Why being a retail pharmacist is a bad career choice?

As someone who has changed careers from pharmacy to computers, I am not totally unbiased. However, I have some objective points to make against being a retail pharmacist.

Let me first qualify what I am about to say about retail pharmacy as being influenced by how that job gets practiced in Egypt, despite finding many similarities with the way it is practiced in the USA and in Canada as well.

 

  • Studying Pharmacy is a lot of hard work
    Studying pharmacy consists of a lot of theory in lecture form, as well as a lot of laboratory hands on work. It involves a lot of senseless memorization, if you do not really love what you are studying. There are frequent exams, almost every month. At mid year and end of year, there are "big" exams. The end of year exams are written, lab and oral.
  • Studying Pharmacy crosses many disciplines
    Studying pharmacy has a lot of medical sciences, three types of chemistry (analytical, organic and pharmaceutical), biology, physiology, botany, microbiology, pharmaceutics, pharmacology, pharmacognosy, pathology, ...etc.
  • Retail pharmacy is monotonous
    The day to day work is repetitive. It basically involves deciphering the bad hand writing of physicians on prescriptions, and handing it to the customer. In Egypt, there are no bulk packaging, and dispensed packages. The medicine comes prepackaged and is dispensed as it is. No counting of pills, no labels, ...etc. So it is a lot simpler than in North America. You are also responsible for a lot of administrative type of work, such as stocking the shelves, ordering medicines that you run out, as well as the adjunct products you sell, such as baby diapers, female makeup, sanitary pads, children toys, ...etc.
  • Retail Pharmacy requires little mental challenge
    If the doctor prescribes it, then you as a pharmacist dispense it. There are of course exceptions to this, such as medicines interactions, but these cases are few and far between. In reality, being a pharmacist and a pharmaceutical assistant is not much different, except for the accreditation and responsibility/liability levels.
  • Retail Pharmacy involves long hours
    All retail pharmacy outlets involve long hours, and opening on weekends, and even on public holidays. This is particularly true if you own your own pharmacy. This is not a medical profession as much as it is a retail outlet that has to cater to the public needs and hours. If you choose to be open on limited hours, another nearby pharmacy will only be glad to take your customers (and revenue) away.
  • Retail Pharmacy is ridiculously regulated
    Prices of medicines are normally fixed by a government authority, and the price is printed on the package. Therefore, the profit is predetermined as well. Moreover, a pharmacist is subject to several types of inspections, including those that apply to any retail store (taxes, balance/scale accuracy, ...etc.), as well as those from health authorities.

The bright side is that this job normally pays well. A pharmacist has some "social prestige" as well, although it is seen as beneath physicians.

Of course, there are other careers a newly graduated pharmacist can pursue, but they are not much better.

  • Promotional pharmacist
    This is basically being a salesman for pharmaceutical companies, and promoting their products at physicians, clinics, hospitals, ...etc. This is a marketing job that involves being a salesman first and foremost. You have to be a sweet talker, do a lot of relationship stuff, give away promotional items and samples of the drugs you are pushing, as well as writing sales reports on everything you do, and collecting information on every physician and how your drug sells in pharmacies nearby!

    There is little if any creativity here, let alone much to do with pharmacy. The field is full of veterinarians, physicians and even dentists doing this line of work beside pharmacists.

  • Quality Control in pharmaceutical factories
    There is virtually no jobs for pharmaceutical research in Egypt. Most of the drugs that are manufactured there are either generics, taken out of Pharmacoepias, or manufactured under license from international pharmaceutical companies.

    There is however a market for quality control pharmacists in these factories. They are supposed to test batches for the correct quantity of active ingredients, as well as disintegration time for tablets, ...etc.

    This job is very demanding, since it requires the person to be standing all day. I know a pharmacist who is suffering from varicose veins in his legs because of that job. Moreover, the job requires you to follow procedure manuals and file results and reports. There is no room for creativity here either.

  • Academic pharmacy
    Academic research in pharmacy is restricted to universities in Egypt. If you do not get an academic job at a university, you do not get to do research.

It is no wonder that the pharmacist is ridiculed as a "Clean Grocer" or "French Grocer" in Egypt. I have found that pharmacists generally suffer from low self esteem and feeling inferior to other medical professions. I have met a pharmacist in New York City who expressed those same sentiments as in Egypt, saying that the doctor has more prestige.

During my studying pharmacy (late 1970s, early 1980s), there was a new and promising job called "clinical pharmacist". This was designed to utilize the full potential of pharmacists capabilities knowledge and training, by making them the experts on anything relating to drugs. They would be a member of a team of health professionals, including physicians and nurses, working in hospitals: the diagnosis would be made by the physician, but the best medicine and dosage was to be prescribed by the pharmacist, taking into account drug/drug interactions, patient history, allergies, ...etc.

