October 2013 Florida Pharmacy Journal by Florida Pharmacy Today

The Official Publication Of The Florida Pharmacy Association OCT. 2013

AMERICAN PHARMACIS T S MONTH

THE WALKWAY OF RECOGNITION

FPA OFFICE

YOUR NAME HERE

Have you been searching for just the right gift or thought of placing your name in perpetuity? If so, then consider purchasing an engraved brick for you or someone else. The main sidewalk at the Florida Pharmacy Association needs replacing. The Florida Pharmacy Foundation has undertaken the project to repair and beautify the sidewalk with engraved personal bricks purchased by pharmacists or friends of pharmacy. Engraved 4x8 bricks can be purchased for $250.00 each with the donor’s name engraved (3 lines available) or you could also purchase an engraved brick for someone you feel should be honored or remembered. The monies earned from this project will be used to fulfill the goals and future of the Foundation. There are a limited number of bricks available – so, it is first come first served.

ORDER FORM

The Walkway of Recognition

❑ YES, I want to order _______ concrete brick/s at $250.00 each. (Please copy form for additional inscriptions). PL E A S E P R INT I NSC RIP TION

The concrete bricks are 4x8 and can be engraved with up to 14 characters per line, three lines available, spaces and punctuation count as one character. Please find enclosed my check for $_________ for _________ bricks. PLEASE PRINT: Please charge my

❑ Master Card

CARD #

Contributions to the Florida Pharmacy Foundation are tax deductible as a charitable contribution for federal income tax purposes. Consult your CPA for complete details. Fed Emp. I.D. #59-2190074

❑ Visa EXP. DATE

AUTHORIZED SIGNATURE NAME ADDRESS CITY

STATE

PHONE (W)

(H)

Send to Florida Pharmacy Foundation, 610 N. Adams St., Tallahassee, FL 32301, or fax to (850) 561-6758.

ZIP

A COPY OF THE OFFICIAL REGISTRATION AND FINANCIAL INFORMATION MAY BE OBTAINED FROM THE DIVISION OF CONSUMER SERVICES BY CALLING TOLL-FREE 1-800-435-7352 WITHIN THE STATE. REGISTRATION DOES NOT IMPLY ENDORSEMENT, APPROVAL OR RECOMMENDATION BY THE STATE.

florida PHARMACY TODAY

Features

Departments 4 Calendar 4 Advertisers 5 President’s Viewpoint 7 Executive Insight 23 Buyer’s Guide

VOL. 76 | NO. 10 OCTOBER 2013 THE OFFICIAL PUBLICATION OF THE FLORIDA PHARMACY ASSOCIATION

10 12 19 22

American Pharmacists Month: Get the Message to the People! The Florida Pharmacy Association 2010-2012 Resolutions Update A Looming Joblessness Crisis for New Pharmacy Graduates and the Implications it Holds for the Academy Adherence: Getting Techy With It

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OCTOBER 2013

FPA Calendar 2013

OCTOBER

DECEMBER

APhA Diabetes Certificate Program Orlando

3-4

Florida Board of Pharmacy Meeting Gainesville

APhA Immunization Certificate Program Orlando

7-8

FPA Regulatory and Law Conference Sarasota

NOVEMBER 1

Advisory Council on Pharmacy Practice

2-3

FPA Committee, Council and Board meetings Orlando

Veterans Day - FPA Office Closed

20-22 ASCP Annual Meeting Seattle, Washington 28-29 Thanksgiving Holiday FPA Office Closed

25-26 Holidays - FPA Office Closed JANUARY 1

FPA Office Closed

Martin Luther King Day FPA Office Closed

FPA Law and Regulatory Conference Sandestin, Florida

Last day to submit election ballots

For a complete calendar of events go to www.pharmview.com

Mission Statements: of the Florida Pharmacy Today Journal

The Florida Pharmacy Today Journal is a peer reviewed journal which serves as a medium through which the Florida Pharmacy Association can communicate with the profession on advances in the sciences of pharmacy, socio-economic issues bearing on pharmacy and newsworthy items of interest to the profession. As a self-supported journal, it solicits and accepts advertising congruent with its expressed mission.

of the Florida Pharmacy Today Board of Directors

The mission of the Florida Pharmacy Today Board of Directors is to serve in an advisory capacity to the managing editor and executive editor of the Florida Pharmacy Today Journal in the establishment and interpretation of the Journal’s policies and the management of the Journal’s fiscal responsibilities. The Board of Directors also serves to motivate the Florida Pharmacy Association members to secure appropriate advertising to assist the

Journal in its goal of self-support.

Events calendar subject to change

CE CREDITS (CE cycle) The Florida Board of Pharmacy requires 10 hours LIVE Continuing Education as part of the required 30 hours general education needed every license renewal period. Pharmacists should have satisfied all continuing education requirements for this biennial period by September 30, 2015 or prior to licensure renewal. Technicians will need to renew their registration by December 31, 2014. For Pharmacy Technician Certification Board Application, Exam Information and Study materials, please contact the FPA office. For More Information on CE Programs or Events: Contact the Florida Pharmacy Association at (850) 222-2400 or visit our Web site at www.pharmview.com

Advertisers EPC........................................................................ 9 HCC...................................................................... 3 KAHAN HEIMBERG, PLC............................... 9 FLORIDA PHARMACY FOUNDATION . ..... 2 PPSC...................................................................... 9

CONTACTS FPA — Michael Jackson (850) 222-2400 FSHP — (850) 906-9333 U/F — Dan Robinson (352) 273-6240 FAMU — Leola Cleveland (850) 599-3301 NSU — Carsten Evans (954) 262-1300 DISCLAIMER Articles in this publication are designed to provide accurate and authoritative information with respect to the subject matter covered. This information is provided with the understanding that neither Florida Pharmacy Today nor the Florida Pharmacy Association are engaged in rendering legal or other professional services through this publication. If expert assistance or legal advice is required, the services of a competent professional should be sought. The use of all medications or other pharmaceutical products should be used according to the recommendations of the manufacturers. Information provided by the maker of the product should always be consulted before use. 4 |

FLORIDA PHARMACY TODAY

E-MAIL YOUR SUGGESTIONS/IDEAS TO dave@fiorecommunications.com

The President’s Viewpoint TERRY GUBBINS , FPA PRESIDENT

Students Provide Our Fountain of Youth

just celebrated my 55th birthday. Five years ago, I started receiving junk mail from AARP. I always shred these mailings without ever opening the envelope. It is my way of denying that I am getting old. It is common to want to look and feel younger, and to continue to do things like younger people. Ever get an injury from playing football or other sport when you should have been a spectator? We all try to delay or deny the aging process. The same is true with the Florida Pharmacy Association. We are over 125 years old, but still want to look young and attractive. How do we try to get rid of some of our wrinkles? We surround ourselves with younger people. Let me tell you what we have been doing and what we have planned in regard to pharmacy students and young pharmacists. For almost 10 years, we have sponsored Legislative Days at the Capitol in Tallahassee every spring. We had a handful of pharmacy students with us a few years ago. Last year, we had over 400 pharmacy students from all six Florida pharmacy schools interacting with legislators. Legislative Days allow pharmacy students to experience one of the main foundations of our association: to lobby our legislators on matters affecting our profession. The energy and excitement level at the Capitol is always raised to new highs with the students present. It makes us all feel younger when we spend time with the students in Tallahassee. Join us next year! The dates are March 10-11, 2014. We’ll have more information later in Stat News and this journal.

