Don't Join State Professional Pharmacy Organizations

REVIEWED RESEARCH

Why Pharmacists Join/Don't Join State Professional Pharmacy Organizations By Donna H. Berardo, PhD, and Carole L. Kimberlin, PhD Summary

Methods

Questionnaires were mailed to 2,432 Florida pharmacists to learn their attitudes toward membership in state pharmacy organizations. Of 608 responses, 364 were members of Florida Pharmaceutical Association (FPA) and 219 were members of Florida Society of Hospital Pharmacists (FSHP); 130 were not members ofany pharmacy organization. Results indicate that pharmacists who belonged to an organization had more positive attitudes toward that organization than those who didn't. Pharmacists who perceived themselves to be outside the mainstream were the younger pharmacists and the nonowners, particularly chain pharmacy employees. Those who belonged to neither FPA nor FSHP suggested that an emphasis on political strength, professional standards, and salary and reimbursement issues may entice them to join. These results also suggest potential benefits could be derived from joint programs and membership discounts.

uestionnaires were mailed to a sample of 2,432 licensed Florida pharmacists. All 600 FSHP members and a random sample of 900 FPA members were included in the sample. Then, using cross matching to avoid any pharmacist on the FPA or FSHP membership list, another 1,000 pharmacists were randomly selected from the Florida Department of Professional Regulations list of licensed pharmacists. All out-of-state addresses were omitted. The mail survey had been developed in a series of meetings with the researchers and a unity of purpose committee and reviewed by volunteer pharmacists for clarity of instruction. A total of 608 (25%) completed questionnaires were returned. Data on the total sample were analyzed and are reported here according to the respondents' demographic characteristics and occupational status. Differences in FPA and FSHP member responses are presented in percentages and rankings. Chi-square tests of significance were used to evaluate differences in responses of owners vs nonowner community pharmacists, older vs younger pharmacists, and member vs nonmember groups.

Introduction

A

Florida joint committee with representatives from the University of Florida and Florida A&M colleges of pharmacy; leaders of two professional pharmaceutical associations, the Florida Pharmaceutical Association (FPA) and the Florida Society of Hospital Pharmacists (FSHP); and several chain pharmacies asked researchers at the University of Florida to help design and conduct a survey of Florida pharmacists. The project, funded by FPA, FSHP, and Revco and SuperX pharmacies, surveyed 2,432 pharmacists to gather information for helping leaders plan how to best meet the needs of the members~ In addition, the group wanted to discover why some pharmacists choose not to join their professional organizations and what might encourage them to do so.

Donna H. Berardo, PhD, and Carole L. Kimberlin, PhD, are faculty members of the College of Pharmacy, Department of Pharmacy Health Care Administration, University of Florida, Gainesville, FL 32610. Received November 1987; revised March 1988; accepted May 1988.

rnerican Pharmacy, Vol. NS28, No.9 September 1988/587

Q

Results and Discussion

A

mong the 608 respondents, several professional organizations were represented (see Table 1). There were 364 members ·of FPA, 174 members of APhA, 219 current members of FSHP, 177 members of the American Society of Hospital Pharmacists (ASHP), and 65 members of the National Association of Retail Druggists (NARD). Of the respondents, 130 were not current members of either FSHP or FPA.

Sample Characteristics and Differences in FPA and FSHP This sample was 80% men and 20% women, which matches the gender percentages of all practicing Florida pharmacists. Only 6% were members of minority groups (see Table 2). The majority of respondents (82%) had completed only the BS degree; twice as many FSHP members as FPA members had advanced degrees (28% vs 13%). The average age of the respondents was 42; 43

TABLE1. Respondents' Membership in Professional Pharmacy Organizations Current Members

Past Members

FPA FPA Unit

364 130

107

APhA FSHP

174

234

219

67

FSHP Regional

142

53

ASHP NARD

177

83

65

81

ASCP NACDS

28 7

14

ACA AACP

12 16

6 7

NPhA PMA

4 1

6 3

PA NWDA

0 2

3

Organization

TABLE 2. Demographics of Pharmacist Respondents Total Sample

All FPA Members

All FSHP Members

Sex:

Male Female

80% 20%

84.0% 16.0%

71.0% 29.0°/o

Race:

Asian Black Hispanic White

1% 2% 3% 94%

0.6% 1.0% 3.0% 95.0%

2.0% 0.7°/o 4.0% 94.0o/o

Education:

BS Master's PharmD PHG/PHC PhD

82% 9% 5% 3% 1%

85.0% 7.0% 4.0% 2.0% 2.0%

72.0°/o 14.0°/o 12.0°/o

Average Age:

42

47

41

Average Years in Practice:

