community pharmacy to take another hit:

B.C. to end generic drug pricing agreement - British Columbia - CBC News

Just a quick update, hospital pharmacist wage rollback has been temporarily rescinded. But community pharmacy is still getting reamed by the government...

Looks like you switched boats at the perfect time

What's the best way to land a job as a pharmacist in Vancouver? Seems like there's no openings at all. So would it be best to float with one company and hopefully they will acknowledge my services and consider me for a spot in Vancouver when there is one available? What are your thoughts? Thanks!

SDM is always looking.
Try some Pharmasaves and independents too.
Most chains are cutting back hours because of the changes that are already happening. Things will only get tougher in the next 5 years.
If you work for a chain now, you'll have the highest probability getting hired by them. If not then just gotta get out there and compete.

it's not that, each yr there's like 86 grads that comes out, but there are only 20-30 or so positions... what do you expect? there are too many grads right now and there just aren't even placements available.

and to see fresh grads coming out asking for 35-40 dollars... get a grip buddy, there are tons of people waiting in line working for less than 35.

this is coming from a store owner and their observations.

There has ALWAYS been an over-saturation of pharmacists in the lower mainland. There are always jobs available in BC. It's only a matter of how far you want to travel. Your best bet is just to go knocking everywhere. You'll find something; just a matter of how persistent you are. There ARE still jobs available at the moment. Might have to pick up multiple part-times, go further out, or accept a lower wage.

And jobs WILL be more scarce in the coming years. The reduction/potential loss in generic support hurts everyone: chains, independents alike and is the biggest blow to pharmacy in the last 15-20 years.
The certified tech movement hurts pharmacists at chains moreso than anywhere else because suddenly your $35-40/hour position is replaced by a $20-25/hour tech. And it's only a matter of 5 years before they estimate the # of certified techs will exceed the # of pharmacists at our own College.

Everyone is waiting for the impact of the new legislation and its effects on the way pharmacy business will be run in the next few years before it settles down. That is the true reason why there is a wage freeze/downward trend in hiring at the moment. Clinical services like adaptations, injections and medication reviews can only help so much but regardless those things can only make up a fraction of the money from the expected loss in generic support/legislation rules. Things do not look good in community. This is how I see it, and I'm a part-owner.

What the.. how many techs are getting regulated every year? I thought to date, there are still less than 100 in all of BC...

Don't know the current number. But check out the section on pharmacy technicians in the latest Readlinks from the College. According to them, they expect up to 5000 registered techs by 2015. They are taking into account those assistants that will complete a bridging program too.

Last I recall, there are roughly 3000 pharmacists in total registered with the College. How pathetic is that that the College of Pharmacists will have more (or equal) certified techs? What happens by 2020? Maybe the College should consider changing their name to College of Pharmacy Technicians & pharmacists.

86?:badpokerface:

even accounting for attrition try 200 by 2016

Yeah not sure where that 86 figure came from......?

My class had 155 which was the norm for a while.

The class sizes have now jumped to 225 and started with grad 2015, I believe.

So with the generic support and rebates ending next year ...how have pharmacies adapted to this projected decrease in revenue? i've heard multiple reports from regional mangers saying how low the wages in toronto are (ld in particular is 25/hour; safeway is 28/hour)...and sadly it seems to be going in that direction....like you said...clinical services won't cover the lost revenue...and if we hold clinics on acne or stuff like that...i don't feel anyone would be willing to pay for it. it's really difficult to see how we can preemptively do some damage control before the legislation is implemented.

weren’t zellers and other comp, hiring pharmacists from other countries, and training them here, . i know this girl a while back came in from Philippines and was going thru zellers training and they were paying for her lic. and stay etc.

It's unclear what will happen to generic support at the moment. It all hinges on the wording of the legislation. Time will tell if there are ways to work around it or if the transition will be more gradual. But regardless, the best days are behind us now for the foreseeable future.

