PharmD is Sending B.pharm Holders to their Death Bed

There are two ways antibiotics have effect on microbial cells, it is either bactericidal or bacteriostatic. Bactericidal antibiotics kill the bacteria and bacteriostatic antibiotics suppress the growth of bacteria. The latter is the current situation in the pharmaceutical industry.

My friend, Wanga, who had been working as a pharmaceutical technologist, made a bold decision to resign from his position in order to pursue a degree at Kenyatta University. This educational endeavor required a substantial investment of approximately 2.4 million Kenyan shillings, coupled with additional expenses. Interestingly, I’ve noticed a growing trend among other pharmaceutical technologists who are also opting for higher education, whether it be at universities like Mount Kenya University, JKUAT, United States International University or abroad.

Individuals like Wanga recognize the privileges and opportunities that come with obtaining a degree, although this may not hold true for many other pharmacists currently grappling with unemployment. I’ve encountered pharmacists who have never practiced their profession after graduation, choosing instead to focus on family businesses, while others have practiced for a few years before venturing into clinical pharmacy.

During a recent interview aired on Citizen TV on 23rd March 2023, Dr. Libeya Bethwel a pharmacist shared his disheartening experience of being jobless since completing his studies in 2020. He attempted to establish a facility aimed at delivering pharmaceutical care to patients, but the retail environment proved hostile and unsustainable. Having been out of practice for 12 months, he expressed a sense of despair, fearing that he may never catch up. This illustrates the potential pitfalls of a misguided investment in pharmacy education, which has prompted him and other graduates to explore alternative roles beyond traditional pharmacy practice.

In his class of 75 graduates, only two managed to secure employment with the county government. This raises the question: why are pharmacists pursuing advanced degrees when numerous colleagues struggle to find work? The answer lies in several factors. Firstly, a degree in pharmacy is financially burdensome, especially when considering that the average salary of a community pharmacist or pharmaceutical technologist amounts to a mere 35,000 Kenyan shillings. Calculations reveal that it would take approximately 68.5 months or 5.7 years to repay a loan of 2.4 million Kenyan shillings without earning any additional income. Clearly, the meager compensation offered in the field makes financing pharmacy education a daunting prospect, reserved for those willing to make significant sacrifices.

From the interview, three key insights emerge in contrast to the prevailing situation. First, the cost of a pharmacy degree appears disproportionate to its value. Second, many pharmacists believe that hospitals represent the only viable avenue for providing patient care. Lastly, pharmacists are hesitant to operate community pharmacies or seek employment due to the low income relative to the substantial time and financial investments required for their studies.

Given the burgeoning pharmaceutical industry, it is disheartening and somewhat surprising to witness the prevalence of pharmacist unemployment. Since 2022, there has been talk of a shortage of pharmaceutical technologists, positions that could potentially be filled by pharmacists. So why does this conundrum persist? The complexity arises from several factors:

  1. Pharmacists command higher salaries, and if given the opportunity to manage independent pharmacies, they would hardly increase their own wages.
  2. Working alongside pharmaceutical technicians creates conflicts in terms of pay disparity, as both parties essentially perform similar tasks.
  3. Running a pharmacy demands extensive dedication, long hours, and carries inherent risks.

Consequently, many pharmacists opt for regulatory roles, ensuring compliance with applicable laws and regulations. Pharmacy degree holders are also trained to supervise diploma holders and oversee the proper functioning of pharmacies. However, such supervisory positions are limited and primarily found within larger pharmaceutical organizations or distributors. Unfortunately, supervision responsibilities are often assumed by individuals without a pharmacy background, since fresh pharmacist graduates lack sufficient experience.

Regrettably, pharmacists find themselves in a predicament where they struggle to identify their niche within the community. They can be readily replaced, as the market is saturated with experienced pharmaceutical technologists who assume “pharmacist” positions and are even pursuing expensive degrees to qualify for senior roles. Additionally, advancements in technology are gradually replacing many tasks performed by both pharmaceutical technologists and pharmacists. Applications such as interaction checkers, pill identifiers, and others empower doctors to manage medications with minimal assistance from pharmaceutical technologists.