We have a lot of student involvement at our annual conventions. Many of our pharmacist members help support student attendance with our “Adopt a Student” program. With this program, members donate the funds to

Legislative Days allow pharmacy students to experience one of the main foundations of our association: to lobby our legislators on matters affecting our profession. cover a student’s registration, and we have a reception to allow students to meet and interact with their mentors. This past July, we adopted 23 students! Want to feel younger? Adopt a student next year! We also provide student poster presentations at our convention. We al-

Terry Gubbins 2013-2014 FPA President

ways learn new information at these poster sessions. This year’s poster presentation winner was Danielle Padgett of Nova. We also sponsor a Patient Counseling contest. At our recent convention in Orlando, Sarah Reeg of Palm Beach Atlantic was the winner. Throughout the year, we have student representation on our FPA Councils and Committees. All six Florida pharmacy schools are represented on five councils and committees. We currently have 30 students actively participating. Having this student involvement helps us have fresh ideas, and keeps our minds young. What’s new in regard to students and FPA? I’m pleased to announce that we have FOUR exciting, new initiatives geared toward pharmacy student members. Let me share these with you. First, we are completing our student membership drive this month. We created a single, one-time membership OCTOBER 2013

2013 FPA Board of Directors The Florida Pharmacy Association gratefully acknowledges the hard work and dedication of the following members of the FPA leadership who work diligently all year long on behalf of our members.

Goar Alvarez............................................................................. Chairman of the Board Terry Gubbins...............................................................................................FPA President Suzanne Kelley......................................................................................... President Elect Alexander Pytlarz................................................................................................Treasurer Gary Koesten.............................................Speaker of the House of Delegates Bob Parrado....................................Vice Speaker of the House of Delegates Tim Rodgers, Director........................................................................................... Region 1 Michael Hebb, Director ......................................................................................Region 2 Stephen Grabowski, Director .......................................................................Region 3 Raul N. Correa, Director ...................................................................................Region 4 Jason Beattie, Director ....................................................................................Region 5 Scott Tomerlin, Director.....................................................................................Region 6 Kimberly Jones, Interim Director................................................................ Region 7 Raul Gallo, Director.................................................................................................Region 8 Nadine Seabest, Interim Director...............................................................Region 9 Richard Kessler...................................................................................... President FSHP Michael Jackson........................................Executive Vice President and CEO

Florida Pharmacy Today Journal Board Chair......................................................Jennifer Pytlarz, jlc_rxdoc@hotmail.com Vice Chair......................................................... Don Bergemann, don@bceinfo.com Treasurer....................Stephen Grabowski, sgrabowski@seniormmc.com Secretary...................................................................Stuart Ulrich, Stuarx@aol.com Member.................................................Joseph Koptowsky, docjik1215@aol.com Member........................Rebecca Poston, rebecca_poston@doh.state.fl.us Member....................................................... Carol Motycka, motycka@cop.ufl.edu Member........................................................Cristina Medina, cmmedina@cvs.com Member................................................................Norman Tomaka, FLRX9@aol.com Member................... Verender Gail Brown, brownvgrx4304@hotmail.com Executive Editor................Michael Jackson, mjackson@pharmview.com Managing Editor...................Dave Fiore, dave@fiorecommunications.com

fee of $20 for students to cover their entire time in school. The pharmacy school with the highest percentage of FPA members will be awarded a $1,000 prize. Second, on January 11, 2014, we will conduct our first Young Pharmacist Leadership Conference in Orlando. This will be a single day conference focusing on leadership skills and development. Students will receive certificates of completion, and pharmacists will receive ACPE continuing education credits. Watch for more details soon on how to register for the Young Pharmacist Leadership Conference. Third, at Legislative Days in March 2014, we will award the first FPA Presidentâ&#x20AC;&#x2122;s Leadership Award to a deserving student. This award includes a $1,000 scholarship to a student FPA member that has shown proven leadership skills in our association. And our fourth new initiative? More scholarships! The FPA Presidentâ&#x20AC;&#x2122;s Leadership Award is not our only investment in our student members. In May, the Florida Pharmacy Foundation will award an additional $9,000 in scholarships. One student from each of the six Florida pharmacy schools will receive a $1,500 Walgreens/Florida Pharmacy Foundation scholarship. As you can tell, we love our student members. We encourage more students to join us. We want you to be active in our profession. We want you to share your ideas. We want to award you scholarships. We want you to make us younger. n

JOIN TODAY! See "Viewpoint", continued on page 6 6 |

FLORIDA PHARMACY TODAY

Florida Pharmacy Association

Executive Insight BY MICHAEL JACKSON, RPH MICHAEL JACKSON, BPHARM, EVP & CEO, FLORIDA PHARMACY ASSOCIATION

FPA Launches New Political Committee

e all know how important it is to become involved in public policy development. You have heard enough of that from me over the years and seen many of my articles on this issue. I suppose that you are wondering why we keep writing about the importance of supporting the FPA’s advocacy efforts. Well, for one reason, it is clear that many decisions at the state Capitol and in Washington, D.C., will have some effect on your practice, your career, your relationship with your patients, your family and also the ability to determine your future. For many years, the FPA has led the way with our advocacy efforts and our political fundraising campaigns. With changes to Florida election laws, the Florida Pharmacy Political Action Committee of Continuous Existence, which had served us well under the leadership of their Board of Directors, had to be modified. Working very closely with the PACCE board, we have now transitioned over to the Florida Pharmacists Political Committee (FPPC) that will have oversight under the existing PACCE Board of Directors. A new political committee campaign account has been created and is now accepting donations.

What is a political committee? A political committee is a combination of two or more individuals that: ■■ Accepts contributions for the purpose of making contributions to any candidate, political committee, affiliated party committee or political party; ■■ Accepts contributions for the purpose of expressly advocating the election or defeat of a candidate or

■■

issue; Makes expenditures that expressly advocate the election or defeat of a candidate or issue; or Makes contributions to a common fund from which contributions are made to any candidate, political committee or political party.

With changes to Florida election laws, the Florida Pharmacy Political Action Committee of Continuous Existence, which had served us well under the leadership of their Board of Directors, had to be modified. Why do we need political committees? Political committees are a way for groups to pool their resources to have an effective way of helping to get their message heard. Consider how messaging through social media affects news broadcasts. If you send a note through your Twitter or Facebook account your friends get to see it and comment. If the note you sent through your Twitter or Facebook account gets out into social media channels and is widely commented on, it becomes a trend that is looked at by the media as well as policy makers and gets noticed. Political com-

Michael Jackson, B.Pharm

mittees help to give your singular contribution a greater impact. Simply put, a sledgehammer will drive a nail deeper into a piece of thick wood than a small hand-held carpenter’s hammer. Who are the board members of the Florida Pharmacist Political Committee? The FPPC board members consist of not less than five volunteers, with one being the chair of the FPA Governmental Affairs Committee. Annually, the Board presents its slate of directors to the Florida Pharmacy Association, and that slate is approved by the FPA president-elect. The FPPC Board members were heavily involved in the transition of the FPCCE to our new political committee and for that we are very thankful for their hard work. The Florida Pharmacist Political Committee board members are the following: ■■ S. Mark Hobbs, Merritt Island OCTOBER 2013 |

FPA STAFF

Executive Vice President/CEO Michael Jackson (850) 222-2400, ext. 200

Director of Continuing Education Tian Merren-Owens, ext. 120 Controller Wanda Hall, ext. 211

Educational Services Office Assistant Stacey Brooks, ext. 210 Coordinator of Membership Christopher Heil, ext. 110

FLORIDA PHARMACY TODAY BOARD Chair............................................. Jennifer Pytlarz, Brandon Vice Chair...................Don Bergemann, Tarpon Springs Treasurer...............................Stephen Grabowski, Tampa Secretary.........................Stuart Ulrich, Boynton Beach Member..................................... Joseph Koptowsky, Miami Member..............................Rebecca Poston, Tallahassee Member.............................. Carol Motycka, St. Augustine Member....................................Cristina Medina, Hollywood Member................................. Norman Tomaka, Melbourne Member..............................Verender Gail Brown, Orlando Executive Editor.........Michael Jackson, Tallahassee Managing Editor.........................Dave Fiore, Tallahassee

