Hive Health

In 1993 George Ritzer described the concept of McDonaldisation. He suggested that the principals behind the world domination of McDonalds had relevance far beyond fast food and were enabling globalised fast living in all sorts of different ways.

In 2000 Harding and Taylor took this theory and proposed that the big high street/ supermarket chains represented the McDonaldisation of pharmacy. ‘Fast-pharmacy’ was built on traits of efficiency, calculability, predictability and control opposed to a service based offering in smaller chains or sole-owned pharmacies.

While these 4 traits remain readily identifiable within, in particular, supermarket pharmacies other large chains (such as Boots) appear to have moved on. In 2006 Ritzer elaborated on his theory to describe the process of Starbucksisation as a variant on the McDonaldisation model. In this incarnation the focus is on promoting a premium product and the customer experience while still benefitting from a streamlined business model. In Starbucks we are encouraged to ‘hang out’ and have meetings on comfortable sofa’s while drinking ‘premium’ coffee in porcelain mugs. In reality however the experience is highly rationalised. Coffee beans are bought in bulk, the vast majority of customers take-out and don’t participate in the ‘community’ offer and barista skill is replaced by standardised protocols. Ritzer argues that Starbucks represents a case of emperor’s new clothes. The apparently individualised and locally determined offer cannot disguise the mass marketing strategy and the critiques of McDonaldised society still apply.

For pharmacy this shift towards a Starbucks-like model is perhaps more significant than it might at first seem. In the drive to reposition pharmacy within the British healthcare system there are calls for pharmacies to become ‘healthy living centres’ at the ‘heart’ of local communities. While the McDonaldised offer finds it difficult to answer to these demands a ‘Starbucksised’ model that provides an ersatz ‘consistently local’ experience seems to be a perfect fit and it is these chains that are most keenly exploring this new direction for pharmacy.

Whether or not this move presents a problem depends perhaps on your perspective.

For pharmacy as a profession a number of concerns associated with a business model that remains strongly determined by centralised management include: decreased personal involvement and autonomy of the individual pharmacist resulting in de-skilling, the need to place shareholder interests over and above potential patient benefit and the fact that the ‘brand‘ sits as a higher level communicator with the consumer and defines the professionality or otherwise of the pharmacist on his/her behalf.

Added to this, with just nine McDonaldised and Starbucksised pharmacy groups now holding around 50% of all pharmacy contracts in the UK the influence of this model in determining the direction of future pharmacy policy cannot be ignored. How the Starbucks model shapes the ‘healthy living centre’ will, in particular, have an impact on the types of environment pharmaceutical products are sold/ dispensed within and the type of expertise and services that are offered alongside medicines.

Food for thought next time you grab a latte…