Joan Cohrs missed her chance to fill a prescription at her regular pharmacy by about 30 seconds.
Shortly after the metal curtain fell, Coles walked over to the counter at the CVS Pharmacy in Indianapolis, closing it for lunch. she does not mind. The 60-year-old said she felt sympathy for the health care workers.
“They definitely needed a break,” said Cohrs, who was working at an assisted living facility when COVID-19 hit.
A vaccine rush, testing for the virus and a busy flu season began overwhelming pharmacies more than a year ago, forcing many to temporarily close without staff.
Big drugstore chains have raised wages and hung signing bonuses to add staff. They’re also emphasizing lunch breaks and sending routine prescription work to other locations to improve conditions at pharmacies hit by the pandemic.
Still, the temporary closures are in place, and experts say bigger changes are needed.
“There’s no shortage of pharmacists. There’s a shortage of pharmacists who want to work in those high-stress environments that are under-resourced,” said Richard Dang, an assistant professor of clinical pharmacy at USC.
Pharmacies rely on pharmacists and pharmacy technicians to fill prescriptions, answer phones, work drive-thru windows, administer vaccines and perform tests.
They also ask them to manage the health of an increasing number of patients. Pharmacists in many stores now help people quit smoking and monitor their blood sugar. Companies like Walgreens are pushing them to work more with primary care physicians.
Pharmacists can now also test for COVID-19 and prescribe medication, a process that can take 20 minutes or more.
Giving pharmacists the opportunity to have a bigger impact on public health is “remarkable,” said Stefanie Ferreri, a professor of pharmacy at the University of North Carolina. But she added, “the workforce is not quite ready yet.”
Like other businesses, pharmacies were hurt early in the pandemic when employees who contracted COVID-19 — or who had close contact with infected people — had to shut down for a few days. Industry observers say the stress is also leaving many pharmacists and technicians feeling burned out and looking for other work.
From 2020 to 2021, the number of job postings for retail pharmacists increased 63%, according to the Pharmacy Workforce Center, a nonprofit that tracks job openings.
Walgreens leaders said Thursday they added a net 600 pharmacists in the recently completed fiscal first quarter. But staff shortages still forced the chain to reduce hours at some pharmacies.
Company representatives declined to elaborate, saying it was a fluid situation.
In addition to staff shortages, pharmacies are also facing thin prescription reimbursement issues. Douglas Hoey, chief executive of the National Association of Community Pharmacists, said that made it difficult to raise pay to compete for workers.
“Drugstores are still getting paid like they were in 2019 or 2018 when almost everything is going up in price,” he said.
Walgreens is opening processing centers to help fill some of the routine prescriptions the store gets from people with chronic conditions. Company leaders expect these centers to eventually take about half of prescription volume from their stores.
The company also said in October that it would eliminate all “task-based” measures that are part of pharmacy employee performance reviews.
CVS Health is trying to spread out data entry and prescription verification to different locations to ease the load on busy stores.
The company also began emphasizing a half-hour lunch break in February.
The drugs are of limited value, according to Bled Tanoe, a former Walgreens pharmacist in Oklahoma City. She said customers often arrive before the pharmacy closes and eat until the break.
Store employees often rush to work during breaks.
Tanoe, 35, said she was leaving the pharmacy to work in a hospital in 2021 because the demand had become “impossible”. She and others say bolder steps are needed to improve pharmacies. Tanoe said pharmacists should have the ability to temporarily close counters or cancel some vaccination appointments when workloads become overwhelming.
“A pharmacist whose license is online has to be responsible for navigating and dictating what’s going on in the pharmacy every day,” she said.
Dang pointed to a relatively new law in California that prohibits pharmacy chains from setting quotas on the number of prescriptions pharmacists must fill during a shift.
He also said that if pharmacies increased their services, they would simply need more counter staff. He noted that larger chains are more likely to have only one pharmacist running the pharmacy.
Pharmacies must be at least staffed on duty in order to operate.
Ferreri would like to see more pharmacies schedule appointments for frequent customers. This provides pharmacists with a predictable workload and more time to fill and check prescriptions. It also reduces the number of trips for customers and can help them keep track of refills.
Jessi Stout, owner of Table Rock Pharmacy in Morganton, N.C., says the appointments can relieve stress.
“It’s not like the patient is waiting for you to fill 15 prescriptions at once,” she said.
A regular Stout customer, Debra Bowles, called the free program “invaluable.”
She refills about six prescriptions each month and enrolls her mom in a similar program at another pharmacy.
“It makes it so much easier to take care of people who can’t take care of themselves,” the 65-year-old said.
While some pharmacies are changing the way they do business, customers can help, too. Ferreri recommends giving pharmacies a few days to refill prescriptions, rather than waiting until the last pill.
Patience is needed, said Brigid Groves, executive director of the American Pharmacists Association. She said they’re hearing more about customers getting frustrated with pharmacy staff because of delays or shortages of medicines.
“I think on both sides of the counter, we all need to be tolerant and realize that this is a very challenging and stressful time for everyone,” she said.
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