Well-being Survey Results | Alex Barker, PharmD, The Happy PharmD

Speech to text:

Mike Koelzer, Host: [00:00:25] Alex for those who haven't come across you online, introduce yourself and let our listeners know what we're talking about today. 

Alex Barker, PharmD: I'm Alex Barker. I am the founder of the HappyPharmD which is all about helping pharmacists create inspiring careers and lives. We help them overcome this insane job market that we're in to discover a career path that makes them come alive and feel excited on Monday morning when they go into work.

Remotely and, uh, create the strategy with them to get into those jobs today. Um, what I'd love to share is kind of like a wellbeing report. We've been working on this pre the pandemic and after the pandemic, we've got this interesting comparison between two reports on how pharmacists have changed.

Over that time period. And just some of the insights that I think leaders managers can take hopefully to their workplace and think about, okay, how can I, how can I make this workplace better? Not ask the question? How can I get more out of my people? But instead, how can we create an environment where people perform at their highest?

That's what I hope we can talk about today. 

Mike Koelzer, Host: This was a huge turnout of a survey. In my opinion, you sent these results. To me, that kind of raw result is like 700 people. I thought that was huge. 

Alex Barker, PharmD: Yes. Yep. So, this survey, well, we actually put some marketing power behind it. Now that we actually have a team because in the past it was just like me have, hazardly doing things.

Now we have systems and processes and things are doing better, but yeah, the, um, 2021 survey had 657 responses. And this is just through our email. This is through our society. Um, so. This is just volunteer, uh, pharmacists putting in, um, you know, their, their answers 

Mike Koelzer, Host: here. All right. Let's cut to the chase. Are things better pre COVID or are they better post COVID for people?

Well, they're not 

Alex Barker, PharmD: good. I would say not good. I think the question that really shows this is, are you happy at work? Yes or no? Pretty simple question. Um, it has a lot of meaning behind it. Here's my rounded numbers. Are you happy at work pre pandemic? 2019 42% of 217 pharmacists said yes. Yes, we are happy after the pandemic that shrunk to a 22%, 22% said, yes, we're happy at work.

Mike Koelzer, Host: So another fifth or so when down 

Alex Barker, PharmD: practically the, and no one I think would be surprised by the answer. When we asked the question, what was your reason or reasons for the previous question? Both happy and not happy. Overworked, understaffed. Over and over again, things like no breaks, rude patients dealing with the public work are overwhelming, fed up.

Lack of autonomy, lack of control. Uh, this job is a show. I dunno. I dunno if you read about people on your podcast, but 

Mike Koelzer, Host: I was mixing myself for the show coming up next week from when we're talking here and I took out the sh. For me because I said it and I was like, I've never said it on the show before, and here's the thing.

I'm sure I could leave it in because I don't think it's really family time listening to the business of pharmacy podcasts. You know, it might be on in the car, but I had to bleed my own self out. All right. So Alex, here's the question I had and I think it's cool how you are now looking at two studies because this is cliche, you know, but the people that fill things out are people that.

Pissed or upset. A lot of people just don't say, Hey, there's a front survey I'm going to do. And then say, I'm happy. Maybe they do. But to take that argument off the table, you have done that by saying here's two studies. And I'm assuming that you. Collected them in a somewhat similar manner of getting people that were not predisposed to answering a certain way.

It was kind of equal. I'm guessing. Well, 

Alex Barker, PharmD: it was volunteer at least I think so. Um, I, you know what, I'm going to need a fact check because it was so long ago we've been analyzing this data though, and we actually hired a statistician to go through it and analyze it much smarter than I could. 

Mike Koelzer, Host: What do you mean by that?

You think it was volunteer? 

Alex Barker, PharmD: I'm forgetting I'm forgetful 

Mike Koelzer, Host: now. I'm all excited. How could the first one not be a volunteer? I want to hear about that. 

Alex Barker, PharmD: The only hint of a hesitation I have is that we may have enticed people to say, like, we'll do a drawing, you know, a $50 Amazon gift card. 

Mike Koelzer, Host: You might get more happy people, that light drawings, and then come in and say, I'm happy.

Something like that. You never know. 

Alex Barker, PharmD: I don't know. You could argue, but I should also preface this, that, you [00:05:25] know, a large part of the. Audience is a community. You know, we're talking probably 50, 60, 70%, probably more than 60%. And then we've got another 25% of our audience is hospital and that's kind of reflected, I would say in our first survey, the first survey was largely, almost 50%.

Community-based. Um, that is both things like outpatient pharmacy that is, you know, non-profits, that's communities, that's changed groceries. We broke it down way more than we probably needed to. Um, and, and in this. Second survey. It was overwhelmingly community. Uh, we're talking to almost 75% of people.

Um, and I, I think it is because we talked about this survey using COVID-19, you know, uh, As a main talking point of why we want to collect this data. So I think, you know, it's very obvious with all of the news articles that have come out lately and Bloomberg NBC, you know, uh, New York times talking about pharmacy workload and the face of pharmacy, at least to the public, is still the guy or gal behind the counter.

And. Um, it's not surprising. 

Mike Koelzer, Host: So your first survey was more mixed. Yes. This one is more retail. Absolutely. Are you able to, have you looked at the percentage by. Retail over retail or what's your gut on that? Because I would argue and devil's advocate here. I would say that, well, there's more retail on this one.

