Pharmacists and support staff at some of the US’s biggest drugstore chains say they are at a breaking point: as the companies take on more healthcare services, both staffing levels and hours have declined, and the pressure is too much, some say.
Angered by increasing workloads and cuts to their hours, workers have walked off the job.
Twelve CVS locations in the Kansas City, Missouri, area closed on 21 and 22 September after “wildcat” strikes, which are organized by workers without union representation or support. Walgreens workers held their own wildcat strikes on 9-11 October at stores around the US, with confirmed closures in Oregon, Arizona, Washington and Massachusetts.
“This has been a decades-long issue, but it’s really been compounded and exacerbated since the pandemic,” said a CVS pharmacist in California who asked to remain anonymous for fear of retaliation. “With these added services, there hasn’t been any added staffing to support the services, and there’s been a reduction in staffing – so more work, less workers to do it. … It’s all the ingredients for a prescription medication error to happen.”
The pharmacist is an organizer with the grassroots campaign PizzaIsNotWorking. The campaign, started by the Oklahoma pharmacist Bled Tanoe, aims to highlight the plight of pharmacists and dismiss the idea that staff morale-boosters – like free pizza – can fix the situation.
Prescription errors can have serious, and even deadly, consequences. In early October, a patient at a CVS in Las Vegas was given the wrong medication, leading to the termination of their in vitro fertilization. About 100,000 prescription errors are reported to the Food and Drug Administration annually, but those are voluntarily reported. Between 7,000 and 9,000 people in the US die every year due to medication errors.
The California pharmacist detailed the numerous duties workers in retail pharmacies have to juggle: filling long queues of prescriptions; handling phone calls with physicians, doctor’s offices and insurance companies; working the drive-through at pharmacies that have them; and, increasingly, handling vaccinations.
“Pharmacists aren’t asking for more pay. They’re not asking for more vacation. They’re asking for more staffing, so that they can do the job that they were hired to do, which is to help patients and maintain patient safety. And right now, they can’t do that safely,” the pharmacist said.
The Ohio Board of Pharmacy recently identified numerous issues resulting from severe understaffing at several CVS locations in the state, including missing controlled substances and prescription medication errors. Despite understaffing woes, CVS reported double-digit revenue growth in 2022 and a profit of $4.1bn.
According to the 2019 National Pharmacist Workforce Study, 71% of respondents reported high or extremely high workloads, and job satisfaction was at the lowest point in 20 years. The 2021 survey found that workers at pharmacies were stressed to the point they could not fulfill all duties.
A former pharmacy intern at CVS in Arizona, who requested to remain anonymous for fear of reprisal from prospective employers, explained that their store was constantly understaffed and their shifts were cut from eight hours to six, with the same workload and no added staffing.
“The workloads have been perpetually increasing but without increased staffing. They add more to the plate without reducing the spread of the work, they add more to the workload, expect you to meet all the requirements for the workloads and then not add staff and in some cases reduce hours,” they said. “That’s hard because if you make a mistake, you’re the one that gets held accountable, but they don’t listen to the fact you’re working by yourself or working as fast as you can to try to assist everyone you can.”
The result of complaints, they argued, was being told to cut corners, such as marking uncompleted computer-based tasks as “done” to keep from being reprimanded.
“Sometimes you’d have to just kind of estimate the numbers because you didn’t have enough time,” they added.
Andrea, who requested to omit her last name for fear of retaliation from prospective employers, worked as a pharmacist at CVS in Arizona for three years but quit on 1 October due to severe short-staffing.
“Most of those days for the last several months, I would come in two hours early, work 12-hour shifts, and work through much of my lunch break in crazy working conditions,” she said.
As a pharmacist, she was paid as a salaried worker and received no overtime pay. She said she had to pick up extra workloads in recent months after experienced technicians left her store and those positions were not replaced.
“We shouldn’t be in a professional status because that just causes these workloads,” she said, in reference to the overtime exemptions for pharmacists because they are salaried. “There was so much that fell on us, and insurance companies don’t want to make it easy. When I’m in these kinds of conditions and forced to play games with an insurance company, unfortunately I’m so far behind I’m just going to fill your scripts and get you out of there.”
Shane Jeromski, a pharmacist in California who has worked at CVS and Walgreens, noted that retail chains have added immunization clinics to pharmacies, increasing revenue for the retailers but without adding staffing. He said pharmacy staff were becoming “high-pressure perfume salesmen” because of how much they were asked to push other services on to customers. He argued there should be national staffing ratio standards for pharmacy workers and their workloads.
“Pharmacy technicians are grossly underpaid for their skill level. They are the frontline workers constantly dealing with patients who are usually not happy when they’re in the pharmacy. They’re sick or there are so many things that can go wrong that are out of our control, it’s always like putting out fires,” said Jeromski. “A lot of technicians and pharmacists are being exploited by these companies by the level of work they have to do. They’re not asking for more pay. They’re asking for more help.”
Jeromski started a GoFundMe to support pharmacy workers who lost income due to the walkouts and to support any union organizing efforts.
“The American public needs to understand how dangerous this is for them to fill their prescriptions in an environment that is unsafe, no matter how good our healthcare system is in America,” said Jeromski.
A spokesperson for CVS did not provide specifics on how they plan to address pharmacist concerns, but said in an email: “We’re committed to providing access to consistent, safe, high-quality healthcare to the patients and communities we serve and are working with our pharmacists to directly address any concerns they may have. We’re focused on developing a sustainable, scalable action plan to support both our pharmacists and our customers, that can be put in place in markets where support may be needed so we can continue delivering the high-quality care our patients depend on.”
A spokesperson for Walgreens said the disruptions occurred at a small number of pharmacies and that the company was making significant investments in wages and bonuses to attract and retain workers.
“The last few years have required an unprecedented effort from our team members, and we share their pride in this work – while recognizing it has been a very challenging time. We also understand the immense pressures felt across the US in retail pharmacy right now,” the spokesperson wrote in an email. “We are engaged and listening to the concerns raised by some of our team members. We are committed to ensuring that our entire pharmacy team has the support and resources necessary to continue to provide the best care to our patients while taking care of their own wellbeing.”
