THE CHANGING
DEMOGRAPHICS IN
PHARMACY,
YES, MORE CHANGE!
Lynnae Mahaney MBA, RPh, FASHP
New York State Council of Health-System Pharmacists
May 2009
Disclosure
I have no actual or potential conflict of
interest in relation to this program.
OVERVIEW
 STATISTICS
 MULTIGENERATIONAL
 WORKFORCE
CRISIS
 LEADERSHIP CRISIS
WORKFORCE
PHARMACY
WORKFORCE
DEMOGRAPHIC
STATISTICS
AGE AND GENDER
TECHNICIAN
DIVERSITY
Pharmacy Demographics

86% of licensed pharmacists actively
practicing
– 230,000 total; 200,000 FTE
– 30% in hospital, health-systems, LTC

Increase in part-time workers
– 2000: 23.4% of females, 11.6% of males
– 2004: 26.8% of females, 15.4% of males
Work Status of Licensed
Pharmacists
Work Status
1990 Males 2000 Males
(n = 1,116) (n = 1,187)
2004 Males
(n=823)
1990
Females
(n = 507)
2000
Females
(n = 905)
2004
Females
(n=647)
Full-time (>30 hours/week)
78.6%
75.9%
70.3%
61.7%
69.9%
65.6%
Part-time (<= 30 hours/week)
8.7%
9.9%
12.8%
25.6%
21.3%
24.0%
Total Actively Practicing
87.3%
85.8%
83.1%
87.3%
91.3%
89.6%
Retired
7.0%
9.4%
10.9%
3.6%
2.1%
3.4%
Non-pharmacy work
4.9%
3.7%
4.5%
3.2%
2.0%
2.6%
Not Working
0.8%
1.1%
1.5%
5.9%
4.6%
4.3%
ASHP SURVEY 2008
Proportion of Active Women
Pharmacists in the U.S. by Year
100
75
Male
Female
50
25
0
1970
1980
1990
1995
Source: HRSA Study on Supply and Demand for Pharmacists 2000
2000
2005
2010
Pharmacy Technicians Statistics




284,000 Pharmacy Technicians in the U.S.
189,000 Active, PTCB certified Jan 2007
310,873 PTCB certified June 2008
Sources: PTCB National Statistics
https://www.ptcb.org/AM/Template.cfm?Section=National_Statistics&Templ
ate=/CM/HTMLDisplay.cfm&ContentID=2432
Paul, R. Technician numbers on the rise nationwide, Drug
Topics, March 10, 2007.
Pharmacy Technician Certification
PTCB Certified Pharmacy Technicians [16]
PHARMACY TECHNICIAN CERTIFICATION BOARD (PTCB) STATISTICS
EXAM DATE
# WHO SAT FORPTCE
1995-2000 Exams 91,741
2001 Exams
31,107
2002 Exams
33,794
2003 Exams
39,710
2004 Exams
41,245
2005 Exams
45,991
2006 Exams
49,689
2007 Exams
45,045
2008 Feb-Mar
7,547
2008 Apr-Jun
14,291
TOTAL



400,160
# WHO PASSED PTCE % PASSED
73,705
80%
24,269
78%
26,917
80%
32,232
81%
32,114
78%
35,838
78%
32,319
65%
31,490
70%
5,165
68%
10,155
71%
304,204
TOTAL # WHO PASSED PTCE
TOTAL # WHO COMPLETED TRANSFER PROCESS
TOTAL # OF CERTIFIED PHARMACY TECHNICIANS (CPhTs)
[16] PTCB Website Statistics, Sept, 2008.
76%
304,204
6,670
310,874
Age Distribution of Pharmacists
 Card
A 55+
 Card B 45-54
 Card C <45
Age Distribution of Pharmacists
 17%
 24%
 59%
55+
45-54
<45
FTE by Gender and Age - 2004
1.2
1
FTE
0.8
2004-Males
2004-Females
0.6
0.4
0.2
0
23- 31- 36- 41- 46- 51- 56- 61- 66- 71+
30 35 40 45 50 55 60 65 70
Age Category
Gender Statistics

