Pharmacy Job Outlook – 5 Ways to Make Yourself Recession Proof

I usually try to ignore this stuff, because it doesn’t do any good to worry about the pharmacy job outlook.  I love what I do and have no intention of switching professions, but for me, the pharmacy job outlook recently got a little more personal as two friends I spoke with within the last six months have been impacted with companies cutting back.  These friends are good people who work hard. They are not slackers by any means.  Harry Truman said, “It’s a recession when your neighbor loses his job; it’s a depression when you lose yours.”  These recent experiences lead me to think the recession is here.

I’m not an expert at this topic, but I know what I see, and from a professional working out in the field, the pharmacy job outlook isn’t getting better.  I did a quick google search and found that American Association of Colleges of Pharmacy (AACP) is promoting this on their website “A shortfall of as many as 157,000 pharmacists is predicted by 2020 according to the findings of a conference sponsored by the Pharmacy Manpower Project, Inc. Complete findings are detailed in the final report, “Professionally Determined Need for Pharmacy Services in 2020.”  They also cite a report from 2000.  Yes, that Y2K that was 15 years ago and nearly 50 less pharmacy schools.  There’s getting to be plenty of anecdotal data, and now more solid literature to refute what AACP is promoting.

What does the future of the pharmacy job market look like? - courtesy PHenry
What does the future of the pharmacy job market look like? – courtesy PHenry

I know what 100,000+ in debt feels like, and while I wholeheartedly take responsibility for my debt, I also had a very good job market (at least for a couple years) when I came out of school.  Put yourself in the shoes of a new grad – imagine 200k worth of debt in an average to poor job market.

Pharmacists better get used to the fact that the job market isn’t going to be as good as it was even just 3-5 years ago, and for new graduates with high amounts of debt (I know, I’ve talked to them and am still trying to tackle my own), that’s a bleak picture.

I want to provide something of value here and not simply just identify problems about what’s going on, so what should you do if you are in pharmacy school or a relatively new graduate who needs a job and cares about the profession?

1.  Show up early, stay late, and work efficiently.  No one owes you anything, just because you have a PharmD.

2.  People know people who are looking for employees who will do number 1(work hard).  If no one knows you, you drastically reduce the number of opportunities available to you. A strong network is so important.  Working hard hasn’t been an issue for me, but networking has historically been a huge weakness for me.  My personality trends more towards the introvert side, but this blog has certainly benefitted me greatly in that department.

3.  Expand your toolbox by volunteering to take on new tasks that no one else wants to.  Be irreplaceable.  If you’re looking to improve your clinical skills, I’m creating a clinical pharmacy Ebook, subscribers will be the first to be notified of this limited time FREE offer!  Click here to subscribe

4.  You have to do things to set yourself apart – Certifications, presentations, community involvement etc.  Take advantage of any on-the-job training a company is willing to give you.

5.  Pay off your debt as fast as you can.  While money can allow you to do some really cool stuff and buy you some really cool things, the most important aspect of money is its ability to provide freedom to do what you want to do.  Being tied to a job you don’t like simply for the paycheck is a bad long term plan.

Eric Christianson, PharmD, CGP, BCPS

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Can Someone Really Have This Many Medication Allergies?

Massive Allergy List adjusted

Medication allergies can get out of hand.  Most often they are not truly allergies at all.  The thing that really amazes me about patients with this many medication allergies is that they have tried this many different medications to begin with!

Some important points to remember about medication allergy lists, feel free to leave some comments on other considerations:

1.  Ask patients what the reported “allergy” is.  As I mentioned above, most often it is an adverse reaction, not a true allergy.

2.  After you ask the patients (sometimes they don’t remember especially in cases like above) about their medication allergies/intolerances, take the time to document the outcome.  Cough from an ACE inhibitor or was it angioedema, or maybe worsening renal function?  Sometimes intolerances can be just as important as allergies.

3.  Communicate with other healthcare professionals.  I’ve seen many cases where a clinic, pharmacy, home care, LTC etc. doesn’t report the allergy or intolerance to other institutions that also take care of that patient.  Critical checks can be missed in the future due to poor documentation and notification.

4.  Try to encourage and engage patients in their own care.  Make sure they have a list of their medication allergies in the event that #3 doesn’t happen.  Also tell them to write down what happened!

