JOHNSON CITY, Tenn. (WJHL) — The 54 new East Tennessee State University Gatton College of Pharmacy students attending Friday’s white coat ceremony were part of a trend — declining enrollment that officials at the privately funded school lay squarely at the feet of a 2019 tuition decrease at Tennessee’s other state pharmacy school.

“We’re going to weather the storm, and we’re going to come out on the other side strong — this is a great program — but it still comes down to the people of this region. The potential future pharmacists in this region are having to make really difficult decisions because of the tuition disparity,” Gatton Dean Debbie Byrd told News Channel 11.

Tuition at East Tennessee State University’s Gatton College of Pharmacy is about 70% higher than that at the University of Tennessee’s Memphis campus. (WJHL photo)

Byrd said those difficult decisions and continued low enrollment come as demand for pharmacists has rebounded sharply. She expects the Southern Appalachian market to continue to need more pharmacists than supply provides for some time as the profession takes on additional roles working within primary care settings.

“We have graduates this past year that received sign-on bonuses to stay in the area because pharmacies are having difficulty filling open positions,” Byrd said. “And the number of graduates over the next few years is going to continue to go down.”

Rep. Gary Hicks (R-Rogersville) led a failed effort last year to get the legislature to provide parity with the UT-Memphis pharmacy school, where in-state tuition is $22,730 a year and out-of-state is $27,374. Gatton, which was established as a self-sustaining school that wouldn’t take state aid, charges $38,676 tuition whether students are in or out of state.

“Back in 2005, Tennessee was not in good financial shape,” Byrd said of the era when Northeast Tennessee committed to funding a college of pharmacy without state money. “That’s not true anymore.”

While the votes weren’t there to add the $3 million-plus to the budget to help close that gap last year, Byrd said she’s still hopeful a day will come when students who choose to attend Northeast Tennessee’s state pharmacy school won’t spend roughly $64,000 more doing it than their counterparts who choose Memphis. She said a group of leaders that includes her, ETSU President Brian Noland’s chief of staff Adam Green and the school’s legislative liaison and provost continue meeting frequently to develop strategies for closing the gap.

“I feel we have some momentum from last year, and honestly, the enrollment decline helps because it’s gotten attention that we couldn’t really get before,” Byrd said. “It’s sort of like ‘this is what’s going to happen if we don’t change some things.'”

Gatton College of Pharmacy Dean Debbie Byrd. (WJHL photo)

She said area legislators have been extremely supportive of the effort and mentioned some previous instances in which funding for new campuses and programs, or even transitioning some schools from private to public, have worked in the past in Tennessee.

For now, though, the numbers are in the third of what is likely to be four years of steep decline. In 2019, the school had 76 first-year students, 78 second years, 76 third years and 68 fourth years. The next year, just 54 came in, followed by 59 last year and 54 again this year.

There are 67 fourth-year students this year, but just 41 third-year students from that 2020 class of 54. The total enrollment has dropped from 298 in 2019 to 272 in 2020, 245 in 2021 and 211 this year and could easily drop below 200 next fall.

So far, those changes haven’t led to involuntary staffing cuts as some people have retired or moved to other jobs.

“We have been fortunate over the years to be able to reduce operations, expenses, but we are to that point now where, you know, future deficits, we can’t cover those with operations, it would be people,” Byrd said. “That’s where the future looks if things don’t settle out. Someone asked me yesterday, you know, ‘how do you sleep at night?’ and I said, ‘not very well.’ Because this is important.”

Byrd said pharmacists’ roles are increasing in health care itself. Gatton co-funded some pharmacist positions at State of Franklin Healthcare Associates and ETSU Health, “and since then those practices have hired their own pharmacists.”

She said the goal of such placements is better patient outcomes but that the additional personnel can be money well-spent.

“If their patients have better outcomes that ties back to their revenue, and if there are complicated patients that need a lot of education, the pharmacists can spend more time with them. And then the physicians can see more patients.”

Byrd’s afraid those kinds of efforts in the region will be hampered if the cost of attending continues to impact Gatton’s enrollment.

“I think the tuition is always a challenge and is even more of a challenge now.”