These days, the professional magazines and journals are filling up with articles about the end of the pharmacist shortage, the number of new pharmacists versus the number of new graduates, and so on and so on. However, in one area of pharmacy, there is a growing shortage, and it is threatening to go to epidemic proportions. I am talking about pharmacists being the Pharmacist-In-Charge (PIC).
Like many of my colleagues, I jumped at the chance to be a PIC back in the early 2000s. A bit of extra pay and the prestige and title. My first issue came not long after I had the position.
During a routine inspection, the state pharmacy inspector informed me that one of the required reference books was too old to be counted as the required reference. Though I was working then at one of the Big Three chains, I knew that failing to bring the references up to standard was my responsibility as PIC and not my employer’s. I contacted my pharmacy supervisor (PS). The PS got back with me at the end of the day; the company would not purchase the pharmacy updated reference material; if they had to do this for several thousand stores it would have an impact on the annual profit. I was taken aback by this, and considered that I was going to be out some big bucks one way or the other: a fine by the Board for failing to meet pharmacy standards or purchasing an expensive book that I would probably rarely, if ever, use. (Luckily, I had rotation students from UK and one gave me a book that met Board standards, so I was spared.)
One of the initial reasons for creating the PIC position was to have a party inside the state (as well as the pharmacy) responsible to the state Board of Pharmacy. Too often, corporations had their headquarters out of the state at issue and this confounded the ability of the Board to sanction a guilty entity. A credible effort to be able to hold out of state parties responsible for wrongful acts, though, has placed pharmacists in a position with more liability than benefit. Now, the bad act of a corporation can result in a permanent black mark on the public record of a pharmacist at a time when the shortage is over and that black mark can be a deterrent to future employment.
Still, the PIC position has a some positives for the pharmacist willing to express his/her power. The PIC, per Kentucky law, is in “full and actual charge” of the pharmacy. The building and stock may be paid for by Walgreens or Rite Aid, but the pharmacy is under the control of the PIC. The PIC can follow or ignore company policy as he/she sees fit, so long as applicable law is followed. The PIC can make decisions regarding policy and make policy. Though many wonder about this in the current environment, the PIC can deny entrance to the pharmacy by corporate people when such a visit comes at a bad time.
But now the liabilities of the position are overtaking the benefits. Many pharmacists turn it down, saying the pay differential is not sufficient.. What is going on? The law goes on to say, as it does in most other states, that the PIC is responsible for all Board identified violations and deficiencies. That is correct. Anything found wrong in the pharmacy and the PIC, not the corporate employer, is responsible. Tech stealing controlled substances? The PIC is held liable for not providing adequate security for the drugs. The computer system does not identify techs and pharmacists filling each prescription? The PIC is held liable. Missing paperwork? The PIC is responsible for all recordkeeping. Intern working without an intern’s license? Along with the intern, the PIC is going to face Board action.
As an attorney, I have handled multiple cases of techs stealing, sometimes with ingenious methods that defy the ability to detect. All of the PICs were sanctioned by a Board of Pharmacy. I have handled issues relating to records and mis-fills and licensing and see good pharmacists get punished because they chose to help their employers by being PICs..
Further, pharmacists are leaning away from being PIC as the chains are making PICs responsible for the store’s performance. Metrics are now the driving force of the PIC and failure to meet them a door to unemployment. Also, at least two large chains require their PICs to put in extra hours, attending meetings and other responsibilities which must be taken care of at some point in time outside of their regular work hours.
As the pharmacist glut worsens, being a PIC may become a requirement to keep one’s employment. If so, the PIC shortage may be short-lived. But, in the meantime, look at the number of pharmacists seeking to get out of the job—it is much greater than those seeking it. Pharmacists should take a long and hard look at what liabilities exist for them if they are to assume a position fraught with peril, much like a minefield.