As health systems look to expand service lines, improve access and take on more complex medication management, pharmacy leaders say workforce shortages are determining where growth is possible — and where it must wait.
Across community, acute and specialty settings, executives describe a common reality: Staffing constraints are no longer isolated operational challenges. They are shaping pharmacy strategy, technology investments and long-term workforce planning.
Reimbursement pressure and margins reshape staffing models
For some organizations, workforce strain begins upstream with reimbursement. Neil Creasey, PharmD, system director of pharmacy services at Holzer Medical Center in Gallipolis, Ohio, said ongoing reductions in payments from pharmacy benefit managers in community pharmacy have stymied new services and altered staffing models.
In response, Holzer is leveraging its broader health system to identify where sustainable margins exist for patient care without increasing costs, while negotiating with supply partners to share the financial burden.
At Signature Healthcare, based in Brockton, Mass., Vice President of Pharmacy Operations David Young said margin pressure also influences staffing decisions, particularly when combined with shortages in specialized pharmacy roles. Limited staffing ratios, he said, directly constrain the system’s ability to expand clinical pharmacy services.
Technician shortages constrain day-to-day operations
Across systems, pharmacy technicians remain one of the most persistent workforce bottlenecks. At Louisville, Ky.-based Baptist Health System, Chief Pharmacy Officer Nilesh Desai said technician shortages have hampered pharmacy operations for more than 15 years — a challenge now compounded by organizational growth and competition from other industries.
To manage limited staffing, Baptist Health is leveraging technology to reallocate human resources more effectively, directing staff to areas of greatest need — an approach it has implemented within its central pharmacy services center.
From a broader perspective, Bickkie Solomon, PharmD, director of pharmacy at HCA Florida North Florida Hospital in Gainesville, said pharmacy technician shortages are “a systemic challenge nationwide, especially in rural areas and less densely populated cities.” Those gaps, she said, “severely limit the ability to scale services such as sterile compounding, centralized distribution and advanced medication access programs,” while contributing to burnout among existing staff.
Technician shortages are also constraining growth in specialty pharmacy. Regina Schomberg, PharmaD, system director of pharmacy at Atrium Health Wake Forest Baptist, said few pharmacy professionals enter the field with experience in prior authorizations, payor navigation, benefits investigation and care coordination for complex patients. As specialty volume and therapy complexity increase, she said, demand for trained technicians has outpaced supply, creating heavier workloads and making it harder to onboard new therapies or expand services.
Technology adoption outpaces informatics capacity
While automation and digital tools are often positioned as solutions to workforce shortages, some leaders say limited informatics capacity is slowing adoption. At Akron (Ohio) Children’s, Kyle Finnerty, PharmD, director of pharmacy services, said rapid growth in automation aimed at improving safety and efficiency has outpaced the resources needed to implement it.
That imbalance, he said, “impedes our pharmacy teams’ ability to remain agile and adapt swiftly within this rapidly evolving environment.” Akron Children’s is seeking additional informatics resources and expertise to accelerate implementation.
At Baptist Health, Mr. Desai similarly pointed to technology as essential for addressing staffing constraints, but emphasized that its value depends on having the right infrastructure and expertise in place to deploy it effectively. Without that support, technology investments can fall short of relieving workforce pressure.
Development and training gaps limit long-term scalability
Some leaders see workforce shortages not just in hiring, but in long-term preparedness. John Armitstead, vice president of pharmacy services at Fort Myers, Fla.-based Lee Health, said the lack of structured, continuous professional development planning for pharmacists can result in “insufficient preparation for future roles, service expansion and leadership openings.”
To address the gap, Lee Health is encouraging pharmacists to develop CPD plans and proactively seek mentorship to support career planning, skill development and readiness for emerging opportunities.
At Indianapolis-based Community Health Network, Vice President and CPO Dawn Moore, PharmD, echoed that recruiting and retaining specialty-trained pharmacists is an ongoing challenge. To mitigate risk, the system is investing in upskilling its existing workforce while expanding residency programs to bolster its talent pipeline.
Health systems deploy multipronged strategies
Rather than relying on a single solution, many organizations are pursuing layered workforce strategies. At Signature Healthcare, Mr. Young said the system is restructuring its pharmacy enterprise with clearer pharmacist and technician progression pathways, competitive compensation and career ladder and apprenticeship models. The organization is also using outcomes data to justify strategic FTE growth while optimizing workloads through automation and flexible scheduling to address burnout.
At HCA Florida North Florida Hospital, Dr. Solomon said redesigning technician career ladders, investing in training and certification pathways, leveraging automation and fostering a psychologically safe workplace culture are all essential to stabilizing the workforce and improving access to care.
Retention is as critical as recruitment
Holding onto skilled staff is just as important as hiring new ones. At Community Health Network, Ms. Moore said retention efforts include redesigning practice models to allow pharmacists to work at the top of their license, expanding the use of technicians and technology, and prioritizing innovative scheduling and engagement strategies.
At Signature Healthcare, flexible scheduling and workload optimization are proving central to reducing burnout, alongside longer-term strategies such as residency program expansion, loan repayment incentives and telepharmacy to extend specialist reach.
It’s clear workforce shortages are a pressing concern, one which is shaping pharmacy growth, access and service-line strategy — and forcing systems to rethink how they build, support and deploy their pharmacy teams.