Not actively working – primary reason
– Men – retirement 10.9%
– Women – not working 4.3%
 Pharmacists
practicing in hospitals
– Women 30.7% vs. men 22.3%
Diversity Statistics
 Female
>65% pharmacy students
 Asian Americans 23.4% of Pharm.D
degrees
 Underrepresented minorities 11.8% of
Pharm.D. degrees
 Applicants > 68% had 3 or more years of
postsecondary education
Workforce Diversity

Racial and ethnic minorities comprise 1/3
US population

African Americans, Asians, and Hispanics
will outnumber Whites in the 21st
Century
MULTIGENERATIONAL
WORKFORCE
For the first time in history, four
generations are present in the workforce.
ALSO KNOWN AS
THE GENERATIONAL TSUNAMI
Traditionalist
Black and white TV
 ‘stretch a buck nine ways to Sunday’
 Ballroom dancing
 Push mower – not motorized

Traditional 1930 – 1945





The "silent generation“
Value loyalty, sacrifice, discipline
Respect authority, rules, and hierarchy
Delayed reward
Duty before pleasure
Pharmacist -Traditionalists
(over 62 yrs)

17% of the nation’s Pharmacist workforce
CARD A
Baby Boomers
Elvis before sequins
 Typewriter
 World’s first trip to the moon
 Woodstock, hippie
 ‘Generation Gap’

Baby Boomers 1946 – 1964
Loyal
 Live to work – largest group of
workaholics in history
 Driven by personal success
 Spenders
 Excellent Mentors, experienced
 Politically active
 Want or need to work longer

Pharmacist - Baby Boomers
(44-62 yr olds)

24% of the nation’s Pharmacist workforce
CARD B
Generation Xers
Prince and 1999
 Road trips in the station wagon
 Know who shot JR
 Know rotary phone
 Term papers on word processor

Generation X 1965 – 1980
Latchkey kids, watched parents
overworked/lose jobs, distrustful
 Best academic training and internatl.
experience in history
 Demand work life balance,work to live
 Technology experts
 Need positive reinforcement and
communication
 Desire stimulation and growth in work

Pharmacist - Generation Xers
(28-45 yr olds)

59% of the nation’s Pharmacists <45
CARD C
Millennials
Term paper typed on computer
 Always had answering machine and
voicemail
 Always had cable TV with remote control
 Popcorn in the microwave only

Millennials /Gen Y 1981 +
grew up in groups
 volunteers, joiners
 close to family, trusting, value
relationships
 technology experts – lived entire lives
with information technology
 excellent multi-taskers
 after BB’s next dominant generation to
influence health care

Pharmacist - Millennials
(18-27 yr olds)

59% of nation’s Pharmacists <45
CARDs C and D
Tomorrow’s Pharmacist
Generational Commonalities
Common life experiences more clearly define
each generation group
 Trad – environment of scarcity, value austerity
 Boomers – spawned social phenomena (hippie,
feminism, divorce)
 X, Y – less social impact due to recent
emergence

RETIREMENT
From AARP report: The Business Case for Workers Age 50 +
(http://research.arp.org).

“Cohort of workers >55 will grow
significantly and opt for second and third
careers or downsize work roles rather than
fully retire.”

