Survey of Retired Military Pharmacist s Transition to a Civilian Pharmacy Career Path

Transcription

1 MILITARY MEDICINE, 180, 12:1219, 2015 Survey of Retired Military Pharmacist s Transition to a Civilian Pharmacy Career Path Lt Col David Bennett, USAF BSC (Ret.)*; Greg Wellman, RPh, PhD*; Maysaa Mahmood, PhD ; Ryan Freye, PharmD ; COL Daniel Remund, MS USA (Ret.) ; Col Phil L. Samples, USAF BSC (Ret.) ABSTRACT Purpose: To explore variables relevant to transition to civilian pharmacy career path for retiring military pharmacists. Methods: A cross-sectional survey was designed to collect information from retired military pharmacists including demographics, military service information, postretirement employment and perceptions of transition, satisfaction, level of responsibility, work environment, rewards (level of financial compensation, opportunities for professional development and career advancement, health benefits), and level of supervisory support. The questionnaire also included additional items asking about their perception of their military experience, transition to civilian work and the impact the military career had on their personal and family life. Results: Respondents included 140 retired pharmacists from the U.S. Army, Navy, Air Force, or Coast Guard. Factors found to be significant predictors of transition to civilian career included: bureaucracy in current job, time elapsed since retirement, extent to which an individual misses military structure and chain of command, access to military facilities and Veterans Administration benefits, and reporting little or no stress in committed long-term personal relationship while in the military. Conclusion: Findings suggest that the majority of retired military pharmacists perceived the transition to civilian professional sector was about what they expected or easier than expected. INTRODUCTION Career transition has been defined as the period during which an individual is changing roles or changing their orientation to a role already held. 1 This definition aptly applies to those who are retiring from a military career and about to take their uniform off for the last time. Pharmacy practice, as it occurs in each of the military service branches, has previously been described. 2 5 In contrast to their civilian counterparts, military pharmacists may be challenged with extremely atypical practice settings, particularly when deployed into a hostile environment. The transition from a military to a civilian career can be a stressful time, as the retiring service members must make the necessary cultural and social adjustments to their postmilitary life, and match their military skill sets and postcareer geographical preferences with job availability and requirements in the civilian sector. 6 The Pew Research Center conducted a survey in 2011 involving 1,853 veterans from across all ranks, military branches, and lengths of time-in-service. 7 A majority of veterans credit the military with helping them get ahead in life though character building, learning to work with others, self-confidence, and growth as a person. Seventy-two percent of veterans characterize their adjustment to civilian life as very or somewhat easy. Factors identified by this study to have a positive impact on transition to civilian life included: *Ferris State University, 220 Ferris Drive, Big Rapids, MI Henry M. Jackson Foundation, Rockville Pike, Suite 707, Rockville, MD Walmart, Indian Drive, Paris, MI Remund Consulting, 7431 Cameron Drive, Larkspur, CO Professional and Government Services, Innovation, 3478 North Farm Road 83, Willard, MO doi: /MILMED-D rank of a commissioned officer, college education, and military assistance. Factors reported to have a negative impact on transition into the civilian life included: having a traumatic or distressing experience; being physically injured or disabled; or serving in combat. Although the Pew study involved a mixed veteran population in terms of the member s time-in-service, job specialty and their enlisted/officer status, only 16% of the veterans surveyed reported serving 10 or more years on active duty, and only 8% reported being commissioned officers. The general population of retired military pharmacists differ from the Pew study population on average, in that it consists of a subgroup of veterans that have achieved an officer rank, have served (unless medically retired) a minimum of 20 years, and are college graduates. Baruch and Quick 8 examined the career transition of U.S. Navy admirals from their military ranks to the private sector. The authors studied the role that career proactivity, organizational role, social capital, support from family, transition process, and perception of the labor market played for these flag rank officers. Vigoda-Gadot, et al 9 followed-up on this work in a population of Israeli officers, and found that retirement preparation, social capital, perception of organizational politics, and work-family conflicts affected military retiree success in a second career. The Vigoda-Gadot study examined a broad range of high-ranking retirees from the military fields of technology, operations, and administration. Although the work by Baruch and Vigoda-Gadot helped to identify antecedents for success in transitioning from military to nonmilitary employment, these two studies did not break out the nature of the postretirement employment for the retirees surveyed. There is a paucity of research examining postmilitary retirement career issues for health care professionals, as well as MILITARY MEDICINE, Vol. 180, December

