Pharmacist Workforce Profile

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1 September 2001 One outcome of our state s shortage of health care workers has been the need for more information about the current supply of and demand for different professionals. For that reason, this pharmacist workforce profile was created to provide Minnesota policy makers, employers, educators, consumers, and others with an overview of current information. Pharmacist Workforce Profile Major Findings Demand for pharmacists in Minnesota is strong 246 actual (330 estimated) vacant fulland part-time positions at licensed pharmacies, 32 percent increase in real wages (1990 to 2000), 30 percent growth in employment (1986 to 1999), and 11 percent projected growth in employment by Rural pharmacies had a higher vacancy rate for pharmacists and faced greater hiring difficulties than those located in urban areas and may be forced to shifting to a part-time workforce to meet the demand for services. The number of pharmacist graduates from regional schools, including the University of Minnesota, may not be keeping pace with employers demand for workers. During the 1990s, an average of almost 80 pharmacists graduated annually from the University of Minnesota. South Dakota State University and North Dakota State University have had a greater impact than the University of Minnesota on the supply of pharmacists in the southwestern, western and northwestern parts of the state. According to the Minnesota Board of Pharmacy, approximately 4,600 licensed pharmacists were employed at practice sites in Minnesota in The majority, six out of ten pharmacists, works in a retail setting. Well over half of the state s pharmacists started a new position in the last three years. This finding further reinforces the view that a tight labor market for pharmacists is currently creating incentives and opportunities for more pharmacists to change jobs. At present, one half of all active pharmacists are over the age of 45. On average, rural pharmacists are almost four years older than their urban counterparts. In recent years, more women than men have become pharmacists. Female pharmacists comprise two-thirds of pharmacists below the age of 40 and are more likely to work part-time than male pharmacists. When compared to the urban pharmacy workforce, the pharmacist workforce in rural Minnesota counties tends to be older, composed mostly of males, and employed in more part-time positions. Minnesota Pharmacist Workforce At A Glance Employment and Demographics All Licensed Pharmacists 4,895 Location Urban 71.2% Rural 28.8% Employment Site Retail 60.4% Hospital 20.3% All Other Sites 19.3% Employed at a Licensed Pharmacy 85.6% Employed Full-time 69.8% Average Age 44.8 Over 50 Years Old 32.8% Gender Female 44.1% Male 55.9% Trained in Minnesota 52. Pharmacist Vacancies Vacancies Actual 246 Estimated* 330 Location** Urban 62.2% Rura l 37.8% Position Type** Retail 59. Hospital 22.9% Other 9.7% Clinical 7. Pharmaceutical Care 2.2% * Calculation that includes survey non-respondents. ** Based on Actual Vacancies. Sources: Minnesota Board of Pharmacy, 2001; Minnesota Pharmacy Vacancy Survey, Office of Rural Health and Primary Care, MDH, Minnesota Pharmacist Workforce Profile, Page 1

2 Most licensed pharmacists dispense drugs and medicines prescribed by medical and dental practitioners. To do this, they must understand the use, composition, interactions and effects of drugs. In addition to dispensing drugs, pharmacists often advise consumers, doctors, and other health practitioners on the selection and effects of drugs. Their professional duties may also include maintaining patient medication profiles, buying and selling non-pharmaceutical supplies, and hiring and supervising personnel. A smaller proportion of pharmacists does not dispense prescriptions, but are still licensed to practice as pharmacists. These pharmacists often work for insurance providers, conduct research for medical and pharmaceutical companies, teach in universities or work as regulators in state and federal government. In 1999, there were an estimated 226,000 pharmacists employed nationally and 3,800 employed in Minnesota. 1 An analysis of past, current and future trends in Minnesota suggests that the supply of available pharmacists may not adequately meet the current and future demands of employers and consumers. Information on the major data sets used to construct this profile can be found on page 10. The Demand for Pharmacists When estimating the demand for pharmacists, it is important to consider two types of related information: (1) information on occupational trends and employer needs and (2) industry and societal trends that can shape the current and future demand for pharmacists and the services they provide. Occupational Trends and Employer Needs One of the strongest indicators of the demand for an occupation is wage growth. During the 1990s the median hourly wage for a pharmacist in Minnesota increased from $19.35 in 1990 to $33.29 in 2000 a 32 percent increase in real wages. 