This report makes a great case for keeping
people longer in the work place.
RETIREMENT
Many cannot afford to retire early –
children/stocks
 2007 survey, nearly 1/3 over-65 workforce will
delay retirement
 AARP 2006 survey, 70% Americans want to
work as long as able

Copeland, Craig. “Employment status of workers ages 55 or older.” Employee Benefit Research
Institute, Notes, Vol 28, No. 8. August 2007, p. 2.
WORK-LIFE BALANCE
Not a gender or generation issue today.
 Boomers
– Sandwich generation
– Personal health issues
– Approaching retirement

Generation X
–
–
–
–
–

Dual working couples
Single parents
Outside interests
Household responsibilities
Community involvement
Generation Y
– Community involvement
– Volunteers
GLOBAL CHANGES



Overall healthcare environment is
changing - permanently.
The Baby Boomers - dominant
generation to influence health care.
Baby boomers retirement, beginning
2011, will be overwhelming and will
dramatically affect the health care
system.
HEALTHCARE CHANGES



50% of US population has at least one chronic condition*
– 36% over 65yo have 3 or more
– By 2025, 25% will have multiple chronic conditions
– Increase in cancer, cardiovascular disease, and type II diabetes (due
to obesity)
Medicare to consume more of the national budget and give the federal
government more direct control over health care dollars.
– MC $ were 3% GDP in 2006, 8.8% in 2030
Baby boomers will unify and become more responsible elders about the
expense of end-of-life care.
*Wye River Group on Healthcare 2008
Global Demographic Statistics
(WSJ Demographic Bomb Ticks On 6/6/06)
2005 16.7% US population 60 years and older
 2050 26.4% US population 60 years and older

US is relatively young….as compared to Japan,
Germany, and China.
By 2040, these nations face even more peril.
Population of the Oldest
Old
age 85 or older
Will grow 377% by 2050
IMPENDING WORKFORCE
CRISIS

76m Boomers will retire in the next 15 years
– 46% of current workforce

45m Gen X’ers available to replace
– 29% of current workforce

14m skilled worker shortage predicted by 2020

80% of Pharmacy directors and 77% of middle
managers plan to resign in the next 10 years
Healthcare Worker Shortage

5.3m new Healthcare Workers needed by
2010

Pharmacist shortage will be 157,000 by
2020
Pharmacy Workforce Changes
Multigenerational work place
 Desire for balance of values to the workforce
 Increasing the demand for alternatives to
traditional work norms
 Increasing ethnic diversity
Job satisfaction does not change across the
generations and indicates pharmacists are
generally satisfied

WHAT CAN WE DO ?
 Teach
four generations to work
together as a team
 Flexible work schedules

Restructure work
 Invest
in the 50+ worker
 Facilitate pharmacist re-entry
Tips for Bridging the Gap:
(Mayoclinic.com)
For the Older working with Younger

Challenge them with important work that matters and
reward them for success. Don’t micromanage and give
them space.

Ask for their opinion so they feel part of a team. Try to
avoid the strict chain of command style of management.

Provide frequent feedback; they are used to quick and
direct criticisms and compliments.

Use e-mail and avoid frequent meetings on menial topics.
Tips for Bridging the Gap:
(Mayoclinic.com)
For the Younger working with Older

Show respect and acknowledge your lack of experience
and need to learn.

Avoid using solely e-mail and voicemail communications;
many baby boomers prefer face to face communications.

Learn about the department/company history, what has
gone wrong and what has worked BEFORE trying to
actively change something.

Play the game of seniors in the office even if you are
turned off by traditional workplace politics.
Tips for Bridging the Gap:
(Mayoclinic.com)
For All Generations

Avoid stereotyping.

Realize that no generational characteristics
apply to everyone, and

Remember: everyone’s personality is unique.
WHAT CAN WE DO?
Flexible Scheduling
Demand for greater work-life balance Gen
X,Y
 Role reversals
 Boomer needs

Flexible Work Schedules

Develop multiple schedules/hour/days of the
week

Engage staff in work schedule development to
meet organizational and staff needs

Obtain regular feedback on schedules and
activity preference

Develop attractive incentives for undesirable
work shifts
*ASHP Task Force on Pharmacy’s Changing Demographics
Flexible Schedules create
perceptions:
 Viewed
as unfair, favoritism
 Workers not seen as valuable
contributors
 Part time staff viewed as competent and
informed
 Pharmacy managers lack understanding
of the differences among generations in
attitudes toward work
Potential negative implications of
alternative work schedules






