Caring For Caregivers

Five years after the initial outbreak of COVID-19, pharmacists saw a transformation of the industry as they navigated a complex array of challenges in a postpandemic world. The surge in demand for vaccinations, testing, and medication management during the pandemic took its toll, leading to increased burnout and stress.

As pharmacists continue to adjust to evolving patient needs and heightened responsibilities, the focus on pharmacists’ mental well-being and working conditions has never been more critical.

Michael Kim, PharmD, president of Grubb’s Pharmacy in Washington, DC, which has served the Capitol Hill neighborhood for over 158 years, noted the pharmacy was at the forefront of the COVID-19 pandemic and among the first community pharmacies in the area to offer COVID-19 testing in partnership with the US Department of Health and Human Services and Health Mart Atlas.

As pharmacists adapt to patient needs, pharmacists' mental wellness remains critical. | Image Credit: blvdone - stock.adobe.com

“The day-to-day responsibilities as a pharmacist have evolved significantly since the onset of the COVID-19 pandemic,” he said. “Pharmacists have taken on a central role in administering COVID-19 vaccines, including managing appointments, educating patients, and handling vaccine storage, reporting, and documentation.”

Kim started to offer COVID-19 testing in response to the pandemic and has now expanded to testing for influenza, strep throat, respiratory syncytial virus, hemoglobin A_1c, and cholesterol.

“I feel that I became the voice and key advocate for public health during the pandemic and found myself interacting with the public more than ever before,” he said.

Michael Dear, PharmD, RPh, from Dear Drugs Inc based in Brooklyn, New York, explained that the pandemic significantly increased the workload for this family-owned and operated pharmacy.

“We became a primary point of contact for COVID-19 information, testing, and vaccinations,” he said. “We also dealt with supply chain disruptions, increased prescription volume, and the need to provide remote consultations. Our responsibilities expanded to include more patient education and addressing vaccine hesitancy.”

He believes there is a greater need for recognition of pharmacists’ role in patient care and the need for better support for mental health and well-being, including increased staffing and resources.

“Streamlining administrative tasks and improving technology to enhance efficiency would also be beneficial,” Dear said. “Crucially, we must fundamentally shift the pharmacy model from a volume-driven business to a service-oriented one. As long as we prioritize prescription volume over the quality of patient care, we will continue to perpetuate high burnout rates and exacerbate staffing shortages. This transition requires a focus on patient outcomes, preventive care, and comprehensive medication management, rather than simply dispensing prescriptions.”

Schools are struggling to fill their classes because there are not enough applicants... — Ryan Ea, PharmD

A CHANGING ENVIRONMENT

The COVID-19 pandemic mandated a significant change to pharmacists’ work environment and required rapid innovation.

For instance, Grubb’s Pharmacy adapted to wearing masks, installing plexiglass barriers, implementing sanitation protocols, and coordinating curbside pick-ups. The pharmacy also had to learn to use new technology, such as telehealth and online appointment scheduling.

“These changes were difficult and stressful during the implementation stages but have enhanced our workflow to better serve the needs of our patients,” Kim said. “One change that has negatively impacted our work environment is the reduction in the number of pharmacists and technicians willing or wanting to work in a community retail pharmacy setting. This has not negatively impacted our ability to care for our patients, but it has impacted the workload and stress on the staff and owners.”

Brian Pinto, RPh, owner of Tiffany Natural Pharmacy in Westfield, New Jersey, thinks there is an increased responsibility in the profession now. This started on the vaccine side, which meant more customers and less time for the pharmacist to accomplish their day-to-day responsibilities.

“There’s also been a change in customer mentality, which may be directly related to COVID[-19], or maybe just more people’s lack of awareness of common courtesy, and that attitude is something pharmacists need to deal with,” he said. “There are also supply chain shortages that continue to this day. That makes things harder to deal with and the working atmosphere less ideal. I feel like I’m working harder than I ever did before.”

Nathan Bhakta, PharmD, CEO and president of South Bay Pharmacy in Redondo Beach, California, noticed patients and employees are falling sick at higher rates in a postpandemic world, adding to the pressures of the pharmacy over the past 5 years.

Over the past 5 years, there have been more reports of burnout in pharmacy than ever, as stress levels have reached new heights due to added responsibilities and changes since the pandemic. | Image Credit: neirfy - stock.adobe.com

“The stress has definitely increased,” he said. “The cost of doing business has gone up, and not just monetarily. Board of Pharmacy, other government agencies, and PBMs [pharmacy benefits managers], all have raised costs and/or decreased reimbursements amid regulations and audits.”

Ryan Ea, PharmD, at Key Compounding Pharmacy in Federal Way, Washington, worked in the pharmacy field before the pandemic, serving as a pharmacy technician at Walmart from 2018 to 2021 and an intern with Koshland Compounding Pharmacy from 2021 to 2023.

