Bob and Sue Quaid have 14 children, 13 adopted and many of them with special medical needs, so the medicine cabinet at home is full.

You nearly have to be a pharmacist yourself when you're dealing with the challenges of fetal alcohol syndrome, hydrocephalus, Down syndrome, heart problems and seizures in children 14 months to 14 years. Or have nearby one you know and trust — and in their case, even love.

"He's one of our biggest heroes," Sue Quaid says of pharmacist James Ammon. "My pharmacist gives me far more information on medications than the doctors do. Sometimes our doctors consult with him to decide what medication would be best."

The Quaids visit the pharmacy as often as most people go to the grocery store.

So what would happen if the pharmacist who monitors the Quaids' complex regimen of medications disappeared from the picture? In an era in which almost every American every day ingests a pill — or a lot of pills or medicine in other forms — the danger is real because the pharmacists who are the experts in such matters are becoming less available.

There's a shortage blooming. And it's just getting started, experts say.

Recruiting blues

While the role of the pharmacist in modern health care is expanding, the number of qualified practitioners relative to population is shrinking, both in Utah and in the nation, according to a report compiled by the Utah Medical Education Council. The August 2002 report says that "the current shortage of pharmacists throughout the nation will make it difficult for Utah to maintain an adequate pharmacist work force for the state . . . The number of pharmacists trained in Utah cannot meet the current state needs."

In Utah, "We have fewer pharmacists and hugely increasing demand," said Warren Young, who heads the "drug" aspect of Smith's Food and Drug stores in a seven-state Mountain West region. He served on the pharmacist committee that helped UMEC compile the Utah report. Each of the 118 pharmacies under his direction has at least two pharmacists — "three to five in the larger stores" — for about 500 in all. It's a continuous challenge to keep those slots filled in a highly competitive market.

The state had 60.2 pharmacists for every 100,000 residents in 2002, compared with a national average of 71.2. Western states in general are below the national norm, leaving little leeway for Utah to recruit nearby. Population growth and limited prospects for increasing the pharmacist pool foretell a deepening problem, the UMEC report says. It would take 247 pharmacists to bring Utah to the national average.