New school hopes to train rural pharmacists

At a time when hometown drugstores are in deep decline, the University of Kansas on Wednesday ceremonially launched a new school in Wichita to turn out more rural pharmacists.

At the "roof-raising" for the new KU pharmacy school, which will share a campus with the University of Kansas School of Medicine-Wichita, Gov. Mark Parkinson said access to pharmacists is critical for small towns.

More than 30 Kansas counties are underserved and seven don't have any pharmacists at all, he said.

"Those counties won't make it if they don't get pharmacists," Parkinson said. "KU has led the way in populating western Kansas with general practitioners.... hopefully and optimistically, this program will fill that same void with pharmacists."

It may not be easy.

The traditional town druggist is faced with unprecedented challenges including high drug prices, increased competition from mail-order pharmacies and insurance company policies that favor national chains and discount stores.

From 2006 to 2008, the number of independent rural pharmacies across the country dropped from 7,395 to 6,892 — a 6.8 percent decrease, according to a study by the Rural Policy Research Institute and the University of Nebraska.

At present, the KU School of Pharmacy admits 105 students a year, all of them at KU's home campus in Lawrence. Expansion is under way there to increase that to 150.

The Wichita campus, near Ninth Street and I-135, is expected to begin admitting students in fall of 2011. The first class will be 20 students, with possible expansion later to as many as 40.

Graduates from the Wichita program will be able to work anywhere, but speakers at Wednesday's event repeatedly expressed hope that many will choose rural Kansas.

"This is a health care imperative, this is an economic development initiative and this is absolutely a quality of life imperative," said Jill Docking, chairwoman of the Kansas Board of Regents. "Most fundamentally, it is a Kansas imperative."

Kansas isn't the first to face the challenge, nor the first to establish a campus geared toward rural pharmacy.

The University of Minnesota established a branch of its pharmacy college in Duluth, a remote city on Lake Superior, in 2003.

Since then, the percentage of U of M graduates opting for rural pharmacy careers has risen from 8 percent to 13 percent overall, said professor Timothy Stratton, an expert on economic and work force issues of rural pharmacists.

Stratton said the college tends to recruit students from small towns because they are most likely to return to that setting after their training.

But for many, the cost of a pharmacy education is a big obstacle, he said.

The average graduate has to pay off $80,000 to $100,000 in debt — a barrier to graduates who might otherwise buy into a local pharmacy.

Also, national chains offer higher pay and a steady paycheck, allowing graduates to pay off their debt faster, he said.

The trade-offs are quality of life and job satisfaction, Stratton said.

The small-town pharmacist is a pillar of the community, gets to know customers as individuals, and can work much more closely with local doctors to manage patients' care, he said.

The communities can help, too, Stratton said. Some Minnesota towns have assisted young pharmacists with financing to buy drugstores from colleagues who are nearing retirement.

And while traditional hometown drugstores are in decline, there are opportunities for rural practice in a variety of settings, Stratton said.

He said when he worked in a small Alaska town early in his career, he served as pharmacist for the community hospital, the town drugstore and the local nursing home.

"It was never a dull moment," he said.

Kansas Rep. Don Hill, R-Emporia, and Sen. Vicki Schmidt, R-Topeka, both of whom are pharmacists, attended Wednesday's ceremony.

They said they think opportunity still exists in rural pharmacy, although there are some hurdles.

For example, mail pharmacy has gone from practically nonexistent to about 10 percent of the market in the past 10 years, Hill said.

"It is a trend and it's a trend that will continue," he said. "But you still have 90 percent of the folks that are going to be served by bricks and mortar pharmacy."

For Hill, it's a numbers game.

"KU has only been turning out 100 to 105 pharmacists a year," he said. "Given the many opportunities for them to pursue with that basic degree, no group has been getting as many as they would like — the mail-order pharmacies, the chain pharmacies, the community pharmacies in rural areas.

"We need more pharmacists, that's the bottom line."