-

48

8

-

2.0°/o

15.6

22

5

TABLE3. Occupational Breakdown by FSHP and FPA Membership overall, the members of FSHP are somewhat younger. There were also more women in the FSHP group, which may be related to the age difference and the fact that more women are entering the profession in the younger age group. The FPA respondents had been practicing pharmacy an average of 22 years, and FSHP members averaged 15.6 years of practice. The total sample included a variety of pharmacy employment categories, the predominant ones being hospital pharmacists (227, or 38%); nonowner community pharmacists (168, or 28%); and owner pharmacists (95, or 16%). In addition, almost 10% of the respondents (n =56) were paid consultants to nursing homes and another 12% (n = 69) were paid consultants to other institutions. The consultant figures are diluted by the variety of the total sample. For example, a higher percentage of FPA members (28%) serve as consultants to nursing homes and other institutions. A further examination of the FPA respondents shows that more than half were community pharmacists and about half of those were owners. Another quarter of the FPA members were hospital pharmacists. Of FSHP respondents, 61% were hospital pharmacy directors, assistant directors, or staff in operations and distributions (see Table 3 for FSHP respondents' occupations).

Attitudes Toward Florida Pharmacy Organizations When asked to rank which of the roles and functions of Florida's professional pharmacy associations were most important to them personally, the FPA respondents reported that the provision of educational programming for continuing education credit was of most importance. Ranked second was serving as an information source to pharmacists on professional, regulatory, and economic issues (see Table 4). When asked which roles and functions of the Florida pharmacy organizations were most important to the 44

FSHP(N = 219) Occupation Academics Industry Hospital Directors Supervisors Staff Self-Employed Consulting Pharmacist Small-Chain Pharmacist Large-Chain Pharmacist Independent Pharmacist Retired Government Other(HMO, wholesale, unrelated fields) Totals

No.

%

FPA(N=364) No.

%

3

5.0 1.4

14 7

3.8 2.0

83 20 61

37.9 9.1 27.8

50 4 46

13.7 1.1 12.7

4

1.8

9

2.5

30 53 112

8.1

11

2

1.0

5 9

2.3 4.0

2

12

3

1.0 1.4

14.5 30.8 3.3

9

2.5

16

7.3

18

5.0

219

100.0

364

100.0

NOTE: 112 respondents reported membership in both organizations.

profession of pharmacy as a whole, the FPA and the FSHP respondents answered that assembling the Florida pharmacists as an interest group for political pressures when needed at the state level ranked first in importance. Second in importance to the profession was serving as the voice of pharmacy on state and national issues. Ranked third was assembling Florida pharmacists as an interest group when needed at the national level. Fourth in importance was serving as an information source to pharmacists on professional, regulatory, and economic issues. Fifth was developing standards and codes of ethics for professional pharmacists. The major difference between the FSHP and FPA American Pharmacy, Vol. NS28, No. 9 September 1988/588

responses was that FSHP members ranked clinical training as more important to them personally than legislative issues. It is important to note that each group -the 364 FPA respondents and the 219 FSHP respondents - as a whole ranked the importance of the role and functions to the profession in exactly the same order even though personal rankings were different. Two-thirds of the FSHP member respondents felt that the pharmacy organizations were dominated by certain groups, whereas fewer than one-half of the FPA members felt that this was true. Both groups, however, gave the same order rank of dominance. For FPA, independent pharmacy owners were perceived as most dominant, followed by organizational staff, and finally employee pharmacists in chains. Hospital pharmacy directors appeared to be most powerful in FSHP; academicians and organizational staff were ranked second and third.

Nonowners were less likely to agree that the current structure of FPA is all right and adequately represents different interest groups of pharmacists. Owners were significantly less likely than nonowners to perceive the state organization as dominated by any one group. However, their perceptions of who dominated the state organization were identical. The ranking was headed by independent owners, followed by the state FPA organizational staff and academicians. Nonowners were significantly more likely than owners to agree that more attention needs to be paid to the

TABLE4. Rankings of Responses on Importance of Roles and Functions of Florida Pharmacy Organizations

Ranked Most Important

'Members of each group felt that their own organizations were meeting the needs of their members, but they did not feel as positive about the other group.' Both organizations received kudos on their current structure. The majority of the respondents clearly felt that the state pharmacy organizations allowed adequate communication between the local and state levels. In addition, they felt that the structure allowed local interests to be known at the state level. Those who chose to rise to leadership positions could do so. The great majority of all member pharmacists thought that state professional organizations should both pay more attention to the needs of employee/staff pharmacists and do more to improve the economic situation of pharmacists. Members of each group (FPA and FSHP) felt that their own organizations were meeting the needs of their members, but they did not feel as positive about the other group. This "We';:e OK, but I'm not so sure about them" perception most likely serves to strengthen group identification. Respondents indicated that FPA and FSHP meetings should be separate and that they should ' maintain separate identities, but many suggested some cost-cutting strategies such as sharing office space, sharing the costs of a lobbyist, and giving discounts to members of both organizations.