This is a peer reviewed publication. ©2013, FLORIDA PHARMACY JOURNAL, INC. ARTICLE ACCEPTANCE: The Florida Pharmacy Today is a publication that welcomes articles that have a direct pertinence to the current practice of pharmacy. All articles are subject to review by the Publication Review Committee, editors and other outside referees. Submitted articles are received with the understanding that they are not being considered by another publication. All articles become the property of the Florida Pharmacy Today and may not be published without written permission from both the author and the Florida Pharmacy Today. The Florida Pharmacy Association assumes no responsibility for the statements and opinions made by the authors to the Florida Pharmacy Today. The Journal of the Florida Pharmacy Association does not accept for publication articles or letters concerning religion, politics or any other subject the editors/ publishers deem unsuitable for the readership of this journal. In addition, The Journal does not accept advertising material from persons who are running for office in the association. The editors reserve the right to edit all materials submitted for publication. Letters and materials submitted for consideration for publication may be subject to review by the Editorial Review Board. FLORIDA PHARMACY TODAY, Annual subscription - United States and foreign, Individual $36; Institution $70/year; $5.00 single copies. Florida residents add 7% sales tax. FLORIDA PHARMACY ASSOCIATION

610 N. Adams St. • Tallahassee, FL 32301 850/222-2400 • FAX 850/561-6758 Web 8 Address: | F L O Rhttp://www.pharmview.com IDA PHARMACY TODAY

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■■ ■■ ■■ ■■ ■■ ■■ ■■

Kimberly Jones, Jupiter Joy Marcus, Miami Humberto Martinez, Miami Steven Nelson, Okeechobee Theresa Tolle, Grant Shannon Wedekind, Orlando Kenneth Wisniewski, Plantation Michael Jackson, FPA Staff, Tallahassee

How much can I give to a Political Committee? Currently, FPA members (and nonmembers) are limited to a $500 contribution per election cycle to the FPPC. On November 1, 2013, and beyond, members can make an unlimited contribution to the Florida Pharmacist Political Committee.1 Donations to the FPPC can be made through the FPA website through the “Donations” menu item, or you can down-

Practitioner Group Physician Association

Osteopathic Physician Association Physician Assistant Association Pharmacists load a brochure and send in a check payable to “Florida Pharmacist Political Committee.” The address will be 610 North Adams Street, Tallahassee, Florida 32301. How does the Florida Pharmacist Political Committee make contributions to political candidates? Currently, the campaign account for the FPPC has some funds available to support our friends in the Florida Legislature. That account, however, is limited and our support of members of the Florida House and Senate must be strategic and targeted to maximize the impact. The decision to support a political campaign comes from careful deliberations between

your FPPC Board of Directors and the Association’s lobbyists and legal counsel. The goal is to identify those members of the House and Senate who have an interest in our business model and issues, as well as support those individuals in key committees and councils that may hear legislation of interest to pharmacy. Remember that there are no pharmacists serving in the Florida Legislature and have not been for a number of years. How does our political committee compare to other health care-related political committees? Fundraising is a very competitive activity. Many of us receive requests from a host of organizations asking for financial support. There is a resource available on the Florida DiviNumber of Department of Health Licensees

Contribution

61,378

$693,268

6,157

$58,410

6,596

$33,356

28,2353

$27,5484

sion of Elections web site where you can download and view the political contributions of various organizations and compare them to pharmacist fundraising. While we have been successful over the years with getting campaign contributions, there are definitely opportunities to do better. Consider the chart in this article from some data I gathered from the Division of Elections website2. The Associat ion is extremely thankful for those members who have committed to support our political committee fundraising efforts. You can see from the data sample above that there is more work that needs to be done. Just during the 2013 legislative session, optometrists were successful in revising their practice acts to allow for the delivery of addiSee Insight, continued on page 14

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American Pharmacists Month: Get the Message to the People! Source: American Pharmacists Association The whole purpose of American Pharmacists Month is to draw attention to your work and celebrate your profession. That means sending the right messages to the right people and generating buzz for your events. Reach Your Community American Pharmacists Month is the time to take your message on the road. Don’t worry—you won’t have to go far. There are countless opportunities in your own community. Patients of all ages can benefit from discussions and information about how to use medications safely and effectively. ■■ Hit the Malls: Ask management at a local mall about staging an exhibit or booth where pharmacists can answer shoppers’ questions about medications. ■■ Find the Traffic: Create a medication education display for your local library, YMCA or other popular community site. ■■ Go Back to School: Visit neighborhood schools for a “show-and-tell,” a science or math class or a career day to talk with students about medication safety, the dangers of prescription abuse and exciting careers in pharmacy. ■■ Reach Out to Seniors: Conduct “medication check-up” reviews or seminars at senior day-use centers. ■■ Go with Groups: Civic, neighborhood, religious, even book groups— ranging from the Lions to the Junior League to Scouting groups—are all good places to target for an educational talk on medication safety or the role of the pharmacist.

FLORIDA PHARMACY TODAY

Attract Media Coverage Attracting media attention requires a good story and good visual opportunities. Determine which media outlets you want most to reach, and tailor your work to what they need in order to appeal to readers and viewers. STEP 1: TARGET YOUR MEDIA OUTLETS ■■

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Find the right size: Local and personal stories appeal more to small and local media. Issue-based stories can warrant regional or national coverage. Broaden your scope: There’s more to coverage than a news story or feature in a particular show or section. Try letters to the editor, opinion pieces, radio talk shows and TV station editorial segments. Don’t limit yourself to health: You might discover your story is more appropriately suited for the metro, business or lifestyle sections of a newspaper. Know your reporters: Check for particular writers, columnists or broadcast journalists who have covered pharmacy-related issues, and take your stories to them first. Check the media outlet’s website for contact information.

STEP 2: HAVE A GOOD STORY

What’s special about your American Pharmacist Month celebration? Are you trying to get as many seniors as possible to an event? Are you spotlighting a pharmacist with a strong relationship with patients? Are you looking at issues in the changing role or science in pharmacy? What are you most passionate about when it comes to pharmacy? What you care about is usually the seed for a story others will care about, too.

STEP 3: CULTIVATE MEDIA RELATIONSHIPS

Even in a short-term contact, a successful relationship with media outlets will go a long way toward accurate and compelling coverage. Here are some professional-caliber instructions to keep your work top quality: ■■ Send a pitch letter or email to your media list about 20 days in advance of an event. ■■ Prepare and send a media advisory the day before or the morning of an event. A follow-up phone call can help increase interest and attendance. ■■ Prepare a press release featuring greater detail. Releases help reporters write full stories. ■■ Assemble media kits to distribute at the event. Include the press release and information about your practice and the services it provides. ■■ Immediately after the event, distribute the release to members of the media unable to attend. ■■ Monitor the media for stories about your event. Send a thank-you to reporters who covered it. ■■ Keep copies of the press clippings to include in future media kits. See if you can get permission to post a video clip to social media. Use Social Media It’s the easiest, fastest and probably your favorite way to promote American Pharmacist Month events. But with social media, your message could get lost in a flood of information. Here are some tips for standing out and getting leverage. And remember—stick with APhA messages for best results. ■■ Just the Facts: For the whole month, post a daily pharmacy fact, tip, link or an article to your Facebook wall or Twitter stream.