And overall retail people are maybe not as happy with her. I don't know. I have no idea if this is true or not, retail people are maybe not as happy with her job as some other pharmacy things. So what's your gut though? Retail over retail. Hasn't gone up for. 

Alex Barker, PharmD: As far as whether or not they're happy. 

Mike Koelzer, Host: Yes. If you look at the percent, this one could be skewed because it's more retail people.

And I would say, well, it's just as many retail people, the same percent as dissatisfied as they were in the first study. But your feeling is the retail one has gone less satisfied also. Yeah. It's, 

Alex Barker, PharmD: it's hard to say breaking it down without the full report. Oh soon will be published, but the F the full report will show that answer.

I, I would say, probably answer yes to both things, right? There's more community, uh, which in turn is a larger portion of those people that say that they are unhappy now. But here's the interesting thing. I think the common view of every pharmacist across the board is community. Pharmacists are in general.

Uh, more unsatisfied and unfulfilled in the workplace, but actually there are studies that contradict that point, or if anything say that pharmacists, particularly in hospital and in clinical settings have just as much burnout as those outside of those settings. So, you know, we're talking anywhere from 50 to 70%, they're all.

I would say as a factor of like three to four times as many burnout related studies in hospital settings in comparison to community settings, 

Mike Koelzer, Host: Alex, I kind of set you up for failure there with my devil's advocate question, because you like doing the back when I was at what's that 

Alex Barker, PharmD: You like doing that don't you.

Mike Koelzer, Host: You should see me with my kids when I was at my last year of pharmacy school, and this is at Purdue. And then we had a, um, our externship or whatever was in Fort Wayne. And so those were like the three to six weeks of hospital stuff that I did.

Coworkers or miserable sobs. I couldn't stand going in there. I just hated it. They were just miserable. And here's the thing about community pharmacy. I can go to work sometimes with a headache and I'll walk in though. And within. 20 minutes it's gone because you've got up on that stage and you're playing that role again.

Now, some people that can be in a negative stage, some people that's a positive stage, but I think it pulls you out of your shell. So my question about people not liking retail, sometimes those customers, if there's any good relationship at all, it's pulling that out of you or some of those hospital people.

They were just miserable. 

Alex Barker, PharmD: I would agree. I think for those people that really value. Interaction with patients in general has more satisfaction, uh, than those that lack that thing. Again, I can't say any of the details of this research project, a separate one that we're doing, but it actually asks a lot of those [00:10:25] kinds of questions and what we find from pharmacists in community settings, both retail chain, grocery, you know, all of the.

That they highly value that patient interaction. So it's, it's no surprise then to see people complain and say, you know what, I'm miserable because. I don't get time. I'm overworked and I can't even have the opportunity to meet with a patient. 

Mike Koelzer, Host: That's interesting because they get their energy by dealing with the people more.

When they're more busy, they're dealing with names and numbers and drugs, but not necessarily people. So that's an interesting take on 

Alex Barker, PharmD: it. You know, an interesting question that I like to ask individuals, I saw it asked in a tech sphere where someone did a poll and asked the question, would you rather. Get the same salary you're getting now, but at a dream job at a dream company, or would you rather get double the salary you're getting now and work at the same job.

And it was like 90% of people wanted the second one. 90 % of people said, I just want to get paid double, but if I work at the same location, I would venture that. Uh, that would be a lot lower in pharmacy, but I don't know. Hmm. I don't know. Were those people 

Mike Koelzer, Host: that said they didn't like their job. And then you ask the question, are those across the board, whether they were happy or unhappy across the board, people said they would just like more money and keep the same job.

It was 

Alex Barker, PharmD: from a tech, uh, influencer, someone who has a really large audience that talks a lot about startups and tech successes, and a lot of people that follow them are people like programmers people in the IT profession. So these were not people that were unhappy with. They did. This was just a simple Twitter poll with thousands of results that I thought, wow, this is really revealing of that industry.

And I doubt I would see similar things in my own profession, but I don't know, 

Mike Koelzer, Host: People are saying, eh, I complain a lot, my job, but not so much that I want to run from it. In fact, if you pay me more, I'm likely to 

Alex Barker, PharmD: stay. That's what they were saying. But I don't know about pharmacy, I don't know. I don't think that is the same atmosphere, but it's a question, you know, that's all.

Mike Koelzer, Host: All right. So Alex, you sent me a little background. So you sent me this spreadsheet and it's got like six to 700. Answers on it. And there were about 10 questions about whether you like your job or don't like it, and the reason for it and whether you needed mental help or whether you didn't need it.

And if you didn't need it, how come you had. Gotten it yet and that kind of thing. So there were a lot of cool questions on there. The one that kind of jumped out at me was I sorted them. I would sort them in a kind of scroll and see which one jumped out at me. The one that jumped out at me was people said I could use some mental help, but I don't have the time to do it.

That kind of jumped out at me. Like people said they would do it. And I have to question myself. It's like, okay, Is that true? You know, cause sometimes people can fill stuff in it's like, is it true? I mean, it's like me telling my daughter why she hasn't cleaned her room up. And she says she doesn't have time, you know?

