Research Spotlight: Dr. Jon Schommer
February 3, 2023
Can you tell us how you became involved in the workforce project and tell us a bit about how long have you been conducting this research?
During my time as a graduate student at the University of Wisconsin – Madison (1987-1992), faculty mentors (Robert ‘Doc’ Hammel, David Kreling and Joe Wiederholt) included us in the conduct of the Wisconsin Biennial Pharmacist Workforce Survey. Not only did we learn about survey research methods, we learned about the evolution of pharmacy practice and the contributions that pharmacists make in society. In addition, it was viewed as a service and contribution to the profession of pharmacy in our state. It built strong relationships and collaborations of trust for other work. Finally, these mentors showed us how this research is used for making public policy and health system reform decisions. Other graduate programs were engaged in similar work and inspired us to engage in this research. Some examples (among many) included University of Michigan (Drs. Ascione and Kirking), Ohio State University (Drs. Rucker and Pathak), Purdue (Drs. Mason and Schondelmeyer), Wisconsin (Drs. Hammel, Kreling and Wiederholt), Iowa (Dr. Sorofman), and Minnesota (Drs. Hadsall, Larson, Schondelmeyer, and Uden).
That ignited a flame in graduate students such as myself, William Doucette, Caroline Gaither, David Mott, and Craig Pedersen. As we started our faculty positions, we carried that flame and quickly engaged in workforce research and other practice-related research for our states that has lasted to this day.
This has historically been a large collaborative effort. Can you tell us a bit about who is involved in the survey and how that has changed over time?
This research lends itself to collaboration since the pharmacist workforce is multi-faceted and addresses unique decisions faced at various points of time. I have been influenced by many collaborative efforts that addressed the issues of the day for pharmacy. Some examples include:
- Shall Pharmacists Become Tradesmen? (1881-1899) - George Seabury
- Commercial Training for Pharmacists (1912-1928) – Rufus Lyman
- Pharmacy Manpower Information Project (1970s-80s) – Chris Rodowskas and Michael Dickson
- Pharmacists’ Compensation and Work Patterns (1980s-90s) – Steve Schondelmeyer and Holly Mason
In each of these examples, key decisions were being faced and workforce research helped inform those decisions. This spanned topics such as professional licensure, commercial viability of pharmacy, education reform, creating sufficient workforce supply to meet demand, reimbursement systems for expanded work activities, and more.
By 1999, the United States Department of Health and Human Services, Health Resources and Services Administration (HRSA), Bureau of Health Professions was preparing a Report to Congress on “The Pharmacist Workforce: A Study of the Supply and Demand for Pharmacists.” They realized that they needed more information than was available and asked leaders in pharmacy about a team of researchers who might be able to help them. Dr. Lucinda Maine (APhA Senior Vice President at the time) knew about pharmacist workforce research that several of us were doing at the state level and introduced us to a representative from HRSA. Our team was comprised of Dr. Craig Pedersen (Ohio State), Dr. Caroline Gaither (Michigan), Dr. Dave Mott and Dr. Dave Kreling (Wisconsin), Dr. Bill Doucette (Iowa), and me from Minnesota. I remember the HRSA representative looking at us and stating that he was not confident that we could successfully complete a national survey of pharmacists since we were so young. After talking a bit, and with the assurance from Dr. Kreling (who was more experienced than the rest of us) that he and his colleagues would provide guidance, we were awarded our first grant for the National Pharmacist Workforce Survey. Dr. Craig Pedersen served as the principal investigator for the 2000 National Pharmacist Workforce Survey.
After completion of the 2000 survey, several pharmacy organizations have collaborated and provided funds for subsequent surveys in 2004, 2009, 2014, 2019, 2022, and 2024 through the Pharmacy Workforce Center. In addition to being grateful for continual funding from the Pharmacy Workforce Center, our group greatly appreciates our respective universities’ support for approving overhead waivers on grant proposals and for obtaining site licenses for library services, online survey research, and statistical analysis software for this work.
Starting with the 2019 National Pharmacist Workforce Survey, we have added additional team members (Vibhuti Arya, St. John’s University; Brianne Bakken, Medical College of Wisconsin; and Matthew Witry, University of Iowa). They bring outstanding new ideas and added expertise for this work.
What are the key research questions that are incorporated into every workforce survey?
Pharmacists are integral practitioners in assuring safe, effective and affordable medication therapy for millions of patients in the U.S. They are able to provide expertise to patients, providers, payers and policy makers. As the healthcare system evolves toward value-based payments and greater care coordination across the providers and settings, pharmacists are being asked to develop and deliver new services, even as their practice settings evolve. While these conditions are creating opportunities for pharmacists, they also may have challenges and unexpected consequences.
Given this dynamic situation, it is vital to assess pharmacists’ practice characteristics, work activities, and quality of work life. Specific objectives include:
Describe demographic and workplace characteristics of the pharmacist workforce in the United States,
Describe work activities of the pharmacist workforce in the United States,
Characterize the quality of pharmacist work life.
What are unique elements of the workforce survey that you incorporated into the most recent survey? And why did you decide to adopt these additional questions at this time?
