Relating ownership type to the organizational behaviour, role orientation and autonomy of community pharmacy managers in Canada
Community pharmacists are unique amongst professionals as they practice their profession in a commercial environment. This environment, where the dichotomy between the professional and business aspects of community pharmacy practice intersect, can place the professional objectives of pharmacy at odds with the business objectives. At the same time, ownership of community pharmacies is transitioning from pharmacist-owned and -operated establishments, to corporate-owned and -operated.The objective of this study was to investigate whether ownership type influences the pharmacists’, or in this case the pharmacy managers’, organizational behaviour, role orientation and professional autonomy. Specifically, exploring whether ownership type (independent, franchise, corporate) impacts the professional, business and environmental (organizational) aspects of community pharmacy practice.This study employed both quantitative and qualitative research methods. A cross-Canada, self-administered postal survey of community pharmacy managers was conducted in the spring of 2007. Contact information was obtained from individual provincial regulatory bodies across Canada and a stratified, random sample of community pharmacy managers was compiled. Items centred on professional and employer authority, manager autonomy, level of managerial control, orientation to professional and business aspects of practice and the manager role, affinity to professional and business characteristics of community pharmacy practice, and innovation. The survey was followed by semi-structured, in-depth telephone interviews with select self identified respondents from the survey portion of the study.The random, stratified sample consisted of 2,000 community pharmacy managers. Of the 2,000 questionnaires mailed out, 39 were returned as undeliverable. A total of 646 responses were received, for a response rate of 32.9 percent (646/1,961); while the response rate may not be ideal, the sample size was purposely made larger to account for the possibility of a low response rate. Seven interviews were conducted following the survey.Ontario, as the largest province, had the most responses with 289 (44.7%), and the majority of respondents were male (393, 60.8%). The greater part of respondents indicated their sole degree was their Bachelor of Pharmacy practice degree (499, 77.2%). A larger majority of respondents were either the pharmacy manager (398, 61.6%) or owner (215, 33.3%). Just under half of respondents practiced in independent pharmacies (44.6%), while 35.4 percent practiced in corporate pharmacies and 18.4 percent practiced in franchise pharmacies.As a whole, respondents were more likely to have access to information required for making clinical rather than business decisions. One quarter (24.4%) of respondents were never or rarely willing to go against company policies to carry out their professional duties, while one third (33.4%) were often or always willing to do so. Less than one-fifth (17.4%) of respondents had to follow policies(professional and business) developed by non-professionals, while 42.6 percent had to follow policies only with regard to business practices. The majority (89.5%) agreed that it is possible to be both a good professional and a successful businessperson.Fifteen distinct constructs emerged regarding (1) professional and (2) employer authority, (3) manager autonomy, (4) decision-making, (5) managerial control, (6) professional characteristics, orientation to (7) professional and (8) business aspects of the manager role, affinity to (9) professional and (10) business characteristics of community pharmacy practice, (11) connection to the employer,(12) role conflict, (13) innovation, (14) bureaucracy and (15) manager requests. The main independent variable was ownership structure: independent, franchise, or corporate. In analyzing the independent variable by the above constructs, significant differences (p < 0.05) arose for all constructs except for three related to the professional nature of practice: professional practice standards, professional orientation and professional affinity. Independent and franchise respondents were more likely to agree that the employer should influence practice standards than corporate respondents (p < 0.001). When exploring the level of autonomy respondents had in their pharmacy, significant differences arose among all three respondent types (p < 0.001); respondents in independent pharmacies felt they had the highest level of autonomy followed by franchise respondents and then corporate respondents, with more than one standard deviation difference between independent and corporate respondents.Significant differences also emerged among the three respondent types with regard to the amount of control the respondent had in their pharmacy (p < 0.001); independent respondents felt they had the most control followed by franchise respondents and then corporate respondents, with almost one standard deviation difference between independent and corporate respondents. With regard to business orientation and affinity to business related aspects of practice, independent and franchise respondents were significantly (p < 0.001) more likely to place higher importance on such activities than corporate respondents. Results of the interview portion of the study were used to bring a greater understanding to the survey portion of the research. There were a total of seven interviews conducted, with each interview lasting between 30 and 90 minutes in length. A total of nine themes emerged from the interviews: (1) autonomy, (2) behaviour, (3) environment, (4) future, (5) human resources, (6) image, (7) incentives, (8) professional standards and (9) role as manager.Finding of this study suggest that regardless of ownership structure, respondents emerge as professionally orientated and focused. Independent respondents appear to have more autonomy, control and decision-making capabilities than corporate respondents. Despite being professionally orientated and focused, corporate respondents appear cognizant of the restrictions placed on pharmacy practice in their pharmacy. On top of ownership structure, the dependent variables of age, gender, geographic region and years with employer appear to play a role in answers provided by community pharmacy managers.As ownership of community pharmacy continues to transition from pharmacist controlled to corporate-owned, managers, owners and the profession must acknowledge the professional implications that may result. While this study adds to the community pharmacy practice literature, there is recognition that additional research is necessary pertaining to the dynamic nature and culture of community pharmacy practice.
DegreeDoctor of Philosophy (Ph.D.)
SupervisorDobson, Roy T.
CommitteeRigby, John; Neubauer, Shannan L.; Findlay, Isobel M.; Farris, Karen B.; Suveges, Linda; Taylor, Jeff G.