2 In addition, pharmacist employment in the state grew by 30 percent over the last thirteen years (1986 to 1999) and is expected to increase by another 11 percent by With regard to employer demand for pharmacists, results from the recently completed survey of all licensed pharmacies in the state (Minnesota Licensed Pharmacy Vacancy Survey, August 2001), reveal (1) how many pharmacists were added over the past year and (2) how many vacancies currently exist. In the survey, employers were asked to identify how many pharmacists were successfully recruited in the past year. Of the employers responding to the survey, 38 percent indicated that they had successfully filled a new or existing pharmacist vacancy in the past twelve months. Licensed pharmacies reported a total of 555 positions being added 63.4 percent were for full-time positions. Nine percent of those employers who had a vacant pharmacist position also reported successfully filling vacancies during the past year. When an estimate for licensed pharmacies that did not respond to the survey (23 percent) is included, the number of actual and estimated positions added in the past year increases to a total of 746. Both rural and urban pharmacies added roughly 18 percent of their total workforce between May 2000 and May 2001, with rural pharmacies, on average, adding slightly more part-time staff than pharmacies located in urban counties. 4 Some regions of the state added pharmacists at a higher than average rate, namely the Twin Cities and Central, South, Southeast and Southwest regions of the state. Current Pharmacist Vacancies With regard to employer demand for pharmacists, results from the survey reveal that there were actual vacant pharmacist positions in the state during the summer of Employers reported actively seeking to fill almost all (93 percent) of these positions. When an estimate for licensed pharmacies that did not respond to the survey (20 percent) is included, the number of actual and estimated vacancies increases to a total of 330 vacant positions. 7 While this accurately estimates the demand for pharmacists at the state s 1,140 licensed facilities, it does not capture the number of pharmacist vacancies in the more than 230 unlicensed firms (e.g., Express Scripts) that employ over 600 pharmacists in Minnesota. The exclusion of these unlicensed firms from the survey strongly suggests that the total number of current pharmacist vacancies may be even larger. Of the licensed pharmacies that responded to the survey, only 21 percent reported a vacant pharmacist position. On average, Twin Cities licensed pharmacies reported slightly more vacancies than those located in Greater Minnesota. Of the 246 total vacancies, employers reported 122 full-time vacant positions and 124 part-time vacant positions. Overall, the vacancy rate (vacancies divided by an estimate of current employment plus vacancies) for pharmacists was 7.4 percent. The vacancy rate for parttime openings (9.8 percent) was higher than the rate for full-time openings (5.9 percent). Even though urban pharmacies had more vacancies than those in rural areas (152 versus 93), licensed pharmacies in rural areas had a slightly higher vacancy rate than urban areas (8.0 percent Minnesota Pharmacist Workforce Profile, Page 2

3 versus 7.1 percent). Parts of the state that had higher than average vacancy rates include the Northeast (8.3 percent), Southeast (9.8 percent), and South Central (10.7 percent) and Central Southwest (10.9 percent) regions of the state. With regard to the type of pharmacist opening, employers reported that almost sixty percent of vacant positions were for retail pharmacist positions. Six of every ten retail vacancies were for part-time pharmacists. Vacant hospital positions had the second highest number of openings with 52 vacancies (23 percent of total vacancies). See Figure 1. Figure 1: Current Pharmacist Vacancies by Position Type Clinical 7% Other Pharmaceutical Care 2% greater hiring difficulties and may be forced to shift to a less expensive, part-time workforce to meet the demand for services. When replacement and new positions are examined as a share of regional vacancy rates an interesting pattern emerges. Most regions, especially those with the highest vacancy rates, were seeking pharmacists to fill replacement positions. Some regions South Central, Central Southwest, Northeast and North had higher vacancy rates than the state average (7.4 percent) due to pharmacist departures. This finding suggests that pharmacies in these regions seem to be experiencing higher turnover in their staff and, perhaps, are having greater difficulty retaining and finding replacements. See Figure 2. In only three regions Southeast, Northeast and East Central do the number of new positions outnumber replacement vacancies. This finding suggests that, at least in three regions, pharmacies may need additional staff to meet the increasing demand for services. Hospital 23% Retail 58% Figure 2: Pharmacist Vacancies as a Share of Current