Catching the Clinical Wave: Changes in Pharmacy Dynamics

August 2015, Vol 3, No 8 - The First Word
Donald J. Dietz, RPh, MS

As pharmacists involved in daily work activities, it is often difficult to recognize or identify changes in our pharmacy or profession. I recently reviewed the 2014 National Pharmacist Workforce Survey, which has surveyed pharmacists since 2000.1 The most recent report, released in April 2015, provides data from 2014, and is an update to the 2009 survey. The report contains a wealth of information about the pharmacy profession, and I was most intrigued by the changing dynamics in pharmacy leading to the provision of more clinical services.

Higher Education on the Rise

There has been a dramatic increase in the percentage of pharmacists who now have a Doctor of Pharmacy (PharmD) degree compared with past survey results. Five years ago, 21.6% of survey respondents reported a PharmD as their highest degree; this percentage increased to 37.8% in 2014, and my hunch is that it will exceed 50% by the time the next survey is completed in 2019. This is because of older pharmacists—most of whom do not hold PharmDs—retiring, and the fact that all new graduates are now required to have a PharmD. Professionally, PharmDs have an extra year of clinical education, enabling them to be better prepared to provide clinical services in addition to medication dispensing.

A Shift in Dispensing Activities

The survey also evaluated the amount of time pharmacists spent doing various activities. Pharmacist medication dispensing activities have decreased from taking 55% of a pharmacist’s work time in 2009 to 49% in 2014. This compares nicely to an increase in nondispensing activities from 16% in 2009 to 21% in 2014. In addition, 35.3% of community pharmacists reported that much more of their time in 2014 was spent in patient care services not related to medication dispensing than in 2009.

The report delves deeper into nondispensing patient care activities performed by pharmacists. In 2014, 60% of pharmacists reported spending time providing medication therapy management (MTM) to their patients, compared with 13% in 2004. Immunization administration by pharmacists has exploded in the past decade, with 53% of surveyed pharmacists reporting that their practice site offered immunizations; this is a steep increase from the 15% of pharmacists with sites offering immunizations in 2004. Furthermore, 52% of pharmacists reported offering adjusting medication therapy—a service that was not even tracked a decade ago—in 2014.

Pharmacist-provided health screenings have also flourished in the past decade. In 2004, only 7% of chain pharmacies reported pharmacist involvement in health screenings, compared with 48% in 2014. Even supermarketpharmacies—which were viewed as forerunners in health screening services—increased offerings from 27% in 2004 to 57% in 2014. The pharmacy profession is clearly more involved in providing clinical services than in the past.

Making Changes and Seeing Progress

In conjunction with the increase in pharmacist-provided clinical services highlighted by the report, pharmacies are also dispensing more prescriptions than ever before. The increased use of technicians, automation, and technology to process prescriptions has enabled pharmacies to dispense more prescriptions in an error-free, highly automated workflow environment. A number of large and midsize pharmacy chains are incorporating central fill and central processing technologies to effectively free up pharmacists to provide nondispensing clinical activities in the pharmacy. Medication synchronization has many benefits, including labor reduction, improved inventory management control, and improved customer service. My belief is that the largest benefit is gained when pharmacists have the opportunity to engage with patients on a monthly basis to review how they are doing with their prescription medications.

The successful migration of routine adult immunization services to retail pharmacies in the past decade has been nothing short of phenomenal! It has successfully demonstrated how pharmacists are able to be effective, accessible healthcare practitioners in retail pharmacies. Although there is a plethora of information in this survey report, I was most excited to see an increase in clinical services provided by pharmacists compared with past surveys. I am eager for the next big clinical evolution in pharmacy that provides positive outcomes for healthcare. Will it be an expanded or targeted MTM approach, collaborative practice agreements with prescribers, adjusting therapy, medication reconciliation, or another yet to be identified clinical service?

It is an exciting time to be a pharmacist. Although I focused on the clinical services, the report contains an array of information that captures the changes occurring in our profession, from demographics and practice settings, to workload and more. In addition to your pharmacist colleagues, this report is worth sharing with pharmacy interns who may wish for a glimpse of their future, or with high school students contemplating pursuing pharmacy as their course of study in college.


  1. Midwest Pharmacy Workforce Research Consortium. Final report of the 2014 national sample survey of the pharmacist workforce to determine contemporary demographic practice characteristics and quality of work-life. Published April 8, 2015. Accessed June 24, 2015.
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Last modified: August 21, 2015
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