offer some germane ideas. Many rigid plastics take over 450 years to break down in the environment. Let’s get busy and do our part to save the planet.

We have some incredibly intelligent and talented people in our field, many are passionate in their zeal to improve our profession, our patients’ lives, and our world. I submit that state pharmacy associations are the ideal place to bring these people together and create the future. You have to be involved to make it happen.