Pharmacist Employment by Position Type and Region Source: Minnesota Pharmacy Vacancy Survey, ORHPC, MDH, South Central Central Southwest Northeast North Slightly over sixty percent of all pharmacist vacancies were the result of a pharmacist leaving an employer. Of those vacancies, 84 percent were due to a pharmacist departing in the last 12 months. On average, there were more full-time than part-time pharmacists whose departure created a vacancy. Vacancies that resulted from the creation of a new position usually resulted in the addition of a part-time position. While the number of positions created by departures and new positions differed only slightly between pharmacies based in urban and rural parts of the state, there were significant differences in the types of pharmacist positions created. On average, more vacancies resulted from the departure of a full-time pharmacist in rural counties (67 percent) than urban counties (52 percent). This difference is also visible for pharmacies located in Greater Minnesota versus the Twin Cities region. At the same time, more of the new positions being created outside of the Twin Cities were for part-time pharmacists than for full-time pharmacists. These findings, along with other anecdotal evidence, seem to support the widely held perception that rural pharmacies are facing Central Southwest Southeast Twin Cities North Central South Northwest West Central East Central 2% 4% 6% 8% Percent Replacement Position New Position Source: Minnesota Pharmacy Vacancy Survey, ORHPC, MDH, Another indicator of the difficulty pharmacies currently have finding pharmacists is how long it takes an employer to fill a vacant position. In the survey employers were asked: On average, how long have you been trying to fill vacant positions at this pharmacy? One quarter responded that they had been trying for less than four months. Roughly half of all employers had Minnesota Pharmacist Workforce Profile, Page 3

4 been trying for less than six months. When examined for rural and urban differences, the data reveal that pharmacies in rural counties wait longer to fill vacancies. In fact, almost half of all rural pharmacies with vacancies have been trying to fill their positions for more than ten months, compared to only 30 percent of pharmacies in urban counties. See Figure 3. Percent of Pharmacies with Vacan Figure 3: Average Duration of Current Pharmacist Openings by Geographic Location 4 35% 3 25% 15% 5% Urban Rural More than 12 or Ongoing Months Source: Minnesota Pharmacy Vacancy Survey, ORHPC, MDH, Industry and Societal Trends It is important to remember that the demand for pharmacists has and will be affected by important changes in the health care industry and sweeping demographic changes. In particular, more comprehensive insurance coverage, increased access to health care services, direct marketing to consumers by pharmaceutical companies, and the addition of new medications have all contributed to the increased use of prescription medications during the last decade. 8 Increased competition between pharmacies for market share, especially with the growth of mail order and internet-based prescription services and the expanded hours for many chain pharmacies, has also placed greater demand on pharmacists. In addition to the increase in the volume of prescriptions and competition between pharmacies, the demand for pharmacy services will also be shaped by significant demographic changes in the state and nation. As the state population ages the proportion of the population that is 65 and older will grow from 16 percent to 24 percent by 2025 the demand for pharmacy services will also increase. On average, the number of medications prescribed to an individual increases as they age. The Supply of Pharmacists While the demand for pharmacists continues to be strong, the supply of pharmacists has remained relatively constant. When estimating the supply of pharmacists, it is important to consider two types of information: the number of graduates from post-secondary institutions and the composition of the current workforce. Pharmacist Graduation and Licensing Trends Similar to other health care occupations, pharmacists have well-defined educational and professional licensing requirements. In 2000, there were 82 colleges and schools of pharmacy with accredited baccalaureate and doctoral degree granting programs in the United States, including the College of Pharmacy at the University of Minnesota. By 2005, all accredited degree programs will only offer doctoral pharmacy degrees. In Minnesota, a baccalaureate or doctorate of pharmacy currently fulfills the requirement for licensure examination. When analyzing this information it is important to remember that newly graduated pharmacists do not account for the entire supply of workers who could fill vacant positions. Still, an analysis of recent graduation trends does provide one estimate of pharmacy program capacity and the new supply of pharmacists. Eight out of every ten licensed active pharmacists working in Minnesota graduated from one of three schools the University of Minnesota, North Dakota State University and South Dakota State University. See Figure 4. Roughly half of all pharmacists working in the state graduated from the University of Minnesota. Graduation trends at these three schools during the last four years reveal that the number of individuals Percent 55% 5 45% 4 35% 3 25% 15% 5% Figure 4: Top Five Pharmacist Workforce Supply Schools, 2001 University of Minnesota All Pharmacists North Dakota South Dakota State University State University All Pharmacists ages 35 and under All Pharmacists ages 55 and over University of Wisconsin- Madison Drake University Minnesota Pharmacist Workforce Profile, Page 4

