ST. LOUIS — The Missouri Board of Pharmacy is forming a task force to examine working conditions inside pharmacies across the state, after hundreds of pharmacists alleged they have been overworked, pressured to meet corporate metrics and haven’t had time to fill prescriptions safely.
Some said they were at times unable to take a break or go to the restroom during shifts.
“I’ve heard pharmacists say that they don’t drink anything before they go on shift because they’re afraid they may not get a bathroom break,” said Ron Fitzwater, CEO of the Missouri Pharmacy Association. “That’s not even healthy, much less a good business practice.”
The pharmacy board responded to the complaints this spring and said it would appoint the task force this month.
“While the Board recognizes business needs, patient safety should not be jeopardized for company profits,” the board said in a statement in April. Pharmacy staff, the board said, “need time to mentally and physically recoup during these unprecedented times of increased demands on the state’s healthcare workforce.”
People are also reading…
Pharmacy giants CVS Health and Walgreens both told the Post-Dispatch they were committed to patient care.
CVS said in a statement that it looks forward to “working cooperatively with the Board of Pharmacy in our common goal of providing safe and high-quality pharmacy services to Missouri patients.” The company said it recently hired 10,000 pharmacy technicians to support COVID-19 testing and vaccinations.
Walgreens said that it is “committed to ensuring that the entire pharmacy team has the support and resources necessary to continue to provide the best care to our patients.” The company said it has hired 9,000 pharmacy employees since the beginning of the pandemic and increased the budgets for pharmacy operations and training.
Walmart did not respond to a request seeking comment.
Pharmacist complaints regarding working hours and safety have surfaced nationwide in recent years.
In a 2019 study by the American Association of Colleges of Pharmacy, 71% of pharmacists rated their workload as “high” or “excessively high.” In April, the Ohio Board of Pharmacy released a survey in which nearly half of the respondents said they do not have adequate time to do their jobs safely and effectively.
And in 2019, Missouri surveyed pharmacists, too:
Of the 963 people surveyed, 60% agreed with the statement: “I feel pressured or intimidated to meet standards or metrics that may interfere with safe patient care at my practice site.”
And 52% said they did not have adequate time to complete their job safely and effectively.
Pharmacy technicians are often the ones who fill prescriptions. Pharmacists counsel patients on usage and make final checks of each prescription before it gets to the patient. Their worry, generally, is that if they’re moving too quickly, they will miss errors in prescriptions and the wrong dosage or wrong medication could end up in the hands of patients.
Kimberly Grinston, executive director of the Missouri Board of Pharmacy, said COVID-19 has placed additional demands on pharmacists. Some had to cope with staff absences because of quarantine or illness. And the vaccines rolled out in winter, which is already a busy time .
“We had a convergence of all these things, so the board had concerns about staffing and working conditions,” Grinston said.
The board said this spring inspectors would specifically look at pharmacists’ working conditions, including staffing, prescription volumes and rest breaks.
Multiple pharmacists at chain pharmacies in the state declined to speak to the Post-Dispatch on the record.
But one, who works in a Walmart in Missouri and spoke on the condition of anonymity for fear of facing discipline, described busy working conditions and inadequate staffing levels going back years. The person said it was not uncommon to start a shift significantly behind on prescriptions and to work through lunch breaks.
“Like anything, the faster you do something, the greater the risk there is for an error,” the pharmacist said.
When the COVID-19 vaccines became available, more pharmacy technicians were hired, which helped somewhat, the pharmacist said. Now that the demand for the vaccines has slowed, shifts are better than normal with the extra staffing.
“But they’re going to take that away eventually,” the pharmacist said.
Some states have passed laws requiring breaks for pharmacists or mandating certain staffing ratios of pharmacists and pharmacy technicians. Missouri does not have any laws around pharmacy staffing ratios or required breaks Grinston said.
Pharmacists can’t be expected to do such high-pressure work without breaks, said Fitzwater, the association chief.
Change, he said, is needed.
“This being Missouri, nobody likes mandates and being forced to do things,” Fitzwater said. “But we’ve got to come up with some kind of guidelines and parameters from a safety standpoint or recommendations on how the pharmacy needs to operate.”