Rather than waiting for the 4-5 year cycle used in the past, the Pharmacy Workforce Center asked our team to complete an interim survey during 2022. This was in response to abrupt and substantive changes that took place in 2020 and 2021 (COVID-19) for pharmacy practice, pharmacy work systems, and the quality of work life for pharmacists. Our central hypothesis for the 2022 interim survey is that COVID-19 affected pharmacists and their work systems and that it is important to understand how and the degree to which the pandemic influenced pharmacists and pharmacy work systems. Our research team’s meetings with leaders from ASHP, APhA, PTCB, NASPA, AACP, and others confirmed that 2022 was the time to systematically study the impacts of COVID on pharmacy practice, pharmacy work systems and pharmacists. Documenting change is needed to prepare pharmacists and pharmacy work systems for future pandemics, to develop strategies to sustain positive pharmacist practice change, and to develop strategies to reduce the negative impacts of the pandemic on pharmacists’ work life. Accordingly, the study aims for the 2022 survey (data collected completed in December 2022) were:
Aim 1: To describe changes in pharmacists’ activities during the COVID-19 pandemic. A mixed methods approach was used to identify, from practice setting experts, how pharmacist activities have changed, and to assess the prevalence and degree of change using a survey administered to a national sample of licensed pharmacists.
Aim 2: To describe a set of work system characteristics that have been barriers or facilitators to changing pharmacist activities and how these characteristics of the work system will allow for activities to be sustainable or not in the future. A mixed methods approach was used to identify, from practice setting experts, work system characteristics that have influenced pharmacist role change. A survey administered to a national sample of licensed pharmacists will assess the degree to which the work system characteristics have been associated with changing pharmacist roles during the pandemic and how they will be associated with changing pharmacist roles into the future.
Aim 3: To determine the prevalence of licensed pharmacists changing their employment status or changing their work setting due to the COVID-19 pandemic, to explore motivations for and characteristics of changes in employment status and work setting, and to assess perceived costs and benefits to pharmacists of changes in employment status and work setting. A survey administered to a national sample of licensed pharmacists, using questions included in previous National Pharmacist Workforce Surveys was used to collect data.
Data analysis is taking place for the 2022 survey now (Spring 2023) and initial findings are being presented at state and national conferences.
At the same time, the team is working on the proposal for the 2024 National Pharmacist Workforce Survey. Research questions of interest that are emerging include a focus on artificial intelligence, technology, logistics, user experiences, and the evolution of existing and new practice models.
Over the life of this project, can you think of an experience where the results of your project resulted in a Eureka moment?
For each survey, there is a ‘Eureka’ moment. We enter the survey design process with great attention to transformation that is taking place, or about to take place, in pharmacy. Our goal is to frame the most germane issues and to design the most rigorous study possible. After the data are collected and analysis commences, we get to see the findings and experience those ‘Eureka’ moments. Typically, many people use information about historical trends and then make predictions through extending a straight line for that trend into the future. However, our experiences in time do not follow a straight line. It is not Chronos (quantitative time) that matters. Rather it is Kairos (qualitative time). As C.S. Lewis stated, “Isn’t it funny how day by day nothing changes but when you look back everything is different?” Those are the ‘Eureka’ findings from our work. The expected (Chronos) does not happen in our work. If it did, why do the study? Each time we look at our study findings, we realize that the unexpected (Kairos) is upon us yet again. The concept of Kairos has its origins in the practice of Greek archery, representing the moment when the archer finds the perfect opening to shoot his arrow and hit his target. That is what we strive for in this research. Some specific examples relate to supply and demand for pharmacists, work activities, work systems and processes, quality of work life, part time work, unemployment, hours worked per week, and places for work.
What is something that you are most proud of from your time conducting the workforce project?
I am so pleased with the diversity of our team members who bring different perspectives to the multi-faceted nature of the pharmacy workforce which includes research domains such as: labor economics, consumer behavior theory, channels of distribution theory, quality of work life, behavioral economics, statistical modeling, clinical science, political science, and public health. This diversity certainly leads to some interesting research meetings that take us all over in our discussions. It adds deep dimensionality to the work. In addition, each one of us finds useful insights from the workforce surveys that we can use in our specific areas of expertise. It is a fabulous reciprocal relationship. In addition, we are intentional about sharing de-identified data with others who can expand the application of the data that go beyond our work and to create new collaborations. One example can be found at: A Most Egalitarian Profession: Pharmacy and the Evolution of a Family-Friendly Occupation
“A Most Egalitarian Profession: Pharmacy and the Evolution of a Family-Friendly Occupation.” By Claudia Goldin, Harvard University and National Bureau of Economic Research and Lawrence F. Katz, Harvard University and National Bureau of Economic Research. Journal of Labor Economics, 2016, vol. 34, no. 3, 705-746.
Another point of pride is how we rotate the principal investigator for the National Pharmacist Workforce Survey every five years. This instills diversity for how the survey is conducted and also how reports are prepared. This has kept us fresh and always creating “the new.” It keeps us exploring for the next Kairos moment in pharmacy.
Pictured above in order from top to bottom and left to right: Vibhuti Arya, PharmD, MPH, Professor, St. John's University; Brianne K. Bakken, PharmD, MHA, Assistant Professor, Medical College of Wisconsin; William R. Doucette, PhD, Professor, University of Iowa College of Pharmacy; Caroline A. Gaither, PhD, Professor, University of Minnesota College of Pharmacy; David H. Kreling, PhD, Professor Emeritus, University of Wisconsin-Madison School of Pharmacy; David A. Mott, PhD, Professor, University of Wisconsin-Madison School of Pharmacy; Jon C. Schommer, PhD, Professor, University of Minnesota College of Pharmacy; Matthew J. Witry, PharmD, PhD, Associate Professor, University of Iowa College of Pharmacy.