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Tag It!: Use the Twitter hashtag #APhM2013 when tweeting about the profession, the month or your event. The more people who use a hashtag, the better chance it has at becoming a “trending topic.” This then ups the chances that other nonpharmacy users will run across the information. Let Facebook Help: If you’re hosting a special event in honor of APhM, spread the word through Facebook. It makes it easy to send invites and for attendees to share the event with friends. It’s also a neat way for attendees to see the guest list of who’s going (which helps get them to the page). Get Visual: Get out your smartphone and start shooting and posting photos of events. Three things to remember: Ask permission, use captions and check before tagging. Document with Video: Create a serious record of your events that others can learn from, or try a short, fun video with music or voice-overs. Once you’ve asked permission, post away. Pin Up: Pinterest and similar visual-based social media sites can be a good place to share tips and information. Consider: • Recipes for people with diabetes, allergies or other chronic conditions • A poster showing flavors available for children’s medication • Ideas on storing or remembering medications • A calendar for medications or a tip-a-day • Photos of pharmacists providing patient care services • GIF videos or images of food and drugs that may interact • Don’t forget to fill in the description box with extra information. Get Personal with a Blog: If you don’t have a blog already, APhM is a great time to start one. Or use a group blog where contributors rotate. Use this month to write about your work or what the profession

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means to you, or to share tips with students or professionals on continuing education or career advancement. A blog is an easy, relatable way to talk about the profession. Posts can be short and informal— the key is keeping the content fresh and consistent. Record a Podcast: This is a great way to address an issue in pharmacy that’s important to you. A podcast is typically a short recorded audio session, and it’s easy to do through the microphone on your computer. Try talking about pharmacy, interviewing a patient or colleague or describing how pharmacists can help someone with a certain condition, such as diabetes. “Tell Your Friends”: After people sign up for your event, take them to a “Tell Your Friends You’re Attending” page. With the click of a button, a customized tweet is created and posted for them. It makes it simple for attendees to share that they’re going—and gives a link for readers in their network to click. Add a Twitter Widget: If people are already talking about the event, why not use that as proof to market to other potential attendees? The widget is a box that allows users to scroll through just the tweets relevant to your event (with your hashtag). Build the Excitement: Are you able to give away some free tickets to your up-

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coming event, or offer freebies or prizes? Social media is particularly conducive to building excitement around things like giveaways. It encourages people to share/retweet/ repost—and it will up the awareness of your event. Capture the Experts: Will your upcoming events feature interesting or popular speakers? Get your social media audience acquainted with them—and excited to hear more. Promote their appearance before the event, and get permission to post content, a report, or a video of their presentation or Q&A. Invite Leaders: Most senators and representatives now use social media tools. Contact your local legislators via social media and invite them publicly to attend your events. Provide Online Answers: Spend some time during APhM visiting a Q&A website, such as WikiAnsers or YahooAnswers, and offer professional advice reminding people to contact their pharmacists with questions about issues such as potential drug interaction-related symptoms.

OCTOBER 2013 |

The Florida Pharmacy Association 2011-2013 Resolutions Update Presented to the House of Delegates Report to the Membership Gary G. Koesten – Speaker, House of Delegates As Speaker of the FPA House of Delegates, I have the responsibility of keeping the membership informed as to the status of resolutions that have been presented to, and voted on, by the House of Delegates at the annual convention. This includes the resolutions from the 2013 convention as well as the status of the resolutions from the 2012 and 2011 conventions as well. By way of explanation, the House of Delegates is YOUR VOICE. This is the forum by which members of the FPA, either directly or through their local unit, can bring to the table subjects that they consider important. These subjects are presented to the House each year at the annual convention as Resolutions. These Resolutions, once presented, are discussed under Robert’s Rules and are voted upon by the registered delegates at the annual convention. One important consideration is that a Resolution has to be submitted to the House prior to the published deadline. Resolutions submitted after the deadline can be considered by the House only if the majority of delegates agree to suspend the rules allowing the Resolution to be heard. What happens when the Resolution is voted upon? The Resolution can be passed as written or as amended and FPA leadership will then use this as direction for the coming year. The Resolution can be referred to one of the FPA councils for further action. ■■ The Resolution can fail, and no further action by FPA will be taken. ■■ The Resolution can be tabled. ■■

2012-2013 House of Delegates Board of Directors Speaker of the House......................................................................................Gary G. Koesten Vice Speaker of the House.................................................................................... Bob Parrado Parlimentarian.............................................................................................. Michael A. Mone’ Director............................................................................................................ David Mackarey Director.................................................................................................... Preston E. McDonald Director...............................................................................................................Robert J. Renna Secretary......................................................................................................Michael A. Jackson Immediate Past Speaker................................................................................. Eric M. Alvarez FPA President Elect.......................................................................................... Suzanne Kelley

FLORIDA PHARMACY TODAY

2011-2013 LIST OF RESOLUTIONS At the 2013 convention, the following Resolutions were presented prior to deadline, discussed and voted upon: Abolish the practice of gifts for transferring existing prescriptions between pharmacies (2013-1) Because the author of the resolution was not present at the House of Delegates meeting, this Resolution could not be introduced. However, this was introduced as an item of new business. There was a motion to refer this to the Professional Affairs Council, and the motion to refer passed.

Physicians to be offered to be retrained in order to prescribe controlled medications (2013-5) This Resolution was not adopted.

To bring everyone up to date on Resolutions pending action in 2013 from the 2012 and 2011 conventions:

FPA to oppose any changes to current pharmacist-pharmacy technician ratio (2013-6) This Resolution was adopted. This Resolution is on the agenda for the 2013 Governmental Affairs Committee.

2012 pending Resolution: Limitation and Reversal of Physician Scope of Practice Expansion into Dispensing (2012-4) This Resolution is on the agenda for the 2013 Governmental Affairs Committee.

Legalization of medical marijuana in Florida (2013-2) An amendment to the Resolution was presented. There was division of the house, meaning aye or nay was counted by raised hands not by voice vote. The amendment failed. The Resolution failed.

FPA to invite FSHP to unite as one single statewide pharmacy association (2013-7) The Resolution was amended. The amendment was adopted. The Resolution was adopted as amended unanimously.

2011 pending Resolutions: Prescription information: The FPA shall pursue the change of FS 893.04 to remove the wording “on the face of the prescription” (2011-3) This Resolution is on the agenda for the 2013 Governmental Affairs Committee.

The following 2013 Resolutions were submitted after the deadline. House rules were suspended and these Resolutions were heard and acted upon: Continuation of medication therapy: “emergency” refill authorization by the pharmacist (2013-3) This resolution was not adopted. Pharmacists to be recognized as health care providers (2013-4) This Resolution was adopted. This Resolution is on the agenda for the 2013 Governmental Affairs Committee.

Centers for Medicare and Medicaid Services (CMS) to clarify definition of “Qualified Provider” in Medication Therapy (MTM) rules (2013-8) This Resolution was adopted. This Resolution is on the agenda for the 2013 Governmental Affairs Committee. FDA to require manufacturers to publish additional data concerning temperature excursions from recommended storage conditions for pharmaceuticals during shipping (2013-9) House rules were not suspended. This Resolution was not considered.

At the 2013 convention, The House of Delegates Board of Directors prepared changes to the House bylaws. These changes were voted on and approved by the Delegates: ■■ ■■

■■

Seat past presidents as delegates Changes in language under Article XIII Section 2 – Elections of Board of Directors Regional Directors Changes in language under Article XIV Sections 2 – Speaker and Section 3 – Vice Speaker

OCTOBER 2013

Insight, continued tional services not permitted by Florida laws. Indeed, they facilitated a formidable advocacy campaign. Health care committee meeting rooms were filled with optometrists when their bill was placed on the agenda. While their campaign resulted in the passage of sweeping new legislation, we cannot discount the power of their political committee fundraising efforts. They gave not only to their state society’s political committee but many also donated directly to their respective state representative or senator. Why should I support political committees? I thought that legislators would simply do what is best for our profession? The decision to support the Florida Pharmacist Political Committee is a personal one that depends on how effective the contribution will be and whether or not it will make a differ-

ence. It is not enough to simply go to the polls on Election Day, mark your ballot and believe that our civic duty is done. We have to make sure that those we send to Tallahassee, and are doing good work for our profession and business, stay in Tallahassee. The membership needs to know that I am a believer in this process and have on many occasions written personal checks to support political candidates in legislative districts where I don’t even live. For our members living in Senate District 30, which includes parts of Charlotte and Lee counties, I have supported Senator Lizbeth Benacquisto, who is the Senate Majority Leader5. I challenge each of you in that area of Florida to do the same. It does not matter which political party we belong to. We have to believe and know how the process works and the best way to achieve success. Supporting political campaigns is the way to do that.

