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Demand outpacing supply in challenging field

Shortage of pharmacists instate 'extremely serious'

While Mississippi politics have been involved with continuing controversy over medical malpractice and the cost of prescription drugs, another area in the medical field has reached the crisis point: The shortage of pharmacists in the state.

“It`s extremely serious,” according to Bo Dalton, executive director of the Mississippi Pharmacist Association (MPA), a service organization which has 1,100 members.

The MPA says there were 2,538 pharmacists working in Mississippi in 2002. In 2003, there were 2,500. That`s a loss of 38 pharmacists in just one year.

Dalton thinks that the genesis of the problem was in 1998, when the University of Mississippi (Ole Miss) pharmacy program went to six instead of five years and only a handful of students graduated that year. Graduates of the pharmacy school now receive a Pharm.D degree – doctor of pharmacy. This is a national policy and Ole Miss changed to the six-year program to stay accredited.

Another cause of the shortage, according to Dalton, is the number of women in the field.

“Like in nursing, many women opt to start families and they may or may not go back to work full time. This is quite different than when I received my degree in 1974. Then, there were few women in pharmacy school.”

The trend is for more and more female pharmacy graduates, Dalton added. He speculated that by now, women are a majority of the students.

“Also, more and more pharmacies are being opened, particularly by chains,” Dalton said. “And there are more 24-hour pharmacies. And they all need pharmacists.”

Independent pharmacies are suffering from this proliferation of chain stores, because it`s difficult for them to hire pharmacists right out of school and pay them the going salary. Chains don`t have this problem.

The going salary for just-out-of-school pharmacists is approximately $46 an hour for a 40-hour week, according to Mac McDivitt, executive director of the Mississippi Board of Pharmacy, which has seven pharmacy members appointed by the governor. That`s about $95,000 a year. (And a long way from the 35 cents an hour that Mississippi pharmacists earned in the 1920s.)

Also, pharmacies usually pay a signing bonus to pharmacists just out of school.

McDivitt agrees that the increasing number of women pharmacists is one of the principal causes of the shortage.

“When I left pharmacy school in 1970, there were only five ladies in my class. Now, a majority are ladies. They’re very competent. But they tend to marry and have children and drop out or want to work only a day or two a week.”

He also cited the growing number of pharmacies, especially the chain stores, and said there are all these openings out there, with no one to fill them.

“Even Target now wants its stores to include pharmacies,” McDivitt said. “And there are all the hospital pharmacies. A hospital in a town of any size is going to have at least four pharmacists.”

Another cause for the shortage, according to McDivitt, is that many pharmacy graduates leave Mississippi for employment in other states, and not just for better salaries.

“Pharmacy school graduates these days, just like graduates in fields such as engineering and business, often want to move to larger, more cosmopolitan areas,” he said. “This is the first time in the pharmacy profession that there`s a total availability of jobs. You can work anywhere you want to go – New Orleans, Phoenix, Memphis.”

Both Dalton and McDivitt mentioned more elderly people needing more medications as another cause of the shortage.

“There are so many aging Baby Boomers and the number is growing by leaps and bounds,” McDivitt said. “People live so much longer and there`s just so much more medication available.”

As for the long-range outlook and what solutions might be found,

McDivitt said that nobody knows.

“If I knew, I’d be sitting in some think tank instead of here.”

A possible solution often mentioned is to admit more freshmen to pharmacy school, and McDivitt said that this is viable, that it makes sense. But this is now a six-year program and not as many people want to teach, not when they can work and make $46 an hour.

“They teach only if they really love teaching.”

David McCaffrey, an associate professor in pharmacy administration at Ole Miss, cautions that there is no way of knowing how long the shortage is going to last and says that, “We have to provide a quality education for these future pharmacists and just doubling the size of the class overnight isn`t the answer.”

A six-year pharmacy degree program is a problem for some students because of the added expense. And even the high starting salary only attracts a certain number of people to a very difficult course of study, heavy with subjects such as organic chemistry.

The U.S. Health Resources and Service Administration cites the increased use of prescription drugs as the cause of the shortage. More elderly people use ever more drugs and there is an increasing number of drugs now that are more effective against chronic illnesses and diseases.

Students in the Ole Miss pharmacy program start on the Oxford campus and complete four years of work there before moving on to Jackson for the final two years. After four years, they get a bachelor of science degree but this doesn`t qualify them as pharmacists.

Some of these students don`t go on to Jackson and, instead, become sales representatives for pharmaceutical companies. Others move into graduate programs in other fields.

A side bar to Mississippi`s pharmacy situation and the changing of the Ole Miss program to six years is a bill, now pending in the Legislature, that would convert all four- and-five-year degrees held by pharmacists in the state to a doctor of pharmacy degree, effective July 1, 2004.

The upgrading would require the pharmacists to complete eight hours of continuing education.

Contact MBJ contributing writer at George McNeill at mbj@msbusiness.com.

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