A Critical Shortage of Pharmacists  

According to a national study conducted by Ipsos-Reid, the shortage of pharmacists for all Canadian retail pharmacies is between 2,000 and 3,500.

According to the Fujitsu Report which was commissioned by the Province of New Brunswick and released in November 2002, there will be a shortage of 210 pharmacists in New Brunswick by 2007. This ranked as the second largest shortage of all health professions.

According to the most recent report issued in June 2005 by the Canadian Institute of Health Information (CIHI) on Health Professionals, New Brunswick ranked well below the average at 80 pharmacists per 100,000 people. The Canadian average was 87 pharmacists per 100,000. The average for the three other Atlantic Canada provinces exceeds 108 pharmacists per 100,000 population.

According to 2005 data from the licensing bodies – The Nova Scotia College of Pharmacists and the New Brunswick Pharmaceutical Society – there were 1,150 pharmacists licensed in Nova Scotia as compared to just 620 licensed in New Brunswick.

According to the most recent Pharmacy Directors reports in New Brunswick Hospitals (Dec 2004), there are 103 FTE positions available and just 75 positions filled.

The vacancies seem to be more pressing in the northern regions and in those areas where a bilingual or francophone pharmacist is best qualified to meet the needs of the community.

The scope of practice of the Pharmacist is changing. Public surveys have demonstrated that patients are demanding more counseling and information from their pharmacist. This is also reflected in the findings of the Fujitsu report.

Reasons for shortage

Society’s increased reliance on medication as well as the significant advances in medication therapy are part of the picture. Greater demand for enhanced pharmacy services (information, advice and assistance in addition to filling prescriptions) has also created a greater need. The concentration of pharmacies in urban areas and the growth of number of community pharmacies, especially in the mass merchant and grocery areas have had an impact. However, it has also increased accessibility to pharmacy services. 

In order to meet consumer demand, pharmacies are offering extended hours, including in some communities in Canada, 24-hour service, as well as “midnight” locations.

Increased opportunities for pharmacists in industry, research and in management roles.

Of the 600 licensed pharmacists in New Brunswick, 67% are female, and the average age is 40. Newer pharmacists are predominantly female as well as in their child bearing years. More flexibility with respect to work schedules (e.g. reduced or part time hours) and maternity leave are the rule in order to accommodate employee interests and family needs. This makes the definition of “vacancy” more complex.

Pharmacists’ workloads include increased complexities and demands required by non-clinical administrative activities, usually resulting from insurance company requirements for payment of drug plan claims on behalf of patients. This can limit the clinical focus of the pharmacist and is clearly reflected in overall job satisfaction surveys. 

Hospital pharmacy shortages are increasing due to the higher wages being offered in community pharmacies.

Dalhousie University is the primary source of supply for pharmacists practicing in NB. In recent years, although they have adjusted their intake from 65 new students to 90 per year, The Dalhousie College of Pharmacy has been limited by aging buildings with limited space and cannot further significantly increase student intake.  

There is no seat purchase agreement with Dalhousie that would significantly increase our ability to ensure NB students (especially bilingual students), would have access. Canadian pharmacists are also attracted by lucrative offers to practice in, or pursue their education in the USA.

Impact of shortage

• Some pharmacies have closed as a result of the inability to find staff pharmacists.
• Pharmacies have been forced to reduce hours of operation.
• The shortage has increased the demand for technicians.
• The demand for pharmacists has caused a significant escalation in wage rates attracting more pharmacists from hospitals to community. Many hospitals in New Brunswick have no pharmacist on staff.
• Reduced chemotherapy services and in-hospital care team support.
• Ambulatory clinics, particularly in the Saint John region, have been forced to decline many new patients into their warfarin management programs.
• Hospital managers taking on staff duties.
• Increase in hospital overtime and on call hours.
• Barrier to a pharmacists’ ability to have a greater impact by practicing at their full potential instead of being tied to the traditional dispensing function.

On the job pressures will increase job related stress as the burden is shared by fewer pharmacists. In New Brunswick, over 8.5 million prescriptions were filled last year by roughly 525 pharmacists in community. That’s an average of 16,190 prescriptions per pharmacist. This creates a tremendous amount of pressure.   

NBPA Position

Many studies have determined that a great deal of hospital admissions are related to adverse drug events. CIHI recently announced that of the seniors who were admitted to hospital in 2004, 30% had been admitted due to “medical toxicity”. While other jurisdictions benefit from pharmacists’ prescribing, pharmacists’ home visits, and pharmacists’ academic detailing, New Brunswick is limited by the poor availability of human resources to be able to fill these roles. 

1) The Department of Health & Wellness commissioned Fujitsu to make recommendations some time ago. Some of them are attached and should be pursued:

NB should commit resources to "difficult to recruit" occupations which could include seat purchases, bursary, student debt programs.  

HHR Unit should work with health associations & bodies to establish consensus on standardized datasets of HHR info (hours of work etc…)

Prepare business case to expand French Language training, decreasing dependency on PQ, and market these programs nationally

2) Enrollment in faculties of pharmacy across Canada should be expanded where possible

3) Government should promote the profession to high school students, and provide financial assistance in terms of scholarships, as well as seat purchases with recognized universities that would facilitate a return to practice in New Brunswick.

4) Government should recognize that pharmacists working in community or retail settings provide value to the overall health system. Currently government appears only to be thinking of pharmacists who can work in hospital or RHA settings as members of the health care team. Fujitsu clearly identifies this in their HHR study.

5) As most of our pharmacists come from Dalhousie University, or Université de Montreal or Laval in Québec, government should review the present reimbursement fee schedule in place and negotiate an agreement with pharmacists that brings New Brunswick in line with other Atlantic Provinces and Québec. 

Board Approved January 18, 2006