References

1 Florida Statutes 106.08 2 http://election.dos.state.fl.us/ committees/ComLkup.asp (Period 4/2012 - 3/2013) 3 Number of licensed pharmacists as of April 2, 2012 (2011-2012 Annual Report to the FPA Membership) 4 Contributions to the FPA political provided by 241 FPA members 5 http://www.flsenate.gov/Senators/ s30

The All-new FPA Website is Now Online Pharmview 3.0 offers more features, greater access and increased opportunities for member interaction. ■■ ■■ ■■

■■

Keep your dues current with the most accurate information in your membership accounts Register for conferences and educational programs Register online and you can print a receipt instantly without having to wait for one to be mailed to you Your continuing education credits earned through FPA programs will be published as transcripts and certificates in your member record

Take advantage of all the possibilities and visit your new website today at www.pharmview.com. 14

FLORIDA PHARMACY TODAY

CALL FOR RESOLUTIONS TO THE 2014 HOUSE OF DELEGATES The House of Delegates Board of Directors will meet in March 2013 to review and approve resolutions for the Annual Meeting. The deadline for submitting resolutions is March 15, 2014! PLEASE NOTE THIS DEADLINE. The following information will be needed when submitting resolutions: 1. Name of organization: The name of the organization submitting the resolutions(s); 2. Name and telephone number of individuals: A contact in the event clarification or further information is needed; 3. Problem: A statement of the problem addressed by the resolution; 4. Intent: A statement of what passage of the resolution will accomplish; 5. Resolution Format: Please type and use double spacing. TITLE OF RESOLUTION NAME OF ORGANIZATION WHEREAS , AND

WHEREAS :

THEREFORE BE IT RESOLVED (THAT THE FPA OR SUBDIVISION OF FPA)

CONTACT NAME AND PHONE #: PROBLEM: INTENT:

Return this form to: Membership Coordinator, Florida Pharmacy Association, 610 North Adams Street, Tallahassee, Florida 32301 or fax (850) 561-6758

OCTOBER 2013

C A L L

F O R

APhA Foundation and NASPA Bowl of Hygeia Awarded to a pharmacist for outstanding community service above and beyond professional duties. The use of the following selection criteria is required: ■■ The recipient must be a Florida licensed pharmacist and a member of FPA. ■■           ■■ T recipient has not previously received the award. ■■                 on its award committee or an officer of the association in other than an ex officio capacity. ■■   has compiled an outstanding record of community service, which, apart from his/her specific identification as a pharmacist, reflects well on the profession. James H. Beal Award Awarded to the "Pharmacist of the Year." The criteria established for this award is that the recipient be a Florida registered pharmacist and a member of FPA, who has rendered outstanding service to pharmacy within the past five years. Criteria: ■■   must be a Florida registered pharmacist and a member of the FPA. ■■   has rendered outstanding service to pharmacy within the past five years. Technician of the Year Award Awarded annually to a Florida pharmacy technician who is recognized for his/her outstanding performance and achievement during his/her career. Criteria: ■■ Candidate must be a member of the Florida Pharmacy Association for at least 2 years. ■■ Candidate must have demonstrated contributions and dedication to the advancement of pharmacy technician practice.

FLORIDA PHARMACY TODAY

N O M I N A T I O N S ■■ Candidate must have demonstrated

contributions to the Florida Pharmacy Association and/or other pharmacy organizations. ■■ Candidate must have demonstrated commitment to community service. ■■ Candidate is not a past recipient of this award. R.Q. Richards Award This award is based on outstanding achievement in the field of pharmaceutical public relations in Florida. Criteria: ■■  recipient must be a Florida registered pharmacist and a member of the FPA. ■■   has displayed outstanding achievement in the field of pharmaceutical public relations in Florida. Frank Toback/AZO Consultant Pharmacist Award Criteria: ■■ Candidate must be an FPA member, registered with the Florida Board of Pharmacy as a consultant pharmacist in good standing. ■■ Candidate should be selected based on their outstanding achievements in the field of consultant pharmacy. DCPA Sidney Simkowitz Pharmacy Involvement Award Presented annually to a Florida pharmacist who has been active at the local and state pharmacy association level in advancement of the profession of pharmacy in Florida. Criteria: ■■ A minimum of five years of active involvement in and contributions to the local association and FPA. ■■ Candidate must have held office at local level pharmacy association. ■■ Member in good standing for a period of at least five years in the FPA and must have served as a member or chairman of a committee of the association. ■■ Candidate must have been actively involved in a project that has or could potentially be of benefit to members of the profession.

F P A

Pharmacists Mutual Companies Distinguished Young Pharmacist Award Awarded to a young pharmacist for their involvement and dedication to the practice of pharmacy. Criteria: ■■ Licensed to practice for nine (9) years or less. ■■ Licensed to practice in the state in which selected. ■■ Participation in national pharmacy association, professional programs, and/or community service. IPA Roman Maximo Corrons Inspiration & Motivation Award Interamerican Pharmacists Association created this award to honor the memory of Roman M. Corrons who inspired and motivated countless pharmacists to participate actively and aspire to take on leadership roles in their profession. Roman was always there with guidance and support that motivated pharmacists and encouraged visionary leadership, approachable active membership and succession planning. This award recognizes the motivators among us who inspire others to continue to advance the profession. Criteria: ■■ The recipient must be a Florida Licensed Pharmacist and a member of the FPA. ■■ Candidate should motivate others to excel within the profession by encouraging them to be leaders. ■■ Candidate is not necessarily an association officer, but guides, supports and/or inspires others. A brief description on the candidate’s motivational/inspirational skills must accompany the nomination. The Jean Lamberti Mentorship Award The Jean Lamberti Mentorship Award was established in 1998 to honor those pharmacists who have taken time to share their knowledge and experience with pharmacist candidates. The award is named in honor of long time FPA member Jean Lamberti for her effort in working with pharmacy students.

A W A R D S

2 0 1 3 - 2 0 1 4

Criteria: ■■ The recipient must be an FPA member. ■■ The recipient must serve as a role model for the profession of pharmacy. Upsher Smith Excellence in Innovation Award Awarded to honor practicing pharmacists who have demonstrated innovation in pharmacy practice that has resulted in improved patient care. Criteria: ■■ The recipient has demonstrated innovative pharmacy practice resulting in improved patient care. ■■ The recipient should be a practicing pharmacist within the geographic area represented by the presenting Association.

Qualified Nominee: A pharmacist practicing within the geographic area represented by the presenting Association. Cardinal Generation Rx Award The Cardinal Health Generation Rx Champions Award recognizes a pharmacist who has demonstrated excellence in community-based prescription drug abuse prevention. The award is intended to recognize outstanding efforts within the pharmacy community to raise awareness of this serious public health problem. It is also intended to encourage educational prevention efforts aimed at patients, youth and other members of the community. The nominee must be a pharmacist who is a member of the state association. Self-nominations are allowed. Applica-

tions will be evaluated based upon the following criteria: ■■ Commitment to community-based educational prevention efforts aimed at prescription drug abuse ■■ Involvement of other community groups in the planning and implementation of prevention programs ■■ Innovation and creativity in the creation and implementation of prevention activities ■■ Scope/magnitude of prescription drug abuse efforts ■■ Demonstrated impact of prescription drug abuse prevention efforts

DEADLINE FOR NOMINATIONS: FEBRUARY 28, 2014 FPA AWARDS NOMINATION FORM I AM PLEASED TO SUBMIT THE FOLLOWING NOMINATION:

NOMINATED BY:

Name:

Address:

Date Submitted: Signature:

FOR THE FOLLOWING AWARD: (Nomination Deadline February 28, 2014)  APhA Foundation and NASPA Bowl of Hygeia  James H. Beal Award

Please describe briefly below the nominee's accomplishments, indicating why you feel he or she should receive this award. (Attach additional sheets if necessary.)