2 the job attributes affecting the success of this transition for pharmacists. The purpose of this study was to explore variables relevant to transition to civilian pharmacy career paths for retiring military pharmacists. METHODS Research Design This study used a cross-sectional survey design to collect information from retired military pharmacists about their work and life experiences in their military and postmilitary careers. Participants Former pharmacy specialty officers were utilized to identify a sampling frame of retired military pharmacists from their respective service branches. These specialty officers also acted as a liaison to communicate and deploy the survey instrument to the sample of retired military pharmacists using established contact lists. These lists were previously created and are maintained by the liaisons for the purpose of keeping contact with fellow officers, and disseminating information on relevant topics such as changes in TRICARE, job opportunities, and benefits. The sampling frame identified retired military pharmacists effective as of March 4, From this frame, 92 were retired Army pharmacists, 78 were retired Navy pharmacists, and 96 were retired Air Force pharmacists. In addition, a cohort of 10 retired U.S. Public Health Service (USPHS) pharmacists who had been detailed to the Coast Guard was made available for a total sampling frame of 276 retired military pharmacists. In an attempt to enhance the dissemination of the survey within the USPHS, the survey was also made available through a monthly newsletter directed at both active duty and retired members of the USPHS. Because of low response generated by the USPHS newsletter-based deployment of the survey, those responses were not carried forward in the analysis leaving a total sampling frame of 276 retired pharmacists. Questionnaire Development, and Measures The questionnaire was designed and tested by an expert panel consisting of four retired military pharmacists, three non-military pharmacists and one pharmacy student. The resulting questionnaire consisted of 47 items. The participants were asked to provide personal demographics (age, gender), military information (branch of service, date of commissioning, prior enlisted experience, geography of assignments, deployment into hostile territory, military pharmacy practice duties), and retirement information (year, rank). Although the Pew study cited previously collected information on race/ethnicity, it was not reported in its findings as a factor influencing transition to civilian life or work life. 7 As a result, ethnicity was not collected as one of the demographics in this study. Information was also collected on the transition period following their retirement including the time lag between retirement and start of first civilian employment, the number of different employers since retirement, and the length of the shortest tenure in case of multiple employments. Finally, the participants were asked to compare different aspects of their current employment with their last active duty assignment to include: level of overall job satisfaction, level of responsibility, work environment (including the levels of bureaucracy, camaraderie, purpose, commitment, flexibility, stress, and coworkers), rewards (including the level of financial compensation, opportunities for professional development and career advancement, and health benefits), and level of supervisory support (including executive leadership and availability of personnel, equipment, and supply recourses). The questionnaire included additional items asking about their perception of their military experience, transition to civilian work, and the impact the military career had on their personal and family life. The primary outcome measure in this study was the perceived ease/difficulty of transition from the military to a civilian work environment. Data Collection The study methods and questionnaire were reviewed and approved by the Ferris State University Institutional Review Board. The questionnaire was administered online using SurveyMonkey (Surveymonkey, Palo Alto, California). The participants in this study received an invitation from their military liaison, providing a brief summary of the study, assurance of anonymity, informed notice of voluntary participation, estimation of time to complete the questionnaire, and the URL for the survey Web site. Two weeks later, participants received a follow-up message, which expressed appreciation for those who completed the questionnaire and reminder for those who did not (with URL). Upon completion of the 10-week data collection period, data obtained from the completed Web-based questionnaires were transferred to an analytical database. Data Analysis Descriptive statistics were used for demographics and employment history information. Spearman rank-order correlation was used to explore the relationship of the attributes of the work environment to job satisfaction and perceived difficulty of transition to civilian life. Forward stepwise multiple regression was used to determine potential predictors of perceived successful transition from military to civilian career path (dependent variable). Independent variables included the level of satisfaction with the current employment, characteristics of the work environment, perception of military career experience, demographics, and variables describing the transition period (number of employers, shortest tenure, and time of first postretirement employment). Regression diagnostics were used to determine if any of the regression models assumptions were violated. An a priori α level of < 0.05 was chosen for statistical significance. The data were analyzed using STATA 1220 MILITARY MEDICINE, Vol. 180, December 2015