5 completing pharmacy programs has remained steady with an average of 120 graduates annually. Overall, the number of pharmacy graduates and the number of applicants declined nationally during the 1990s. 9 There are also regional differences with regard to where graduates practice after school. For instance, a majority of the practicing pharmacists in the eastern portion of Minnesota, that includes the Twin Cities, graduated from the University of Minnesota. However, in other regions of the state, such as the southwest and northwest, the proportion of graduates from the University of Minnesota is much lower 21 percent and 12 percent respectively. In these regions, South Dakota State and North Dakota State have had a greater impact on the production of the pharmacist workforce. See Figure 5. Given these regional differences, changes in the number of pharmacists graduating from the University of Minnesota and other regional workforce suppliers impact the total number of pharmacists who were able to fill vacant positions. Pharmacist Employment When examining the composition of the pharmacist workforce, it is important to note the different ways to estimate the total number of pharmacists. One approach is to count how many licensed pharmacists work as pharmacists. Through a survey of employers, the Minnesota Department of Economic Security (MDES) estimates that there were approximately 3,800 pharmacists employed in the state in Since MDES bases its estimate on a list of job titles obtained from employers, they likely omit those licensed pharmacists with non-pharmacist job titles who were in pharmacy or pharmacy-related positions. The second approach is to count the number of individuals who hold an active license. Using this approach reveals that there are approximately 5,500 individuals who hold an active Minnesota pharmacist license. According to the relicensing data collected by the Minnesota Board of Pharmacy, approximately 4,600 (84 percent) licensed pharmacists are employed at practice sites in Minnesota. Of those licensed Minnesota pharmacists, 4,051 (86.5 percent) work at one of the more than 1360 licensed pharmacies and 633 (13.5 percent) work for one of the 230 unlicensed employers. Through its licensing and relicensing process the Minnesota Board of Pharmacy collects practice information for each pharmacist and pharmacy with a state license. An examination of these data reveals a Figure 5: Regional Distribution of Pharmacists by Educational Attainment Location of Pharmacist, Percent East Central Twin Cities South Northeast Central South Central North Central Southeast Central Southwest North Southwest West Central Northwest University of Minnesota South Dakota State North Dakota State Other Institutions Minnesota Pharmacist Workforce Profile, Page 5

6 number of important factors about the supply of pharmacists, including important educational and demographic trends in the workforce and the geographic distribution of pharmacists working at licensed pharmacies and for unlicensed employers. Retired 2.3% Other, Pharmacy Related 7. Table 1: Top 20 Employers of Pharmacists, 2001 Employer City Number Percent of State Total St. Mary's Hospital Rochester % Express Scripts * Bloomington % VA Medical Center Minneapolis % Abbot Northwestern Hospital Minneapolis % University of Minnesota * Minneapolis United Hospital and Children s Saint Paul HCMC Outpatient Pharmacy Minneapolis Fairview Southdale Edina HCMC Hospital Pharmacy Minneapolis % Fairview University Medical Center Minneapolis % Methodist Hospital Outpatient Saint Louis Park % Regions Hospital Saint Paul % Children's Hospital Minneapolis % Mayo Clinic Rochester % Methodist Hospital Saint Louis Park % Advance PCS * Minneapolis % North Memorial Medical Center Robbinsdale % Advance PCS * Bloomington % Saint Cloud Hospital Saint Cloud % St. Mary's Medical Center Duluth % Total % *Unlicensed employer. Figure 6: Distribution of Pharmacists by Employment Site, 2001 Relief 1.3% Teaching/ Government 1.9% Home Health Care 2.6% Other, Non Pharmacy Related 1.1% Hospital 20.3% Unemployed 1. Retail 60.4% Manufacturing 0.9% Nursing Home 0.7% Nuclear 0.4% Employment Overview Pharmacists work at a variety of employment sites. The majority, six out of ten pharmacists, works in a retail setting. See Figure 6. Hospital pharmacists account