And then I go and look at her Tik TOK, you know, and see all the things she's liking and all that kind of, I mean, not her tic-tac I see it through my account. And so on, you see the answers of some things and you see. Is it true or not? And you can't answer that. That's what the people have answered. You just wonder, and I'm not saying it's not true.

It's just like, is it true if they had time? Would they go do that or not? 

Alex Barker, PharmD: Yes. This is highlighting, I think a deep, fundamental problem about the mental wellbeing of, of our workforce and, and this isn't just a reflection of pharmacy. This is our entire work system. So one of the first questions we asked was that you're, I think you're referring to.

Does your workplace offer a program that reduces stress or burnout? So in our latest survey, out of the 657 people, 22% said, yes. Um, that yes, there is some sort of program of those people that had a program only 28% said they actually used it. So the vast majority of people. They have a program at their workplace, and don't even use it.

This is something that I've thought about for a while and I've dug into the literature. And there's a couple of things that are clear from the literature. As soon as you offer programs to help people with their own mental health, the vast majority do not. Take it, they don't take the opportunity. And if you force it, like you force a man, you know, you [00:15:25] mandate this activity, you know, everyone we're going to, you're going to take an hour on, uh, during your shift and you're, you have to do this.

Not only does it not help, but it actually causes even more stress for 

Mike Koelzer, Host: people. I would never get it. Unless they said here's 200 bucks, go find a therapist of your own liking wherever you want to. I would never trust a company's therapist. I just wouldn't. I would just feel they're just, they've got this underlying thing to get people.

A little bit out of the dumps enough to get them back to work and you know, back kind of stuff. I would never trust it. 

Alex Barker, PharmD: Right. It's kind of like, uh, you know, you're indebted to a mob boss and they're like, Hey, talk to my guy Vinnie over here, he's going to vouch, you know, just tell your secrets to Vinny. He won't say anything, you know?

Right. It's and that's what people said as well. They, they, when I asked them further like, well, why. Why haven't you used these programs? Most of them said time. Like, I, I just don't, I can't fit this into what I am doing already. And if you think about it, people who are burned out, have programs available to them.

By definition, they are disengaged with their work. They don't want to engage more with work because they are burned out. So the idea of trying to fix their problem with the very company that. Allowing or in fact, maybe even causing the burnout, it actually doesn't make logical sense when companies offer programs or activities or things to help with mental health, every company's got a different approach and, and most of them don't work.

In fact, all literature and meta analysis point to. Programs and activities servicing one's mental health do not significantly improve individual burnout. It's almost never the case. They may incrementally improve things such as, um, uh, depersonalization, but in general, what helps the most is. Um, organizational interventions.

So working in the environment in which the pharmacist works in that's what helps improve burnout metrics, um, and increases engagement. Um, sadly though, most of the narrative, both from companies, um, some literature as well, and some other quote experts on the subject in quote, throwing a little shade there, throwing a little shade, sorry.

But uh, those people say that, you know, if we have these programs, it'll help, uh, burnout. And you know, my data just even here, like clearly shows, Hey, pharmacists that have. The vast majority, 72% won't even use your program. So why invest the millions and millions of dollars that these major major organizations are throwing money at to try to solve individual burnout.

It just doesn't make logical sense, but that's what people are doing. 

Mike Koelzer, Host: Devil's advocate, Alex. Did you need any of this information or was this just like a marketing ploy for happy PharmD I 

mean, 

Is this going to help anything outside of you just saying, all right, here's our article and we got some clicks and we're going to do this.

Did you come up with anything from this that will change anything for you? 

Alex Barker, PharmD: I love 

your devil advocates questions because it's like telling the truth to power. Very few people. Question me, what is the way to go as a company? It's absolutely self-serving. We are wanting to become a publisher and a Truth Sayer, I suppose, to what is actually happening in the workplace, what is working and what isn't working.

And it's very clear from this. Programs that reducing mental health don't work, 

Mike Koelzer, Host: But you're being humble by saying it's self-serving, that's like Mother Teresa saying she's not totally benevolent. She's actually doing this for selfish reasons because she wants to go to heaven. Something like that. Yes, this is good for your company, but it's going to help everybody.

Alex Barker, PharmD: I have a hard time. Internalizing the good that I have done, or the company has done and like taking credit for that. 

Mike Koelzer, Host: You see it mainly as self-serving not really accepting the good that your company does spreading this out and returning the favor, tenfold to [00:20:25] help mental health across the profession.

You know, 

Alex Barker, PharmD: I have to think about it to come to the ladder. You know, that's why my first answer to you was, yeah, of course this is self-serving. This is absolutely about authority building on a subject matter for our company, which we logically should obviously do. Um, but at the end of the day, what, what do I think the effect will be when this report's ready?

And it gets out there like in this podcast, I think it's going to happen. A ripple effect that will ideally inspire leaders to change their environment, make things better in the workplace, and also inspire lots of pharmacists to say, I don't have to stay at this job. That's causing all this stress. I can go somewhere else and I can do something else.

You 

Mike Koelzer, Host: I think one of the take homes of looking at this is saying. Employees can't change and are not going to change. It's up to the job to change. What part of this jumps out and says employers, it's your problem. It's not the employee's problem. I think 

Alex Barker, PharmD: it would have to be the question. What are the factors at work that contribute to your current state of burnout?

