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Thursday, September 29, 2011

Betting on the future, pt2: Why pharmacists are doomed

In part 2 we explore why pharmacists are doomed in the 21st-century and in doing so get some clues for how to predict if a career is likely to survive the coming decades.

Previous: Part 1: Career guidance is more valuable than Huck Finn

Pharmacists are doomed. Well, at least in the United States. Rather than take my word for it, take a look at an article that was just published by Slate's primary technology writer, Farhad Manjoo: "Will robots steal your job?"

In it Manjoo argues that "Pharmacists will be some of the first highly skilled professionals who'll lose their jobs to machines." What I thought would be 5-10 years down the line already seems to be here; the pharmacists that he interviewed said "that the computers keep getting better, and that today's best robotic pharmacists are faster and less prone to error than the best human pharmacists." Whatever technology hurdles there are--hardware pill picking robots; reliable, exhaustive drug interaction databases--seem to have already been solved.

What is it about pharmacy or any other profession that makes it vulnerable? Manjoo articulates the factors quite well:

The fundamental problem, for pharmacists, is that their jobs are marked by insufferable repetition. This should serve as a lesson for every professional in America. If you're wondering whether your career is under threat from robots, think about what you do every day. Machines excel at doing small routines over and over and over again. Anyplace where you find humans engaged in repetitive tasks—even if those tasks aren't all physical, and sometimes require deep intellectual problem-solving skills—there's a fair chance they'll be replaced by computers.
Also think about economics. Pharmacists are paid extremely well--"in 2010, the median salary for an American pharmacist was $111,000"--partially because of the extensive schooling it takes to become a pharmacist. It requires an undergrad degree in Pharmacy or Chemistry and an additional four years to complete a Pharm.D. And every pharmacy in America requires at least one pharmacist to be on staff. Pharmacy robots will surely be expensive. But if a $500k robot can replace two pharmacists, it'll earn back its value in less than two and a half years. And those robots will continue to get cheaper. Pharmacists won't.

And speaking of all that education, isn't that what creates this enormous $111k/year value for the pharmacist? I mean after all that schooling, they really are highly-trained experts with invaluable knowledge, right?

In theory, yes, but the unfortunate reality is:
I asked several pharmacists to estimate how much medical judgment was involved in [their job]. They all said the same thing: not a lot. [...] Pharmacists spend these years learning about the deep connections between pharmaceuticals and human biology. But when a pharmacist gets into the workplace, she jettisons most of that training and instead spends her days on more menial tasks.
It takes a lot of value to justify a $111,000 salary. But if the job largely consists of "menial tasks," then that salary is not justified, regardless of the employee's level of education. Economics just doesn't work that way; the market will find a way to remove that inefficiency.

So if there are already pharmacy robots doing a decent job, why do the Targets of the world keep paying pharmacists such high salaries? It turns out that
"Most pharmacists are employed only because the law says that there has to be a pharmacist present to dispense drugs," one pharmacist told me. In other words it's not the pharmacists' skills that will keep them employed—it's the fact that the humans have good unions, and good lobbyists. Once the law catches up to the reality of robot superiority, the humans will be out on the street.
So it's Federal regulation that's preventing the wholesale replacement of pharmacists. With seniors unable to afford their prescriptions, Medicare liabilities soaring, and big businesses like Target and Walmart watching their bottom lines, who do you think is going to win this fight? If robot pharmacists reduce drug costs by passing efficiencies and savings on to consumers, what politician in his right mind is going to side with obsolete, expensive pharmacists?

Those Federal regulations will go away--and soon. And as soon as they do, pharmacists' days will be numbered.

Now let's consider an alternative. What if the public is wary of these machines and insists that a trained expert continue to oversee the process. Fine, but does that person really need to be physically present when you pick up your pills? India can train pharmacists just as well as we can, but Target can pay an Indian pharmacist a fraction of what they have to pay an American pharmacist. 21st-century technology makes telepharmacy trivial to implement. You could even videoconference directly with your Indian pharmacist from your Walmart in, say, Baton Rouge, LA.

The moral of the story is...
Education and advanced degrees do not guarantee a safe career path in the 21st-century. Pharmacists look great on paper now but shouldn't we already suspect that something is fishy? Get paid $111,000 to dispense pills at Target? It's a deal that's too good to be true, even after you factor in the four years of graduate study required.

There has to be real, deep value in the work you do. And that work has to be safe from both automation and outsourcing overseas if your job is to survive the evolution of industry in the next 10-15 years. Pharmacy is vulnerable to both automation and outsourcing.

So is accounting. For years I used TurboTax for my tax filings. That's automation. As for outsourcing, well, I eventualy ditched TurboTax and mailed my documents to an accountant I never met in person or even talked to on the phone. Accounting doesn't need to be a face-to-face transaction. And that means it can be outsourced. In 2003 "about 20,000" US tax returns were prepared in India. A 2006 estimate put that number at 1.6 million this year. What will that number be by 2015? By 2020?

The world is constantly changing. The stable careers of yore are no longer safe guarantees. It's not enough to just get our kids into college; we need to set them up for success after college and well into their professional lives. And, needless to say, you can't have professional success if your chosen profession ceases to exist.