 R.Q. Richards Award  Frank Toback/AZO Consultant Pharmacist Award  DCPA Sydney Simkowitz Award  Pharmacists Mutual Co. Distinguished Young Pharmacist Award  Academy of Pharmacy Practice Practitioner Merit Award  The Jean Lamberti Mentorship Award  IPA Roman Maximo Corrons Inspiration & Motivation Award  Upsher Smith Excellence in Innovation Award  Technician of the Year Award  Cardinal Generation Rx Award MAIL NOMINATONS TO: Annual Awards, Florida Pharmacy Association, 610 N. Adams St., Tallahassee, FL 32301 (850) 222-2400 FAX (850) 561-6758 DEADLINE FOR NOMINATIONS IS FEBRUARY 28, 2014

OCTOBER 2013

A Looming Joblessness Crisis for New Pharmacy Graduates and the Implications It Holds for the Academy Daniel L. Brown, PharmD

Introduction The new millennium ushered in a period of hope and change for the profession of pharmacy. The doctor of pharmacy (PharmD) degree became the exclusive first professional degree as of 2000, bringing with it expectations for a dramatic expansion of direct patient care roles for pharmacists. Just 1 year later the pharmacy academy began a period of unprecedented growth, fueled by a long-standing shortage of pharmacists and an outstanding job market for new pharmacy graduates, making jobs for PharmD graduates easy to find and causing salaries to spiral upward. As a result, the PharmD degree became a hot commodity, generating a seemingly inexhaustible supply of applicants to colleges and schools of pharmacy. Inevitably, higher education came to see pharmacy as a “golden goose.” But no goose harbors an infinite supply of golden eggs, and the inordinate rate of academic growth that ensued has put the academy at risk, along with its students. Calls for measured academic growth, brought forth in published commentaries in 2005 and 2010, went largely unnoticed.1,2 The house of student delegates of the American Pharmacists Association-Academy of Student Pharmacists even weighed in on the subject in 2012 by approving resolution 2012:2 — Creation, Expansion, or Reductions of Schools and Colleges of Pharmacy Relative to Pharmacist Demand, which called upon current and future schools to evaluate the demand for pharmacists before taking action.3 Remarkably, most leaders of pharmacy organizations and academic institutions remained relatively silent 18

FLORIDA PHARMACY TODAY

on the matter. This commentary examines the massive increase in the number of pharmacy graduates since 2001 and the vast overestimations, in the author’s opinion, made back in 2001 about the number of pharmacists that would be needed by 2020. It also identifies potential implications of the changing pharmacist job market for the pharmacy academy. Projected Manpower Needs In 2001, the Pharmacy Manpower Project sponsored a conference of 2 dozen pharmacy experts to project a vision of pharmacy services and manpower deployment for the year 2020.4 The participants envisioned a significant expansion of the pharmacist workforce and a shift in their roles and responsibilities from order fulfillment to patient care. Based on a needs forecast, they estimated that by 2020 there would be a 27% decrease in the number of pharmacist full-time equivalents (FTEs) engaged predominantly in order filling (136,400 to 100,000) and an increase in the pharmacist FTEs providing primary patient services (30,000 to 165,000). Overall, they projected a need for 417,000 pharmacist FTEs by 2020, and given the expected supply of only 260,000 pharmacist FTEs, a shortfall of 157,000 by 2020.4 However, their analysis assumed that the academy would add only 3 new PharmD programs every 10 years. Growth of the Academy The size of the academy was relatively stable during the 1980s and 1990s. In 2000, there were 80 colleges and schools of pharmacy in the Unit-

ed States. Since then, 48 new programs have been established and 2 schools combined into 1 college, bringing the total to 127 accredited colleges and schools as of fall 2012—a 60% increase from 2000.5 According to AACP reports, there were 7,000 first-professional PharmD degree graduates in 2001 and 11,931 in 2011, a 70% increase.6,7 Despite the rapid rate at which new pharmacy colleges and schools have been established, even greater growth of the academy has resulted from the expansion of previously existing programs. Of the increase in graduates from 2001 to 2011 by 4,931, only 1,886 (38%) can be attributed to new pharmacy programs; 62% of the increase resulted from the expansion of existing programs. Since 2001, 31 colleges and schools increased their number of PharmD graduates by more than 50%.6,7 There are now 41 satellite campuses—5 of which are in a state other than that of the parent program.5 Growth has been widespread, affecting every region of the country. Twenty-one states are projected to increase the number of statewide graduates by 100% or more during the 15year period from 2001 to 2016.8 Table 1. First Professional Degree Pharmacy Graduates by State for the Years 2001, 2011, and Projected for 2016 State Alabama Arizona Arkansas California Colorado Connecticut DC Floridac Georgiac Hawaii

2001 2011 2016a 186 57 71 584 63 54 62 319 179 0

246 203 112 849 121 98 59 712 353 84

246 203 169 949 192 174 59 921 480 84

15-Year Growth, %b 32 256 138 63 205 222 -5 189 168 NA

Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland

48 327 222 154 87 77 178 0 91 427 250 71 56 211 53 155 0

Michigan Minnesota Mississippi Missouri Montana Nebraska Nevadac New 0 Hampshirec,d New Jersey 97 New Mexico 74 New York 379 North 189 Carolina North 59 Dakota Ohio 373 Oklahoma 84 Oregon 100 Pennsylvania 468 Rhode Island 80 South 45 Dakota South 80 Carolinac Tennessee 90 Texas 340 47 Utahc 0 Vermontc,d Virginia 121 Washington 147 West Virginia 49 Wisconsin 100 Wyoming 44 6948 TOTALe

59 437 272 211 101 190 241 0 146 547 296 155 63 297 65 216 188

59 658 339 211 101 190 241 156 273 567 309 155 109 297 65 216 138

23 101 53 37 16 147 35 NA 200 33 24 118 95 41 23 39 NA

212 79 824

293 79 959

202 7 153

315

378

100

588 197 185 933 89

638 197 185 936 89

71 135 85 100 11

182

320

300

272 626 50 0 319 171 162 136 48

542 656 159 66 319 196 238 217 48 14277

502 93 238 NA 164 33 386 117 9 105

a Projections for 2016 are based on the 2011 values for existing schools and 95% of class size for schools starting after 2011. Data taken from www.aacp.org and www. pharmcas.org. b Percent growth from 2001 to 2016. c LECOM, Roseman, Albany, MassWorchester, and South (GA) each have a satellite program in another state (FL, UT, VT, NH and SC, respectively). AACP reports all graduates within a program’s home state. For this table, projected 2016 graduates of satellite programs have been shifted to the state of graduation. d Alaska and Delaware do not have a pharmacy school. New Hampshire and Vermont only have a satellite PharmD program from a school in another state. e These totals do not include graduates in Puerto Rico or Lebanon as reported by AACP.

The growth has yet to abate. Although 27 new pharmacy colleges and schools had not graduated a class as of 2011, their class sizes totaled 2,250 students. By 2016, when the graduates of these colleges and schools are included in the count and when the recent expansion of existing programs has taken effect, the number of PharmD graduates will range between 14,000 and 15,000 per year, more than double the number in 2001. Trends in the Pharmacy Workforce The Pharmacy Workforce Center (PWC), formerly known as the Pharmacy Manpower Project, Inc, tracks the pharmacist workforce for multiple pharmacy organizations.7 The primary data element compiled by the PWC is the aggregate demand index (ADI) which is derived from feedback obtained from a nationwide panel of participants who are engaged in hiring pharmacists. Panel members report their impressions of the pharmacist job market to PWC on a monthly basis using a 5-point scale, where 5 = high demand—difficult to fill open positions; 4 = moderate demand—some difficulty filling open positions; 3 = demand in balance with supply; 2 = demand is less than the pharmacist supply available; and 1 = demand is much less than the pharmacist supply available.9 A national 10-year trend map of ADI shows that it remained fairly steady at a level of about 4 (moderate demand) from 2002 through early 2008, indicative of a modest but stable pharmacist shortage (Figure 1).10 However, the ADI then began a downward trend that brought it closer to the “equilibrium point” of 3 in 2010, where it has hovered since. The drop in ADI of a full point in just a couple of years, in contrast to predictions of a persistent pharmacist shortage for many years to come, is cause for concern. The November 2012 regional ADI results shed a bit more light on the job market and might serve as a harbinger of what lies ahead. The Northeast, with several states already having demonstrated major academic growth, has seen the ADI drop to 2.85.11 Several states