I have not seen or heard that this was put into action anywhere so far. Until it does, I advise people who want to do something creative and challenging to stay away from pharmacy, like I did.

Feedback

Since publishing this article on my web site, I have received feedback from several pharmacists who have abandoned pharmacy as a career. One of them made the same switch, from Pharmacy to Computing. The other went from pharmacy to the stock market. You can read about some of them in the feedback page.

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Comments

You Have Given Me Hope! Part II

My last post wasn't thorough enough and so I came back to post a more comprehensive opinion on pharmacy.

A Doctorate of Pharmacy (PharmD) is the contemporary standard for entry into the pharmacy profession. Attaining such a degree entails two years minimum of undergraduate coursework plus an additional four years of graduate course work. Meaning that today's pharmacist would've spent six years in school at minimum. I have major criticisms of the pharmacy educational requirement. Four years of graduate-level education is excessive. The graduate portion of pharmacy school could realistically be reduced to approximately two years. The majority of the intensive drug-related curricula occur during second year of the graduate program. The other three years are throwaway years. What is the maximum number of years that any sane person is willing to attend pharmacy school? Look to med school for the answer. Doctors spend four years in graduate school. And yes, med school does require a four year undergraduate degree. But consider that now a significant number of pharmacy school students have four year degrees in hand before pharmacy school attendance. Nobody would ever enroll into pharmacy school if 5 years of graduate coursework where the requirement. More time is wasted in pharmacy school than I have the means to express in this document.

Community pharmacy is the most popular job. It pays the most.......for now. Community (i.e. retail) pharmacy's current business model is dying. Community pharmacy chains are putting much time and energy towards extirpating the need of pharmacists or at least to thin out pharmacist salaries. I'm in Florida. Off the top of my head, I can count six schools with pharmacy programs in the state of Florida alone: University of Florida (UF), Florida Agricultural and Mechanical University (FAMU), Nova Southeastern, LECOM, Palm Beach Atlantic (PBA) and the new pharmacy school at University of South Florida (USF). I believe the company Walgreens sponsored the insipient USF pharmacy school. This school isn't needed. There is no shortage of pharmacist in Florida. It is my belief that Walgreens long term goal is to flood the market with an abundance of pharmacist in order to decrease salaries. Supply and demand. Ignore universities telling you that there is a great need for pharmacist. Universities see pharmacy schools as cash cows. They couldn't care less about them over saturating the market.

Hospital pharmacy is a popular second option. In a hospital you're either a staff pharmacist or clinical specialist. Staff pharmacist traditionally completed the task of order entry and checking for drug-drug interactions should they occur. The traditional need for pharmacist in said capacity is in its twilight years thanks to technology. Computer Physician Order Entry (CPOE) technology is obviating the need for pharmacist to enter doctor orders. And that technology is only improving. On one of my hospital rotations I sat in on an informational meeting by Epic Systems centered on their CPOE product implementation at the particular hospital I was rotating at. These machines are insane. Primary literature and interactions are instantaneously pulled up as physicians enter in their orders through CPOE. The technology isn't perfect but as I said, the technology will only improve (thank you Moore's law). CPOE will decrease need for hospital staff pharmacist.

Clinical pharmacy is new to the scene. I believe clinical pharmacy came into being in the early 2000s. Obtaining a clinical pharmacist specialty requires completion of a PGY-2 residency program. A PGY-1 is a one year residency post pharmacy school graduation. This year entails exposing you to the hospital environment in an intensive manner. Most of the people I know in pharmacy residency programs work 60-80 hours/week for half salary (if you're lucky). A PGY-2 is a second year residency geared towards becoming a clinical pharmacist. As a clinical pharmacist, ideally, you are an expert on a particular subject. There are clinical specialties in oncology, infectious disease, and transplant and so on (I can't recall them all). PGY-1 and PGY-2 residencies were meant to remove pharmacist from the hospital basement and onto the floor in order for pharmacists to be more involved in patient care. Clinical pharmacy is a fantastic opportunity, right? Hold on. Let's analyze this. A great majority of students have completed PGy-1/2 residencies and are now working in positions at academic hospitals, government facilities, or at progressive private hospitals. Today, pharmacy students are completing PGY-1/2 residencies only to have no job afterwards because all of those fancy clinical pharmacist specialty positions are filled with pharmacist in their late 20s, early 30s who are in no rush to leave their job. Adding more insult to injury is that I've met pharmacist who have completed PGY-1/2 residencies to only end up working as a staff pharmacist or, worse, in community pharmacy. To spend an extra two years in training, working your ass off, making little money (where talking $30,000 - $40,000 USD) only to end up as a staff pharmacist or in community pharmacy is heartbreaking. I've stated the effect that technology will have on the staff pharmacist. Add this to the mixture. The abundance of pharmacists who have completed PGY-1/PGY-2 residencies and were unable to obtain clinical specialist jobs is quickly becoming the standard for entry as a hospital staff pharmacist. Most hospitals now require at least a PGY-1 just to be a staff order entry pharmacist. So, now were looking at seven years minimum of education. Want to work in a hospital setting? Go to medical or nursing school.