And we left that open. We did provide a few examples, but people can write in 

Mike Koelzer, Host: anything they did. There was paragraphs in there, long 

Alex Barker, PharmD: paragraphs. Yeah. And some of the things that people said that could have been fitted into other things, but people want to speak their truth. And based on what we know about disengagement in the workplace, and what we know about burnout, which are two totally different things, but very similar then.

They have established that the cause of burnout is not an individual's problem. Meaning like your burnout, isn't related to you having a daughter moved back into your house while you're working and they have this unruly, unhealthy kid that's causing you all sorts of sleep deprivation. Not a cause of burnout.

What is the cause? And what is the top reason why the answer to the question? The top reason why 75% of pharmacists said that the factor leading to their burnout was, was the organization prioritizing profit over patients. Second one was long work hours. Third, one is overloaded with administrative tasks. These are all organizational problems.

And the causes of burnout are things like work overload, lack of support, lack of autonomy. And all of these things are dictated by the organization. They are, obviously , like the individual does have some responsibility in these things, but they are organizational factors and not personal or individual, which I argue.

Means that the individual that is suffering from burnout, um, I could go as far as saying this it's not their fault and that's a bold statement and you could, you could argue with me and I probably would agree that it's definitely arguable. I wouldn't argue with you. Yes, you wouldn't, you know it, but the individual does not have to stay there.

The individual does have some responsibility in that they can go somewhere else. They're a flip in doctrine of pharmacy or equal thereof. They do not need to subject themselves to a place that causes them to be essentially depressed in the workplace. Um, cause there's dire consequences for this. That's the other thing I don't talk about enough is like, The consequences of what burnout is.

I mean, not only is it a myriad, an ugly myriad of diseases that you likely are, uh, serving patients with like CV, uh, CHF, diabetes, obesity, but there's also hospitalizations. There's divorce. There's suicide. All of this stuff is so important for people to do and to take care of themselves. That in my opinion, it demands you to look at face to face and say, am I going to do something about it, or will I continue on this path?

Mike Koelzer, Host: The pharmacist is so burned out they're oblivious and maybe by definition, they're oblivious to their option. It's 

Alex Barker, PharmD: actually the battle that my company has dealt with over the last five years, do we try to help pharmacists that are engaged with [00:25:25] pharmacy and like they enjoy what they do, but they also want to do something even bigger and greater than what they're doing right now.

Or do we help people that are so disengaged with work and want to leave pharmacy altogether? That. They don't even know if there's a place for them in the profession. And unfortunately the answer to that question, the one that we've decided to go down the path of, is yes, we're helping out both of those types of people.

Um, admittedly though, the, the, the pharmacists who I would say their hair's on fire, like the problem that they have is those with burnout. And many of them don't know or understand how to overcome it because I mean, rightly so, they've, they've so suffered for sometimes years, if not, well, over a decade or two and ask themselves, I'm so disengaged with pharmacy, I really don't care about any of this stuff.

And now all of a sudden. I have to switch around how I think about this. And I have to engage with my work again and find something to be excited about. It's it can be a daunting task for some, 

Mike Koelzer, Host: You mean to say that we've given up on pharmacy, it's going to be hard for me to ever think positively about anything.

And therefore I maybe can't see the rainbow in any profession because I've gotten so used to saying work socks. Yeah. 

Alex Barker, PharmD: Some people are that way and admittedly, some people are so, um, Jayden. That we've had to create really clear guidelines and boundaries for our coaches and train them on recognizing when a pharmacist needs more help than what a coach can provide.

So therapy, mental health, that kind of thing, because some people come to us petrified by our program. And some of the things that we've asked them to do, even though in my opinion, like it isn't much. You know, something as simple as, um, reaching out to someone on LinkedIn, which isn't asking very much, in my opinion, can all of a sudden become a mental roadblock for others because they thought for so long in these positions, I'm dispensable.

I'm not, I'm not capable of doing something great or getting into a job, like what I want to get into. That it has become second nature to guess oneself. And to guess your own value as to what you bring to the game, 

Mike Koelzer, Host: depression, doesn't let you look out like that. Anxiety. If you're in the fonting mode of anxiety, you can't look out.

Alex Barker, PharmD: No, even in my last podcast with you where I shared what my journey through grief and, and what I've gone through, you know, I was coming out of it near that point in your podcast and. I recognize that, that we feel that way, that depression is what people's entire existence has been for years. Um, and I think in my book indispensable, I actually talk about this really bad study.

They did this test and this was back in the fifties. Where they took, they took some dogs and they took one group of dogs, group one, we'll call them. And they conditioned them to a room where they were shocked. Um, uh, their, their feet were shocked, uh, in this, in this one room and they conditioned them to that room.

Um, I don't know for how long. And then what they did is they put them in the same room, but they only applied a shock to one side of the room. And when the dog was conditioned to that first room and put in the same room, but with the separate. That split the room in half. Those dogs did not go over the separator to the side where there was no shock.

Now dogs that weren't conditioned obviously figured it out, Hey, if I jump over this thing, I probably won't get shocked. And lo and behold, they did that. The simple idea here, although that's an awful, you know, experiment is that every animal is included. Is conditioned to an environment. And even if it is awful, it feels painful.

