At Bentley Pharmacy in Princeton, there is exactly one of everything — one bottle of Pert 2-in-1 shampoo and conditioner. One tube of Desitin diaper cream. And one full-time pharmacist.
Working for a small, independent pharmacy has been a refreshing change for pharmacist Justin Mielke, who spent more than a decade at retail giant Walgreens before joining Bentley in 2019.
“The staffing issue is probably what pushed me out,” Mielke says of his decision to leave Walgreens five years ago.
Retail pharmacies, like many industries, have been plagued by recent staffing challenges. Shortages have impacted both large chains and community pharmacies. In a 2023 National Community Pharmacists Association survey, 67% of respondents reported trouble filling open positions. More than 80% said pharmacy technicians are the toughest positions to fill.
Mielke joined Walgreens in 2006 as a pharmacist and eventually became a pharmacy manager. In the beginning, he says the pharmacy would be adequately staffed by two to three pharmacists as well as five to seven technicians. By the end, Mielke was working 12-hour shifts as the only pharmacist on duty, filling 400 to 500 prescriptions and administering 30 to 40 vaccinations by himself.
“It’s tiring in a 12-hour day to just never have a 10-minute break,” he says.
Whether caused by an inability to fill open positions or by corporate-led cutbacks, Mielke says the understaffing created a stressful and unsustainable working environment.
“You have about 15 seconds [for each] prescription,” he says. “When everything goes well, that’s doable, but when you need to stop and call a doctor, or when you have an insurance problem, or a customer has a question that you take 10 minutes to answer, think how far behind you are.”
But it’s not just the nation’s largest pharmacies that are struggling. In a November interview with Wisconsin Public Radio, Pharmacy Society of Wisconsin CEO Sarah Sorum said the overall drugstore industry is plagued by a compounding set of issues.
“I talk with our members every week about these issues, whether it be patient expectations, health plan challenges, staffing issues, shortages of pharmacy technicians,” she said. “Those are all topics that are coming up on a weekly basis. They’re urgent issues that need conversation, and they’re complex.”
Drug shortages and staffing challenges
Today Mielke doesn’t mind being the only pharmacist per shift on duty. In fact, he prefers it. On Bentley’s busiest day — Monday — he fills at most 200 prescriptions.
“I like that I’m able to build relationships with people. I know 90% of our customers when they walk in, which is really nice,” he says. “I think that the community relationship was a big game changer, as well as just having a little bit more time.”
According to a 2022 National Pharmacy Workplace Survey, nearly 75% of respondents felt they did not have enough time to perform their job duties safely. This time crunch caused by understaffing was one of the issues that prompted CVS and Walgreens pharmacy workers to stage walkouts last fall.
When it comes to some of the largest retail pharmacies, the headlines have been bleak. CVS announced it would be closing dozens of its pharmacies located in Target stores between February and April. Walgreens reported it will close roughly 150 locations by August. Last October, Rite Aid filed for Chapter 11 bankruptcy protection.
Inflation, increased competition from online pharmacies and lower drug reimbursement rates have all been cited as causes for this downturn.
Meanwhile, drug shortages persist nationwide. Nearly all — 97% — of community pharmacists said they are currently facing a shortage in some drugs, according to a 2023 National Community Pharmacists Association survey. Diabetes medicine, Adderall and the antibiotic amoxicillin were the most reported to be in short supply.
During the last eight months, Mielke says there are always three or four medications that start to run low, but he closely monitors their availability status multiple times a day.
“The second I see it’s available, I submit my order,” he says, “but if you’re one pharmacist running 500 prescriptions, checking on [a drug] that hasn’t been available might not be something you can do every hour.”
Accelerating education and licensing
While the issues facing pharmacies are complex and without a single solution, education and licensing may offer some relief.
In October, UW-Milwaukee and the Medical College of Wisconsin announced a new partnership that would enable students to earn both a bachelor’s and a PharmD degree in just six years as opposed to the typical eight.
“The traditional pathway to becoming a pharmacist — four years of college followed by four years of pharmacy school — can seem daunting to many, particularly first-generation students,” Scott Gronert, dean of UWM’s College of Letters & Science, said in a statement. “Programs like this that streamline the experience will attract more students and help fill the demand for pharmacists faster. Today’s pharmacists play a critical role for individuals and for the public health system, providing vaccinations, health screenings, mass education and chronic disease management.”
In addition to accelerated academic options, the pharmacist licensing process in the state of Wisconsin has recently been streamlined.
In November, the Wisconsin Department of Safety and Professional Services (DSPS) reached an agreement with the National Association of Boards of Pharmacy (NABP) that will lead to faster licensing of Wisconsin pharmacy students.
The new agreement is two-fold: It eliminates some redundant steps in the licensing process and utilizes technology to expedite it further, says DSPS Secretary-designee Dan Hereth.
In the next one to three years, if things don’t change,
not every pharmacy
running right now is going to fully be able to say the customer is their top priority.— Justin Mielke, pharmacist, Bentley Pharmacy
In order to complete post-graduate competency testing, pharmacy school graduates must currently send proof of graduation to the DSPS, which then notifies NABP. Under the new agreement, students send proof directly to NABP.
“While we were having to review that information, the NADP was simultaneously collecting and reviewing that information too as a part of their internal processes,” Hereth says. “It only made sense for us to work to de-duplicate the process.”
The DSPS will now also receive electronic notification when test takers pass the exam, eliminating the need to manually enter test scores. A license will automatically be issued once electronic notification is received.
The changes went into effect last November, but the impact will be first realized by this spring’s graduating classes from the state’s three pharmacy schools.
Hereth says faster licensing is a win-win-win for students, employers and the communities in which they operate.
“It’s really all about moving folks into the workforce as quickly as possible,” he says. “When you get your first job in a community, the likelihood that you remain in that community long after you’ve graduated is much higher. Our goal is to make the transition from being a student to being a professional as easy as possible.”
These changes are chipping away at the iceberg, but until working conditions improve — particularly for pharmacy technicians at large chains — Mielke believes staffing shortages are likely to persist.
“Techs get thrown into the fire. The pay is going up, but there’s a lot to do for little pay for a technician. They see the work environment and they quit,” he says. “In the next one to three years, if things don’t change, not every pharmacy running right now is going to fully be able to say the customer is their top priority.”
On the web ncpa.org
