CPJ/RPC • MAY/JUNE 2020 • VOL 153, NO 3 137 EDITORIAL COMMENTARY © The Author(s) 2020 Article reuse guidelines: sagepub.com/journals-permissions DOI:10.1177/1715163520913902 COMMENTARY * PEER-REVIEWED 913902CPH XX X 10.1177/1715163520913902C P J / R P CC P J / R P C research-article 2020 Professional identity in pharmacy: Opportunity, crisis or just another day at work? Jamie Kellar, BScHK, BScPhm, PharmD ; Jennifer Lake, BSc, BSc(Pharm), PharmD; Naomi Steenhof, BSc, BScPhm, MHPE ; Zubin Austin, BScPhm, MBA, MISc, PhD, FCAHS Vignettes A pharmacist receives a prescription and believes there is a dos- ing error, so calls the physician to clarify. Te ofce secretary takes a message to pass on to the physician. An hour later, the secretary calls back and says, “I spoke with the doctor and the prescription was written correctly. Dispense as it is written,” providing no other information or details. Te pharmacist then documents “spoke with MD ofce and confrmed dose.” In this scenario, the pharmacist identifed a potential prob- lem and contacted the physician’s ofce. Instead of speaking directly with the physician, the pharmacist passed information to the secretary and was satisfed when she called back con- frming that the physician wanted the prescription dispensed as written. Why are we so easily convinced that just because physicians confrm they want something, it is automatically correct? Now, let’s look at the scenario below. A mother approaches the pharmacist—her son has just been prescribed medication for attention-defcit hyperactivity disor- der (ADHD). She is alarmed by the research she has done on these drugs and wants the pharmacist’s thoughts on the use of these medications. Te pharmacist responds, “I’m sure the phy- sician thought this was the best thing for your son. You should probably go ahead with it.” In this scenario, the pharmacist has an opportunity to pro- vide education to a concerned mother about her child’s medica- tion but ignores her request and defers the responsibility for the medication choice back to the physician. In both cases, the phar- macist behaves in a manner that is deferential to the physician and discounts their own skills and expertise. Why? We propose that the underlying reason pharmacists practise in this way is because they lack a professional identity. Tis has a signifcant impact on the uptake of professional services and how the pro- fession is perceived by other health care providers and society. Pharmacists have discussed the topic of practice change for decades, yet research suggests there is little substantive change in day-to-day practice. 1-5 Despite signifcant transitions in both health care and education, including expanded scopes of prac- tice and a change from Bachelor of Pharmacy to entry-level Doctor of Pharmacy degrees, 6-8 many pharmacists are not engaging with new roles (e.g., renewing and adapting prescrip- tions, prescribing, regulation of pharmacy technicians) and continue to focus largely on dispensing functions, resembling practice of a century ago. 8 Why is this the case? Some proposed barriers include lack of time, autonomy, confdence, remu- neration, information and recognition by both physicians and patients. 1-5,9-11 However, even as many barriers are addressed, resistance to change continues. 1-5 Tis is not a Canadian phe- nomenon. Pharmacy around the world is experiencing the same resistance to practice change. 9,10 Other professions have looked to professional identity formation and its role in prepar- ing health care practitioners to function in and adapt to chang- ing health systems. Specifcally, we propose that the absence of a clear professional identity in pharmacy 12-15 contributes to the profession’s inability to embrace change and move forward. Professional identity and pharmacy Interest in the importance of professional identity and its infuence on pharmacy practice is growing. 16,17 Elvey et al. 12 identifed 9 unique identities of pharmacists, which they argued lead to role confusion and a lack of clear professional direction. Gregory and Austin 14 examined how pharmacists navigated personal health crises and reliance on professional identity; their fndings suggested that pharmacists may have