Wages for existing pharmacists seem to be holding as it's too demoralizing to cut across the board that way for now. New pharmacist wages are the ones that are being hit first. I believe the wage is sitting somewhere between $32-35/hr at the moment.
Next to go will probably be the # of hours of existing pharmacists before actual layoffs or decrease in wages occur.
The only other thing that pharmacies can do is to maximize earnings while it's still available from whatever clinical services are available and getting that generic money while it's still there. There are SO many factors working against pharmacy at the moment. Even among pharmacists, it is absolutely retarded when I hear that they "don't want to do a medication review for a patient because it's not worth $60 of the government money to do it" without even understanding where the hell this money is coming from. And yet these same pharmacists think they deserve their $38-40/hour. It's absolutely ridiculous and shows how little they understand what's going on in this profession and the landscape of the current economic situation with pharmacy.

I encourage all the pharmacists here that are part of BCPhA to actually listen to some of the member briefings from a few months ago. They are archived under Professional Resources\Bill 35. All 3 archived clips have mostly the same information, but the last briefing on May 2nd in Victoria is the best. It really sums up how pharmacy got to its current state and why negotiations fell apart. The attendance (online and in person) was pathetic for these and just goes to show what is wrong with our profession and how the majority of pharmacists are so misinformed and don't give a shit until it's too late and they're about to get axed.

There is a lot of misunderstanding about what pharmacists do and how much/why they get paid what they get paid because there really isn't a physical aspect to it. In the end I think that new prescriptions should costs much more as a dispensing fee whereas the refills should be the current cost. I actually wish community pharmacy was government owned because I also think that the business of healthcare is getting out of hand, but thats an entire other topic.

I work in a hospital and I can tell you on a daily basis I save the hospital 3-4x my wage on a normal day by preventing ADRs or using evidence based medicine. So I think I deserve my wage if not more, we get paged at 2am from doctors asking insanely complex questions over the phone and are expected to aide in patients healthcare. The med reviews done in the community that I have seen are absolutely ridiculous. MOST (not all) community pharmacists are robots and don't understand the medication and how it relates to the patients because the patient only cares about their insurance and therefore that is the only thing people focus on.

Every long term care facility needs a pharmacist so they can manage medications appropriately. The GP with 10,000 patients cannot effective keep these people out of the hospitals and the nurses at these homes are lost because they don't know anything about the medications. They continue to give medications despite obvious side effects or they hold them for some random reason and the patient strokes.

This is a topic I can go on and on about but in the end, 90% of pharmacists don't care enough about healthcare because 99% of patients don't either, they just want pills to fix the problem regardless of the harms or other obvious solutions.

Sorry for the rant....

I agree that there is a lot of misunderstanding about what pharmacists do and how the whole reimbursement model works for community pharmacy. If community pharmacy were government owned then we'd be the ones striking and causing problems instead ;)

Who among us DOESN'T think we don't get paid enough for our jobs? You're not the only one working your ass off. Different setting, different application of skills, but not more important than anyone else doing their job in community or hospital alike.

Why do MOST (not all) hospital pharmacists always have an elitist attitude when it comes to how they view their own colleagues in community pharmacy? Have you read the guidelines for what is required in a med review in the community? What makes you think that something that is 'absolutely ridiculous' to you is not useful for a patient with little or no knowledge of what they are taking? Do not take it for granted that medical knowledge is so easy to come by. Something obvious to you is not obvious or useless to patients.
And the reason why patients only care about insurance is because it hits their bottom-line. If you had to deal with asking a patient for money in the hospital you can be damn sure you'd get yelled at a lot more and would focus on that a lot more as well.

90% of pharmacists care about healthcare but feel their hands are tied because the system in the community does not reward/provide incentive to use their clinical knowledge. Like it or not, the bulk of reimbursement is based on Rxs going out and the individual pharmacist does not see that money which leads to the complacency.

