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Insight
We have a problem in oncology pharmacy, and it’s been going on for years. We are hemorrhaging pharmacists, and most concerning, we’re hemorrhaging EXPERIENCED pharmacists.
There are several reasons, one was COVID spotlighting all the problems in healthcare which sped up the burnout path many of us were already on. The pandemic also showed us, and the world, what we were capable of doing with our backs to the wall. We innovated and found ways to take care of patients, such as with remote work. That type of work gave us some autonomy, something we dreadfully lack in most patient care roles and something that is needed for long term happiness and motivation in our careers.
The professional space has also changed a lot from our parents generation. Long gone are the days when people stayed in one organization for their entire careers, received a pension, and retired comfortably. Did attrition start rising when pensions started dissipating? Perhaps. Regardless, people don’t stay at jobs forever anymore. And much more commonly, we are leaving our patient care roles for non-traditional roles, mostly in industry.
If you ask any oncology pharmacist, you probably wouldn’t be surprised to hear them say they will always love direct patient care; we get into this specialty for that love of patients. But that love isn’t enough to overcome the downsides of this type of work. The moral injury, the mundane tasks that get in the way of that patient interaction, the poor management and leadership micromanaging everything, the required administrative duties without dedicated time to do them. A person can only take so much pressure before they crack.
And when they crack, they leave, especially the experienced ones who have been putting up with it for the longest. That leaves centers with the difficult job of filling their spot. Because so many of us are leaving patient care, there isn’t a lot to choose from in most areas of the country. Although there is a shortage of experienced oncology pharmacists, there is not a shortage of pharmacists interested in oncology, it’s just a lot harder to find ones with PGY2 training and BCOP certified which institutions will always want when available.
During these times of high attrition we also have cancer centers expanding and new ones being built which further reduces the workforce pool. We need a way to bring up our less experienced colleagues to be able to practice at a high level. Residency is great for that, but it isn’t enough with only ~220 positions across the country. And most PGY2 grads want to work at the large academic urban centers where they are trained, not the community and often rural centers that desperately need help too. Let’s not forget it’s about a $100k investment to do 2 years of residency, a tax many pharmacists cannot afford on top of crippling student loan debt.
Richard Branson has said: “train people well enough to leave, treat them well enough so they don't want to” and gosh do we need to internalize this in oncology pharmacy!
We have to train people well enough to leave, because when they are trained that well they do great work! If you hire someone without residency training and expect them to “learn on the job” you are doing both them and your organization a disservice. Oncology cannot be learned that way, especially in a busy center.
And it isn’t rocket science, but we should be treating our current staff well enough that they never want to leave! Employee loyalty is not that hard to achieve. Ask people want they want and do everything you can to support them in getting it.
We need to be thinking about the future of oncology pharmacy and not getting stuck with how we did things in the past - we have to cauterize this wound! Both our profession and oncology is changing. We must step up to meet the future needs of patients with cancer. |
