Staff Shortages

Pushed by Corporate Quotas, Massive Pharmacist Burnout Leads to Dangerous Errors in Medication

November 30, 2023 | Lebowitz & Mzhen

In recent years large pharmaceutical corporations such as CVS, Rite Aid, Walgreens, and Walmart have consistently slashed pharmacy staffing levels while simultaneously increasing the burden on their frontline workers with an increasingly significant list of additional duties. A decade ago locations might have had teams of two pharmacists and six pharmacy technicians filling approximately 500 prescriptions a day. Today, many such locations have half that number of staff and an even higher prescription volume while simultaneously handling vaccine appointments, rapid tests, and patient consultation calls.

Rather than respond to the increased demands on pharmacists and pharmacy technicians by reducing work volume or hiring more staff, major pharmaceutical chains have increased the pressure on workers. A recent investigative news piece documented what pharmacy staff is experiencing. The article detailed how every task is timed and measured against corporate goals that reward speed and profits. Staff who do not fill prescriptions fast enough, answer the phones quickly enough, or drum up enough vaccination business can face discipline, reassignment, or termination. Burned-out pharmacists sound the alarm, saying “It’s nearly impossible to meet all the demands without cutting corners, and when corners get cut, patients can get hurt.”

What Is the Reason for So Many Pharmacy Errors?

While pharmacists must take an oath to hold patient safety in the highest regard prior to beginning their work, the massive internal pressures coming from their workplaces and their working conditions are increasingly forcing pharmacists to choose between that oath and their job security. Working conditions began to deteriorate even prior to the onset of the COVID-19 pandemic, but things have only become worse. This fall, the industry experienced a number of high-profile work walkouts as burned-out workers attempted to draw attention to the unsustainable working conditions.

California Legislature Passes First-in-Nation Pharmacy Safety Bill

October 30, 2023 | Lebowitz & Mzhen

According to reports, the U.S. Food and Drug Administration (FDA) receives approximately 100,000 medication error reports annually. In 2010, the FDA received only 16,689, but by 2018, the agency was receiving more than 100,000 reports per year. Experts point out that medication error reports are submitted on a voluntary basis, meaning that true medication errors are likely even higher.

Dr. Randall Tackett, a clinical and administrative pharmacy professor at the University of Georgia College of Pharmacy states “What’s reported to the FDA usually only accounts for 1 to 10 percent of what actually occurs.” Dr. Tackett went on to theorize that most medication errors result from the extreme workload that pharmacists are faced with. In an effort to combat this issue, some states have implemented prescription shift limits for pharmacists, limiting them to filling 150 prescriptions per shift. A recent news report describes a first-in-nation pharmacy safety bill recently passed by the California legislature.

What is the California Pharmacy Act?

California state lawmakers recently passed Assembly Bill 1286 or the Stop Dangerous Pharmacies Act after months of negotiations with chain pharmacies, labor groups, and regulators. The measure will now be sent to Gov. Gavin Newsom’s desk to be signed. The bill is the first state-level regulation in the nation to crack down on understaffed chain pharmacies making medication errors, setting up California to be a national leader in pharmacy safety if it is passed. The proposed law requires corporate chain pharmacies to report all medication errors as well as provide baseline pharmacy staffing rules to ensure that California pharmacists are receiving the support they need as they fill prescriptions, and give injections.

The Health Care Costs of Pharmacists and Technician Shortages

February 21, 2023 | Lebowitz & Mzhen

A recent news report reveals information regarding the pharmacist and technician shortage and its impact on access to healthcare. For example, in the state of South Dakota, pharmacies have been randomly reducing hours and closing the pharmacy, which has led to patients being unable to get the prescriptions they need. These pharmacy issues are happening across the country. The stress from the pandemic on the healthcare industry can be attributed to the pharmacy technician shortage and impending pharmacist shortage. Some pharmacists have no choice but to work through their lunch hour despite the pharmacy being closed to patients.

Additionally, there may be underserved areas of a state where there are only a couple of pharmacies or even one pharmacy in the entire county. For patients who depend on their local pharmacy for their medications, this can be a difficult predicament to be in if the local pharmacy can no longer remain open. In addition to pharmacists playing a pivotal role in helping patients, pharmacy technicians are essential. Technicians not only help pharmacists with administrative tasks but also assist with locating, dispensing, packing, and labeling prescriptions. In some cases, pharmacists may be paid to cover a technician shift due to the shortage. Some workers in the field believe that increasing the pay of technicians, who are now expected to do a wide array of tasks, may help with creating more interest in the position.

Pharmacy schools have also seen a drop in enrollment, which may stem from the pandemic playing a role. In addition, the pandemic causes a number of early retirements in the field. Pharmacists were essential employees, still needed even during the height of the pandemic. There’s been a decline in the number of applications that pharmacy locations are receiving, whereas, in the past, one opening would garner many interested applicants. As a result, some stores have offered sign-on bonuses for pharmacists to help recruit.