3 statistical package software, version 10.1 (StataCorp, College Station, Texas). TABLE I. Characteristics of the Study Respondents Mean (SD) Range Age (6.76) Years in the Military (4.73) Time Since Retirement (7.46) 0 39 Number (Total) Percentage Gender Male 121 (134) Gender Female 13 (134) 9.70 Service Air Force 55 (135) Army 40 (135) Navy 35 (135) PHS Corps detailed to 5 (135) 3.70 the Coast Guard Highest Rank Achieved a O-3 1 (135) 0.74 O-4 8 (135) 5.93 O-5 61 (135) O-6 65 (135) Enlisted Experience (Yes) 39 (135) a Rank Designation: O-3 (Army/Air Force-Captain; Navy/Coast Guard- Lieutenant), O-4 (Army/Air Force-Major; Navy/Coast Guard-Lieutenant Commander), O-5 (Army/Air Force-Lieutenant Colonel; Navy/Coast Guard- Commander), O-6 (Army/Air Force-Colonel, Navy/Coast Guard-Captain). RESULTS At the end of the data collection period, 140 (50.72%) retired military pharmacists responded to the questionnaire. Characteristics of the respondents are outlined in Table I. The average age reported by the study participants was (standard deviation [SD] = 6.76) and 90.30% were male. Thirty nine of the respondents (28.89%) indicated having prior enlisted time before they were commissioned as pharmacy officers. For these individuals, the average number of years of prior enlistment was 4.21 (SD = 3.05). Army (35.89%) and Navy (35.89%) retirees were most likely to have a prior enlisted experience. While in the military, respondents reported being assigned to facilities within the continental U.S. area (CONUS) for an average of years (SD = 4.37) and to facilities outside of the continental U.S. (NonCONUS) for an average of 3.84 years (SD = 3.57). Respondents generally perceived NonCONUS assignments more favorably with 51.92% describing them as either much more favorable or somewhat favorable. Out of the total number of respondents, 68 (48.57%) indicated that they have been deployed to hostile areas for an average of 4.46 months (SD = 7.09), and 71.64% of those deployed rated their deployment experience as either very favorable or somewhat favorable. Army and Navy retirees reported longer deployments in hostile areas with an average of 5.64 (8.88) months and 5.60 (7.89) months, respectively. Participants retiring at O-4 rank (Major for Army/Air Force, Lieutenant Commander for Navy/Coast Guard) reported longer deployments in a hostile area with an average of 9.56 (9.40) months. When asked if they would repeat the decision to follow a Uniformed Services pharmacy career path, 91.85% of respon dents indicated that they would be either very likely or somewhat likely to do so. The majority of participants (81.48%) indicated that it is either very likely or somewhat likely that they would encourage their offspring to follow a Uniformed Services pharmacy career path. Participants were asked to rank-order the importance of a number of postretirement military benefits. Military retirement pay was ranked as the most important by 83.1% of respondents, health care services was ranked as the second most important benefit by 70.37% of respondents, Veterans Administration (VA) benefits was ranked third by 43.38%, access to military services was ranked fourth by 44.12% of respondents, and 58.1% of respondents ranked access to professional military organizations as the least important. In terms of influence on respondent s personal and family life, 71.97% of respondents indicated that they either strongly agree or somewhat agree that the growth and development of their children benefited by being raised in a Uniformed Services Environment. On the other hand, 70.9% indicated that the relationship with their spouse or partner was either very stressed or somewhat stressed by their service in the military. Respondents did enjoy certain aspects of a military pharmacy career path with 88.24% having either agreed or strongly agreed that they enjoyed the opportunity to relocate and experience new geographic locations. Following their retirements, a significant portion of participants in this study (83.58% and 66.91%) indicated (either agree or strongly agree, respectively) that they miss the pride of wearing a uniform and the military structure and chain of command respectively. Participants were also asked to rate how well their transition from a military to civilian professional career met with their expectations. Of the total number of respondents, 19.3% perceived it as more difficult or somewhat more difficult than they thought it would be. More than half of the respondents (52.6%) perceived it to be about what they expected, while 25.9% perceived it as somewhat easier or much easier than they thought it would be. Figure 1 describe categories reported by the study participants for their first post- Uniformed Services job and their current job. Out of the total number of respondents, 75 (53.57%) changed jobs at least once since they retired. More than half of the participants in this survey (51.97%) reported having two or more employers since their first post- Uniformed Services job. For those who switched jobs, the shortest tenure reported was, on average, days (SD = 41.58). The majority of study participants (80.2%) started their postretirement employment either immediately or within 1 to 3 months of their retirement date. Respondents were asked to compare certain attributes of their current job with their last active duty assignment (Table II). They generally perceived the level of responsibility, MILITARY MEDICINE, Vol. 180, December