“Now that we are past [the] COVID[-19 pandemic], I believe that social media has placed a huge emphasis on health, natural products, and being in control of what goes into your body,” Ea said. “In turn, this has increased workload in all aspects—the number of prescriptions, number of patient inquiries, and number of doctor calls. Additionally, I have noticed an increase in the utilization of our clinical knowledge as pharmacists. [Because] providers are seeing a plethora of new patients, they often call to inquire about novel therapies, dose recommendations, and guidance for therapy, much more than before.”

As someone recently graduated from pharmacy school, Ea noted that he saw fewer and fewer students entering the pharmacy field.

“Schools are struggling to fill their classes because there are not enough applicants, and those [that] have filled their classes have not kept the same quality standards for students as they once had,” he said. “On the retail side, we’re seeing whole stores staffed by 1 pharmacist and 1 technician, struggling to find pharmacists to fill shifts and forcing closures all around the US.”

Ea had not personally experienced burnout, increased stress, or a general lack of motivation but saw a number of his colleagues and peers experience them, specifically in the retail space.

“Many left their jobs to seek work elsewhere, decreased their hours, or straight up transitioned out of health care altogether,” he said.

DEALING WITH STRESS

Over the past 5 years, there have been more reports of burnout in pharmacy than ever, as stress levels have reached new heights due to added responsibilities and changes since the pandemic.

Dear noted burnout and increased stress posed significant issues for pharmacists and staff at his pharmacy.

“The high volume of work, emotional toll of dealing with sick patients, and constant changes in guidelines have all contributed,” he said. “Staffing shortages have also added to this burden. The constant exposure to potentially sick individuals was also a large stressor.”

Kim has also experienced increased stress since the pandemic due to the inability to hire and retain pharmacists and technicians who possess professional skills, personal attributes, a commitment to providing quality patient care, and a simple desire to show up and do one’s best.

“The process of searching, interviewing, hiring, firing, and being disappointed has definitely increased my feeling of increased stress,” he explained.

Bhakta noted that talking to patients is an excellent relief valve for forgetting the pressures.

“I haven’t had any need to use resources apart from doing personal things such as exercise, meditation, and eating well,” he said. “I want to work ‘smart.’ If a PBM offers a mostly underwater plan, I can choose to decline that plan, for example. I’m trying to take more time off when I can.”

Our pharmacist friends and colleagues in community and retail settings remain critically under-resourced and overburdened, struggling to provide patient care with limited support. — Helen Newland, PharmD

UTILIZING A SUPPORT SYSTEM

Grubb’s Pharmacy helps pharmacists manage stress and hopefully prevent burnout.

“We make sure that pharmacists take a 1-hour lunch break to decompress and enjoy an hour of rest,” Kim said. “We also make sure that pharmacists are only working their scheduled shifts and are not putting in overtime.”

Helen Newland, PharmD, secretary at the Society of Infectious Diseases Pharmacists (SIDP), which represents more than 2000 pharmacists, saw many challenges related to posttraumatic stress and burnout around the industry.

“Many hospital-based pharmacists have left the workforce since 2020, and health systems are still trying to recover financially,” she explained. “Meanwhile, our pharmacist friends and colleagues in community and retail settings remain critically under-resourced and overburdened, struggling to provide patient care with limited support.”

For that reason, Newland noted, many institutions implemented wellness programs, peer support groups, and mental health services to help address burnout.

“Professional organizations like SIDP and other pharmacy associations have provided support through podcasts, webinars, mentorship programs, and advocacy efforts focused on pharmacist well-being,” she said. “Personally, I have found peer support, professional networking, and staying engaged in antimicrobial stewardship advocacy to be particularly effective in managing stress and maintaining resilience.”

MAINTAINING WORK-LIFE BALANCE

In the years since the pandemic, there has been a better understanding of the positives of a healthy work-life balance. In fact, Kim believes his work-life balance has improved over the last 5 years.

“I’ve become more aware of the amount of time I spend on work outside of business hours so that I’m not always working,” he said. “I’ve been more intentional about being home and interacting with my family instead of being home and hidden in my office. It was a process of becoming more aware of how I was spending my time, prioritizing work and family, and being intentional about what I do with my time, especially outside of business hours.”

CONCLUSION

The state of community pharmacy business today is more complex and demanding than it was 5 years ago, Kim said. He noted that although the pandemic brought new challenges, it also highlighted the critical role of community pharmacies in public health and accelerated innovations in new pharmacy services.

“However, financial pressures from decreasing reimbursements and rising costs create an unsustainable business model. Staffing issues also contribute to [the] higher stress of operating a pharmacy business in 2025,” he explained. “My pharmacy business will continue to adapt and innovate to remain viable and e ective in my Capitol Hill community, but if I’m honest, there are times that I feel like throwing in the towel because of the pressures of having to adapt and innovate.”