Truth or Consequences

As is almost always the case, I struggled a bit as I thought through my remarks to the House for this final session of our amazing, record-breaking meeting in Chicago. After other leaders have so clearly outlined where we are from both a strategic and financial perspective, as well as where we are going, my charge to "report annually to delegates on the status of the Association" as per the American Association of Colleges of Pharmacy (AACP) Bylaws seems satisfied. But I have always enjoyed this micro opportunity to put together a few messages that are about where we are as the members, leaders, and staff of this fantastic organization. For some reason in the early hours of the last weekend before we traveled here I arose early, thinking about the unfinished preparation tasks still ahead. Obviously these remarks were pretty close to the top of that list. The phrase "Truth or Consequences" came to my mind so I went to Wikipedia to remind myself about what that game show was all about. Most of you are likely too young to have listened to the show when it came out on the radio in the 1940s and many would not have even watched it on TV through its run into the late 1980s. Eclipsed by Survivor and other reality TV shows, this game that asked contestants somewhat bizarre questions that they had virtually no time to answer was, at the time, fun and entertaining. I will come back to how each show ended as I wrap up my brief remarks. So let's play a little Truth or Consequences this morning with some not really so bizarre questions. Remember, you only have a few seconds to answer! Since we are using no electronic voting this morning just shout out the answer if you have one for each of the following questions. Question 1: Is there an oversupply of pharmacists in the United States today? Yes or no? I can't tell you how many times I'm asked that question on a weekly basis. The belief that the answer is yes has made it to print as any of you who read Dan Brown's commentary in the last issue of the American Journal of Pharmaceutical Education already know. It is in other media, and I am sure this includes places like StudentDoctor.com. As the companion commentary by Drs. Knapp and Schommer pointed out, the answer to whether we have tipped the balance in supply and demand for pharmacists is a complicated one with many intersecting components. Key questions include the retirement plans and timeframe of the graduates from the 1960s and early 1970s -- the capitation era cohort of clinicians; the practice patterns of both men and women as professionals strive for that elusive work/life balance; and the alignment of payment and practice models that fully liberate the talents of our graduates to contribute to preventive, acute, and chronic care to the full extent of their education and license. But my dear friend and former boss John Gans really nailed the answer to this question when he began reacting to the question of having too many pharmacists by asking "Too many pharmacists to do what?" That is really the key. Too many pharmacists to do what? Earlier this year I collaborated with Kathy Knapp from Touro University California and Doug Scheckelhoff from the American Society of Health-System Pharmacists on a paper for the journal Health Affairs which we hope will be published as part of a themed issue on the health workforce this November. The editors asked that we address the pharmacy workforce holistically, including both pharmacists and technicians. We addressed the need for more proactive medication management and how this was the societal need that led to the conversion to the entry-level PharmD now fully implemented 10 years ago. It was in thinking through this story that I was struck, perhaps for the first time, with 2 thoughts. With respect to supply and demand, I realized that all our work to equip the 21st century health workforce with an army of doctorally prepared medication-use specialists was truly blunted by the national shortage of pharmacists in the pre-recession portion of the last decade. …