The question of whether a pharmaceutical technologist is on par with a pharmacist is difficult to answer in the Kenyan market. Although pharmacists have received more extensive academic training, the distinction between the two is often only discernible through identification badges. It’s akin to comparing an orange to an apple or Messi to Ronaldo if we were to draw a parallel.

In fact, many tasks traditionally performed by pharmaceutical technologists and pharmacists are being gradually supplanted by modern technology. Consequently, pharmaceutical practitioners need to think innovatively and adapt to these new advancements. Currently, only a few individuals utilize resources like British National Formulary (BNF) and drug indexes. Online pharmacies like My Dawa, Goodlife pharmacy, Pharmaplus, and PharmEasy are already revolutionizing community pharmacies, while applications such as WhatsApp, HealthX, and Livia pose their own threats.

One intriguing development I came across is Mark Cuban’s Cost-plus drug company, which has generated considerable buzz. His unique business concept involves eliminating middlemen and price manipulation, resulting in significant cost savings through a transparent cost-plus pricing model. While the drugs primarily consist of generics, this approach provides substantial savings, especially for patients requiring multiple medications. If such a model were implemented in the Kenyan market, it would likely cause some pharmacies to lose clients who rely on long-term medications as a primary source of revenue.

Nevertheless, we are still far from adopting such radical changes, and it remains uncertain whether this approach would succeed in the Kenyan market. At present, our focus should be on creating a profession that can sustain the lifestyle of a pharmacist while remaining accessible to the general population seeking healthcare. Even pharmacists who shun retail positions, citing financial motivations, will ultimately be compensated through taxes, and the hospitals they work in may suffer from drug shortages.

First and foremost, we must understand the needs of individuals seeking pharmaceutical services—our consumers. This understanding will guide us in developing effective training methods for future pharmaceutical practitioners. Currently, three distinct groups seek pharmacy services:

Patients who first visit a doctor to obtain a prescription before heading to the pharmacy.

Individuals who initially approach a pharmacy and provide an explanation of their symptoms.

Those who contact the pharmacy via phone call or text message.

These individuals seek the guidance of healthcare providers capable of offering solutions to their health needs, which may include:

  1. Addressing general health conditions that can be easily diagnosed and managed through consultation.
  2. Providing advice on existing medications patients are taking.
  3. Offering contraceptive guidance, such as identifying the most suitable contraceptive method.
  4. Administering vaccinations.
  5. Providing reassurance to patients on long-term medications, such as those with diabetes or hypertension, who find comfort in receiving regular blood pressure and blood sugar readings.
  6. Assisting clients with beauty products, ear piercing, and other health-related needs.

An effective training program should prioritize the clinical aspect, equipping pharmaceutical practitioners with strong diagnostic and prescribing skills. Upon entering a pharmacy, patients often begin describing their symptoms, expecting immediate solutions. Therefore, training should cultivate critical thinking skills, enabling pharmaceutical practitioners to think creatively. Perhaps we should even consider integrating a pharmacy business with a spa to address pain management.

In conclusion, I propose several suggestions to address the current challenges:

Pharmacy degree programs should incorporate internships and attachments as early as the second year of study. By the fourth year, students should be encouraged to seek employment while continuing their studies.

The exorbitant cost of academic fees should be revised to make pharmacy education more affordable. This could be achieved through the introduction of entry criteria exams or alternative methods.

Training programs should strike a balance between theory and practical aspects, reducing excessive focus on theoretical knowledge.

Pharmaceutical technologist practice should be encouraged as an entry point into the pharmacy career, with opportunities for further professional development. This could be facilitated through a flexible work-school arrangement.

By implementing these measures, we can strive to create a sustainable and thriving pharmacy profession in Kenya, capable of meeting the needs of both pharmaceutical practitioners and the communities they serve.

Do you find yourself fearful of the impending monster? Rest assured, there is a means to reach out to the Pharmacy and Poison’s Board by means of the relevant societies and associations. That is;

The Pharmaceutical Society of Kenya (PSK) is a representative organization for pharmacists.

Kenya Pharmaceutical Association for pharmaceutical technologists.

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