Owner vs Nonowner Attitudes Some significant differences emerged in the responses of owner vs nonowner community pharmacists in FPA. Of the roles and functions, owners felt that political pressure at the state level was most important to them personally while nonowners ranked it third. Nonowners ranked serving as an information source on professional, regulatory, and economic issues as most important while owners ranked this item second. American Pharmacy, Vol. NS28, No. 9 September 1988/589

Ranking FPAMembers (n =364)

FSHP Members (n =219)

To Pharmacist Personally Continuing Education Programs Information Source on Professional, Regulatory, and Economic Issues Educational Programming to Improve Clinical Skills Opportunity to Exchange Knowledge and Ideas With Colleagues Assemble Florida Pharmacists as Interest Group for Political Pressure When Needed at State level Serve as Voice of Pharmacy on State and National Issues

1

1

2

2

3

4

5

5

3

4

To Profession Assemble Florida Pharmacists as Interest Group for Political Pressure When Needed at State level

1

1

Serve as Voice of Pharmacy on State and National Issues

2

2

Assemble Florida Pharmacists as Interest Group for Political Pressure When Needed at National Level Information Source on Professional, Regulatory, and Economic Issues

3

3

4

4

Develop Standards and Codes of Ethics for Professional Pharmacists

5

5

45

need of employee pharmacists and that unions would provide a better structure for representing employee pharmacists. However, fewer than one-fourth of the nonowners and about 10% of the owners agreed with the pro-union statement. Although neither group thought that too much organizational money was being spent on legislative activities, owners were much more likely than nonowners to think that not enough money was being spent on such matters. Owners were significantly less likely to agree that the two organizations should share office space or think that discounts should be available for those who join both groups. Owners were more likely to be current members of NARD and APhA. Nonowners were more likely to be past members of APhA, a factor that APhA might consider investigating.

those who were members ofFPA only (251), those who were members ofFSHP only (106), those who were members of both (112), and those who were members of neither state association (130). Some pharmacists could not be definitely classified because they failed to fill out some of the membership section. Comparisons that indicated a significant Chi-square difference (p<0.05)

'Responses of those who belong to neither association indicate that an emphasis on the political strength, along with professional s~andards and salary and reimbursement issues, may be the most powerful leverage to entice them to participate.'

Older vs Younger Responses of pharmacists who graduated after 1975 were compared with those who graduated in 1975 and before. Younger pharmacists were less likely to agree that the current structure ofFPA allows adequate communication between local and state levels, that the structure allows those who choose to do so to rise to leadership roles at the state level, or that the state meetings meet the needs of most pharmacists.

Why Join? The most compelling reason for joining the FPA state organization, according to the respondents, was the belief that banding together gives pharmacists more strength when dealing with the legislature. Second in importance was the belief that the benefits outweighed the costs of belonging. More than one-half of the 130 nonmember respondents noted that their reason not to join an organization was that the cost outweighed the benefits gained. Another one-fifth of the nonmembers also gave a second reason for not joining- that the meetings did not serve their needs. One out of 10 said that no one ever asked them to join.

'One out of 10 nonmembers said that no one ever asked them to join a pharmacy organization.' When asked what might persuade them to join, 41% said that emphasizing that joining together gives pharmacists more strength with the legislature; 29% said that the belief that benefits, such as the journal and continuing education discounts, outweigh the costs would get them to join. Thirteen percent said the opportunity to improve knowledge and expertise was the best case, and another 13% wrote in a response in the "other" category, which included giving pharmacists strength against corporate structures and emphasizing the strength of a unified voice both professionally and monetarily. Subjects were further separated into four groups46

among groups showed in general that pharmacists were most positive about their own organization and most negative about an organization they did not belong to. As could be expected, those who belonged to both organizations were loyal and supportive of both, and those belonging to neither were overall more negative about both associations. There was support for joint ventures between the associations, but members of FSHP only showed slightly less support for these ventures and members ofFPA only were less positive about discounts for multiple organization memberships.

Conclusions t seems that, among FPA members, those who perIwere ceived themselves as more "outside" the mainstream the younger pharmacists and the nonowners, particularly the chain pharmacy employees. Several unsolicited responses from employees identified a problem in receiving time off for attending meetings. Once pharmacists had joined an organization, they tended to perceive that organization in a more positive light than did nonmembers, regardless of whether those nonmembers are part of another association. For this reason, joint programs and membership discounts to encourage hospital pharmacists to join FPA may pay dividends to FPA as well as FSHP in having pharmacists who perceive both associations in a more favorable light. Responses of those who belong to neither association indicate that an emphasis on the political strength, along with professional standards and salary and reimbursement issues, may be the most powerful leverage to entice them to participate. State member and nonmember surveys such as this one can serve as an aid in planning the future pharmacy professional organizational goals and activities. Such assessment identifies membership perceptions of leadership and importance of functions. Keeping in touch with the needs and values of pharmacists in different work settings assists leaders in balancing strategies to accomplish the most for the greatest numbers in the profession. ® American Pharmacy, Vol. NS28, No. 9 September 1988/590