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Pastoral power in the community pharmacy: A Foucauldian analysis of services to promote patient adherence to new medicine use

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  • Waring, Justin
  • Latif, Asam
  • Boyd, Matthew
  • Barber, Nick
  • Elliott, Rachel

Abstract

Community pharmacists play a growing role in the delivery of primary healthcare. This has led many to consider the changing power of the pharmacy profession in relation to other professions and patient groups. This paper contributes to these debates through developing a Foucauldian analysis of the changing dynamics of power brought about by extended roles in medicines management and patient education. Examining the New Medicine Service, the study considers how both patient and pharmacist subjectivities are transformed as pharmacists seek to survey patient's medicine use, diagnose non-adherence to prescribed medicines, and provide education to promote behaviour change. These extended roles in medicines management and patient education expand the ‘pharmacy gaze’ to further aspects of patient health and lifestyle, and more significantly, established a form of ‘pastoral power’ as pharmacists become responsible for shaping patients' self-regulating subjectivities. In concert, pharmacists are themselves enrolled within a new governing regime where their identities are conditioned by corporate and policy rationalities for the modernisation of primary care.

Suggested Citation

  • Waring, Justin & Latif, Asam & Boyd, Matthew & Barber, Nick & Elliott, Rachel, 2016. "Pastoral power in the community pharmacy: A Foucauldian analysis of services to promote patient adherence to new medicine use," Social Science & Medicine, Elsevier, vol. 148(C), pages 123-130.
    • Handle: RePEc:eee:socmed:v:148:y:2016:i:c:p:123-130
    DOI: 10.1016/j.socscimed.2015.11.049
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    1. Shih, P. & Worth, H. & Travaglia, J. & Kelly-Hanku, A., 2017. "Pastoral power in HIV prevention: Converging rationalities of care in Christian and medical practices in Papua New Guinea," Social Science & Medicine, Elsevier, vol. 193(C), pages 51-58.
    2. Petrakaki, Dimitra & Hilberg, Eva & Waring, Justin, 2018. "Between empowerment and self-discipline: Governing patients' conduct through technological self-care," Social Science & Medicine, Elsevier, vol. 213(C), pages 146-153.
    3. Kendrick, Hannah & Mackenzie, Ewan, 2023. "Austerity and the shaping of the ‘waste watching’ health professional: A governmentality perspective on integrated care policy," LSE Research Online Documents on Economics 120265, London School of Economics and Political Science, LSE Library.
    4. Butler, Clare, 2019. "Working the 'wise’ in speech and language therapy: Evidence-based practice, biopolitics and ‘pastoral labour’," Social Science & Medicine, Elsevier, vol. 230(C), pages 1-8.

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