4 FIGURE 1. Postretirement job category: (A) First post-retirement job. (B) Current job. Other Category: include entries like retired, volunteer, student, mail-order pharmacy, long-term care pharmacy, health IT, federal government, professional associations, paramedic/firefighter, and business development. Pharmaceutical Industry Category includes: sales, clinical, research. Hospital Pharmacy Category includes: dispensing, clinical, administration, non-pharmacy related. Retail Pharmacy Category includes: dispensing, administration. TABLE II. Respondent Perception of Current Job Characteristic as Compared to Last Active Duty Assignment Much Greater Somewhat More The Same Somewhat Less Much Less Level of Responsibility (%) Level of Camaraderie (%) Level of Purpose (%) Level of Commitment (%) Amount of Flexibility (%) Level of Stress (%) Level of Support-Supervisor (%) Level of Support-Leadership (%) Level of Resources (%) Level of Competency (%) Level of Bureaucracy (%) Level of Satisfaction (%) Level of Financial Compensation (%) Career Broadening Activities (%) Opportunities for Promotion (%) camaraderie, stress, and opportunities for promotion and career broadening activities to be somewhat or much less than their last active duty assignment. On the other hand, a sizable portion of study participants perceived the level of financial compensation (55.1%) and flexibility (40.3%) to be somewhat or much greater than their last active duty assignment. Responses to the perception of transition difficulty and level of satisfaction with the current employment were correlated with response to characteristics of the work environment items (Table III). The level of responsibility in the current work environment, level of stress, and perceived competence of co-workers were not significantly correlated with perceived difficulty of transition. A number of variables were found to be significant predictors in a multivariate regression analysis (Table IV). The perception of an easier transition was more likely among participants who have been retired earlier, those who rated postretirement VA benefits and access to military facilities highly, participants who are currently working in the pharmaceutical industry (sales), and those indicating that their committed long-term personal relationships were not stressed by their service in the military. Perception of a more difficult transition on the other hand was more likely among participants who strongly miss the military structure and chain of command and those reporting greater levels of bureaucracy in their current job. DISCUSSION According to our model, approximately 50% of the variation in transition to the civilian sector by retiring military pharmacists is explained by continued access to military and VA benefits, a perception of bureaucratic obstruction in their current job, the degree to which they miss the structure and chain of command of the military, time elapsed since their retirement from the military, stability of their long-term relationship, and current job-pharmaceutical industry (Table IV). Those who rated certain postretirement military benefits (particularly access to military facilities and VA benefits as most important) were more likely to perceive their transition as easier. A possible explanation for this finding may lie in the fact that retirees who perceived a significant continuation of military and/or VA benefits did not feel the pressure to select future employment based on what an employer s benefit package did or did not include. A retiree could thus direct their employment search to jobs that better matched their skill sets and desires rather than those that provided a secure benefit package MILITARY MEDICINE, Vol. 180, December 2015

5 TABLE III. Correlation Coefficients between Characteristics Attributes of the Work Environment to Job Satisfaction and Perceived Difficulty of Transition to Civilian Life Level of Satisfaction Transition (r) With the Current Job (r) Level of Responsibility a Camaraderie a a Purpose a a Commitment a a Flexibility a a Stress a Supervisor s Support a a Leadership s Support a a Resources a a Bureaucracy a a Co-workers Competence a Financial Compensation a a Career Broadening a a Promotion a a Level of Satisfaction a a The Measures of Association were Statistically Significant at p < The only aspect of work environment that was identified as having a statistically significant influence on the transition experience for retired military pharmacists was the amount of bureaucratic obstruction they perceived in their current job. Military pharmacist retirees who perceived a high level of bureaucratic obstruction in their current job were less likely to report an easier transition to the civilian sector. Upon retirement, military pharmacists are usually at a rank and position within their organizations that are associated with considerable authority, latitude, and autonomy. A retirement career move which places them in a work environment where they do not have the same ability to influence the bureaucratic pace of an organization could explain the more difficult perception of the transition variable. The extent to which a retired military pharmacist misses the structure and chain-of-command of the military is a statistically significant predictor of the perceived difficulty of transition to the civilian sector. The military work environment is usually defined by a chain of command and a clear set of rules of behavior and interaction. 