New roles blocked by pay, workload worries


Stressed pharmacist in dispensary

Worry about pay and increased workloads may be holding pharmacists back from engaging in expanded roles, an AJP survey suggests.

Last week the AJP asked readers whether they would be keen to expand into professional services such as providing some repeat prescriptions, vaccinating and working with GPs to help patients manage chronic conditions, as suggested by Grattan Institute leader Dr Stephen Duckett.

The Pharmacy Guild welcomed his suggestions, while the AMA was perhaps predictably outraged.

Close to 200 readers responded to the AJP poll, but only 21 (11%) answered, “Yes, I’m keen to participate in all of these areas”.

Another 39% said they were interested, but had concerns: 5% were worried their workload would increase, 10% were worried they wouldn’t be paid more, and 24% said they had both pay and workload concerns.

A whopping 48% answered that they were not interested in moving into these expanded areas, because of pay and/or workload concerns.

Only 2% said they were not keen to expand their role regardless.

“Unless we are getting decent extra money for the extra role, we don’t want it,” reader Walter responded to the original article on Dr Duckett’s suggestions.

And United We Stand wrote, “Please stop giving us more things to do. $26/hr doesn’t justify the level of expertise you expect from us.”

Reader Cameron Walls wrote in our forum that he has concerns about the areas being expanded, particularly vaccination.

“I’m concerned that the way these new services are introduced mean that many pharmacy owners will expect these services to be done on top of what we already do without supplying the resources (training, time, staff, space, IT, advertising, etc) that are needed to complete them,” he wrote.

“Then when the services don’t succeed, we are blamed.”

But Jarrod McMaugh wrote, “With expanded services, this will create new areas of employment: from a basic supply and demand model, this means there’ll be more demand for pharmacists, so your wage demands can increase with a higher chance that they’ll be met.”

 

Essential debate

Pharmacy Guild Victorian Branch president Anthony Tassone told the AJP that the debate around the sustainability of our health system is essential to have.

“It’s been well documented that pharmacists are an underutilised health professional within the health workforce, and any expanded role by pharmacists should be underpinned by appropriate resourcing and support to ensure an optimal consumer and patient experience,” he told the AJP.

“There is vast international experience of pharmacists providing great benefit for patients and consumers with expanded roles. It just makes sense to ensure that our health workforce practices to the top of their scope and are best utilised.

“The Pharmacy Board has guidelines with regard to dispensary workloads, and we would encourage all pharmacist owners to be familiar with those guidelines.

“Ultimately we want to provide a health service that provides optimal patient outcomes and appropriate support for our staff and teams to deliver those outcomes.”

Tassone warns that deregulation of the pharmacy sector, particularly ownership, would not help improve pay and conditions for pharmacists.

“Given the recent media coverage of Boots in the UK and the harrowing stories of pharmacist experiences within that group, I cannot see any evidence that a deregulated ownership would provide benefits for pharmacists in terms of their workload or the patient experience.”

“I think it’s important to differentiate between expanding their workload, and expanding their role,” says Pharmacist of the Year Noel Fosbery.

“I think there’s a fundamental difference there and I expect most employers wouldn’t expect pharmacists to extend their workload. I certainly don’t.

“In theory what should happen is a greater demand for pharmacists to cover the extra roles, therefore there would be pressure on the number of pharmacists needed, and therefore upward pressure on wages.

“I think it’s unfair to say that we’re expecting them to do more work. The way I look at it is we’re expanding their roles, and their training, and certainly their professional satisfaction.”

Fosbery told the AJP that pharmacists need to consider looking beyond the dispensary, as in the future it is likely that technology and online services will fill the supply role. As it stands, much of this work is handled increasingly by dispensary technicians.

He says he has seen many of his pharmacists “really blossom” in professional services and other customer-facing roles.

“They’re really excited about it. And that’s what the profession is – we need to be making a difference to our clients, and to the health of Australia, rather than just filling an order.”

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10 Comments

  1. Kevin Hayward
    05/08/2016

    Well done Noel, adapt and survive.

  2. pagophilus
    05/08/2016

    Prescribing would be good, but they will put so many requirements and restrictions on you that it won’t be professionally satisfying. Prescribing inpatient medications on admission would be OK (but can be done under current legislation APPARENTLY). But I wouldn’t want to sit in a clinic and prescribe nothing but Capecitabine to a specific group of patients, like I once read an article about. How tedious and boring!

  3. Noel
    05/08/2016

    As a pharmacy owner I am dismayed at the proliferation of extra services we are being asked to offer, none of which are really financially viable options if you have to employ more qualified staff to do them, and at this stage, as a pharmacist owner/manager I have more than enough to do already. I nearly got caught with the Medication review story, as I had worked everything out and was about to employ a new pharmacist

    As a pharmacy owner I am dismayed at the proliferation of
    extra services we are being asked to offer, none of which are really
    financially viable options if you have to employ more qualified staff to do
    them. At this stage, as a pharmacist owner/manager I have more than enough to
    do already. The time spent training, the technology and the equipment, and the
    protocols and procedures that are required for little and uncertain
    remuneration makes them pretty frightening. I nearly got caught with MedsCheck,
    Diabetes MedsCheck and HMR’s. I had developed a whole new system of how we were
    going to incorporate these exciting new services into our pharmacy. I was about
    to employ a new pharmacist and organise training for my staff when the rug was pulled
    out from under our feet without any warning. If I had been one week later I would
    have been in all sorts of strife. We
    need certainty and we need to be well paid for these new extra service so that
    we can go out and employ new pharmacists at a decent and fair wage. I cannot
    understand how Tradies can be earning around $70/hour but a pharmacist is
    expected to work for half of that. I for one will not be adopting any further services
    in my pharmacy for which we are not fairly paid and have at the very least some
    degree of certainty attached. I am still baffled for example as to how nobody can
    us what we should be paid per intervention. Submitting your interventions is
    like a lottery, sometimes the pay day is good but who knows?

