PSA16’s panel discussion on improving pharmacists’ remuneration acknowledged widespread concerns in the industry

Employees are worried about pharmacist wages, said PSA CEO Dr Lance Emerson in opening the panel discussion at the conference on Friday 29 July.

“It’s the single largest issue facing the profession in community pharmacy,” he said.

“We hear your concerns about low income and wages. The PSA is actively working with others to look at that, but we’re also looking at diversifying with evidence-based roles.”

For example, the organisation is working with practice groups to find a sustainable model for pharmacists to work in general practices, said Dr Emerson.

PPA President and panellist Dr Geoff March said surveys are coming back saying remuneration is one of the problems, as well as lack of skill utilisation and high workloads – that pharmacists are not being allowed to actually use their professional skills.

“I think there’s structure problems with the whole process. What should be driving pharmacy? Firstly, we have a high level of medication problems but our practice isn’t really addressing the issue. We put a lot of scripts through but are we caring for patients?” said Dr March.

“We’re also poorly integrated with the health system. The CPA has its advantages and disadvantages. The government ticks us off then works with the rest of the health system, so that’s one thing that needs to be addressed,” he said.

According to figures collated by pharmacy industry consultant Bruce Annabel and shown at the conference, there seems to be a clear correlation between gross profit per script and pharmacist wages.

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“It seems like owners are doing the right thing – that when profits go up they pass it onto the pharmacists as well,” said Dr Emerson.

However, Dr March pointed out that different pharmacies pay different wages.

“We’re seeing discount pharmacies pay $4-7 per hour less than other pharmacies. The fact is, since 2009 the rate of wages has fallen and quite dramatically, the evidence here is that the wages have fallen,” he said.

“Some discount pharmacies tend to underpay fresh grad pharmacists… apparently they get paid $26 per hour as compared to about $30 in the market,” a Sydney-based intern pharmacist who didn’t wish to be named told AJP.

“Interns get paid so poorly even though they’re doing the same job as the pharmacist,” she said.

“The current rate is lower than the night fillers at Coles or IGA.”

It’s no surprise, then, that pharmacy students are concerned about their future, according to the National Australian Pharmacy Students’ Association (NAPSA).

NAPSA former vice president and panellist Matthew Scott said that in a survey run by the student organisation, 72% reported being worried about remuneration. A further 17% of members reported not seeing themselves in pharmacy after completing their studies.

The organisation’s president Shefali Parekh echoed members’ concerns at the conference.

“Students – including me – are definitely worried about what wages will be like after graduation,” Parekh, who is in the third year of her pharmacy degree, told AJP.

 

What can be done?

Panellist and PSA board member Rachel Dienaar said there are a few strategies the PSA is working on to improve members’ remuneration.

“Some issues are in remuneration packages, in retaining the skills of pharmacists to be remunerated appropriately.

“There are quite a few strategies that we’re looking at to move that forward. For example, investing in programs that assist in community pharmacy such as Health Destination Pharmacy.

“Early career pharmacists can start to build their brands and start to be able to negotiate, show what they can deliver and argue how they can help build their business and deliver excellent care.

“Essentially you can put forward a business model that will want other people to remunerate you appropriately,” she said.

Dr March agreed that pharmacists can do more than just dispense.

“What we have to think about as a profession, are there other opportunities for pharmacists to work outside those four walls?” he said.

PPA has come out saying the King Review should consider low pay rates and the under-utilisation of pharmacists’ skills, and these issues will form part of the organisation’s formal submission to the review in September.

“PPA believes it would be a mistake if the Review were not to consider the impact that low pay has on the sector,” a spokesperson told the AJP.

“To do so would ignore the majority of pharmacists – employees – who perform the vast bulk of services available at your local pharmacy.”

President of the Pharmacy Guild of Australia George Tambassis said wages aren’t great but the focus should be on a strong pharmacy model.

“It has to be around the viability and sustainability of community pharmacy, and bringing new and innovative ideas to community pharmacy. Unless we can create a viable pharmacy network then there’s no way to find a solution.

“Obviously it’s hard to keep everyone happy – being leader of the Pharmacy Guild – but when there’s discussion in my pharmacies around remuneration of pharmacists, I turn to my experience as a staff member.

“You need to bring something to the equation, learn your trade and get involved, then something good can come out of the discussion.

“Profit is not a dirty word. It’s about being viable, sustainable and bringing those ideas through,” Tambassis added.

PSA board member Taren Gill agreed with Tambassis that pharmacy needs to be sustainable and commercial.

“Should we be getting paid more? Who wouldn’t say yes in this room right about now?

“When we’re talking about this we’re talking about people’s livelihood and the capacity to earn. Right now it’s not sufficient. Young people can’t afford to buy a house or to put a down payment on a pharmacy,” she said.

Pharmacists need to think outside the box when it comes to expressing value.

“Don’t let the patterns stop you from being an awesome pharmacist on an awesome wage. But start with a one-page plan about what success looks like for you,” said Gill.

“I want to challenge early career pharmacists to become more commercial – to understand where sustainable income comes from to keep yourself employed and well-remunerated to provide a skill. Being clinical and being commercial are not mutually exclusive.”

However Dr March disagreed. “Looking back at my 40 years, I’ve never seen it so commercialised in pharmacy, and that’s been a real disappointment for me personally. I think with the balance between commercialism and practice, it’s out of kilter at this time,” he said.

Professor Michael Dooley, President of the Society of Hospital Pharmacists of Australia and director of pharmacy at Alfred Health, said the issue isn’t with remuneration and that it’s about what motivates the practitioner.

“When you look at pharmacy as a profession, it’s a reflection as a lack of worth in our professional role when it’s offset by how much we get paid.

“Sometimes people may actually offset their salary with the rewards they get from the way that they care.

“In community pharmacy where they’re pumping out scripts, they see the main thing as remuneration. We need to see an increase in the care that pharmacists provide.

“They get paid about the same as nutritionists and physiotherapists get paid, but the care they provide and the personal reward they get from their job takes the focus off the remuneration aspect,” he said.

“Pharmacists as an identity have to know what we’re here for. Are we here for business, small business, healthcare? If we’re healthcare professionals we have to act as professionals. Students need to know what they’re signing up for when they’re doing a science,” he concluded.

Scott from NAPSA said that when he graduates in 2017, he’s looking at rates back to 2006 levels. However he points to the potential for pharmacists to move into rural positions, where there seems to be an undersupply.

“There’s a role pharmacists are not looking at and that’s rural. We know that our members are worried about an oversupply, but I’m getting involved in rural placements where they are offering me a job on the second day of placement. I know there are jobs available in rural areas that pay higher rates,” he said.