Workplace Conditions Push Pharmacists and Pharmacy Technicians to the Brink

The Tennessee Pharmacists Association (TPA) unwaveringly supports our members and the work of pharmacy teams, as they seek overdue action to improve eroding workplace conditions. We have heard our members’ concerns, and we reassure you of our commitment to helping you. Our profession rightfully demands action to keep themselves and their patients safe, while not compromising public welfare by abandoning patients who rely on them. Serving patients and ensuring patient safety are core to the profession of pharmacy.

In the Oath of a Pharmacist, our members vow to consider the welfare of humanity and relief of suffering as our primary concerns. At the same time, our members embrace and advocate for changes that improve patient care. Pharmacy workforce issues have led to frustration and burnout. These issues have been building for some time, but they have become more acute with the stressors brought on by the COVID-19 pandemic. Workplace conditions have pushed many pharmacists, pharmacy technicians, and other pharmacy team members to the brink of despair. Pharmacy burnout is a significant patient safety issue. It is impacting patients today with delayed prescription fulfillment, unacceptable waits for vaccines and testing, and potential errors due to high volume, long hours, and pressure to meet performance metrics.

Pharmacists and pharmacy technicians are caregivers, and we must address the fundamental issues causing burnout and frustration. The public, decision-makers, and regulators must be educated about, and recognize, the seriousness of our pharmacy teams’ negative well-being and the need for both additional resources and realistic expectations to safely provide patient care services. Pharmacy employers across the healthcare system must have meaningful dialogue with their teams, resulting in realistic expectations that are supported by appropriate staffing levels and procedures. Employers have an obligation to increase staffing in their pharmacies, in order to promote safety and access for patients and to improve well-being for their pharmacists and pharmacy technicians. In addition, the Board of Pharmacy, which is tasked with protecting public safety and public health, including timely access for patients to needed medications and services, must also examine current experiences and regulations contributing to this issue, and take appropriate action.

A significant contributing factor that causes understaffing and unrealistic performance metrics is a misaligned payment system that rewards volume and not value. Pharmacists and pharmacies are primarily reimbursed for dispensing a product, not for addressing the clinical needs of the patient. The payment system for pharmacy services is fundamentally flawed. TPA has long advocated for change in our healthcare system to assist in improving workplace conditions.

Pharmacy benefit managers (PBMs) are intermediaries who have siphoned tremendous profits from the prescription drug system, leaving pharmacies to depend upon unrealistically high transaction volumes with minimally viable staffing, to stay in business. In recent years, the state of Tennessee has adopted legislation to hold PBMs accountable for their unregulated business practices across the healthcare system. TPA will continue its work with state leadership to ensure that all Tennessee laws impacting the practices of PBMs are upheld and enforced.

In healthcare, the widely accepted Triple Aim seeks to reduce healthcare costs and improve population health, while improving the patient experience. In recent years, the Triple Aim has been adapted to the Quadruple Aim, embracing a new fourth domain—improving the healthcare team’s well-being. TPA recognizes that the concerns expressed by our members are not just a pharmacy issue, they are widespread across the healthcare system. The profession of pharmacy and other aligned health professionals follow a code of ethics that ensures pharmacy professionals act for the benefit of the patient (beneficence) and not harm the patient (non-maleficence). The profession of pharmacy is frustrated that poor workplace conditions are impacting the health and well-being of Tennesseans.

Pharmacy teams have been meeting a significant need within their communities during the pandemic, through the provision of acute and chronic medications and associated services, including testing, vaccination, and treatments. These services are provided on top of a model that was stretched to its limit prior to COVID-19, due to the misaligned payment model.

To assist the profession, TPA, in collaboration with the American Pharmacists Association and other state pharmacy associations, has developed the Pharmacy Workplace and Well-being Reporting (PWWR) tool, a safe, confidential, and anonymous space for pharmacy personnel to report positive and negative workplace experiences. PWWR reports create a pool of aggregated data that will be used to influence and educate our pharmacy community and leaders—including those who can do something about it—on meaningful and actionable changes. The experiences and situations submitted via PWWR help tell a collective, powerful story that can spark change and improvement in well-being, delivery of care, and patient safety in pharmacies.

TPA will continue to promote resources available to support our members throughout these difficult times. The Emotional Support Line for Pandemic Stress provided by the Tennessee Department of Mental Health & Substance Abuse Services is free for healthcare workers to talk to someone about feelings of stress, anxiety, sadness, or depression related to your work. Please call 1-888-MHART-TN (888-642-7886) between 6:00 am – 10:00 pm (CT) for help. In addition, the Tennessee Pharmacy Recovery Network (TPRN) is available to pharmacy professionals at risk for chemical dependency or other impairment. Please call 1-615-256-3023 to be connected with someone who can help.

Multiple factors have contributed to the situation we are in, and thus a multifaceted approach to a solution is needed—both in the short term and long term. TPA calls on anyone who can impact the well-being of our pharmacy teams and the safe delivery of patient care, to address these issues now with their teams and others who can make a difference: employers, the Board of Pharmacy, and third-party payers. To sustain public access to pharmacy services, relief is needed now. TPA stands with our pharmacists and pharmacy technicians in making the case for timely change.

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About the Tennessee Pharmacists Association
The Tennessee Pharmacists Association represents the profession of pharmacy across the state, united for the purpose of promoting safe and effective medication use to improve the health of patients. Since 1886, the Tennessee Pharmacists Association has preserved and advanced the interests of the profession and has served the professional needs of all pharmacists, student pharmacists, and pharmacy technicians.