I don't expect a hospital pharmacist to understand the issues at hand in community pharmacy, but for some reason they always tend to chime in about it as if they know better and compare with what they do in hospital and think they do more and deserve more.
Sorry for my rant.

http://i11.photobucket.com/albums/a1...o/blakckid.gif

i was here for the term 1 interviews this year and something that surprised me was rexall. in the okanagan area...they're offering new grads $51 an hour, which is considered to be high even for that area.....my sister makes $45 for superstore there....are any of you familiar with rexall at all? they're expanding massively in bc right now and it's really counter intuitive from my point of view. i'm really tempted to take the offer, but no information was given on the working conditions...staffing...etc. i know that we have to manage the drive through pharmacy tho.

$45 in okanagan seems low, unless she graduated recently. The historical going rate is around $47-54/h (from maybe 5-6 years ago).

Rexall in terms of compensation is fantastic. Be prepared to work like a dog though. You'll be 'expected' to be doing at least one med review per day. You'll likely be taking a manager position, and if thats the case, a free trip to Niagra falls every Autumn! In addition, based on the performance of your store, you get annual bonuses as well. My friend took over management of a store on the island and turned his numbers from -10% to +15% (in his first year of work from May-December) and around January, he received a $15,000 bonus, on top of his regular $5x.xx/hour.

They are expanding massively, trying to be on the same scale as SDM. From a market view perspective, they are doing exactly what makes sense, in my opinion.. Buying spaces in a time of 'low', when independents are shutting down etc. and riding it through the highs, which will likely come again in several years - decade. Due to the evolving nature of the profession, it's not likely that we will have pharmacist salary cuts indefinitely. We may very well one day become independent prescribers (especially if the naturopathic doctors can do it).

I currently work in a community pharmacy and a local hospital as well... and I can say from experience that each respective position is difficult in it's own ways. Community pharmacy, you always feel the push to be faster, do med reviews (which btw, you will feel like a sleazy car salesman 50-60% of the time, giving someone a product they don't really need just to increase the store numbers) and all the while not f'ing up the patients insurance.

In the hospital, it's a lot more mentally stimulating from a clinical perspective. Get asked lots of questions, most of the time it's not so hard to be honest, the resources are all in front of us. Even when I'm 'on-call' all I have to do is go to my computer at home and verify certain things. The super clinically-complex questions are usually referred to other physicians (mostly internal medicine). There are definitely LOTS more clinical problems in the hospital, mistakes everywhere, things that are usually overlooked, renal function, allergies, duplication, etc.etc. It's easy to make our money in 'cost-savings' in the hospital, but in community it's a little more difficult because we do not have the full clinical picture in front of us. Once lab values become available on community pharmacy systems, we will probably be making a lot more clinical interventions than we currently do.

thanks for the fabulous insight sirv! do you know anything about the support that rexall usually gives? is there overlap most of the time, or are we gonna have to feign for ourselves


also one thing that's strange is they have gave us a verbal confirmation of the offer about day days ago...however i see the job websites and they posted
a public job offering for my position 10 days ago

http://ca.indeed.com/jobs?q=Pharmacist&l=Vernon%2C+BC

https://katz-openhire.silkroad.com/e...=&tosearch=yes

Will have to strongly disagree with this point. I don't put my integrity on the line when making recommendations.

Thats great.

I wasn't talking about a specific physical product per say (i.e. multivitamin reccomendations etc.), but the product being the 'med review', paperwork etc. Especially if patients were on a topical cream 3 months ago, naproxen 2 months ago, and most recently a nasal spray, tylenol 3 and amoxil. Med reviews for these guys are pointless, yet I see them being done on people all the time when I pull Pharmanets on patients while I'm in hospital (a note of caution, it's gotten to the point now where a few of us are REPORTING these types of med reviews to the college).

Don't get me wrong, I think our job is important in the community and I don't like the sleezy way of doing it either, hence why my numbers are quite below par. I do however, make up for my shortcomings in adaptations, immunizations and other things that I think are actually useful and time saving for patients (couple common examples being patanol --> pataday interchanging because it's on manufacturer short, flonase/nasonex to mylan-beclomethasone for full pharmacare coverage for those that cannot afford, list goes on).

