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A Bitter Pill to Swallow

Rx for Disaster?

The Effect on You continued...

Topping the prescription-pad list of reasons for the shortage of pharmacists, experts say, is an increased demand for medications.

"I am going to stop saying 'shortage' and begin referring to it as an excessive demand," says Maine. "That really is what is happening here: an increased demand for processing prescriptions."

Roberts agrees.

"The demand has really gone gangbuster," he says. "In 1992 there were approximately two billion prescriptions dispensed on an outpatient basis; by 1999 it had risen to three billion and is expected to increase to four billion by 2005. I must tell you, we have not seen an increase even approaching that in terms of infrastructure for pharmaceutical distribution."

The Ever-Increasing Demand

Why the boom? The baby boom chiefly, says Roberts, as members of that needy, numerous generation are reaching the age of peak consumption of health services.

Coupled with that, more medications are out there to treat diseases -- including chronic ailments requiring multiple drugs, like AIDS, and conditions like erectile dysfunction that, before Viagra, really had no treatment. The final factor is the explosion of direct-to-consumer advertising that prompts well-informed patients to walk into their doctor's office and demand a prescription.

And of course, people are living longer. "What's keeping them alive?" asks Roberts. "It's longer living through chemicals."

On the other side of the equation is the nationwide shift from a five-year bachelor's degree in pharmacy to the six-year doctor of pharmacy degree. This means some may skip an advanced degree in pharmacy in favor of, say, a business or law degree.

The new PharmD degree requirement has another unintended consequence.

"Our graduates are very well educated and are finding many more career opportunities," says Roberts. Careers exist not only as a pharmacist at a hospital, large chain, or independent store, but also at pharmaceutical companies, in managed care organizations, and insurance companies. Oftentimes these new opportunities mean better money, less stress, and more job satisfaction.

In addition to the growing number of prescriptions waiting to be filled, and the fact that the number of trained pharmacists isn't growing at the same explosive rate, there is another issue. More Americans are taking complex drug regimens requiring counseling and checking for interactions and contraindications. Additionally, more Americans are taking herbal medicines, which can also interfere with prescription medications.

"Our [new] curriculum places greater emphasis in patient care," says Roberts. "Unfortunately, this high demand is working counter to pharmacists being able to spend quality time with patients and help them understand why they have to take medication, understand how to use it, and appreciate side effects."

Possible Rx for a Growing Problem

"Unfortunately, we can't snap our finger and respond to this instantly," says Roberts. The first step, he says, is improving educational opportunities. "It needs to start in education facilities so that we have capacity to produce more graduates."

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