Is Unnecessary Pharmacist Overlap Hurting Your Pharmacy’s Performance?

April 1, 2025

Pharmacist overlap, where two or more pharmacists work simultaneously, is commonly justified as a measure to increase professional service revenue, decrease errors, reduce burnout, and enhance customer service. However, for many pharmacies, this practice may be unnecessary, inefficient, and costly unless carefully calculated based on prescription volume. Understanding the ideal pharmacist overlap for your pharmacy’s needs can help you strike the right balance between optimal operations and labor costs.

What is Pharmacist Overlap, and Why Does It Matter?

Pharmacist overlap refers to having multiple pharmacists on duty at the same time during a pharmacy’s operating hours. While overlap can provide more hands to handle high workloads or complex steps in the prescription process, blindly adding overlap can lead to unneeded expenses and inefficiencies.

Pharmacies must determine whether their prescription volume justifies having overlapping pharmacists. For low- to medium-volume pharmacies, extra coverage may seem like an attractive measure to ensure quality, but it can strain budgets unnecessarily.

The Data on Overlap and Prescription Volume

An EVCOR study conducted to evaluate pharmacist overlap found that pharmacies filling fewer than 35,000 prescriptions annually achieve success and profitability without requiring multiple pharmacists on duty. For pharmacies exceeding this annual volume, calculating appropriate overlap using the formula 0.003 x number of annual prescriptions provides a guideline for the weekly number of overlap hours “necessary” to maintain efficiency.

For instance:

• A pharmacy filling 40,000 prescriptions annually would require approximately 12 hours of overlap per week (2.4 hours per weekday).

• Meanwhile, a pharmacy filling 70,000 prescriptions annually may justify 21 overlap hours per week (roughly 4.2 hours per weekday).

This targeted approach allows pharmacies to manage labour costs effectively while providing adequate staffing during peak times.

The Financial and Operational Strain of Unnecessary Overlap

Staff costs are one of the highest operational expenses for most pharmacies. Unnecessary overlap, particularly in lower-volume pharmacies, leads to avoidable labour costs. These additional expenses can eat into budgets that could otherwise be used for upgrading technology, employee training, renovations to improve workflow, or customer experience improvements.

Adding overlapping hours without careful analysis also risks creating inefficiencies. If workflow isn’t optimized or volume remains low, the workload divided among overlapping pharmacists may fail to justify the cost of extra staffing.

How Unnecessary Overlap Impacts Patient Safety

Pharmacist redundancy, while seemingly a safeguard for error prevention, does not always translate into improved patient safety. Studies, including reports from the National Coordinating Council for Medication Error Reporting and Prevention, indicate that the quality of workflow and staff training plays a greater role in minimizing dispensing errors than increased pharmacist numbers alone.

However, as highlighted in research from the New Hampshire Board of Pharmacy, overlap becomes crucial when high prescription volume overwhelms a single pharmacist. Data showed that pharmacies handling 251–300 daily prescriptions (or about 65,000 to 78,000 annually) predominantly staffed with one pharmacist experienced higher rates of errors (68%) compared to those with two pharmacists sharing the workload. At this volume, we estimate that implementing about 24 hours of overlap per week is warranted and scheduling this strategically during peak times ensures pharmacists can perform critical checks while maintaining accuracy.

Addressing Burnout Without Resorting to Overlap

It’s also important to address the human element in pharmacy staffing. Burnout among pharmacists is reaching critical levels, driven by increased workloads and non-clinical responsibilities. According to Dr. Angela German, a pharmacist at Wolters Kluwer Health, burnout is fueled not only by staffing shortages but also by excessive administrative tasks and moral distress from drug shortages.

Overlapping coverage can relieve pressure on staff by distributing responsibilities. However, overlap is not the only solution for combating burnout:

• Automation technologies like automated dispensing systems can ease the manual workload, streamlining repetitive tasks.

• Workflow optimization ensures that technicians efficiently support tasks like data entry, allowing pharmacists to focus on clinical work.

• Redistribution of non-clinical responsibilities, such as administrative tasks, to non-pharmacist staff can free up pharmacists’ time for more meaningful patient interactions.

When Does Overlap Make Sense?

While blanket overlap for all pharmacies is unnecessary, there are situations that benefit from multiple pharmacists on duty:

1. High-volume pharmacies exceeding 35,000 prescriptions annually often require calculated overlap to accommodate the workload.
2. Pharmacies with complex workflows, such as handling specialty medications or compounds that require additional checks or counseling, may rely more heavily on overlapping shifts for quality assurance.
3. Peak periods, including Monday mornings, after long weekends, or other busiest times for prescription requests, justify overlap to help manage surges in demand effectively.

Regularly reviewing prescription volume, workflow efficiency, and operational challenges helps identify when and where overlap is genuinely beneficial.

How to Optimize Staffing Efficiencies Without Sacrificing Quality

1. Evaluate Prescription Volume Regularly

Monitor trends in prescription counts and workflow requirements. Base overlap decisions on quantified needs rather than assumptions.

 2. Invest in Technology

Leverage automation to reduce reliance on additional staff during peak hours.

3. Train Pharmacy Assistants and Techs

Well-trained ancillary staff can take on more non-clinical responsibilities so pharmacists to focus on clinical and patient-facing tasks.

4. Implement Flex Schedules

Consider scheduling pharmacists flexibly based on the busiest times of day or week. For instance, part-time pharmacists can be brought in during peak periods without committing to full overlap.

5. Focus on Workflow Optimization

Streamline processes or renovate to maximize efficiency, such as reducing interruptions during the pharmacist’s final check stage, and reducing steps to fill a prescription.

6. Support Employee Well-being

Provide sufficient break times and avoid overly long shifts. Addressing burnout at its root can improve staff performance more effectively than increasing overlap hours.

7. Use Professional Services Software

Implementing software specifically designed for delivering professional services can help optimize the process. Additionally, it can allow the pharmacist to deliver these services as part of the fill process without duplicating pharmacist staffing.

Balancing Efficiency and Patient Safety

Pharmacist overlap is a tool best used with precision. While it can reduce errors in high-volume settings, unnecessary overlap in pharmacies that don’t meet specific thresholds increases costs without delivering added benefits. With the right combination of data analysis, staffing strategy, and technology adoption, pharmacies can operate efficiently while prioritizing patient safety and addressing pharmacist well-being.

Is your overlap strategy optimized to your pharmacy’s needs? Regularly review your operations to ensure you strike the perfect balance between staffing and efficiency. By taking a targeted approach, you can save costs, reduce errors, and foster a healthier workplace.