It's hard for majority of companies to follow the rules of integrity because they just can not sustain themselves, they will starve, especially if they are independent low volume stores to begin with. When we go the way of Ontario and have 0% rebates eventually, these guys can either do tonnes of med reviews to feed their families (and I'll bet hard money that 60-80% of these reviews would not be necessary), or they can follow their integrity and shut down shop to join a corporation paying them 30$/hour or less.

In an ideal world, integrity should = employability, but I think very soon, this might not be the case, the bottom line for most corporations and even independents is numbers, numbers, numbers. If someone can bring that in while keeping their integrity, thats great, but just from the viewpoint I've developed through hearsay about how to boost numbers (of MR's), I get the impression that individuals pulling in 10+ med reviews per week care more for their job and career goals than they do for actual patients. I would be happy if you could change my viewpoint on that to help make me better at my job.

It was disappointing to me while I was in school that even one of our guest lecturers from CPSBC told us that if a patient does not meet the 5 drug criteria for coverage, just recommend that they take a calcium and vitamin D to make their pharmanet total 5 drugs so we could bill for it.

I am praying for the day to come soon where this med review thing goes down the drain, and the government starts reimbursing us for skills where we are actually able to offer something more valuable to society.

Just out of curiosity, in those cases where a patient may be on 5 meds in the last 6 months that you do not feel warrant a med review, what makes you think they AREN'T using their meds improperly or something? Maybe there was an issue that the pharmacist saw after actually SPEAKING to the patient that they wanted to resolve? Did you call you the pharmacy to ask them for a copy of the professional form to see what was written? Did you take that extra step to give the benefit of the doubt to the pharmacist?

I'm not saying doing a med review in those cases is always correct. In fact I'd like to see what justification was given on the professional form for this med review to be done. But perhaps there is more to some of these cases that you did not consider before accusing the pharmacist of being "shady".

Btw, reporting to the college will obviously do nothing because you even illustrated in your own post above that people FROM the college encouraged these types of med reviews to be done.

It is always easy to point out things that are wrong, but can YOU think of a new clinical service in the community that would be sustainable and viable both financially and also that would satisfy your integrity that the government should be funding?

The bottom line is that the government is taking away a lot of money in the community market suddenly and swiftly with very little means to sustain pharmacy which has been so reliant on "rebates" to make up for the lack of funding for the past 15-20 years. Again, I ask, do you even KNOW what is going on and why med reviews, adaptations, injections, and other clinical services are suddenly being pushed and where this funding is coming from?

Maybe we should flip this issue around and change the way hospital pharmacists are reimbursed as well. Let's take away 30% of your yearly wage next year and say that that 30% is being "reinvested into better health outcomes for all British Columbians in hospitals". Then, how about we say you can "earn" your 30% back individually if you complete discharge summaries and transfer summaries for patients in hospital for $60/patient provided they are on 5+ meds and you use government approved forms that are made in such a way that encourage easy auditing and mistakes that will be retroactively audited for clawbacks. I'd like to see what type of anarchy occurs among hospital pharmacists in a hypothetical case like this. As ridiculous an example as this sounds this is exactly what happened in community. So before you hate on community pharmacists, try to understand why this even happened.

Edit: Just out of curiosity, do you even know what is funding your $38-40/hr wage that I assume you expect? Would it shock you to realize that the money to pay for your wage is directly proportional to the number of med reviews done? Maybe you should be asking your employer to pay you less so that nobody needs to commit these acts that lack integrity anymore.
Posted via RS Mobile

I may have overstated the reporting. The actual number of cases I've personally seen reported in total hover around 3. And in each time, what led to the reporting would be us asking for the pharmacy to fax a report of the med review, and when they send us a blank form with just meds listed, and have no idea whether the patient switched from a CCB or BB (or if they are on both continuously - one example) we get frustrated, because the patient has no idea.