for the second largest group of pharmacists. Hospitals also tend to have the highest concentration of pharmacists at one employment site. For example, St. Mary s Hospital Pharmacy in Rochester employs over 90 (2.4 percent of all pharmacists in Minnesota) full- and part-time pharmacists and the Veterans Administration Medical Center Pharmacy in Minneapolis employs 61 (1.5 percent of all pharmacists in Minnesota) full- and part-time pharmacists. See Table 1. Of those pharmacists working for an unlicensed employer, most work in teaching, government, or for pharmacy related employers. Some of these pharmacy related employers employ a large number of pharmacists i.e., Express Scripts (85) and Advance PCS (48) and focus mostly on mail/internet order and healthcare management aspects of the pharmaceutical business. Almost 70 percent of pharmacists at both unlicensed and licensed employers work full-time. Pharmacists working in urban counties have a slightly higher rate of full-time employment compared to rural counties. Close to 800 pharmacists (20 percent) report currently holding more than one pharmacist position. The median years of tenure for pharmacists with their current position is three years. This includes pharmacists who were new to the labor market and those who have worked in the profession for many years. While this figure is roughly the same as the national average, 10 the fact that well over half of the state s pharmacists started a new position in the last three years is remarkable. This finding further reinforces the view that a tight labor market for pharmacists is currently creating incentives and opportunities for more pharmacists to change jobs. Demographic Trends: Age and Gender The pharmacist profession is undergoing a profound demographic change. At present, one half of all active pharmacists are over the age of 45. See Figure 7. On average, rural pharmacists are almost four years older than their urban counterparts. At the regional level, the pharmacist workforce in several regions, including Southeastern, Central and South Central Minnesota along with the Twin Cities have an average age near or below the state average of 44.7 years of age. All other regions of the state have a pharmacist workforce above the state average, including the Northwest at 52.3 years of age and the Central Southwest at 50 years of age. In addition, over half of the pharmacists in these two regions were over the age of 50. As the pharmacist workforce ages, a dramatic shift has taken place in the younger pharmacist workforce. In the Minnesota Pharmacist Workforce Profile, Page 6

7 Percent 18% 16% 14% 12% 8% 6% 4% 2% Figure 7: Age Distribution of Minnesota Pharmacists Age Cohort past, the pharmacist profession was composed mostly of men. At present, the proportion of pharmacists who are women in Minnesota is 44 percent. In the future, the number of female pharmacists will likely grow due to the fact that more women than men are attending and graduating from schools of pharmacy both in Minnesota and the rest of the nation. In fact, the vast majority of young pharmacists working in Minnesota are female two-thirds of all pharmacists below the age of 35. By contrast, almost nine of every 10 pharmacists over the age of 55 are male. See Figure 8. On average, female pharmacists are more likely to work part-time hours than male pharmacists 38 percent and 24 percent respectively. While male pharmacists still outnumber female pharmacists at retail pharmacies, female pharmacists compose the majority of the workforce at public, private and satellite hospital sites and parenteral/enteral and home health care sites. Female pharmacists were more likely to work in urban areas than Percent Figure 8: More Women Are Becoming Pharmacists: Pharmacist Age by Gender, 2001 Females Males Age Cohort their male counterparts. For example, only 24 percent of female pharmacists work in rural counties, compared to 34 percent of male pharmacists. In fact, almost twothirds of all female pharmacists work in the Twin Cities metropolitan region, compared to only 52 percent of male pharmacists. Distribution An analysis of the distribution of pharmacists, and the pharmacies they work at throughout the state, suggests that the state s rural residents do not have the same level of access to services as do their urban counterparts. While there is relative equality in the number of pharmacies between rural and urban regions of the state, there were more parts of rural Minnesota that were either served by only one pharmacy or have no local access to pharmacy services. This finding is reinforced by the fact that there were more pharmacists employed in urban than in rural counties by a ratio of 2 to 1. See Table 2 on the following page. One reason for fewer pharmacists practicing in rural areas is the greater difficulty rural employers have finding and affording an additional part- or full-time pharmacist to fill an already vacant or new position. Rural pharmacists also report working longer hours to meet the demand for services. In addition, rural pharmacists report they have added difficulty finding a replacement or relief pharmacist to fill in for them when they want to take time off. 11 In strict population to provider terms, the ratio of pharmacists to the population is slightly lower in rural Minnesota 1 pharmacist for every 1,184 rural Minnesotans and 1 pharmacist for every 1,010 urban Minnesotans. Minnesota s population to provider ratio for pharmacists is slightly higher than the national average. 