**4. Results**

Responses from 1200 pharmacists in 2009, 1382 in 2014, and 4766 in 2019 were used for analysis. Cluster analysis identified five segments of pharmacists that we labeled as (1) medication provider, (2) medication provider who also provides patient care, (3) other activity pharmacists, (4) patient care provider who also provides medication, and (5) patient care provider. Figure 2 shows the proportion of pharmacists in each of the five segments, and Table 1 provides a description of each segmen<sup>t</sup> in terms of time devoted to medication providing and patient care services.

**Figure 2.** The proportion of U.S. Pharmacists by Segment 2009, 2014, 2019.


**Table 1.** Description of Pharmacist Segments.

Table 2 provides summary comparisons among the five segments in terms of (1) demographic characteristics, (2) work contributions, (3) work settings by column %, (4) work settings by row %, and (5) time currently spent in work activities.





**Table 2.** *Cont*.




**Table 2.** *Cont*.




Note: All statistical comparisons (ANOVA, Chi-Square) significant at p < 0.002. a "Community Pharmacy Practice" included independent, chain, mass merchandiser, and supermarket pharmacies. b "Other, Pharmacy Setting" included nursing home, long term care, health maintenance organization, nuclear, clinic-based, mail service, central fill, and home health/infusion pharmacies. c "Other, Setting Non-Pharmacy" included pharmacy benefit administration, academic, government administration, pharmaceutical industry, consulting companies, professional associations, and other organizations that were not licensed as a pharmacy. d Other include activities, such as computer analysis, audit control, continuing education, grants, committee work, communications, consultation, data analysis, drug information services, formulary management, systems implementation, inspections, investigations, information technology work, manufacturing, marketing, medication safety, meetings, policy work, problem resolution, quality assurance, regulatory issues, and writing. **Medication providing**: professional services associated with preparing, distributing, and administering medication products, including associated consultation, interacting with patients about the selection and use of over-the-counter products, and interactions with other professionals during the medication dispensing process.

**Patient care services**: professional services not associated with medication dispensing for assessing and evaluating patient medication-related needs, monitoring and adjusting patients' treatments to attain desired outcomes, and other services designed for patient care.

#### *4.1. Medication Providers*

In our study, 41% of pharmacists in 2009, 40% of pharmacists in 2014, and 34% of pharmacists in 2019 who were employed in pharmacy or in a pharmacy-related field were in the medication provider segment. In 2009/2014/2019, these pharmacists devoted an average of 88%/83%/88% of their time to medication providing and only 5%/6%/4% to patient care services, as defined in this study. Table 2 shows that they were the oldest of the five segments in 2009 and 2014, but not in 2019. Also, in 2009 and 2014, they were less likely to be female and hold a PharmD degree compared to other segments. In 2019, this was no longer the case. In all three study years (2009, 2014, and 2019), this segmen<sup>t</sup> contributed the fewest hours worked per week of any segment, and relatively few had residency training (see Table 2). This segmen<sup>t</sup> of pharmacists primarily worked in community pharmacy practice settings (78% in 2009, 68% in 2014, and 76% in 2019). In 2019, 57% of respondents who worked in community practice settings were identified as being in the "medication provider" segmen<sup>t</sup> of pharmacists, which is similar to 61% of the respondents in 2014 and 60% of respondents in 2009. For 2019, three questions were added to the survey and showed that this segmen<sup>t</sup> of pharmacists worked an average of 1.0 hour per week from home or remotely, worked at an average of 2.0 locations for their primary employment, and interacted with an average of 17.6 patients per day as a pharmacy care provider (highest among the five segments).

#### *4.2. Medication Providers Who also Provide Patient Care*

In our study, 25% of pharmacists in 2009, 22% of pharmacists in 2014, and 25% of pharmacists in 2019 who were employed in pharmacy or in a pharmacy-related field were in the medication provider who also provides patient care segment. In 2009/2014/2019, these pharmacists devoted an average of 65%/60%/63% of their time to medication providing and 19%/22%/16% to patient care services, as defined in this study. Table 2 shows that, in 2009, 48% percent of this segmen<sup>t</sup> were female, only 17% had a PharmD degree, and only 4% had residency training. In 2014, 59% were female, 48% had a PharmD degree, and 5% had residency training. By 2019, 62% were female, 59% had a PharmD degree, and 6% had residency training. In 2009, 67% of this segmen<sup>t</sup> of pharmacists worked in community pharmacy practice settings, 25% in hospital settings, and 7% in other pharmacy settings. In 2019, 64% worked in community pharmacy settings, 21% worked in hospital settings, and 13% worked in other pharmacy settings. For 2019, three questions were added to the survey and showed that this segmen<sup>t</sup> of pharmacists worked an average of 1.5 hours per week from home or remotely, worked at an average of 1.8 locations for their primary employment, and interacted with an average of 16.9 patients per day as a pharmacy care provider (second highest among the five segments).