It [00:30:25] feels like you just can't escape. People. Don't leave. People don't leave. And for a while, in my own company, I had to wrap my brain around this very problem, because we would talk with people, people that were interested in our coaching program and. I had a struggle where people just like D they didn't get it.

They didn't see how this would help them. Even though I had evidence, I had success stories, we had our program laid out. People did not believe that they would escape. And it was, we would question them like, okay, well, why aren't you joining? And the answer that came up over and over again was. Myself me, I'm the, not Alex Barker, but them, they thought they were the problem.

And one pharmacist put this so well, in words, and in my LinkedIn as a comment, she said, pharmacists, help others. Not themselves. And I was like, oh man, this is it. This is in my opinion. This is the dilemma of our age in pharmacy. We are freaking doctorate level professionals and yet many people do not believe that they can do something as simple as make a job transition.

So. I'm hoping to change that. 

Mike Koelzer, Host: You'll see that with some kids that were held kidnapped, you know, they were taken hostage and that's with her own crazy parents, life might be better on the outside, but through their anxiety and depression, at least they're still alive. They know that they were able to survive with those terrible feelings they had.

And they said, well, surviving with these terrible feelings is maybe better than not surviving. And so. They say this sucks, but I'm comfortable with this sucking. Yes. 

Alex Barker, PharmD: Yeah. Because what other alternative is there, right? 

Mike Koelzer, Host: Yeah. At least that's all they can see. 

Alex Barker, PharmD: Right. You see the same behavior in, in abuse. And that is so sad.

I would hate to say something as simple as these companies where people are working are causing abuse. 'cause I would, I'd be certain that they would not view it that way. And yet, since I talked to so many pharmacists, I would have a hard time arguing differently. The majority of pharmacists when, when I interview people or when I talk to them after our program, I ask them, what is the thing that drives you?

And I, and I have to ask the question a lot to like, get to the heart of what people say. And the message is really clear. I love helping people. And if you have a doctorate level person, Who is so intelligent that they go through this insane, sanely, difficult program to do a job where they just want to help people.

And you turn that into this toxic disengaged person. Over time. To me feels very much akin to a crime. Oh man. Those, I don't think I've ever been so bold to say that, but. You know, I, I. I couldn't imagine doing something like that to my daughter, you know, someone who I love and respect and twisting her and manipulating her and getting her to believe, ah, this is just my life and this is who I am.

And I can't find anything better. Like that is not all that I want or hope or dream for my daughter. I hope she grows up, marry someone. She absolutely loves to work. She loves and helps a ton of people. That's what I want her to be. But, and, and I would, a thousand times bet that executives, they say they want that same thing.

It's under the guise though, typically under like, how do we get people to be more productive? How do we get people to perform? They want their people to be engaged. You know, they want them to be on fire. 

Mike Koelzer, Host: No. here's what they've got. You've got a. Spouse who's abusing their other spouse, 

Alex Barker, PharmD: like Johnny Depp and Amber heard how timely 

Mike Koelzer, Host: oh it is.

Isn't it. Have you been watching that at all? 

Alex Barker, PharmD: Oh yeah. It's addicting. 

Mike Koelzer, Host: As someone called her Amber turd yesterday, I read that. 

Alex Barker, PharmD: Oh yeah. 

Mike Koelzer, Host: I'm pro Johnny. I guess if I look at it, I don't know. What do I know? I'm not sitting there. I thought OJ was guilty. I mean, that shows you how bad I was, but if you look at the two of them, I kind of like watching her act up.

She's got crocodile tears and stuff. I like that acting as far as I know, it's acting, you know? 

Alex Barker, PharmD: Yeah. It, it clearly is acting on both parts, a 

Mike Koelzer, Host: [00:35:25] battering spouse. One of their tricks is to say, You're going to remain a batter because there's nobody else. There's no other way out. We're going to batter you.

We're going to let you know that this is it. You'll never have a better life. I'm all you got. And I'm in a battery. The typical battered spouse thing, the pharmacy upper echelon is smarter than. Battering spouse. They know exactly what they're doing. They're driving, their pharmacists are saying, we're giving you this.

And this is all you got and there's nothing better out there. 

Alex Barker, PharmD: They made their move 20 years ago when they started funding new pharmacy schools by 

Mike Koelzer, Host: saturating the market supply and demand. 

Alex Barker, PharmD: Yeah. I mean, let's be honest. They didn't fund every. But they were certainly encouraging. Many grants were made. They made their move way back then because what's the most expensive thing on their sheet?

You know, their budget sheet. It's you, it's you and me. It's the pharmacist. So how do you decrease the value you flood the market? So in today's case, it isn't the spouse telling them you got it, you're not going to get anything better than this. It's everyone else telling them you're not going to get anything.

Because of how competitive it is. 

Mike Koelzer, Host: How did they flood with the pharmacy schools? Did they help open pharmacy schools? Or 

Alex Barker, PharmD: I wrote a blog about this explaining my, I, I put a top hat on, you know, and I said, okay, let's all put our conspiracy thoughts here. With, with definitive evidence. I cannot say that the, you know, the chains where all the bad guys, what I can say though, is the congressional report that was published in the year 2000 that said famously, there's going to be a shortage of pharmacists, you know, um, that unequivocally has been proven wrong.