One thing that I can think of off the top of my head in terms of sustaining ourselves, I think the adaptation fee schedule should be changed. Adaptations for renewals can remain at $10 since it's not a super cognitive service (I always renew for 1 month max anyway b/c theres no lab work I can ever use to safely give a 3 month for). Drug substitutions, direction changes 15-20$ etc.

An MD bills approximately 30$ for a 15 minute appointment, we tell patients to stay in our pharmacy for 15 minutes after a flu shot and get ~14$ (correct me if I'm wrong) out of it? , maybe give us a little more for injection services because we still DO full assessments on whether or not it's appropriate, whether or not it's provincially funded, or out of pocket etc. After doing injections at high volume (100 injection/day) store, I think it's totally ridiculous how govt spending was mis-allocated to injections being given only by Dr's/public health nurses the last few years when we were already there and able to provide these services.

In addition, I think if we could properly document/bill all our work on pharmanet and get reimbursed for certain OTC counselling ($5), especially after hours when Dr offices are closed.

Last point. I can't remember the exact figures, and I may have already posted this in the thread somewhere here. But last year, I had a big corporate sponsored dinner where I had the chance to speak to some people from Ontario. They were saying that previously, the Ontario government was giving $100 million in funding for pharmacies, after the cuts, it's been brought down to $15 million (85% cut!) almost overnight. They took a huge chunk of money away and gave back 15% just to toss up in the air and say "you guys can use this for your 'clinical services' and be reimbursed from this pot of money". Obviously, even IF they maxed out on all the clinical services they could have possibly done, they would still end up nearly 85% short. The way our professions salary is dictated by the government is very scary, especially for those that have a mortgage/kids/debt.

Eventually, we will probably have to look at people paying out of pocket for these services for us to survive. Or hope that our profession changes enough in the right direction that we can find a different source of income somewhere (drug prescribing within limited scope?).

Yeah that's an example of bad med reviews done in the community. I agree that the quality of them should be improved from the ones I've seen as well, but I don't think it's a bad initiative at all. We're finally getting a chance to get paid for something other than dispensing. It's a good first step and it'll take time for the quality to improve. I'm pretty sure it's here to stay and will be refined over time. I just feel it's about time we get paid to "talk" to patients about their medications. How often do we counsel otcs for 10 mins or something and the patient goes elsewhere that's cheaper? The $10 fee right now does not even cover the cost of dispensing a medication from Pharmacare own joint study (cost is closer to $14).

Good points brought up about adaptation fee schedule changes that would be reasonable. Unfortunately pharmacare doesn't see it that way. In fact for existing adaptations they are paying $9.60 I believe, because they say it was something negotiated before the agreement to increase the fee to the current $10.

Injections are paid at $10. I don't think they'd pay more for us to do injections because that is how much they pay physicians as well. Injections is probably one area that pharmacy's role will gradually expand in and completely overtake the physicians. It's just way more convenient to go to a pharmacy to get them done than to wait at a doctor's office.

The problem with pharmacy is there are only so many revenue streams available: dispensing fees (which we do not get paid enough for to cover the cost of dispensing), injections ($10 does not actually cover the cost of training and supplies unless you do a very large volume yearly), adaptations, med reviews, and generic support. Generic support is by far the only way to sustain pharmacies in the current model. To get rid of it and then reallocate only a small % of it to fund these clinical services is a joke and will not work. I hope they have something better coming or service levels will drop and every little thing will need to come out of pocket from patients. To be honest, it's time patients DO pay for some things we do. Calling doctors for stupid mistakes, or refill requests, answering otc questions, answering questions from patients that did not even get meds from you are all done for free at the moment and they are all time consuming tasks within our work flow. It just annoys the hell out of me that pharmacists have been trained to believe their skills are worth nothing.
Posted via RS Mobile