#### *4.3. Other Activity Pharmacists*

In 2009, 16% of pharmacists who were employed in pharmacy or in a pharmacy-related field were in the other activity pharmacists segment. In 2014, the proportion was 18%, and, in 2019, the proportion was 14%. In 2009/2014/2019, these pharmacists devoted an average of 5%/6%/3% of their time to medication providing and 3%/5%/4% to patient care services, as defined in this study. Most of their time was devoted to other activities, such as business/organization management, research, education, and other health-system improvement activities. Table 2 shows that, in 2009, 40% were female, 42% had a PharmD degree, and 19% had residency training. In 2014, 54% were female, 58% had a PharmD degree, and 27% had residency training. By 2019, 60% were female, 60% had a PharmD degree, and 26% had residency training. This segmen<sup>t</sup> contributed the most hours worked per week of any segmen<sup>t</sup> in 2009, 2014, and 2019. In 2009, 45% of this segmen<sup>t</sup> of pharmacists worked in 'other, setting not licensed as a pharmacy', and 30% worked in a hospital setting. This remained consistent through 2019, with 50% of this segmen<sup>t</sup> of pharmacists working in 'other, setting not licensed as a pharmacy', and 27% working in a hospital setting. For 2019, this segmen<sup>t</sup> of pharmacists worked an average of 11.9 hours per week from home or remotely (highest among the five segments), worked at an average of 2.2 locations for their primary employment, and interacted with an average of 5.5 patients per day as a pharmacy care provider (lowest among the five segments).

#### *4.4. Patient Care Providers Who also Provide Medication*

This segmen<sup>t</sup> (12% of pharmacists in 2009, 13% of pharmacists in 2014, and 15% of pharmacists in 2019 who were employed in pharmacy or in a pharmacy-related field) devoted an average of 33%/29%/30% of their time to medication providing and 43%/49%/43% in 2009, 2014, and 2019, respectively, to patient care services, as defined in this study. Table 2 shows that they were the younges<sup>t</sup> of the five segments, on average, in both 2009 and 2014, and second younges<sup>t</sup> in 2019. In 2009, 64% were female, 40% had a PharmD degree, and 25% had residency training. In 2014, 66% were female, 59% had a PharmD degree, and 30% had residency training. In 2019, 65% were female, 75% had a PharmD degree, and 28% had residency training. In 2009, the hours worked per week by this segmen<sup>t</sup> were below the overall average. In 2014 and 2019, the hours worked per week were above the overall average. In 2009, 54% of this segmen<sup>t</sup> of pharmacists worked in hospital settings, 23% worked in community pharmacy practice settings, and 16% worked in 'other, licensed pharmacy settings'. In 2014, 70% worked in hospital settings, 13% in community settings, and 14% in 'other, licensed pharmacy settings'. In 2019, 57% worked in hospital settings, 15% in community settings, and 20% in 'other, licensed pharmacy settings'. For 2019, this segmen<sup>t</sup> of pharmacists worked an average of 2.7 hours per week from home or remotely, worked at an average of 1.6 locations for their primary employment, and interacted with an average of 10.4 patients per day as a pharmacy care provider.

#### *4.5. Patient Care Providers*

In 2009, 6% of pharmacists who were employed in pharmacy or in a pharmacy-related field were in the patient care provider segment. In 2014, the proportion was 7%, and, in 2019, it grew to 12%. In 2009/2014/2019, these pharmacists devoted an average of 5%/5%/5% of their time to medication providing and 82%/84%/81% to patient care services, as defined in this study. Table 2 shows that they were the second younges<sup>t</sup> of the five segments, on average, in both 2009 and 2014 and the younges<sup>t</sup> segmen<sup>t</sup> in 2019. In 2009, 59% were female, 53% had a PharmD degree, and 26% had residency training. In 2014, 68% were female, 61% had a PharmD degree, and 34% had residency training. In 2019, 74% were female, 81% had a PharmD degree, and 40% had residency training. In 2009, 64% worked in hospital pharmacy practice settings, 27% worked in 'other, pharmacy settings', and 8% worked in 'other, setting non-pharmacy'. In 2014, 49% worked in hospital settings, 36% worked in 'other, pharmacy settings', and 14% worked in 'other, setting non-pharmacy'. In 2019, 47% worked in hospital settings, 34% worked in 'other, pharmacy settings', and 17% worked in 'other, setting non-pharmacy'. For 2019, this segmen<sup>t</sup> of pharmacists worked an average of 6.0 hours per week from home or remotely (second highest among the five segments), worked at an average of 1.8 locations for their primary employment, and interacted with an average of 10.9 patients per day as a pharmacy care provider.

#### *4.6. Year of Licensure Cohorts*

Table 3 summarizes comparisons for U.S. pharmacists by year of licensure cohorts and provides insight regarding future pharmacy profession capacity as cohorts of pharmacists exit the workforce and newly trained pharmacists join the workforce. For example, Table 3 shows that pharmacists who were licensed before 1980 were typically male, not likely to hold a PharmD degree, and not likely to had residency training. This cohort comprised only 8% of the 2019 survey respondents (393 out of 4686). In comparison, pharmacists who were licensed from 2005 onward were much more likely to be female, over 95% held a PharmD degree, and over 20% had residency training in addition to a PharmD. In 2019, this cohort accounted for 49% of the pharmacist respondents (2300 out of 4686). Pharmacists who were licensed between 1980 and 2004 accounted for the remaining 43% of respondents and showed the transition from BSPharm to PharmD training during this time period.


**Table 3.** Comparison of U.S. Pharmacist Year of Licensure Cohorts in 2009, 2014, and 2019.