12 The ratio is at parity for the number of community/hospital outpatient pharmacists per urban and rural residents. At the regional level, the Southeast, the Central Southwest and the Twin Cities had pharmacist to population ratios well above the state average (1:1,022). Several regions of the state, including Southern and Central Minnesota, had much lower pharmacist to population ratios 1:1,397 and 1:1,391 respectively. See Map 1 on Page 9. While the ratio of providers to the population is an important indicator of access, it can be misleading since it does not account for the distance that must be traveled to obtain pharmacy services or the hours of service at the pharmacy. On average, rural residents in Minnesota must travel farther to receive services than their urban counterparts. 13 When compared to the urban pharmacy workforce, the pharmacist workforce in rural Minnesota counties tends to be older, composed mostly of males, and employed in Minnesota Pharmacist Workforce Profile, Page 7

8 Table 2: Urban and Rural Differences in the Distribution of Licensed Pharmacies and Pharmacists Location Employment Percent Women Percent Ages 55+ Percent Full-time Pharmacy Type Rural Urban Rural Urban Rural Urban Rural Urban Rural Urban Community/Hospital Outpatient ,076 1,877 35% 46% 29% 18% 64% 71% Private Hospital % 52% 16% 6 71% Home Health Care % 63% 21% 9% 66% 66% Nursing Home % 5 21% 17% 75% 79% Public Hospital % 6 21% 8% 57% 58% Federal % 5 26% 6 7 Satellite Hospital % 74% 3% 10 57% Nuclear Total ,495 3,037 Rural to Urban Ratio 1:1 1:2 Percent 35% 49% 26% 16% 64% 71% more part-time positions. See Table 2. Overall, roughly one-third of all pharmacists working in rural counties are female compared to almost half of all urban pharmacists. Furthermore, new pharmacist graduates are more likely to begin their professional careers with an employer in an urban rather than a rural setting. For example, of the 150 pharmacy school graduates (graduated in 2000) hired in 2000, 83 percent were employed in urban counties in Minnesota. Of the three schools that supply the majority of the state s pharmacists, South Dakota State had the highest proportion of 2000 graduates go to work in rural Minnesota (7 out of 18 or 38.9 percent), followed by North Dakota State (4 out of 20 or 20 percent) and the University of Minnesota (12 out of 85 or 14.1 percent). Is there a shortage of pharmacists in Minnesota? Findings from this workforce profile do suggest that a shortage currently exists both in terms of the total number of pharmacists needed in the state and their distribution across Minnesota. However, it is impossible to measure with precision the severity of the shortage without more information. Greater precision through the collection and analysis of a comprehensive set of supply and demand data, including the data presented in this profile, over time is needed and would result in a more precise measure of the contours and the severity of a shortage. So what does the workforce profile reveal about the current condition of the pharmacist workforce? Overall, the results from the survey of licensed employers reveal a very tight labor market and strong demand for pharmacists. Pharmacist employment and wages showed strong growth during the 1990s. In addition, the current demand for both part- and full-time pharmacists is greater than the number of pharmacists currently being graduated by the three schools that train eight out of ten of the state s pharmacists. Still, this simplistic matching of new graduates to current openings fails to account for the constant churning that occurs in the pharmacist workforce. It is important to remember that not all vacant pharmacist positions are filled with a new or recent graduate. Many are filled with experienced pharmacists who left one employer to work for another. This employment churning in the labor market is somewhat visible in the total number of pharmacists successfully added to licensed pharmacies in the past year 555 actual pharmacist positions reported through the survey. It is even more observable in the relicensing data that shows that almost one-third of the pharmacist workforce started a new pharmacist position in 2000 and Not all of these new pharmacists were new or recent graduates, but instead reflect a much broader range of ages and professional experience. In fact only one-third of all the new positions filled by pharmacists in 2000 graduated from a pharmacy school between 1995 and See Figure 9. Regional differences were also very important in defining