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Opinion

Your pharmacist might be permanently out to lunch

CVS and Walgreens are limiting the amount of baby formula you can buy — a grim reminder of what shortages mean, and how dependent we have become on retail chains, especially when it comes to vital supplies, including drugs.

Maybe you have noticed that it is getting crowded in CVS or Walgreens these days as you wait for an item, a vaccine or medication.

Maybe you’ve been on hold for a pharmacist and finally given up. Perhaps you have argued with a pharmacist or been standing on a long line while someone else demanded better service from the pharmacist.

Within the major drug store outlets, you often see a sign that says, “We’re Hiring.” What I never considered is that the people they most need to hire are critical to our health.

Recently I was living in Massachusetts and went to pick up a prescription at my local Walgreens. A sign on the pharmacy counter read, “Closed for the weekend” with a list of nearby locations. I subsequently learned that the pharmacy was closed because of a shortage of pharmacists. And COVID-19 was not the culprit.

I did a bit of research, including a long chat with a pharmacist. It turns out my experience with a closed pharmacy was just one of many across the nation.

Here’s what I learned.

Pharmacists in America are struggling, and many are leaving the profession. Over the next 10 years, it is estimated that America will see a nationwide decline of at least 2 percent of its pharmacists, according to the Bureau of Labor and Statistics.

That might not sound like a lot until you consider that new prescription growth in the United States is off the charts. Last March, the volume of prescriptions increased 34 percent over the previous year. Much of that is mail-order prescriptions, which don’t require a pharmacist. But there are certain things that require a human pharmacist, including vaccines, advice on side-effects of medication, help with finding a generic brand to reduce costs and even what to do if you can’t find baby formula. Pharmacists are also wizards at dealing with insurance companies on your behalf.

The problem for pharmacists today, I learned, is not wages. A good pharmacist can earn $75 an hour. Not bad.

The problems have to do with working conditions for pharmacists. One pharmacist at a leading chain told me he does not drink water before his 13-hour shift because there is no time to use the bathroom. The phones are ringing off the hook. Angry customers are demanding refills. And the average pharmacist is backed up trying to prioritize competing demands for antibiotics and inhalers. Volume is up, staffing is down.

Unruly airline passengers got the lion’s share of attention this year while pharmacists were facing angry customers of their own. It is time to admit that Americans have become increasingly short-tempered.

What worries many pharmacists is that dismal conditions can lead to mistakes, accidents and shortages. A 2022 survey by the American Pharmacist Association found that 74 percent of respondents said they did not think they had sufficient time to safely perform patient care and clinical duties.

The pharmacist shortage comes at a time when COVID infections are up and the supply of nurses and medical technicians is down. According to the American Hospital Association, almost every hospital in the country has a nursing shortage due to burn out from COVID. One study found that 35 percent of hospitals report a nurse vacancy rate of greater than 10 percent. Whether or not you believe in vaccines is not relevant if you need medication or medical attention or vital goods.

Yes, we know. The American health care system is broken. There is no shortage of reports and commissions looking at America’s health crisis. The answers about how to fix the health system are as complex as the system itself.

But the narrow sector of pharmacists is a good place to start reform. Major companies like CVS, Walgreens and RiteAid need to staff their stores with more qualified people to ease the burden on existing staff. They can afford it. CVS posted a profit last year of $7.9 billion — up over 10 percent from the year before. Walgreens also had a good year.

Another answer to the pharmacy problem might be to put some of the burden for vaccination back on the internists who have quietly avoided COVID by telling patients to take home tests or get vaccinated at their local pharmacy.

Ultimately, we all want to support small, local businesses, including the neighborhood pharmacy. But we still turn to the big chains, confident that they will be open and well-staffed and have products on the shelves. In this era of increasing resignations, it is not helpful to have pharmacists resign anywhere in the country.

Tara D. Sonenshine is the Edward R. Murrow Professor of Public Diplomacy at The Fletcher School of Law and Diplomacy at Tufts University.

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