Surveys and studies reveal that over 60% of pharmacists report experiencing a high level of burnout. This is one of the highest rates among healthcare professionals. The rate is higher than that found in nurses, surgeons, oncologists, and emergency medicine practitioners. Data suggest pharmacists, pharmacy residents and pharmacy technicians in both community as well as health-systems pharmacy are affected by burnout caused by numerous factors.
To date very few studies have been done on pharmacists burnout versus physician burnout. A 2019 Medline search shows over 2500 studies of physician burnout and approximately 40 studies on pharmacist burnout.
Studies that were done on pharmacist burnout revealed some disturbing information. Most studies found that 50-60% of pharmacists in all practice settings reported burnout. The tool used in many of these studies was the Maslach Burnout Inventory for Human Services Survey (MBI-HHS), a tool generally considered the gold-standard tool to assess burnout among health care workers. Responses to the 22-item instrument are given based on frequency of a described feeling associated with burnout and related to a numerical score. The MBI–HSS measures emotional exhaustion, personal accomplishment, and depolarization to identify not only burnout, but also the specific cause of the subject’s stress. The survey uses statements such as “I feel emotionally drained from work” or, “I worry this job is hardening me emotionally” and point scores are used to determine if the subject is experiencing burnout and what the possible causes may be.
In community retail pharmacists, the burnout rate is in the 60% range, with much of this attributed to poor job satisfaction. We discussed this problem in our previous blog post “Are You Happy Being a Pharmacist?” where, according to a survey by Communications International Group Healthcare Research, nearly 60 percent of community pharmacists said they would not choose the same profession again and almost three-quarters would not recommend the career to their children.
Is there an official definition of burnout? The World Health Organization has approved the latest update of the International Classification of Diseases (ICD-11) definition of burnout as:
Syndrome conceptualized as resulting from chronic workplace stress that has not been successfully managed. It is characterized by three dimensions:
- Feelings of energy depletion or exhaustion
- Increased mental distance from one’s job, of feelings of negativism or cynicism related to one’s job
- Reduced professional efficacy
So what exactly are the specific causes of burnout?
- Increased workload and job stress
- Insufficient rewards in professional fulfillment and compensation
- Lack of control
In the Final Report of the 2019 National Workforce Study (NPWS), an entire section is devoted to “Pharmacists Quality of Work-Life”, looking at job stress, professional fulfillment and job burnout. The NPWS survey is conducted every 4-5 years and is commissioned by the Pharmacy Workforce Center, Inc (NPW) whose Board of Directors is comprised of AACP, ACCP, APhA, ASHP, BPS, NASPA, NACDS, NCPA and PTCB.
The on-line survey was sent to a random sample of 96,100 licensed pharmacists in the U.S. coordinated by the National Association Boards of Pharmacy Foundation. A total of 5,467 useable responses were received. A total of 50% of actively practicing pharmacists were in community based practice settings, 27.8% hospital/health systems. Refer to the study for complete demographics of the survey respondents.
71% of full-time actively practicing pharmacists rated their workload level as “high” or “excessively high” with the highest proportion being in chain and mass merchandiser pharmacy settings, 91% and 88% respectively. The lowest was independent community pharmacy at 48%.
The NPWS survey focused on job professional fulfillment, or a lack thereof, as one of the leading causes of burnout. Independent (51.4%) and hospital/health-systems pharmacists (48.8%) reported the greatest fulfillment. Chain (18.9%), mass merchandisers (21.3%) and supermarket (21.9%) pharmacists had the lowest scores. Female pharmacists reported lower professional fulfillment scores (36.2% vs 39.9%) and greater work exhaustion scores (37.1% vs 29.1%) compared to male pharmacists.
Independent pharmacists felt they had the greatest amount of control at 45.7%, followed by hospital/health-systems pharmacists at 31.3%. Chain, mass merchandiser and supermarket pharmacy were at 24.1%, 23.9% and 22.3% respectively.
So what does all this mean? It is far more than just individual pharmacists being unhappy as they struggle with burnout. Reduced job performance can lead to increased prescription errors, turnover of staff, less empathy for patients and colleagues and even suicides. (This is currently being tracked in the physician community.)
The NPWS notes in its conclusion that many more licensed pharmacists were working outside of the profession of pharmacy or were unemployed relative to their 2014 study. Over 40% of pharmacists under the age of 40 were likely or very likely to search for a new job and over 20% likely or very likely to leave their current job within the next year.
It is clear there is a necessity to create sustainable solutions addressing factors driving burnout. In a future blog post we will look at various solutions that individual pharmacists and employers could adopt to address this challenge pharmacy faces.