    Diabetes testing, Cholesterol checks, DNA testing etc are
    all feel good programs that cost money to deliver with no real financial
    reward. We need real services with real rewards.

    I am also somewhat perplexed with all the new policies and
    all the hoops we have to jump though as far as CPD goes, and QCPP, not
    forgetting the costs involved which are in all truth bore by the individual pharmacist
    or pharmacy. The QCPP payment certainly does not cover the costs of accreditation.
    It’s time we started getting real with remuneration for pharmacist.

    • Karalyn Huxhagen
      05/08/2016

      I was one of the pharmacists who was a week later and suffered having my remuneration cut to smithereens. I enjoy the expanded roles that I perform but you are correct that we cannot expect community pharmacy owners to foot the bill for these services.
      Every other profession e.g. medicine, dentistry have speciliasts within their profession e.g. Orthodontists. The dentist sends the more specilised problems on to his collegaues with advanced training and this person charges th consumer accordingly.
      Pharmacy is so caught up within the community pharmacy agreement and the payment system that goes with the agreement that we have never learnt how to expand the model and be paid for providing advanced practice.

    • Big John
      05/08/2016

      Spot on Noel! Finally an owner speaks up about something I have been going on about for years now. It’s ridiculous that pharmacists are these days vitually expected to perform all these extra services for little return. Furthermore, many owners were caught out taking on extra staff hours for the Medschek fiasco & by the way, the limits still need to be lifted.
      Pharmacy needs reliable income. Pharmacy needs income streams that make basic financial sense. Then and only then can wages and employment potential increase.
      The burden of all these extra services cannot be denied. It is all very well for banner head offices and expert consultants to push these via novel ‘models’ on pharmacy, but the reality is that most do not get implemented optimally due to lack of time and funding thereby wasting everyone’s time. I’ve seen some really stupid stuff being done in lately and it smacks of desperation and irresponsible experimentation likely fed by financial kick-backs (not to owners, mind). In fact I often hear the latter word ‘experimentation’ being bandied around with these novel ideas and with new stock lines – I don’t think it is in the best interests of owners to ‘experiment’ with their businesses.
      It’s high time that those in the front line of pharmacy speak up like Noel. It’ll soon be your last chance.

  4. Yesman
    05/08/2016

    Pharmacist (employees) are already the lowest paid graduate out of all courses! Yet they are also the poorest amongst other healthcare colleagues!

    I highly doubt it would get worse – deregulation won’t make it worse because we are even paid less than shelf stackers at ColesWorth! Mr. Tassone spare us twaddle of nonsense, your business could be on the line and that your only excuse of a reason!

    Maybe the PGA could focus on matters they can actually make a difference if they are NOT willing to adress, issues like REMUNERATION FOR EMPLOYEES.

    Focus on let’s say –
    1. Reduce university quotos
    2. Push the pharmacy counsel to make sure numbers are reduced!
    3. Maybe really push for independent prescribing pharmacist
    4. Stop the AMA from encroaching into making pharmacist their new slave.

    Professionals Australia:

    Act like a union! If I don’t see any action from you guys I’m canceling my membership. It may make no difference to you but maybe others will follow suit with me!

    Extra roles for pharmacists are great! Who cares about increasing workload, it’s better! Dont stress about workload, automation and the advent of new tech will make sure your replaced quicker! Better adapt or be sorry! After all we are ‘expensive showgirls or shopboys!’

    • Big John
      05/08/2016

      Yes, the AMA should not be financially supported into getting slave pharmacists into GP practices. Back in 2013 the AMA pushed for such pharmacists in pharmacy as they knew there was a surplus hence lower wages could be easily negotiated.
      The AMA were hoping to use pharmacists to perform ‘extra testing’ of patients in the practises. (Of course they didnt want pharmacists in PHARMACIES to perform that). In the same breath they also did not want pharmacies to provide vaccinations, BP checks, INR testing or other medical services in pharmacies!
      Why don’t we push for a GP or prescribing nurse within a pharmacy instead and funding thereof?
      Pharmacists need to think carefully why the AMA so desperately want pharmacists for cheap in their practices! They have never supported pharmacists or their endeavours for specialisation and have constantly critised the pharmacy profession and its abilities.

  5. United we stand
    05/08/2016

    To Pharmacist of year Noel Forsby: ever since new roles and responsibilities got rolled out in Pharmacy things have gotten progressively worse. We are working harder and getting paid much lower than ever before. We have taken on extensive new roles like: Meds checks, CIs, medical certificates, vaccinations, continued dispensing etc etc. Guess what. we are getting $26/hr to do it at a time where housing is least affordable and transport prices have sky-rocketed.

    Your theory is incorrect. They will make us do more and pay us peanuts.

    • Big John
      08/08/2016

      Never before have pharmacy employees given so much and pharmacy given so little.

  6. William
    08/08/2016

    It just goes to show that pharmacists are small shop owners in mentality rather than professionals. Meanwhile nurses are taking more and more professional roles.
    The sooner the supermarkets are allowed in and the automation of dispensing by technology the better.

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