Spike in Pharmacy Error Claims Downplayed by Lax Reporting Requirements

May 3, 2022 | Lebowitz & Mzhen

A common theme of the last two years has been the burnout suffered by pharmacy employees, and the increase in patient risk that results from the lack of skilled, motivated, and healthy pharmacy staff. Although some symptoms of burnout, such as increased overtime, lack of retention, and mental health issues among employees are easily measurable, the actual number of error claims may not always be. A recently published investigative report demonstrates that a large increase in pharmacy error claims in the last two years has been obscured by lenient reporting requirements that keep such claims out of the public view. The pattern appears to apply nationwide.

According to the investigative report, several public records requests were used to discover that a large increase in pharmacy error claims corresponded with the labor issues related to the pandemic. The correlation serves as further evidence that the pharmacy industry is unable or unwilling to meet the industry standard of care that patients are entitled to and have come to expect. Pharmacies have little incentive to report instances of error when they are not required to, as public dissemination of such information may hurt the pharmacy’s bottom line. A pharmacy is a business after all.

Patients who are victims of pharmacy error and are hurt or killed as a result may have a significant claim for damages against the pharmacy or employees. Pharmacies are accountable for the conduct and mistakes of their employees, and if they are unable to safely staff their businesses, then they should not be operating under dangerous conditions. While the solutions to this problem may vary, the most important matter is that patient health and safety must come first. Maybe pharmacies need to pay more, maybe they need better training, maybe they need more safeguards, or maybe they need to temporarily close until the adequate standards can be met. Regardless of this, patients can expect adequate care and take legal action in the event of an error or mistake.

COVID-19 Pandemic Induced Burnout May Impact Maryland Pharmacists

February 15, 2022 | Lebowitz & Mzhen

From March 2020 until now, the COVID-19 global pandemic has taken a toll on everyone—but especially healthcare workers. Less discussed, however, are pharmacists and the burnout they have experienced as healthcare providers, since many may assume that other frontline workers, such as physicians or nurses, are bearing the brunt of the pandemic’s impacts. Pharmacists, however, have experienced similar record numbers of burnout and exhaustion during the course of the pandemic, and mistakes resulting from being overworked could injure or even kill patients.

According to a recent news report, the COVID-19 global pandemic has taken a significant toll on pharmacists, particularly as new variations of the virus continue to emerge and mutate with no signs of slowing down. For many who work in pharmacies, the work was a great fit initially because of the drive to give back and help people. Now, many pharmacists report being burnt out and exhausted from the daily demands of work, which have been exacerbated by pandemic specific tasks that added more work to each pharmacist’s already busy schedule.

Before the pandemic, for example, pharmacists mostly focused on filling prescriptions and providing a limited number of vaccines, such as the flu vaccine. Now, many pharmacists are struggling to fill up to 250 prescriptions a day while administering COVID-19 vaccines, COVID-19 tests, and manning the phones and other customers with limited staff available.

Maryland Healthcare Worker Shortage Leading to Pharmaceutical Errors

February 8, 2022 | Lebowitz & Mzhen

Reducing medication errors and improving patient outcomes is not a recent concern; however, the recent healthcare worker shortages have increased the likelihood of Maryland pharmaceutical errors. Improving the judicious use of prescription medications and reducing adverse reactions has been at the forefront of the public health movement. While these are legitimate concerns, they do not address the issues that stem from healthcare worker errors. Even simple errors can have long-term and disastrous consequences for a patient.

Medication errors refer to “an act that through ignorance, deficiency, or accident departs from or fails to achieve what should be done.” In the context of medication and pharmacy errors, patients maintain five “rights,” including the right medication, right dosage, right route, right time, and right patient.

What Are the Most Common Causes of Prescription Errors?

Although errors occur for various reasons, some factors enhance the likelihood and severity of a mistake, for example, poorly written communications, failure to obtain informed consent, and systemic issues within the pharmacy. Computerized systems and changing orders to plain English have helped to reduce errors. However, many pharmacies are understaffed because of the COVID-19 pandemic and increased demand for tests and vaccinations.

Maryland Pharmacies Stretched to Their Limits As a Result of Covid-19 Pandemic

January 10, 2022 | Lebowitz & Mzhen

In light of the COVID-19 global pandemic, many pharmacies have been stretched to their limits because pharmacists are often manning the phones, the drop-off and pick-up area in the pharmacy itself, dealing with drive-through customers, and giving out vaccinations—all at the same time.

No matter how busy a pharmacy or pharmacist team is, however, consumers should be able to trust that the medication they are receiving is correct. Because pharmacists must exercise extreme attention to detail when prescribing medication down to the type, dose, and patient who is receiving the prescription, when a mistake is made, it can often have devastating consequences. When pharmacies are especially busy and prone to mistakes, it is more crucial than ever that they are held accountable for any injuries or issues their mistakes may cause.

According to a recent local news report, a Baltimore pharmacy has temporarily stopped administering COVID-19 vaccines because its staff has been stretched to its limits. In addition to the global pandemic resulting in a greater demand for pharmacy services, a state-required audit of Maryland pharmacies has pushed already busy pharmacies to their breaking point. Although the state of Maryland offered an extension, the owner of the Baltimore pharmacy stated that holding off for a few extra weeks simply would not be enough.