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Digging Deeper #2 - Student Loan Debt

Where else can you start an entry level job and make over 100k a year? That's what everybody said about pharmacy school when they were encouraging me to make it my career. It was a time before the burgeoning student loan debt crisis, before the 2008 recession, before the encouragement for high school students to consider trade school just as heavily as college was more than a whisper from the periphery.


I thought I was in good shape, having completed my undergraduate work with no debt. I had money in the bank, even some scholarship funds left over that I could put towards pharmacy school. Most other students had undergrad loans as well. I had three different part time jobs at one point during undergrad, and I thought I could cut back a bit during professional school, focus on learning and relax a little more. I did keep my intern job, mostly to maintain my connection to the company, but by no means was I one of the folks working nearly full time during pharm school, as the input to output ratio didn't make a lot of sense to me (and because I was definitely THAT person who was convinced I was going to fail pharmacokinetics and then turning up with a B, rinse and repeat).


My personal situation isn't that bad. I graduated with about $160,000 I needed to pay off (close to average at the time). I had a job lined up 6 months before I graduated, so it was easy enough to start payment off with a bang. I still have hope to pay mine off within the standard 10-year repayment schedule, but many pharmacists I know aren't that lucky. Some have payments just as high as mine even though they are on the 25-year plan, hoping forgiveness comes before the tax-bomb gets them.


Even those pharmacists aren't in as bad of shape as many other Americans suffering under unrealistic student loan burdens that they can never hope to pay off in a lifetime - but that doesn't mean things aren't still bad. Even if saturation wasn't a looming concern, a heavy debt burden means a lack of mobility. A lack of room for innovation. Higher barriers to entry for would-be entrepreneurs and game-changers. Pharmacists already tend to be fairly risk-averse individuals, so how on earth will we expect anyone to take a leap of faith when their family's dinner and the roof over their head are at stake?


Unfortunately in the US we have a heavy victim-blaming culture across many social issues - student debt being one of them. With the discussion of student loan forgiveness active on a nationwide political level, I can't tell you how many people I have heard tell me that anyone who is suffering under a heavy debt load has no one but themselves to blame because they should have known not to waste their money on a "worthless" or "economically unsustainable" degree, usually just before launching into a speech about the uselessness of humanities studies and the merits of STEM studies without ever taking into account the possibility of their own ignorance.


It's not always easy to explain that when I started my degree path, an average debt of $150,000 was an acceptable cost for a doctoral degree and that conditions dramatically changed during the course of my scientific degree path. It's not easy to convince those that attended college in the 1980's that their hard work at their summer job to pay the year's tuition is simply not a realistic option for anyone today due to the stagnancy of wages over the past decades. Although, you can use the data found here to try, if you are so inclined. If not, here's the tl;dr: "...the average student in 1979 could work 182 hours (a part-time summer job) to pay for a year's tuition. In 2013, it took 991 hours (a full-time job for half the year) to accomplish the same." Keep in mind this does not account for living expenses, the increased cost of increasingly required advanced degrees, or compounding interest...and also it was 6 years ago, and costs have risen still more since then.


At the time of this writing, sudden and sweeping changes have occurred that may put many pharmacists in dire financial straits if they dared to refinance their federal loans prior to being affected by the wave of Walmart pharmacy staff "displacement". Some reports claim that the layoffs affect up to 40% of Walmart's senior pharmacy staff, both technicians and pharmacists. Pharmacists are living in fear that they could be next, as many expect other chain pharmacies to follow suit by trimming down their already bare-bones staffing levels.


This fear prevents most from speaking up about the blatant disregard for patient safety that is seen when these decisions are made by non-practicing pharmacists and other non-clinical management and executives. Retaliation is alive and well in pharmacy and there's a reason that myself and many other pharmacy bloggers do not reveal our personal identities. There's a reason I have received numerous messages at my website inbox telling me how much my readers wanted to share my posts, but they dare not, in case someone they worked with saw. There's a reason I received messages from pharmacists too afraid to even write a letter to their legislative representatives and/or respective state Boards of Pharmacy, for fear they'd be targeted by their employers (especially if their Board consists of chain pharmacy executives).


These conditions are unacceptable. There isn't much more to say than that. The conditions are unacceptable for pharmacists' workplace safety and sanity, and even more so, they are unacceptable for the safety of the American public.

Public knowledge CAN make a difference, and we are the only ones who are going to tell the true story. If you have not already, please take both the Pharmacy Workplace Safety Survey published by Change Pharmacy and the National Pharmacy Representation Survey published by myself. The results of these surveys will help us quantify the issues facing us and present them in a coherent form to the public.


And yes, I am 100% talking to YOU. If APhA can have 60,000 dues-paying members and pretend these issues don't exist (or at least that they should not be the 100% top priority), how can we not get more than 4,000 responses to a free survey?


That means, don't just share this on Facebook.


Tweet it. Gram it. Snap it.


Twist it, Bop it, Pull it.


If you're afraid someone you don't trust will see, email it to those you trust. Text it to your pharmacy friends. Post it on any other pharmacy forum or website where that is acceptable. Private message it to your old classmates. Provide the link to your technicians.

There's more than one way to get the message out.


We all took a professional practice oath, likely the one that includes, "I will hold myself and my colleagues to the highest principles of our profession’s moral, ethical and legal conduct," and, "I will embrace and advocate changes that improve patient care."


Here's your chance.


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