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2004 Salary Survey Results
Salary statistics and shortage data give broader picture
To see tables illustrating the 2004 Salary Survey results, click here.
Administrator positions are overly burdened with regulations, pharmacists say
New salary statistics show that hospital pharmacy administrators may make $100,000 or more and work 50 hours a week or fewer. Even so, pharmacy management positions are some of the hardest to fill, according to a second survey.
The administrator shortage is directly related to the continued shortage of pharmacists nationwide, pharmacists tell Drug Formulary Review (DFR). The positions also are overly weighed down by regulatory requirements and the pressure to reduce costs.
Responsibilities have become very burdensome by Joint Commissions on Accreditation of Healthcare Organizations surveys, Centers for Medicare & Medicaid Services surveys, and state board of pharmacies across the nation because of the attention given to medication errors and negative outcomes, says Nadrine K. Balady-Bouziane, PharmD, director of pharmacy services at High Desert Health System in Lancaster, CA. "Since more regulations are addressing safe medication management, the pharmacy directors at hospitals are receiving the most pressure from administrators, even though the intent of the regulations is meant to be accomplished with a multidisciplinary approach."
A look at the statistics
Pharmacy administrators’ salaries at least seem to be moving in a positive direction, according to the 2004 Drug Formulary Review Salary Survey. DFR recently tabulated the results of its survey to assess the financial and workplace demographics of its readership. Here are some of the findings:
In comparison, the Social Security Administration calculated the latest automatic cost-of-living adjustments (COLAs) to be 2.1%. The COLAs prevent inflation from eroding Social Security and Supplemental Security Income benefits. (To see how COLAs are calculated, see www.ssa.gov/OACT/COLA/COLA.sum.html.)
In addition, the inflation-adjusted income of the nation’s median household fell slightly in 2003, from $43,381 to $43,318 (the decline was statistically insignificant), according to the Economic Policy Institute in Washington, DC. Since 2000, the median household income has declined consistently in real terms, down $971, $502, and $63 in 2001, 2002, and 2003, respectively, for a cumulative loss of $1,535 — a 3.4% drop — over these years.
It’s not an easy job
The salaries are much higher than the nation’s median, but health systems across the nation are struggling to fill their open pharmacy manager positions, according to the latest staffing survey conducted by the American Society of Health-System Pharmacists in Bethesda, MD. Conducted annually, the study found that 36% of those surveyed believe that there are severe shortages of health system pharmacy directors and assistant directors. Last year, 27% of the respondents perceived this shortage.
A director of pharmacy at a teaching hospital says the position is high stress and high profile. "Typically, drugs are the largest part of a teaching hospital budget, and there is tremendous pressure from administration to reduce costs in pharmacy, either in drugs or in people," reports Gae M. Ryan, PharmD, director of pharmacy at Oregon Health & Science University Hospitals and Clinics in Portland. "It is sometimes difficult to make the case that reductions are not always the best answer to a financial crisis, and being caught in the middle is part of the stress."
Taking a stand and saying that there are no more reasonable reductions to be made can be hazardous to your job, she says. "There isn’t a real sense of job security in this situation. Increasing regulation — both federal and state — pressure to reduce costs, staffing shortages, benchmarking, and increasing demand . . . all of these make survival in this role more difficult than it was in the past."
Younger professionals are not always willing to make the time commitment that is required of a director of pharmacy, she continues. James Neff, MS, RPh, director of pharmacy at Holy Cross Hospital in Fort Lauderdale, FL, also sees a lack of pharmacists stepping up to do the job.
"When you have 25- and 30-year people in the business, at what point do you get the new blood? New blood is less willing to step up and face those challenges."
Neff knows why they may hesitate. "You have more regulatory pressures that are out of your control than ever before. You have financial and budgetary constraints that squeeze your resources and your ability to respond to these regulatory rules and regulations.
"You get whipsawed in two different ways," he says. "No. 1, you don’t have what you need to get the job done; and No. 2, you are being forced to do things that you don’t have the resources to do."
Staff pharmacists might make less money, but they can go home and not worry about everything or have the phone ring in the middle of the night.
"I wouldn’t mind being a staff pharmacist any day of the week, but I happen to love what I am doing," Neff says. "I know there is a challenge even being staff, so I have chosen where I am."
Balady-Bouziane works with per-diem pharmacists (she cannot recruit them full-time) whose hourly rate works out to be more than what she receives as a director. They also can choose day and weekday shifts and not work holidays.
"In addition, they do not have the responsibilities I have. They do not have to manage people problems or deal with making a schedule. Once they leave High Desert at the end of the day, they are free and not responsible for anything."
The salary and flexibility of hours are definitely attractive and would be a strong influence if she were starting over in her career today. Becoming a staff pharmacist after being a director, however, is a step down.
Even is pharmacy administrators are considering making the change, the anxiety the switch would create can be a major hurdle, Neff says.
"The minute you don’t do those day-to-day orders, don’t stay up on those latest protocols, don’t actually get involved and dirty your hands and mash the calculator buttons on a daily basis in terms of patient care and contact, you lose your skill. If they are directors for 20-something years and have not maintained that frontline mentality in patient care and contact and treatment, they are afraid to move back into that arena. It would be more stressful initially but less stressful in the long run."