Figure 9: New Pharmacist Postions by the contours of the demand for pharmacists and access to Graduation Year of Pharmacist Filling Position in pharmacy services. On average, pharmacies in rural 2000 counties currently have to wait longer to find a 25% pharmacist to fill a vacant position. The rural pharmacist workforce tends to be older and more male than the urban workforce. In addition, rural residents in many parts of the state 15% do not have the same access to pharmacy services that urban residents enjoy. Percent On the supply side, two demographic factors gender 5% and age continue to shape the current and future composition of the workforce. As the pharmacist workforce Before ages, the proportion of female pharmacists (currently percent) will account for more than half of Graduation Year the workforce in the state. This demographic trend, when combined with the fact that female pharmacists were, on Minnesota Pharmacist Workforce Profile, Page 8

9 Map 1: Population to Pharmacist Ratio, Minnesota, 2001 Minnesota Pharmacist Workforce Profile, Page 9

10 Regional differences were also very important in defining the contours of the demand for pharmacists and access to pharmacy services. On average, pharmacies in rural counties currently have to wait longer to find a pharmacist to fill a vacant position. The rural pharmacist workforce tends to be older and more male than the urban workforce. In addition, rural residents in many parts of the state do not have the same access to pharmacy services that urban residents enjoy. On the supply side, two demographic factors gender and age continue to shape the current and future composition of the workforce. As the pharmacist workforce ages, the proportion of female pharmacists (currently 44 percent) will account for more than half of the workforce in the state. This demographic trend, when combined with the fact that female pharmacists are, on average, more likely to work part-time than males, suggests that the state will need to add to the pharmacist workforce simply to remain at current capacity levels. See Figure 10. in the long-term will require several interrelated initiatives: (1) expand the capacity of the University of Minnesota s School of Pharmacy to produce new pharmacists, (2) require that additional state assistance to the University of Minnesota s College of Pharmacy be dependent upon the school s ability to create rural pharmacists, (3) create scholarship and loan forgiveness programs for pharmacists, especially for those who are willing to serve in rural Minnesota, and (4) strongly recommend that the federal government further subsidize those pharmacy schools that produce rural pharmacists. For more information about this profile, please contact Michael Grover by phone at (651) or at michael.grover@health.state.mn.us. This information will be made available in alternative format large print, Braille, or audiotape upon request. Available on the Web at: Full-time to Part-time Ratio Figure 10: Employment Status by Gender and Age Age Cohort Female Pharmacists Male Pharmacists The findings in this profile also imply a number of shortand long-term policy directions that could be followed to meet the current (and future) demand for pharmacists in the state. Approximately 20 percent of the state s pharmacist workforce works part-time for one employer. One short-term resolution would be to encourage more of these part-time pharmacists to add additional hours or work full-time. While this solution seems straightforward it may actually require considerable effort for both employers and pharmacists to change wellestablished staffing patterns and employment practices. Overall, the aging of the pharmacist workforce, the current demand for pharmacists, along with trends in pharmacist graduation rates within the state and nation, strongly suggest that increasing the supply of pharmacists Data Sources The data used to construct this profile come from four sources. Three of these data sources come directly from the Minnesota Board of Pharmacy (MBP). MBP annually licenses new and relicenses existing pharmacies and practicing pharmacists and pharmacist technicians. The first data set contains the original application information and updates for every pharmacist licensed to practice in the state and contains mailing information, license number, license status and renewal, birth date, gender, education and graduation information. This file was last updated on March 1, The second file from MBP is a list of all licensed pharmacies that have active status from July 2000 to June In order to practice as an active pharmacist, every licensed practitioner must annually renew his or her license. The last data set used in this profile contains information obtained through the license renewal form, including employment location and type and part- or full-time employment status. This file was last updated on March 1, Because this file contained missing values and errors in respondent coding, this database was edited in order to provide a more robust estimate of current pharmacist employment. Examples of editing included completing incomplete address and license information and standardizing the addresses listed by respondents using the licensed employer dataset. The final information source is from data collected through a survey of all licensed pharmacies conducted through the MBP by the Office of Rural Health and Primary Care at the Minnesota Department of Health in Minnesota Pharmacist Workforce Profile, Page 10

