The community pharmacy and discursive complexity: A qualitative study of interaction between counter assistants and customers

The present paper examines the developing role of the medicines counter assistant (MCA) based in community pharmacies in the UK. In recent years, community pharmacies have been promoted as sources of primary care advice, and this has been accompanied by an increase in the number of pharmacy-only medicines made available for purchase without prescription. At the forefront of these changes is the MCA, who responds to requests for medicines and also advises customers seeking guidance on treating minor illness. This paper uses qualitative data drawn from non-participant observation of interactions between MCAs and customers in six community pharmacies in the south-west region of the UK. The data show communication in the pharmacy to be a complex process, characterised by multiple discourses including medical, retail and pharmaceutical information. At times, the different discourses worked in equilibrium, but there were also regular occurrences of clashes between the different discourses, where interaction became problematic. The authors argue that the current focus on pharmacy protocols to structure communication is, in some cases, too rigid for meaningful interaction and does not acknowledge the complexity of the encounter. A specific way forward for developing the interaction is discussed.