Scheduling challenges
Resentment from full-time staff about flexible
schedules for certain workers
Difficulty filling part-time vacancies
Challenges training part-time workers
Part-time workers lacking connection to overall
health system because of limited work hours
Lack of availability of part-time workers with
desired skill set
*ASHP Task Force on Pharmacy’s Changing Demographics
Positive implications of alternative
work schedules







A pool of extra staff to cover time off
More uncompensated hours from a larger number of workers
More flexibility in covering schedules with several part-time
workers
Management does not have to provide benefits for some
part-time workers
Access to qualified pharmacists that would not otherwise be
available for full-time work
Flexible hours can be used as a recruitment tool
Flexible scheduling allows for re-entry into the profession
*ASHP Task Force on Pharmacy’s Changing Demographics
WHAT CAN WE DO
Restructure the Work

Phase out purely distributive roles and replace with more
integrated roles

Find responsibilities that can be share

Leverage technology to increase schedule flexibility
– Dispensing and cart fill robotics
– Work that can be done from home, long distance
e.g. VA computer system enables work from home very well
*ASHP Task Force on Pharmacy’s Changing Demographics
ASHP Position
on Pharmacy Technicians





Evolving role of technicians is key to advancing
what pharmacists do
Developing well-qualified pharmacy technician
workforce, with defined skills and competencies,
is essential to the success of this role
Support uniform training – ASHP-accredited
Support certification through PTCB
Support registration through state boards
A well-qualified pharmacy technician
workforce is critical to our future

Growing complexity of medication use

Continued focus on medication safety, quality

Increased public visibility, accountability

Described in the ASHP Long-Range Vision for the


Pharmacy Workforce in Hospitals and HealthSystems
Supports goals described in the JCPP Future
Vision for Pharmacy Practice 2015
Objective within the ASHP 2015 Initiative
Definitions

Registration is the process of making a list or being

Certification is the process by which a nongovernmental

Licensure is the process by which an agency of government
grants permission to an individual to engage in a given
occupation upon finding that the applicant has attained the
minimal degree of competency necessary to ensure that
the public health, safety and welfare will be reasonably well
protected.
enrolled in an existing list; registration should be used to
help safeguard the public through interstate and intrastate
tracking of the technician work force and preventing
individuals with documented problems from serving as
pharmacy technicians.
agency or association grants recognition to an individual
who has met certain predetermined qualifications
specified by that agency or association.
Accredited Training Program
Statistics
• 112 programs in 32 states (TX = 24, CA = 23)
• 6,400 graduates in 2006 (5,000 78% are related to chains)
• < 10%of all technicians completed an accredited program
Chain, 2
Universtiy , 2
Department of
Defense, 3
Hospital , 3
Community
Colleges, 49
Vocational/Techni
cal colleges, 53
Status of State Regulation of Pharmacy Technicians
(NABP Survey of Pharmacy Law-2007)
Regulations on REGISTRATION:



34 states require registration
5 states require licensure
11 states have no registration or licensure requirements
Regulations on CERTIFICATION


PTCB Recognition in 30 states as one option for registration or for
expanded tech responsibilities
- MT only state that requires PTCB
310,873 CPhT’s Nationwide
Regulations on TRAINING

29 states require education and training (non-accredited)
(ND and NV specifically recognize ASHP accreditation in some form)
ASHP Pharmacy Technician
Initiative

What: Advocacy partnership with goal of
developing an educated, trained, certified and
registered pharmacy technician workforce.

Who: ASHP and individual state affiliates.

How: Joint advocacy to promote a qualified
technician workforce, with strategies and tactics
unique to each state.

When: Seeking affiliate sign-on starting January
1, 2008.
What can we do?
Invest in the 50+ Worker

They represent a solid and sound investment
proposition.