The, um, ever since then was the start of the mandate of, oh, we need more schools to meet this demand. Otherwise we're gonna, you know, we're going to have a real problem here. I don't know who the real problem would be for the right patients. Or companies. That's, that's what, that's what the problem 

Mike Koelzer, Host: is.

You could argue that they could see our 20 years and know they were going to use more robotics and more telepharmacy and more mail, or maybe they didn't need the pharmacists. They needed more pharmacists who would be willing to do so. Take less money or feel less 

Alex Barker, PharmD: important. Yes. And we're definitely getting off the subject here of, you know, the individual well-being, but no, we're 

Mike Koelzer, Host: No, we're not Alex, because you said it doesn't have to do with the individual.

It has to do with these companies that need to change somehow. They do. Um, right. I mean, that's what you said from your studies. It's not the people. Company that has to change. The people have done enough breathing exercises and, you know, whatever, whatever the hell you do when you're burned out. I mean, it's the companies.

Alex Barker, PharmD: Yes. If, if I had a message that I could speak to all the executives out there and, and leaders, even of smaller organizations, uh, it would be don't buy into this resiliency message. That's being perpetrated. Um, resiliency is a great quality. I want my kids to be resilient, but what my survey says, what a mountain of literature about this problem says is that it's the organization.

You have an unhealthy organization that is allowing this to happen, and you do not have the systems for people to recover. From this. And you also do not have probably the systems that are, uh, preventing the problem from even happening. 

Mike Koelzer, Host: Now I'm listening as one of those people you're talking to. And I say, I don't care what my pharmacy needs to be sustained on is people that come out of school.

A lot of them have a lot of debt. And a degree and a license and I'm replaced every two years. I don't want long-term success as far as they go, because then I got a bunch of old Forks that look like Kelzer, you know, doing a half-ass job. I want these younger people coming out who are licensed.

Thanks for the information, Alex, but I 

Alex Barker, PharmD: don't care. And why else would you write? Because pharmacists are a dime a dozen. There's a lot of issues here. Let's boil it down to maybe the big picture. First, I think policy is really the thing that our associations need to tackle. I think the pharmacy [00:40:25] industry is heavily regulated.

However, the regulation that is in place is heavily controlled by. Uh, companies that do not have pharmacist's best interest in mind. I think policy does need to play a role here to protect pharmacists. Here's an interesting study for an intern, and if you're a student reach out to me, let's work on a project together with the people on the boards of pharmacy for the 50 states of America.

Who are they? I think a lot of people already are like, oh, I know who I know who yeah. That person works for that organization. And that person works for them. It's the who's who of pharmacy for sure. But it's all probably executive it, I would venture a guess. The majority are not people on the front line.

You know, it's not a staff pharmacist. And so once you don't have a staff pharmacist, you lose that perspective in the boardroom where laws are being suggested, reviewed, and mandated. I think what has made this problem worse is. Our own lack of control of our profession, but my survey did not prove that it's more so looking at the consequences of those things.

I think a lot of people would agree with me, but a lot of my points are arguable for sure. The state of pharmacy, in my opinion, is one of a child being fought between two divorced parents. You know, one, one, parent's saying one thing, the other parents saying this thing and, and the child doesn't know what to do, what to say.

And it's heavy. You know, identity crisis upon identity crisis. Wondering how I should behave? What should I do? And it comes out in ways of, do I get a residency? Do I need another certification? Should I do this? Should I do that? Community pharmacy sounds awful. So does the hospital, I don't know if I want a residency.

Pharma sounds great. And I mean, even 10 years ago when I graduated pharmacy school, uh, pharma was the bad one. Like no one said that, but everyone was like, yeah, those pharma guys are really slimy. They just care about Megan's money today. That is not the attitude at all, because the word has gotten now they have the bat, one of the best, uh, work-life balance.

How did that happen? That's not our profession. You don't think of a pharmacist as working in a pharma company. No one thinks that. And yet the people within our own profession are like, those are the jobs I want. It's because in my opinion, we have an identity crisis and no one is leading us well into a well-defined identity that, uh, we're all happy with.

And so we're stuck in this weird situation. 

Mike Koelzer, Host: I think you and I talked about identity. I think we talked about this couple of years ago. May 

Alex Barker, PharmD: I've been thinking about it a long time. 

Mike Koelzer, Host: So what's our identity? 

Alex Barker, PharmD: I don't think it's for me to decide, but who decides it at the happy pharm? D what we empower people to do is to determine that for themselves, because so many people say things like I can't do that, or I don't know how to do that.

When in actuality, we have a system to help them do those things, and they transitioned to do them without experience, without residencies certifications and all that mumbo jumbo, who dictate. Our identity. It is formed in our professional journey. So doctor Zubin, Austin is a Canadian pharmacists and psychologist of the university of Toronto has done a plethora of research on this subject.

Uh, the man is brilliant and, uh, I've used a lot of his research for my own development and, and research as well. Who forms our identity is often the institutions that train on. And then in turn, when we become a true pharmacist, legally, it is the institutions in which we perform or, or practice this identity that we have.

It's so fluid that we don't know what we are. Are we a clinician? Because most pharmacists that graduate do not get clinician roles. They get staff roles. So they're taught three to four years. You know, that they're going to be this clinician, they're going to change people's lives. They're going to change all these doses and make all these recommendations.

