A study co-authored by UCSF School of Pharmacy professor Jonathan Watanabe, PharmD, MS, PhD, is driving federal changes in how pharmacists nationwide are counted, a shift that would more accurately reflect their increasingly diverse roles.
 
For years, many in the profession have drawn attention to the fact that the pharmacist workforce has been undercounted. Updating the federal approach to these counts would provide a more accurate picture of the workforce, while aligning pharmacy with other health professions that use multiple and more detailed occupational codes.
 
The implications are significant for universities, employers seeking to hire, and students weighing career paths.

“It’s important that we understand the market dynamics so we know if the profession is receding or growing. We can’t do that if the pharmacy workforce is being undercounted,” said Watanabe, chair of the school’s Department of Clinical Pharmacy. “Having appropriate categorization of pharmacists also gives more credence to the many roles pharmacists play as medication specialists.”
 
More accurate workforce data can shape recruitment strategies and curricular planning at pharmacy schools, he said. It can also influence how students assess the profession’s stability and opportunities as they choose their career path.
 
“This impacts young people and families who are making career decisions,” said Michael Hogue, PharmD, FaPhA, FNAP, chief executive officer of the American Pharmacists Association (APhA). “You want a career that has a lot of job opportunities and advancement. When the federal numbers are off, people might not get the right impression of the pharmacy profession.”

How Pharmacists Are Currently Counted

The Bureau of Labor Statistics (BLS) currently uses one standard occupational classification code for pharmacists. That code reflects a traditional clinical role and fails to account for the growing number of pharmacists in non-traditional roles, particularly positions that do not involve direct patient care.
 
“There are thousands of pharmacists working in industry as medical science liaisons, in regulatory affairs, in research and development. Those people are not being counted,” Hogue said. “It is also questionable if they are counting pharmacists who are embedded in physician offices or pharmacists in private practice.”
 
Other roles excluded from the BLS count include pharmacists in managed care and faculty members who teach and train new cohorts of future pharmacists, Watanabe said.
 
In contrast, health professions such as medicine and nursing have multiple BLS classification codes that capture the varied roles within those fields.

Documenting the Gap 

Momentum for change grew after the 2023 study “Minding the Gap and the Value of Metrics: Count of Working Pharmacists in the United States,” which was authored by Watanabe and Dean Jan Hirsch, PharmD, and Associate Dean Megan Nguyen, PharmD, both of the UC Irvine School of Pharmacy and Pharmaceutical Sciences.
 
Researchers analyzed pharmacy school graduates between 1965 and 2019, taking into account the average working age of pharmacists and age-based mortality rates. They compared those figures with federal workforce data.
 
In 2020, the BLS reported 322,200 pharmacist jobs based on a semi-annual survey of employers who reported the number of employees whose duties met the single occupational code.
 
The study found that as many as 46,000 pharmacists were missing from the BLS’s numbers.
 
To address the gap, the paper recommended creating more inclusive job classification codes; expanding BLS surveys to pharmaceutical companies, managed care companies and universities; and convening a national roundtable to develop more comprehensive workforce measurement approaches.
 
“This undercount has negative ramifications for the job market and the perception of pharmacy as a strong career path,” said Watanabe, who is co-presenting the paper’s findings at the APhA Annual Meeting on March 27. “By better classifying and counting pharmacists, we’re recognizing how diverse their roles are, especially as more pharmacists move into industry and other growing areas.”

From Research to Policy

APhA advanced the issue to Congress. Hogue used the study’s findings to craft a policy statement that proposed changing how BLS counts the pharmacy workforce, and submitted it to the Appropriations Committee for consideration.
 
APhA and the Academy of Managed Care Pharmacy lobbied lawmakers to include language addressing the issue in federal legislation. 
 
In February, the House Appropriations Committee instructed BLS to work with APhA, American Association of Colleges of Pharmacy (AACP), and National Center for Health Workforce Analysis to determine what changes are needed to better reflect the nation’s pharmacist workforce.
 
APhA and AACP have notified BLS of their readiness to begin partnering, with work expected to begin this year.
 
Hogue credited the study with providing the key evidence needed to advance the effort.
 
“The paper stated what lots of folks have been thinking: we didn’t have good numbers,” Hogue said. “Had they not written that paper, we wouldn't have had the independent documentation to support our ask for this change.”