APESMA’s Pharmacy President Geoff March provides a summary of the key findings from a recent study published in the International Journal of Clinical Pharmacy.
“Why do Australian registered pharmacists leave the profession? A qualitative study” a research piece recently published in the International Journal of Clinical Pharmacy, has exposed an unacceptable level of dissatisfaction in the working lives of Australian pharmacists and issued a challenge to the industry to provide a working environment that is more respectful to its participants.
The article, authored by UniSA researchers Vivienne Mak, (former PSA Young Pharmacist of the Year), Emeritus Prof Andrew Gilbert (former PSA Pharmacist of the Year), Dr Alice Clark (CEO of Shelter SA) and myself, explored why a sample of pharmacists left their chosen profession.
Previous surveys conducted by APESMA and other organisations have found increasing levels of dissatisfaction in regards to opportunities to utilise their knowledge and skills, workplace relations including adequate remuneration and lack of career structure. Interestingly, the findings of this research reinforce the findings of pharmacist surveys.
We estimate that over half of the pharmacists leaving the profession do so because they are dissatisfied with the professional environment. Reasons for leaving the profession identified in the study included;
• Dissatisfaction with the professional environment
• Lack of career paths and opportunities
• Under-utilisation of pharmacists’ knowledge and skills, and
• Wanting a change
The lack of a professional environment was the major source of dissatisfaction. One participant noted that her experience was that community pharmacy was motivated by profit rather than service, the job was isolating professionally and she spent most of her time satisfying the owner’s profit driven approach. Another participant was disheartened by the rigid culture at the upper levels of the profession which made innovation difficult. Others noted they spent too much time on technical aspects and were not given the opportunity to practice their patient care skills to their fullest extent.
The participants also said the lack of professional recognition and remuneration were also causing people to leave community pharmacy. They highlighted a number of issues including little opportunity to negotiate salaries, and a feeling of being undervalued with the threat hanging over them that they would be replaced with other pharmacists who would be willing to work for lower pay. One participant said:
“You know, long hours, no breaks, pay’s pretty ordinary and the level of responsibility and stress with the amount of prescriptions that you’re expected to do, I think it’s totally unreasonable. And also with small business owners who run pharmacy, it’s just like working in a factory. To me, I felt like a glorified factory worker to be honest.”
The study highlights some of the structural challenges facing pharmacy especially in light of the National Health Reform Agenda. Some participants felt that the profession consists of a small number of powerful individuals, resistant to change overseeing a highly controlled profession profit motivated and culturally rigid. Addressing the requirements of the Reform Agenda will require innovation and flexibility for the profession.
We know there is already a worrying level of dissatisfaction but most choose to stay in the profession, but what this study is showing is that there is a significant leakage of trained pharmacists from that pool.
While there are concerns about the level of student intake in Universities, there is little doubt that the health workforce needs to expand to care for the ageing population in the coming years. Pharmacy cannot afford to lose any practitioners, let alone experienced practitioners, if they are going to contribute to the future health care requirements of this country.
Looking into the future, the participants in this study do reconfirm the need for structural reform. It saddens me that so many pharmacy graduates head into the profession and find their skills being largely ignored leading to frustration and disillusionment.
It is sad to see how some pharmacy owners undervalue their staff. It often strikes me that the Australian population has much greater respect for the work done by professional pharmacists than some pharmacy owners do. It is also frustrating to see the ongoing resistance to meaningful change to professional practice in the profession, and the structural barriers that the CPA erect that stifles innovation and thinking outside the square.
There are many opportunities for pharmacists to move into areas of clinical practice outside the traditional areas, but these moves are stifled by the rigidity of structural components of the profession. As we concluded in the paper;
“If pharmacists are to be retained in the workforce strategies are needed to increase pharmacists’ ability to participate in decision making that affects their professional working environment. Processes are needed to assist and empower pharmacists to overcome the feelings of helplessness and to guide them to take control of their role within the profession.”
From an APESMA perspective, the need to address the issue of poor workplace relations within the working environment needs to be addressed. While APESMA wants pharmacies to be profitable, pharmacy owners do need to this is not carried so far to the detriment of the profession.
While the issue of illegal underpayments relating to wages and conditions was not addressed in the report there is no doubt that such practices evidenced by the recent Fair Work Ombudsman’s audit of pharmacies in Queensland severely damage workplace morale and greatly contribute to the lack of recognition for professional pharmacists, all leading to worrying levels of frustration and disillusionment.
The way forward looks difficult due to those dominating influences. However APESMA, other like-minded organisations and individual pharmacists will continue to advocate for change both in the professional and workplace areas of practice.
Our vision for pharmacy would shift the role orientation to a patient care role, of which just part is about the storage and supply of product. This would allow pharmacists to use their skills more broadly and create new opportunities and career paths.
I believe pharmacy is a profession that has been established to meet a social need. One of those needs is around primary health care; another need is the supervision of medications; a third need is to work to reduce the harm associated with the use of those medications, ensuring people get the best out of them. It appears that the profession needs serious reform to satisfy those needs and the current structures are simply not working.
APESMA Pharmacy President