Chances are not good Utah can woo pharmacists from the broader national market to fill Beehive State gaps. The Utah study summarizes a December 2000 U.S. Health and Human Resources report for Congress that cites "demonstrably increased vacancy rates, difficulties in hiring and other phenomena commonly associated with shortages." A separate study by the Pharmacy Manpower Project Inc. predicts a national shortage of 157,000 by 2020.

Making do with less

That's why, on a Friday, supposedly his day off, Ammon is behind the counter at the Wee Care Pharmacy in Layton. His is an independent pharmacy, which provides its own challenges. Larger chains can afford to pay more, so it's difficult to woo a young pharmacist to his shop. He tries to compete in other ways, creating a family atmosphere, pointing out there's no demanding corporate structure to deal with, that the pace is a little more laid-back.

But as reimbursement rates go down in this extremely competitive field, he has to fill more prescriptions to keep his light on, Ammon says. That means he's spending a little less time counseling patients, though "people need my undivided attention, and I try to give it to them."

Intermountain Health Care does more and more of its recruiting out of state by necessity, says Russ Hulse, director of pharmacy services for IHC's urban central region, which includes LDS, AltaView and Cottonwood Hospitals.

The situation in Utah probably is worse than in most places, he says, though he's not quite sure why. But he knows the local college of pharmacy at the University of Utah can graduate only half of Utah's current need. And he suspects that much of the pressure comes from the state's makeup: More very young and more very old, two populations who use more medical services in general and prescription medications in particular.

Root of the matter

Changing roles, changing market and changing training requirements affect the availability of pharmacists. Root causes, both nationally and locally, are the increase in the volume of prescriptions that doctors hand out to patients — 44 percent from 1992 to 1999 (about 1 billion additional prescriptions), the fact that more health-insurance plans cover prescriptions and the proliferation of available drugs.

Congress has debated adding prescription coverage for those receiving Medicare benefits. It has been a rancorous discussion that isn't yet resolved, but "if the feds get on the bandwagon, coverage will be about 100 percent," Young said.