in the South are about to drop below 3.0 in the not-too-distant future (Florida already has), and other regions will follow suit shortly thereafter. Furthermore, the November 2012 national ADI for community pharmacies was only 2.83, suggesting that the most prevalent pharmacy practice setting is already showing a net surplus of pharmacists nationwide.12 Plot of monthly national averages of the Aggregate Demand Index for the 10-year period of December 2002 through November 2012.10 Note the downward trend of data points that started in June of 2008. Institutional pharmacy shows similar trends. Pharmacy Forecast 2013– 2017, a strategic planning report for institutional pharmacy, reports that the vacancy rate for pharmacists in hospital practice dropped from 7.2% in 2002 to 2.4% in 2011.13 The report notes that although the market for staff pharmacists has leveled off, it remains difficult to fill some managerial and clinical specialist positions. This phenomenon might have been exacerbated by the rapid expansion of academia, which has created a bountiful supply of new leadership and clinical positions to be filled since 2001. Along with an increasing rate of production of pharmacy graduates, a lower-than-expected creation of new pharmacist jobs also serves as a critical component of the pharmacy manpower equation. The projected need for pharmacy services in 2020 assumed a reduction of 36,400 pharmacist FTEs needed for dispensing and a pronounced increase of 135,000 FTEs for primary care services.4 This role transformation is simply not happening, at least not at the rate or extent predicted. According to results from the 2009 National Pharmacist Workforce Survey, 70% of pharmacist time in the community setting is devoted to dispensing, with just 10% spent on patient care activities.14 In hospitals and other patient care settings, 43% of pharmacist time was allocated to dispensing activities, compared to 27% allocated for direct patient care. The reasons for which medication therapy management services and primary care activities in amOCTOBER 2013

bulatory clinics have not dramatically impacted the pharmacist job market are beyond the scope of this commentary. However, there is no disputing that direct patient care jobs for pharmacists outside of acute care facilities have been slow to develop. Furthermore, not much has changed in community pharmacy practice to enhance the level of direct patient care services provided with every prescription. Community pharmacy jobs are still more closely linked to prescription volume than to the demand for patient care services.15 The Math of Supply and Demand When considering the dynamics of increasing the supply of pharmacy graduates into the job market, one must account for a 4-year lag period from the time at which a PharmD program starts or expands. Thereafter, following graduation of the first new or expanded class, it takes another 2 to 3 years for the job market to equilibrate, as it adjusts to a higher annual input of graduates. From that perspective, the net impact of academic growth is best measured when equilibrium is achieved— about 6 to 7 years after the initial increase in the number of students entering a PharmD program. Even if 2012 proves to be the last year of major academic expansion, the full impact will not be felt until 2018, at which time the job market will have to assimilate new pharmacists at a rate of about 15,000 per year. Contrast that rate with the 30year period from 1974 to 2003, during which the annual number of pharmacy graduates ranged between 6,000 and 8,000.16 The number surpassed 8,000 for the first time in 2004. By 2008, it had risen to 10,000. It exceeded 12,000 in 2012 and is poised to exceed 14,000 by 2016.7 No one can question that producing the 2003 rate of 6,000 to 8,000 graduates a year was not sufficient. In retrospect, however, it would have been prudent for the academy to engage in a plan of moderate growth up to about 10,000 graduates per year and then reassess the need to expand further. Realistically, a graduation rate in the range of 10,000 to 12,000 a year is probably warranted. The math is not complicated, which suggests that it may have been 20

FLORIDA PHARMACY TODAY

overlooked due to the lure of economic gain, a possibility that is beyond the scope of this paper. The health needs of aging baby boomers and the Affordable Care Act could serve as mitigating factors to increase the demand side of the pharmacy manpower equation, though it is likely to be a matter of “too little too late.” Even if the job market is able to accommodate up to 12,000 graduates a year for the next several years, that still translates into at least 3,000 graduates each year who will not find suitable employment—20% of the cohort of new graduates! Despite the overall unemployment rate for the profession remaining relatively low, the joblessness rate among new graduates could be staggeringly high. In the 2012 Pharmacy Graduating Student Survey conducted by the American Association of Colleges of Pharmacy (AACP), 88.7% of graduates indicated that they had taken out student loans, with an average loan amount of $123,000.17 While the potential of a 20% (or higher) joblessness rate among new pharmacy graduates is alarming enough, the looming economic hardships and personal tragedies are incalculable. Implications for the Academy Unfortunately, it is too late to call for the academy to pursue a more prudent plan of growth. To paraphrase an old cliché, “The horse is out of the barn.” The pendulum has swung so far to the supply side that the market is about to take over, forcing the engine of academic growth to finally grind to a halt. But there will be a high price to pay in the form of a pharmacist surplus for years to come until the market establishes a new manpower equilibrium. Ironically, academic expansion is not only contributing to new graduate joblessness, but it has also functioned to mask the problem. By creating a plethora of pharmacy practice faculty positions, the academy has provided employment for hundreds of pharmacists with advanced training who might have otherwise brought more attention to a weakening job market outside of academia. Consequently, when academic growth subsides and vacant fac-

ulty positions are no longer plentiful, pharmacists coming out of residency training will find it increasingly difficult to secure jobs commensurate with their abilities—particularly if they have specialized in ambulatory care. New PharmD and/or residency graduates will not be the only victims of academic overgrowth. The academy itself will suffer repercussions. Awareness of new graduate joblessness will eventually lead to a decrease in applications to pharmacy colleges and schools, making it more difficult to meet enrollment targets. Risks of diminished enrollment will jeopardize anticipated tuition revenue that has been counted on to fund faculty positions and/or new facilities. Economic pressures may inevitably force downsizing of programs, if not outright closing of some colleges and schools. If that occurs, some faculty positions likely will be lost. Challenges Going Forward Regardless of the job market, those new graduates who are “fittest” will be able to find employment. But the profession of pharmacy should not fall victim to viewing graduates as commodities who must fend for themselves in Darwinian fashion. Some might opine that the profession would benefit from filtering out its less capable pharmacists, but faculty members and administrators must not become insensitive to the plight of each graduate amid a backdrop of broader institutional concerns. The academy must honor its fiduciary responsibility as teachers, first and foremost, to serve the best interests of every student. The academy exists for students and because of students— the reality of which is going to become gravely evident as 2020 approaches. Pharmacy colleges and schools would be wise to revisit their respective strategic plans and prepare for a new era in which the challenges of recruiting and admitting student applicants will be vastly different from just a few years ago. In the meantime, it is incumbent upon the academy to responsibly focus on that which is within its control. Growth of the academy needs to cease forthwith. Institutions considering es-

tablishment of a new PharmD program should be discouraged from doing so by all sectors of the profession. Existing programs contemplating expansion should seriously consider putting their plans on hold. All of the profession’s organizations need to focus more heavily on establishing new pharmacist roles and activities that will create sustainable jobs as rapidly as possible. The patient care vision of pharmacists widely employed as ambulatory clinic practitioners may need to give way to a more practical vision of a new breed of community pharmacy practitioner, such that new jobs are the result of expanded patient care roles rather than increased prescription volume or the construction of new stores.15 To better influence job creation, academia would be well served to pay greater attention to where the majority of pharmacists practice: community retail pharmacies. If the academy is to remain on a path of growth, let the emphasis shift from PharmD expansion to the formation of partnerships that establish new community pharmacy residencies. That is where the innovative clinical leaders of tomorrow are most needed. No one could have anticipated the magnitude of academic growth that has taken place since 2000. Likewise, no one knows what the future holds for those who are about to embark on a career in pharmacy. Those in academia should look to the future with hope and optimism, born of the knowledge that the academy has done everything possible to prepare the next generation of pharmacists for whatever lies ahead. References

1 Hussar DA. How many colleges of pharmacy is enough? J Am Pharm Assoc. 2005:45(4):428–431. 2 Brown DL. From shortage to surplus: the hazards of uncontrolled academic growth. Am J Pharm Educ. 2010;74(10):Article 185. 3 American Pharmacists Association Academy of Student Pharmacists. Active Resolutions. APhA-ASP Adopted Resolutions 1973–2012. http://www.pharmacist.com/sites/ default/files/files/APhA-ASP%20 Adopted%20Resolutions%20-%20 Updated% 20September%202012.pdf.