Promote Mentoring: From the AARP report:
“Mentoring can invigorate middle and older
workers, creating challenges, conveying
critical knowledge and sharing institutional
history.”
What Can We Do?
Re-entry Programs

Severe problem existing in all health
professions.

How do we ensure competency prior to
return to work?

It is not a question of expense for the reentry program, we NEED pharmacists.
Why do Pharmacists Leave
the Workforce?
Caretaking issues
 Personal illness
 Dissatisfaction
 Pursue alternative careers

The National Task Force on Re-entry into
Clinical Practice identified several barriers to
funding of re-entry programs:
Limited public information regarding programs
 Resource-intensive
 Lack of standardized curricula and no officially
recognized national accreditation
 Key factors for success include

– Absolute commitment from the highest level of the
organization
– Excellent examples exist from successful business re-entry
programs.
Pharmacist Re-entry
Develop innovative programs to recruit
community Pharmacists to transition to
Health-system positions
 Develop competitive recruitment packages

THE FACTS? True or False
Card A or B

Women and both sexes of Generation X bring
a desire for balance of values to the workforce

Generational differences are increasing the
demand for alternatives to traditional work
norms

Job satisfaction does not change across the
generations and indicates pharmacists are
generally satisfied
THE LEADERSHIP
CRISIS
Part-time pharmacists CAN move
into leadership roles.
THE FACTS? True or False
Card A or B

Many Pharmacy leaders are reaching retirement and will
be leaving in the next 5 to 10 years, e.g. VA.

“In a survey of 290 current pharmacy practitioners, only
30% wanted a leadership or managerial position during
their career.”

Male or female want leadership responsibilities, but are
not willing to work the long hours as their bosses.

There is an ample supply of senior mentors.
Women are still under-represented
in leadership positions
In academia - higher administrative position
and tenured faculty
 In the corporate sector executive leadership
and board membership
 In leadership positions in the healthcare
industry

There are a lack of nontraditional role models
and job structures for leaders and managers.
Can we reconcile the impending crisis of
a leadership shortage and the
increasing number of women in the
profession with the lack of alternative
ways to be a manager or leader in
health-systems?
Yes or No
Card A or B
Reconciliation
Develop leadership skills in all Pharmacy staff
members
 Combine clinical and management functions into
the responsibilities of specific positions
 Recognize and reward staff with the goal of
fostering interest in leadership
 Educate students, residents, and staff about
importance of their leadership role in daily practice

*ASHP Task Force on Pharmacy’s Changing Demographics
FACT OR MYTH
There is nothing we can do
within an organization to
affect the change in the
demographics.
TRUE!
BUT WE CAN AFFECT
WHAT WE DO ABOUT THE
CHANGING
DEMOGRAPHICS!
From the ASHP Task Force on
Pharmacy’s Changing Demographics
Final Report

The profession of pharmacy needs to respond
quickly to these demographic changes and
create a workplace that engages and retains a
diverse multigenerational workforce that can
make many unique contributions to improve
patient care.

Educate leaders and pharmacy directors about
generational differences and the need for
greater options in the workplace.
Alternative methods must be developed
to cultivate leaders and opportunities
in nontraditional programs.

Consider alternatives to current norms so
that diverse ways of working are recognized and
rewarded and that people have opportunities to
fully contribute to the success of the organization

Formal mentoring programs that address the
business imperatives for leadership, skilled
workforce, diverse workforce
Alternative methods must be developed
to cultivate leaders and opportunities
in nontraditional programs.

Leadership track programs for
talented and committed workers

Create formal “off ramp” and “on
ramp” programs that make it possible
to leave and re-enter an organization
THANK YOU!
Lynnae Mahaney MBA, RPh, FASHP
Chief, Pharmacy Services
Wm. S. Middleton Memorial Veterans
Hospital
Madison, WI
608-256-1901 x11028
Lynnae.Mahaney@va.gov