6.7.1 Compartmentalisation
Two conflicting discourses have been indicated that guide pharmacists’ practice in private drugstores. One is being patient-centred, which has been identified as a professional value, and the other is profit, which has been identified as a business value. Being guided by different values, pharmacists in private drugstores clearly have mixed identities between professional and business persona. These hybrid identities are obviously incompatible because the different values guide pharmacists’ practice in either an ethical or non-ethical way. When pharmacists draw on the patient safety value, they adopt the identity of a professional delivering a pharmacy service in an ethical way. On the other hand, when pharmacists draw on the profit value, they construct and perform the identity of a businessperson; hence, their practice is aimed at their own rather than patients’ benefit.
This thesis finds that, in order to cope with conflicting identities, pharmacists in private drugstores choose to maintain both identities and perform different identities in different situations. This circumstance can be explained using Pratt and Foreman’s (2000) term “compartmentalisation”, which refers to the mechanism by which an individual preserves conflicting identities without achieving synergy between them.
In situations in which pharmacists perceived low risk to patient health, they would advertise products or supplements to increase sales. In such situations, pharmacists performed the identity of a businessperson. Drawing on a business discourse (profit value) in the identity construction process, pharmacists used sale techniques to increase profits for the business.
On the other hand, in situations in which drug misuse or abuse were presented, pharmacists drew on their professional value of patient safety to construct the identity of a professional and deliver their service ethically. Hence, it is clear that the private drugstore pharmacists maintained both identities and chose to perform each in different situations.
6.7.2 Dis-Identification, Identification and Integration
On the other hand, it is evidenced that some pharmacists were unable to balance the conflicting identities of being a professional and a businessperson. Hence, they left the role in which they were unable to identify their personal identity with their role identity, and maintained their other role which was congruent with their personal identity. Evidence is provided by a pharmacist who used to run her own drugstore whilst being a full-time public hospital pharmacist.
I used to run a drugstore but I closed it down because I think the role at the drugstore does not match with myself. I feel guilty about making profit from my work. I like to work in a hospital more because I think I can help people (P07).
This pharmacist perceived the business goal as conflicting with her personal value, and having to draw on the business goal in her service caused her to feel guilty. She could not reconcile the conflicting goals; hence, she decided to leave one role and maintain her public hospital role, which had a role identity more congruent with her personal identity.
The goal of business is to make profit but I feel guilty about selling drugs at expensive prices for them. I know that if they go to the hospital, they will pay much less than they pay in the drugstore. So I always recommended patients to the hospital instead of coming to my drugstore
(P07).
When asked why she liked to help others she further explained that:
... Since I was a child, my family taught me to believe in morality. Personally, I also like to help others (P07).
From her accounts, it can be seen that her personal identity, which was nurtured by her parents, is congruent with the role identity of a public hospital pharmacist. Thus, she formed a professional identity by integrating her personal identity with the role identity of a pharmacist in the public hospital context. Her interview reveals that the businessperson identity of a private pharmacist did not match her personal identity. Thus, she felt guilty about make a profit, because the profit value was mismatched with her personal value of helping others.
Another pharmacist also experienced a mismatch between personal and role identity.
I don’t like to work in business. I think I am more suited to a hospital role (P08).
She added:
I like being able to help other people. I also feel guilty about making money from other people’s illness (P08).
Both pharmacists expressed conflict between the role identity of a businessperson and their personal identities. Neither was able to trade off their professional value against the profit value, so they left one role and remained in the role of hospital pharmacist, which was more congruent with their personal identity.
The terms “dis-identification” and “identification” are borrowed from social identity theory to explain the identity construction processes evidenced in the above examples. When personal identity and role identity were in conflict, the pharmacists dis-identified themselves from the role identity and chose to identify themselves with the role of public hospital pharmacist, which was more congruent with their personal identity. They also integrated their personal identity with the role identity of a hospital pharmacist to strengthen their professional identity.
It is worth noting that the two respondents have personal values which are congruent with their professional values. Their professional value of being patient- centred is seen as being rooted in their family background, as they said that their parents played a role in nurturing their moral values. Family-influenced identity construction will be discussed in Section 6.8.
In conclusion, pharmacists who work in private drugstores acknowledged two conflicting identities – being professional and being businesspeople. These two identities require different behaviours. Those who remain in private pharmacist roles may be able to balance the two conflicting values, or may trade off their professional value against their business value. The process used to maintain both identities without achieving synergy between them is the compartmentalisation mechanism. Hence, pharmacists who perform both roles may maintain both identities and perform each of them in different situations.
On the other hand, two pharmacists who were unable to balance these conflicting identities dis-identified themselves from their business identity and identified themselves with the hospital pharmacist identity, integrating their personal identity with the identity of hospital pharmacist. Thus, they left one role and remained in the other which was congruent with their personal identity.