But when they start practicing, it's like, that's not what I'm doing. That's not what I'm doing. So, I mean, you know, just imagine that for someone else, imagine you go to, you know, I don't know, art school and you learn how to. I have been doing oil painting for four years. And then when you get your first quote job, you know, you're doing [00:45:25] digital marketing.

You'd be like, what the, what, why did I just spend all that money? Why am I here? What is my purpose? And you have a lot of people asking the question, what is this profession? And the public doesn't see us that way. The lawmakers don't see us that way. It is a true, odd juxtaposition between what we're taught and what we do on a day-to-day basis.

Mike Koelzer, Host: I mean, I just look at it from my history, teaching us more of clinical stuff back then, and then you come out, you're like, oh, this, this isn't what we were taught. This is more product based. And now that divide it's bigger, but the job description is about the same. I mean, there's gotta be a huge divide right now.

There's 

Alex Barker, PharmD: an interesting study that asked the question. Do, do jobs prefer or require certification? Or residencies the vast majority do not. And so this identity crisis, I think, is leading us to doing things like creating more hurdles for us to jump over to quote, to prove to others that we know things that we can do.

Things when they were never needed in the beginning, they were never needed. And yet we have so many people falling into the trap of external validation. To prove what we can do at the end of the day, it's just studying and memorizing more junk that you may or may not use to pass a test. 

Mike Koelzer, Host: You're saying students are coming out now, but the demand isn't there for what they're being trained for.

Alex Barker, PharmD: Oh, absolutely. But I think that's a question about what's the value of a pharm D. I do not believe that the market demanded a pharm D 

Mike Koelzer, Host: We've tried to invent a demand and the schools are teaching towards the demand, but that demand isn't there. And let's define it by a demand that has some monetary value to it.

It's just not 

Alex Barker, PharmD: there. No, it's not. And if you want more evidence, if you look at. Residency programs, although this is starting to change particularly in the last couple of years, the vast majority of residents get jobs at the location where they got the residency. What this indicates is that people are getting jobs in the place where they're being trained.

So it's cheap labor to create some new clinic or some new system for them to implement an employee and ideally generate more. But what we're finding over and over again, particularly in the last three years is that many residents graduate with a residency. Can't find it. Um, I can't find a job that requires four years of graduate school, one year residency sometimes too.

Can't find a job 

Mike Koelzer, Host: It's skewed. It's like meeting degrees. And then my dad hired me or something years ago, these residents are getting jobs because they already know the position. They may have formed a position for them and so on, but they're not wanted in the job market in general. 

Alex Barker, PharmD: It's funny because I believe it was in the late eighties when they started contemplating this idea of the doctrine of pharma.

And it was based off of seeing what certain pharmacists were doing in the workplace and like pointing out like, Hey, this is clinical. What you're doing is very much like what a doctor or a specialist would do. And so rather than saying, you know, we're going to create this new program where a select few pharmacists, if they want to do it, they can.

And it's an additional year of pharmacy school. They instead chose, we're going to, we're going to raise the bar for everyone when there was no market demand for doing so 

Mike Koelzer, Host: there wasn't a market demand for it. 

Alex Barker, PharmD: No, maybe a small, you know, less, less than four, less than 5% of institutions that were like, yeah, we could use a clinical pharmacist.

We could use someone who could do that. But you know what the truth of the matter is you could get on the job training for that. You could have just gone to work, tried it out, learned. And then make it happen. And then what they learned after the doctorate, after they added an additional year of school, which by the way, you know, as another back then, I don't know, eight, $10,000.

That's a nice chunk of change for a hundred. So students on top of that, now you need a residency you need on the job training because your additional year of schooling wasn't enough. And now you need to do this one year training program. Oh. And by the way, now we have PGY two where you can get a second year of cheap labor out of your workforce to learn this job that you can do.

Oh yeah. And now, by the way, they have PGY threes. [00:50:25] 

Mike Koelzer, Host: Your study. What comes out at me is burnout. And we said that burnout is enough to take notice. I mean, a lot of things go bad with burnout, family relationships break down and your health breaks down and you could argue crime and drugs and all those things come from burnout.

Alright, that's established what the. Is the breaking point that hits the news that hits the front page. When you're talking about this larger thing, going down 

Alex Barker, PharmD: the systems that currently exist, do such a good job at protecting pharmacists. That it's going to be very hard for a problem to make itself known.

So here's an example of what, I mean, do you remember a few years ago? That technician that was posing as a pharmacist for like 11 years. Yeah. As far as we know, there wasn't a single problem with that. So that company that had that problem did have to pay out some fine to the government, but that was the biggest tech check tech program that has ever existed.

Because as far as we know, no problem ever occurred. And that was a technician pretending to be a pharmacist, the systems that currently exist, protect pharmacists very well. And that's great, but what's going to happen? For us to really address this problem, there's going to be some media backlash. It's going to be some case where a state representative or Senator has a son that died due to some problem that happens in the workplace where the pharmacist didn't have enough time.

And I mean, I hate to say it, but in that setting, That fake pharmacist did nothing bad. And if a technician could do a quart pharmacist job for 11 years and not get caught, then what again, what the heck is our profession? 

