In the New England Journal of Medicine for November 18, medical professionalism in society is discussed. The term profession originally denoted an avowal of belief in or obedience to the rigours of a religious order, but later came to mean the adoption of an occupation where expertise was expected of its practitioners. The concept of a profession has now been complicated by elements of a financial incentive, market competition, and the erosion of the trust of those whom the profession seeks to serve.
The true concept of a profession, be it medical, legal, instructional or pharmaceutical, involves co-operation and not competition among members of the body concerned. The desire to acquire wealth through the monopolising of specialised services to society was originally subordinated to the ambition to achieve recognition as a sound practitioner among one's fellow professionals. Without a moral and ethical background, professional services become a covert way of monopolising business. Professional self-regulation, though susceptible to abuse if not critically observed, serves essential social functions.
Professions, properly organised, protect not only vulnerable individuals but also vulnerable social values. They must take great care not to exert power for the object of advancing their members' interests. Moreover, they must not give way to the belief that if services are not thought to be adequately rewarded by the authorities their scope must be curtailed to conform to the notion of ‘‘value for money". Above all, they must not permit the idea that it is right to give the patient or the client what he or she demands rather than what the expert practitioner judges to be best in the circumstances. In pursuing these objectives, it is ethically permissible, if not obligatory, for members of a profession to exert political pressure on governments which decide on remuneration.
Within the practice of pharmacy there are signs that the ideals of professionalism are being eroded in the interests of commerce. It is inescapable, though perhaps regrettable, that the history of pharmacy has to a great extent established the pharmacist in the eyes of the public as a shopkeeper. Most of our present troubles arise from the need, in community pharmacy particularly, to compete in the market place, where enormous corporations strive to overcome the stumbling block which small businesses present to their directors' and shareholders' eyes.
Today, power, commercial and political, is concentrated in the hands of multinational corporations, the result of