According to Michigan Health Council’s (MHC) 2023 Healthcare Workforce Index, which ranked the 'healthiness' of professions based on a variety of factors, Pharmacists were one of the healthiest. They ranked well in growth, turnover, wage, and lack of shortages. However, few surveys have been published identifying demographic trends and emerging issues for this seemingly exemplary profession. In fact, pharmacists are often overlooked when conducting in-depth studies of healthcare occupations. The MHC Michigan Pharmacist Survey set out to fill this gap by including questions that gauged the mobility of pharmacists under current industry standards and by enabling pharmacists to highlight the developing issues that could potentially harm the healthy status of the pharmacist profession.
Between October 4th, 2023 to October 22nd, 2023, MHC received 683 responses, a total response rate of 14.6 percent. 52 percent of pharmacists identified as women and 45 percent identified as men. Education completions (PharmDs) are currently on pace with the previous decade, while 27 percent of pharmacists practice in a subspecialty. 72 percent of pharmacists practice in a community or hospital pharmacy setting and 64 percent of survey respondents signaled that they are satisfied with the state of their profession.
Sex
According to the survey results, Michigan’s population of pharmacists deviates significantly from the national breakdown of pharmacists by sex. In Michigan, the proportion of women making up the pharmacist workforce lags behind the national average by seven percentage points. According to the 2019 National Pharmacist Workforce Study completed by the Pharmacy Workforce Center (PWC), nearly 62 percent of respondents identified as women, while 38 percent identified as male. The PWC survey also shows that the proportion of women to men in the pharmacist workforce has risen since their past surveys, representing 53 percent in 2014 and 45 percent in 2009. Future surveys should continue documenting this breakdown to see if Michigan is following a similar trend, albeit trailing the national pace.
Education
The majority of survey respondents completed their education between 1980 and 2019. Shown below, the significant drop in completions during the 1960s and 1970s is expected as the baby boomer generation starts to retire. Additionally, if the rate of pharmacist completions in the current decade remains steady, Michigan is on pace to graduate a similar number of pharmacists as the previous decade, a marked improvement from 2000-2009.
Subspecialties
27.2 percent of respondents presently practice in a subspecialty, while three percent of subspecialty respondents indicate they are currently completing a residency. Five respondents are currently in their first year of residency, while one respondent is completing their second year. Efforts to engage pharmacists currently completing their residencies require more targeted surveying methods.
Work Setting
52 percent of respondents work in a community pharmacy setting - this category broadly covers pharmacists who serve patients through independent, franchise, or hospital-based pharmacies. 12 percent of actively-licensed respondents are retired and no longer practicing.
Salaries
When comparing the overall salaries of pharmacists to those practicing in a subspecialty, there are several findings and caveats to note. Due to a limited number of responses, several subspecialties have a volatile salary average, where each response holds a significant influence on the mathematical average. Such subspecialties include solid organ transplant, pediatrics, and cardiology. Conversely, pharmacotherapy and oncology garnered enough responses for a more robust average, with pharmacists earning $133,833 and $136,000 respectively.
Overall, pharmacists appear to be well-compensated (earning an average of $124,000 a year). This is supported by the open-ended section - where respondents could comment on any issues of concern in pharmacy - where only eight percent of the 466 open-ended responses mention that salaries did not properly rise alongside education costs.
Job Satisfaction
Most respondents reported being satisfied with their work. However, nearly 70 percent of respondents identified issues and areas in their profession that could improve job satisfaction and retention.
Of these 466 open-ended responses, 41 percent mentioned low staffing levels, and 32 percent mentioned high workloads. Persistent themes included dissatisfaction with corporate retail pharmacy metrics, the frustrating intrusion of pharmacy benefit managers, and the rate of prescription reimbursement. Pharmacists also recognized that the role of pharmacy technicians is undervalued by retail pharmacies and increasing pharmacy technician compensation could help alleviate staffing and workload challenges. When comparing comparable entry level positions in healthcare, pharmacist technicians are in the middle of the wage spectrum, earning $0.96 and $0.32 more per hour than certified nursing assistants and medical assistants respectively. On the other end, pharmacy technicians fall $2.09 below the average hourly wage of dental assistants and $8.23 below physical therapy assistants.
Residency Influence on Place of Practice
In order to practice in another state, pharmacists must pass that state’s licensing board examination, or take the National Boarding Examination (NAPLEX) and pay to register in each state. Additionally, some states require a legal exam, or wet lab, meaning the barriers to pharmacist mobility are high, even when factoring in the ability to register for licensing in multiple states through the NAPLEX. The survey responses reflected this reality, with 66 percent of pharmacy residents and 70 percent of pharmacy school graduates practicing in the same state as their residency or pharmacy schooling.
With telehealth increasing the capacity of pharmacists to provide care to a more geographically diverse population of patients, the creation of a multi-state compact allowing pharmacists to meet with patients in nearby states could help pharmacists become a more mobile profession. Policy developments like these could provide another avenue for Michigan to recruit pharmacists, bolstering the pharmacist workforce.
Conclusion
The MHC Michigan Pharmacist Survey identified general demographic characteristics of pharmacists and key deviations in the sex makeup of the pharmacist workforce compared to pharmacists nationally. Both of these items represent developments worth tracking in future studies. While pharmacists have enjoyed a relatively healthier career outlook in terms of turnover, growth, and satisfaction than other occupations that are the focus of discussions about policy and workforce remedies, pharmacists have highlighted several issues related to job satisfaction that impact pharmacy practice and threaten the health of the pharmacist occupation.
If proactive legislative action can address the issues of increasing pharmacist workloads and the inefficient pharmacy benefit managerial system, pharmacists can remain one of Michigan’s healthier occupations. Similarly, as the pharmacist occupation continues to change with the rise of telehealth, improving the issues pharmacists raised can improve the retention of pharmacists as the profession becomes more mobile and Michigan attempts to attract pharmacists to the region.
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