Mike Koelzer, Host: Pharmacists basically could be killing themselves literally in a job setting.

And as long as there's a couple left, no, one's really going to hear about it because the patients in the public are not really affected. 

Alex Barker, PharmD: Sadly, they are killing themselves. They have the 14th, highest suicide rate suicide rate. According to my study with the CDC, however, people don't care if the tech 

Mike Koelzer, Host: can do it for 11 years.

And whether it's a pharmacist being able to oversee more or better technology or whatever's happening, the general public has not been afraid. No, 

Alex Barker, PharmD: the general public doesn't has no idea what is happening to pharmacists. They just don't know. And I know that some people are trying to work on that.

There's some very interesting documentaries that are being worked on, but even then, who cares? Part of my obsession is trying to figure out how we make pharmacists more accessible to the public? Not in terms of like patient care, but in terms of. Thinking about them. And I have ideas for video games.

I have ideas for books. That was it from 

Mike Koelzer, Host: our first one. Yes. Now it all comes back to me though. The pharmacy video game. Yes. Now it's all coming back to me, Alex. That was it. 

Alex Barker, PharmD: Yeah. Because one of the most popular games on, uh, PCs right now is a truck simulator like 20. According to esteem, uh, store page for where you can buy the game.

There's like over 200,000 re overly positive reviews of this game. Meaning at least 200,000 people have purchased a game about driving a car. Now I would not buy that game, but I would certainly be interested in buying a game. Make me help pretend to be a pharmacist. And I don't know how to make that fun or interesting, but the whole point behind this is to make people care.

We have to be in the public light and we have to tell our stories. And I think we have to shift our identity away from being the subservient profession and to a profession where we know. And we train people on their value and what they're capable of, and we can step into it by doing that value, not counting by fives, not doing things that robots can do, but by, uh, providing real patient care, um, through a myriad of different kinds of jobs that are out there, it sounds like a daunting task.

And I really don't think I'm the one to lead them. [00:55:25] Charge, but I hope I can be someone who is like a cheerleader or probably better a coach, someone who can help someone do that, who can, who can make the video game that can make the movie or the TV show or a documentary to change people's viewpoints about what we are and what we're capable of.

Mike Koelzer, Host: I think where you're coming from is saying that. The pharmacists in general, don't have to reach inside themselves. It's something that can take advantage of the current technology and whatever. And someone can raise the value of pharmacists, but it's like, hang tight. All you people that are going crazy.

I'm not saying don't do anything to help yourself, but we're not saying you have to necessarily rise up, but somebody has to right. 

Alex Barker, PharmD: I would say, don't try to aspire to be that person. If you're down in the depths, um, reach out to us, try to figure out what's something small that you can do. Because of the transformation I get, I'm very privileged in my company.

I get, I no longer talk to every single person anymore. Like I used to, but now what I get to do is I get to talk to people after they go through our program. I talk to maybe about a quarter of those and I get to talk to them. You know, when they make that transition and they're doing the thing that they love.

And these are people that say things like, I hated my job. I hated pharmacy. I wanted to leave. I was thinking about going into real estate, you know, all these other things that people consider and they say things like now I'm excited. And I'm a part of things now, and they're doing all these other things related to their career, both in their job and outside of it.

And. They become those kinds of people that want to create media to change how people view things and to see that transformation, you know, after they go through our program is like, that's the crack that I need, you know, to go get through my day when I'm having a bad day. Um, and it's a real privilege to just be a part of it.

Mike Koelzer, Host: One of those. Responses. I read the guy said, uh, I was reading this morning and he said, I can't believe I turned into this pharmacist. This is not the guy that I thought I would be kind of, you know? And so it's like, you might not be able to change the world or you might not be able to even change your own surroundings or the schools that we've been talking about.

If you can at least cliche kind of look in the mirror, you can look in the mirror and at least know you're making some steps. I think that's the right direction. Talk 

Alex Barker, PharmD: about an identity crisis for that. Just one individual. This isn't who I want to be. It's really, it's where we're at, but it doesn't have to be true for everyone.

It can change. 

Mike Koelzer, Host: Alex, you have always met people where they are. And where is that right now? 

Alex Barker, PharmD: We actually have a care package that we're giving away to any pharmacist or student. And we in this package have my digital copy of my book, indispensable a prescription for a fulfilling pharmacy career. And it's really meant for any pharmacist, whether you feel like how I felt a burned out miserable, unfulfilled.

Um, or whether you feel like you're at your top of your game, but maybe you feel like there's something more that I can give to my career. There's something more that I can do than what I'm currently doing. Um, that's what that book is for. Hopefully help inspire you, but also to give you some actionable steps that make sense and in a digestible way.

And then we also have in the care package, our pharmacist salary guide. So use the book to kind of help you start taking action, move in a direction. Um, ideally in some, uh, either maybe a promotion or a new career path. And then you can use the salary guide to negotiate for your next opportunity. And if you want those things, you can go to the happy farm d.com/care.

Mike Koelzer, Host: Alex. Thank you. Good to see you 

Alex Barker, PharmD: again. Of course, it's always good to hang out with you. Thanks for having 

Mike Koelzer, Host: me. Thanks for everything. You do get back to work. Thanks. I'll talk to you soon. Talk to 

Alex Barker, PharmD: you soon. We'll see you later.