Disruption Coming to Pharmacy and Pharmacy Education

To the Editor: Romanelli and Tracy write persuasively about a coming disruption in pharmacy.¹ Evidence that pharmacy graduation rates may lead to pharmacist supply overtaking job openings is found in US Bureau of Labor Statistics (BLS) data, which report pharmacy employment projections for 2012-2022.² The bureau projects a positive employment change over this period of 41 400 positions, from a 2012 base of 286 400, an increase of 14.5%. Between 2012 and 2022, job openings, as a result of growth and replacement needs, are projected to be 109 800. Assuming that 14 000 to 15 000 new graduates will enter the workforce annually during the period, an oversupply of 40 000 or more is likely to accumulate by 2022.

The authors suggest dealing with the incipient disruption in the profession by proposing a return to a 2-tier system of “dispensing” and “nondispensing” pharmacists. The former would supervise “super technicians” and robotic systems for drug distribution, while the latter would continue to develop clinical therapeutic roles and also help to meet primary care gaps. However, even if implemented by 2022, the total number of job openings for tier-1 and tier-2 pharmacists probably would be less than the BLS projections because market pressures would drive down demand for tier-1 pharmacists and the rapid projected growth of physician assistants (up 38.4% by 2022) and nurse practitioners (up 33.7%) would create more competition for the tier-2 clinicians.²

If we cannot deal successfully with the coming disruption by altering the demand side (at least in the next decade), we have to examine the supply side. That means greater attention to enrollment in all schools and colleges of pharmacy. It is easier to increase enrollment than to decrease it, especially if the decrease is large enough to impact the size of the described disruption in the pharmacy profession. The answer lies with individual schools.

What we have is a classic case of tragedy of the (academic) commons wherein each school reaps more individual benefit from increasing enrollment than by acting for the good of the pharmacist community and enrolling fewer students.³ Therefore, coercing pharmacy schools on some level to hold down enrollment may be necessary. This could come from mandates from higher administration, disengagement of major donors, cuts in budget for public pharmacy schools, unwillingness of students to pay the price for an uncertain future, influence of large employers, or a combination of market forces.

Ignoring the signs and symptoms of the coming disruption in practice could be equally or more disruptive to pharmacy schools. Solutions for individual schools are more likely to be found within the institutions themselves than through discussions across the academy.

• © 2015 American Association of Colleges of Pharmacy