10 Since many civilian work environments lack such a clear structure, some military retirees may face difficulty adjusting to what they may perceive as ambiguous work environments. This may make the transition to civilian life more difficult because of perceived lack of structure, order, and direction, especially for those whose career identity has been shaped more by their experiences as a professional military officer. Similar to any transition process, most people take time to adjust to the new realities of their lives after retirement. Our findings indicate that as more time elapses after retirement, perception of transition becomes significantly easier. The stability of a participant s long-term personal relationship(s) while in the military was found to be significantly associated with perceptions of easier transitions. This finding is consistent with what researchers at the Pew Research Center reported. 7 The Pew Research Center report showed that among those married while they were in the military, 61% veterans who had experienced problems with their marriage while deployed had a difficult time re-entering civilian life. In contrast, 39% of those who reported that deployments had a positive or no impact on their marriage said they had problems re-entering civilian life. Interestingly, the only job category that was found to be significantly associated with a perception of an easier transition was pharmaceutical industry. Sample size restrained our ability to perform subset analysis to investigate aspects of working for the pharmaceutical industry that are more likely to be associated with an easier transition. Working in sales in the pharmaceutical industry was associated with higher than average scores in terms of flexibility and financial compensation. LIMITATIONS This study has a number of limitations that should be considered. The use of service branch list serves maintained by the military liaisons may result in the study results not being generalizable to the target population of retired military pharmacists. Future studies may consider implementing a strategy which utilizes sampling frames derived from the official discharge records kept by each of the branches of the U.S. Armed Forces for retired military pharmacists. This was an exploratory study intended to generate preliminary TABLE IV. Predictors of Successful Transition from a Military to a Civilian Work Environment Variable Coefficient p Value Confidence Interval Intercept to Level of Bureaucracy in Current Job to Time Since Retirement to Miss Military Structure and Chain of Command to Current Job-Pharmaceutical Industry (Sales) < to Access to Military Facilities < to VA Benefits to Committed Long-term Personal Relationship Not Stressed by Military Career to Model Adjusted R 2 = 0.482, p < MILITARY MEDICINE, Vol. 180, December

6 information to shed light on the transition experiences of retired military pharmacists and identify salient factors predicting an easier and more successful transition. CONCLUSION Findings from this exploratory study suggest that the majority of retired military pharmacists surveyed perceived transition into the civilian professional sector to be about what they expected or easier than they thought it would be. Future studies are needed to validate these findings and demonstrate their generalizability to the entire target population. ACKNOWLEDGMENTS The following individuals are acknowledged for their participation in the study: Allison Bernknopf, Carl Tullio, David Price, Roger Williams, and Aaron Middlekauff. REFERENCES 1. Louis MR: Career transitions: varieties and commonalities. Acad Manage Rev 1980; 5(3): Bayles BC, Hall GE, Hostettler C, Gibson J, Woker DR: Pharmaceutical services in the United States Navy. Am J Health-Syst Pharm 1997; 54(7): Strate RD, Brier KL: Pharmacy practice in the United States Air Force. Am J Hosp Pharm 1987; 44(4): Williams RF, Moran EL, Bottaro SD 2nd, et al: Pharmaceutical services in the United States Army. Am J Health-Syst Pharm 1997; 54(7): Young JH: Pharmaceutical services in the United States Air Force. Am J Health-Syst Pharm 1997; 54(7): Farley J: Military-To-Civilian Career Transition: The Essential Job Search Handbook for Service Members (Military-To-Civilian Career Transition Guide), Ed 2. Indianapolis, IN, Jist Works, Pew Research Center: War and Sacrifice in the Post-9/11 Era: The Military- Civilian Gap Available at 10/veterans-report.pdf; accessed March Baruch Y, Quick JC: Understanding second careers: lessons from a study of U.S. Navy Admirals. Hum Resour Manage 2007; 46(4): Vigoda-Gadot E, Baruch Y, Grimland S: Career transitions: an empirical examination of second career of military retirees. Public Pers Manage 2010; 39(4): Yanos RC: Perceptions of Transition to Civilian Life among Recently Retired Air Force Officers. University of Maryland, Department of Human Development, College Park, MD, MILITARY MEDICINE, Vol. 180, December 2015