The Enduring Irrationality of Rationalization: The Unchangeable Work of Pharmacy Workers During a Global Pandemic



Pastor, Nina

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The notion of ‘making a living’ has transformed how society thinks about work and how institutions and organizations shape how work is performed; not simply through the physical elements, but also through the social, cultural, and economic implications of work (Watson 2008). Modern work structures are highly bureaucratic, rationalized, and driven by capitalistic pursuits. This study aims to investigate how bureaucratization, capitalism, and rationalization or its modern take, McDonaldization, determine work structures and work experiences in retail pharmacies before and during the COVID-19 pandemic. Retail pharmacies exist at the intersection of capitalist and non-capitalist pursuits (healthcare) and thus are especially insightful spaces for understating modern work structures and experiences. To do so, I conducted field observations of retail pharmacies and 14 semi-structured in-depth interviews with pharmacy workers (4 pharmacists, 7 certified pharmacy technicians, 2 non-certified pharmacy technicians/trainees, and 1 pharmacy intern) at three of the biggest retail pharmacy chains in the country. This research was supplemented by my eight years of work history with multiple retail pharmacies. Findings suggest that the increasing bureaucratization, rationalization (or McDonaldization), and drive for profit significantly impact work structures and experiences of retail pharmacy workers. Results also indicate that the arrival of the global pandemic only temporarily slowed down these effects, which picked back up immediately along with a boost from new pandemic-related processes, operating procedures, and services. Further, increasing bureaucratization and rationalization has led to rampant irrationalities in pharmacy work such as inefficient and unpredictable bureaucracies, poor quality services, and loss of human and practical control. As a result, pharmacy workers are leaving retail pharmacies for other fields and non-retail pharmacy jobs. Pharmacy workers leaving retail pharmacies can significantly affect communities. Further research on similar work structures and organizational institutions is needed to bring attention to and address the irrationalities of highly bureaucratized and rationalized healthcare systems with the expanding profit-driven capitalist approach.



Rationalization, Bureaucratization, McDonaldization, Capitalism, Retail pharmacy, Healthcare