5.  Don’t ignore “big” allergy lists like this.  It’s easy to have a lax attitude and assume that all these allergies are intolerances.  It isn’t a good idea.  What if one of these was severe?  Are you willing to take that chance?

New to the blog? Please check out the 30 medication mistakes I see in my practice as a clinical pharmacist.  It’s FREE of course!

Eric Christianson, PharmD, BCPS, CGP

Diltiazem Induced Rash

A nice guest post from an anonymous contributor, thank you!
84 year old female residing in community was recently treated with several courses of antibiotics to treat cellulitis of the right lower leg. Several different antibiotics were tried due to ineffectiveness and an itchy skin rash.  The rash continued for months after the courses of antibiotics were completed and the infection healed.
Potential causes such as Steven-Johnson Syndrome, Leukemia were ruled out.

Med List: Synthroid, Diltiazem, Cymbalta. Triamcinolone Cream

After reviewing her medications, it was suggested to her cardiologist that a Diltiazem allergy may be causing her rash.  The Diltiazem was discontinued and Verapamil started. Within 2 weeks, the patient’s diltiazem induced rash had resolved.
Allergic cutaneous reactions to Diltiazem may occur anytime during therapy and generally not predictable with respect to onset (7days to 10 years with the average of 95 days)/Lexicomp
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Pharmacist Board Certification: Which one is Right for You?

There has been growing interest in pharmacist board certification.  I think it will only be increasing as the job market seems to be tightening up.  Another reason for the increase might be the steady progression toward provider status.

I’m not going to discuss the value of board certifications in the post, but I’ve been asked by several pharmacists; which one should I try to obtain?

There are a lot of board certifications now available for pharmacists.  Pharmacotherapy, Ambulatory Care, Geriatrics, Oncology, Pediatrics, Psych, etc.  I can’t exactly tell you which one is right for you, but I can tell you my thought process in deciding to become a Certified Geriatric Pharmacist (CGP) and Board Certified Pharmacotherapy Specialist (BCPS).

I took my CGP exam a few years back now and don’t regret it.  I work primarily in geriatrics and the certification made a lot of sense given a significant amount of my work as a clinical pharmacist was done in long term care (heavily geriatrics).

Why did I do BCPS?  I view BCPS as the most universal certification.  The topics covered in this certification are extensive and include everything from pediatrics, critical care, geriatrics, ambulatory care etc.  I want to fully disclose that I do have a BCPS mock exam for sale on this website, however, I took the BCPS exam long before I ever considered creating a practice exam.  For your reference, per accp.com, about 14,000 pharmacists have BCPS certification.  About 1,500 have ambulatory care and oncology respectively, the next two most popular certifications from BPS.

Which pharmacist board certification is right for you?
Which pharmacist board certification is right for you?

My take: If you know 100% you want to practice in a particular area/specialty of pharmacy for the rest of your career, then doing a specific certification like oncology makes a lot of sense.  If you are not exactly sure where your career path will take you as many younger pharmacist are not, I would probably recommend the BCPS certification.  Feel free to add your two cents!

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Eric Christianson, PharmD, CGP, BCPS

Case Study: Zocor and Diltiazem Interaction

66 year old female was newly diagnosed with atrial fibrillation.  Her other diagnoses included hypertension, diabetes, hyperlipidemia, and GERD.

Current medication list included:

  • Aspirin 81 mg daily
  • Simvastatin (Zocor) 40 mg at bedtime
  • Tylenol as needed
  • Protonix 40 mg daily
  • Lisinopril 10 mg daily
  • Metformin 500 mg twice daily

With the new diagnosis of atrial fibrillation, the primary provider started the patient on Diltiazem (Cardizem) CD 180 mg daily.

Within a few weeks, the patient began to feel worsening muscle pains and aching.  She could not attribute it to physical activity or anything else going on in her life.  She began taking the Tylenol as needed 2-3 times per day to try to help with the pain she was having.

Upon investigation of the medication regimen, it was discovered that the Diltiazem had been started a few weeks back.  Diltiazem can increase the serum concentration of simvastatin which is likely what happened in this case leading to the muscle pain/soreness.

photo courtesy of medimoon.com
photo courtesy of medimoon.com

Per Lexicomp, simvastatin and diltiazem used together should be avoided if other alternatives exist.  If use can’t be avoided, then a maximum recommended dose of Zocor at 10 mg daily should be considered.  The Zocor and Diltiazem interaction is one you need to be aware of!

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Interprofessional Medication Education