There is opportunity for pharmacist in the industrial setting. To be honest, I don't know much of that environment and so will say no more on this area.

Pharmacist could participate in research but a PhD is required for such work. Obtaining a PhD requires about 4-7 years of course work not related to pharmacy school. Not for me.

As a pharmacist you are constantly defecated on. Community pharmacy is horrendous. The actual job itself isn't that difficult. You're basically throwing pills at your customers (please don't call them patients, they're far from it). Large community chains have reduced community pharmacy to your standard fast food joint. Customers are rude, EXTREMELY RUDE. The attitudes thrown at community pharmacist from irate clientele are incomprehensible. There you are, an educated individual being talked down to by an ignorant customer because you are simply doing your job. It boggles the mind that the same person cussing out a pharmacist for taking 15 minutes to ensure that they have correct medications will patiently wait at their favorite restaurant for forty-five minutes up to an hour for their favorite artery clogging dish. And the insulting thing about it is that the community chain pharmacies encourage abuse from customers by not allowing you as the educated professional the opportunity to defend yourself. Community chains are more concerned about customer service than they are about pharmacist voicing cogent opinions to confused customers. I always laughed at how my professor would give accolades to community pharmacy when they are in academia walled off from the public at large. Don't believe anything professors say. I won't belabor this point further as there are a plethora of blogs of community pharmacist expressing their disdain for the community setting. The high salaries are in place because most humans won't stay long in such inimical environments. And as I type this community chains are cogitating on how to obviate the need to pay pharmacist for their troubles.

Hospitals are, in my opinion, similar. Not near as bad as community but insulting in the manner that your medical opinions are just that: opinions. You are not licensed to make true medical interventions. As a pharmacist, even a clinical specialist, you must convince medical doctors to implement your recommendations even though you are more knowledgeable on drugs than they are. It's difficult for pharmacist to obtain respect in hospital systems. Doctors automatically receive it.

The science of pharmacy is interesting but the job is anathema. There is very little creative thought involved. Pharmacists are basically auditors. The task of double-checking quickly gets old. I graduate in May from pharmacy school and I have already started to think of a plan to get the hell out of pharmacy. I'm giving myself two years to work a little, save up, and depart. This career isn't for me. I would rather make less money and be happy doing something passionately. I have definitely made a mistake in pharmacy but it's one that I can correct. To my other irritated pharmacist out there reading this, yes, pharmacy is disappointing. But you always have the power to make changes. It is most certainly in your power to do so.

I agree with most you say but

I agree with most you say but at least we have many options and avenues to try with a pharmd degree. The real problem maybe the economy corporate and even academic greed along with social and political reform and insurance companies and greedy pbm's - pharmacy benefit management companies/monopolies strong arming and dictating and skimming profits to effectively run a true customer/patient therapy mangement/consultive service care. Some of the older greedy MDs/physicians are even starting to whine and definitely the newer ones as they are seeing long hours and less pay/billing returns along with loan debtand practice insurance. But the big difference - you touched on it- they are revered and top dog. But why? Because of their arroance and swollen egos and brashness and all backed up by the poweful AMA. What does the sheepish timid chemist have? Pharmacists need to have alittle bit of that super jock attitude too at least enough to preserve our profession so we can do best practice for our customers or patients. And we shoupd have a stronger arm than our current weak associations that dictate very little if at all to the health care industry or government. PHARMERS UNITE!!

avoid pharmacy at all cost,

avoid pharmacy at all cost, it is the most hopeless degree you can ever encounter in your entire life.

I would not avoid if I'm one

I would not avoid if I'm one of those who can put up with the public's attitude as long as I'm making a 6 figure salary. It beats staying in the unemployment line and asking for a hand out.

Your mindset is important

When you look like a loser ... You think like a loser
Positive people lead and create positive lives - especially pharmacists
Maybe you should visit a 3rd world country and see how pharmacists affect peoples lives in a positive inspiring way my friend

(1) Change your mindset
(2) You live as you dress and think
(3) Think and Grow Rich as a pharmacist

I feel sorry for you loser ... But if you're not willing it's your loss

Pharmacists Rule!
Matt

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