11 Notes 1 Occupational Employment Estimates, BLS and MDES, The Consumer Price Index (CPI-U) is used as a proxy for inflation and 2000 Annual Average, CPI (U), BLS and 1990 and 1999 Salary Surveys, MDES. 3 Examining the occupational projections from the Minnesota Department of Economic Security reveals that the present level of pharmacist employment is roughly equal to the projected employment in Consequently, only the projected percent change in employment is used. 4 Urban counties include Olmsted, Saint Louis, and Stearns counties and the seven county Twin Cities metropolitan area (Anoka, Carver, Dakota, Hennepin, Ramsey, Scott, and Washington counties). 5 The number of actual (246) and estimated pharmacist vacancies (330) is very different from the estimate of 69 openings derived by the Minnesota Department of Economic Security s (MDES) Statewide Job Vacancy Survey for roughly the same period of The difference between the estimates produced by the two surveys is likely due to (1) methodological differences in the type of firms MDES sampled and surveyed, (2) the focused mailing of the Minnesota Pharmacy Vacancy Survey through the State Pharmacy Board s pharmacy relicensing packet and, to a lesser extent, (3) the more streamlined survey instrument that was used. 6 The Minnesota Pharmacy Vacancy Survey is a survey of all licensed pharmacies conducted through the MBP by the Office of Rural Health and Primary Care at the Minnesota Department of Health. The survey was sent to all relicensing pharmacies in May 2001 and asked pharmacies to indicate how many vacant pharmacist and pharmacy technician positions were currently vacant and how many they were actively recruiting to fill. Survey responses were received and recorded during June through August of There were approximately 1,375 pharmacies, including those based in Minnesota (1,142) and outside of the state (233), that were eligible to be relicensed during this period. Of all eligible active Minnesota-based pharmacies, 899 (78.7 percent) responded to the survey. 7 In order to estimate the number of vacant positions for all licensed pharmacies, a pharmacist vacancy weight for all licensed pharmacies that replied to the survey by the location (economic development region) and size of the pharmacy was computed. These weights were, in turn, applied to non-respondent pharmacies in order to estimate non-respondent vacancies. 8 The Pharmacist Workforce: A Study of the Supply and Demand for Pharmacists, BHP, HRSA, DHHS, 2000, Chapter 2. 9 Ibid., Chapter Findings from the Current Population Survey (CPS) reveal that workers in health diagnosing positions, of which pharmacists are included, had a median of 3.3 years of tenure with their current employer. See 11 Michelle Casey, Jill Klinger and Ira Moscovice, Access to Rural Pharmacy Services in Minnesota, North Dakota, and South Dakota, working Paper Series, Rural Health Research Center, University of Minnesota, July 2001, According to estimates obtained by HRSA, the number of Pharmacists per 100,000 population was 70.5 in Minnesota and 65.9 nationally. HRSA State Health Workforce Profiles, Minnesota, BHP, HRSA, DHHS, 2000, Ibid., Health Service Personnel Survey and Database In 1993, the Minnesota Legislature mandated regular surveys of the state's health care providers on a variety of issues. To meet this challenge, the Health Services Personnel Survey and Database Program was created within the Office of Rural Health and Primary Care at the Minnesota Department of Health. The Office maintains a database of about 110,000 Minnesota medical professionals. Although these health practitioners do not have to complete the surveys to renew licensure or registration, response rates vary between 60 percent and 90 percent depending on the position surveyed. Which professions are surveyed? Physicians Registered Nurses Licensed Practical Nurses Dentists Dental Hygienists Dental Assistants Physical Therapists Physician Assistants Respiratory Care Practitioners Chiropractors Pharmacists What information do the surveys gather? Professional activity Work hours Practice location Practice setting Practice specialty Educational background Job tenure Practitioner age and gender For more information about the survey and database, please contact: Michael Grover Senior Health Care Workforce Analyst Office of Rural Health and Primary Care Minnesota Department of Health P.O. Box Saint Paul, Minnesota (651) michael.grover@health.state.mn.us Minnesota Pharmacist Workforce Profile, Page 11

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