Accessed January 5, 2013. 4 Knapp DA. Professionally determined need for pharmacy services in 2020. Am J Pharm Educ. 2002;66(Winter):421–429. 5 Accredited Programs. Accreditation Council for Pharmacy Education. https://www.acpe-accredit.org/ shared_info/programsSecure.asp. Accessed January 6, 2013. 6 American Association of Colleges of Pharmacy. Table 26. Number of Degrees Conferred by 2000–01 by School, Degree and Gender. http://www.aacp.org/resources/ research/institutionalresearch/ Documents/01DegConf.pdf. Accessed May 20, 2013. 7 American Association of Colleges of Pharmacy. Table 22. Number of Degrees Conferred 2010–11 by School, Degree and Gender. http:// www.aacp.org/resources/research/ institutionalresearch/Documents/11_ Degrees%20Conferred.pdf. Accessed May 20, 2013. 8 Pharmacy College Application Service. Colleges and schools by institutional name. http://www.pharmcas.org/ collegesschools/directoryalpha.htm. Accessed January 5, 2013. 9 American Association of Colleges of Pharmacy. Pharmacy workforce center. http://www.aacp.org/resources/ research/pharmacymanpower/Pages/ default.aspx. Accessed February 10, 2013. 10 ADI data for national (Dec 2002 to Nov 2012). Pharmacy Workforce Center. American Association of Colleges of Pharmacy. http://www. pharmacymanpower.com/trends.jsp. Accessed February 10, 2013. 11 Regional and Divisional Demand Index – Nov 2012. Pharmacy Workforce Center. American Association of Colleges of Pharmacy. http://www.pharmacymanpower. com/region.jsp. Accessed February 10, 2013. 12 National Pharmacist Demand by Practice Setting – Nov 2012. Pharmacy Workforce Center. American Association of Colleges of Pharmacy. http://www.pharmacymanpower. com/setting.jsp. Accessed February 10, 2013. 13 Pharmacy Workforce. Pharmacy Forecast 2013 – 2017. American Association of Health-System Pharmacists Research and Education Foundation. http://www.nxtbook. com/ygsreprints/ASHPFoundation/ d28547_ashpf_forecastbook2013/#/14. Accessed May 20, 2013.

14 Midwest Pharmacy Workforce Research Consortium. Work activities for pharmacists working full-time. Final Report of the 2009 National Sample Survey of the Pharmacist Workforce to Determine Contemporary Demographic and Practice Characteristics. http:// www.aacp.org/resources/ research/pharmacymanpower/ Documents/2009%20National%20 Pharmacist%20Workforce%20 Survey%20- %20FINAL%20REPORT. pdf. Accessed January 5, 2013. 15 Brown D. The paradox of pharmacy: a profession’s house divided. J Am Pharm Assoc. 2012:e139-e143. doi:10.1331/JAPhA.2012.11275. 16 Midwest Pharmacy Workforce Research Consortium. Figure 1.2: number of U.S. pharmacy school graduates: 1960–2008. Final Report of the 2009 National Sample Survey of the Pharmacist Workforce to Determine Contemporary Demographic and Practice Characteristics. http:// www.aacp.org/resources/ research/pharmacymanpower/ Documents/2009%20National%20 Pharmacist%20Workforce% 20Survey%20-%20FINAL%20REPORT. pdf. Accessed January 5, 2013. 17 American Association of Colleges of Pharmacy. Pharmacy Graduating Student Survey Summary Report 2012. http://www.aacp.org/resources/ research/institutionalresearch/ Documents/2012_GSS_final%20 summary%20report_all%20 schools_105_ with%20charts.pdf. Accessed January 5, 2013. Reprinted with permission: American Journal of Pharmacy Education 2013;77(5) © 2013 American Association of Colleges of Pharmacy

OCTOBER 2013

Getting Techy With It By Andrea Stan, PharmD It is estimated that 35 percent of the U.S. population owns a smartphone (such as an iPhone, Android, or BlackBerry). Marketing firms predict a rapid growth over the next few years and some estimates report as much as 65 percent owning a smartphone and/ or tablet device by 2015. Smartphone applications (“Apps”) enable users to have a multi-use device, and the types are limitless. Pharmacists more commonly use drug information apps, but could we use this avenue to increase our patients’ medication adherence? Yes, there are initiatives explored by universities and health care associations to help develop the best adherence app for patients. While we are waiting for those apps, let’s look at a few which are patient-centered and currently available. Dosecast is a free app that has iPhone and Android capabilities and can operate without an Internet connection. Users will program medication information such as drug name, type, dose strength, dosing schedules, and start/stop dates. Reminders can be set for a specific time and are accompanied by sounds and push notifications. This means a message will pop up whenever a phone is on to notify user it is time to take the dose. Dosecast will adjust to time zone changes when traveling, allow users to program bedtime to prevent late night notifications, and will log doses as taken on time, taken late, or skipped. Lastly, a log can be emailed to any user with a record of the last 30 days of medication history. There is a “Premium” edition available for a cost, which allows you to program dosage forms other than pills, track refills and multiple family members’ medication, compliance information, doctor, and pharmacy information.

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MedCoach is also free, and essentially provides the Dosecast Premium edition features. However, it does require an Internet connection. Some additional features include a drug database where the user can enter a drug name and the information will automatically populate fields such as the dosage form and strength. Along with using stock clip art, users may take a picture of the drug so the image will pop up alongside the reminder notification. Entries are linked to the software’s drug information database, which answers questions about missed doses and basic drug information. This technology is best utilized on a device with phone or cellular data network capabilities, instead of an iPod touch or tablet, to allow the seamless ease of calling the pharmacy for refills, contacting a physician office, looking up drug information, and staying on top of scheduled medications. The apps available are quite impressive and provide our patients a way to manage their prescriptions and over the counter medications as a supplement to visiting their pharmacist and other health care professionals. The next step in adherence app advancements will be synching medication information directly from the pharmacy to the patient. In the meantime, in our efforts to increase medication adherence, let‘s help make our patients more accountable for their medication use. Do you know a patient who could benefit from this technology? Reprinted with permission from National Community Pharmacists Association in the September 2012 issue of America’s Pharmacist. For more information about NCPA, visit www.ncpanet.org.

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FREQUENTLY CALLED NUMBERS AHCA MEDICAID PHARMACY SERVICES 2727 Mahan Drive Tallahassee, FL 32308 (850) 412-4166 www.fdhc.state.fl.us/medicaid/ pharmacy AMERICAN PHARMACISTS ASSOCIATION (APhA) Washington, D.C. (800) 237-2742 www.pharmacist.com AMERICAN SOCIETY OF HEALTH SYSTEM PHARMACISTS Bethesda, MD (301) 657-3000 www.ashp.com/main.htm DRUG INFORMATION CENTER Palm Beach Atlantic University (561) 803-2728 druginfocenter@pba.edu FLORIDA BOARD OF PHARMACY 4052 Bald Cypress Way Bin #C04 Tallahassee, FL 32399-3254 (850) 245-4292 www.doh.state.fl.us/mqa FLORIDA POISON INFORMATION CENTER NETWORK (800) 222-1222 www.fpicn.org NATIONAL COMMUNITY PHARMACISTS ASSOCIATION 100 Daingerfield Road Alexandria, VA 22314 703.683.8200 703.683.3619 fax info@ncpanet.org RECOVERING PHARMACISTS NETWORK OF FLORIDA (407) 257-6606 “Pharmacists Helping Pharmacists”

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OCTOBER 2013