"Reigns but does not govern": A reflection on professionalism and the autonomy of the pharmacist.

Introduction: In recent decades, the professionalization of pharmacy has been debated worldwide. With the advent of industrialization, pharmacist autonomy has weakened, especially in the retail pharmacy market. Manegers and mentors of pharmacy chains serve as links between the profession and drug users. This study sought to understand the perceptions of retail pharmacy stakeholders regarding pharmacist autonomy and how to improve it, and to reflect on theories of professionalism.

Method: 19 semi-structured interviews were conducted. The interviews were transcribed and analyzed through analyst triangulation and categorical content analysis, using the ATLAS.ti software.

Results: Interviews were conducted with nine mentors and ten managers in retail medicine. They reported aspects related to managerial and technical autonomy regulated by law, and strategies for enhancing professional autonomy in retail pharmacy. Autonomy was considered limited by pharmacists' dependence on employability and self-devaluation; and market control exposed the weaknesses in pharmaceutical professionalism. Entrepreneurship and ownership attitude strategies were feasible only in a retail micro-political context.

Conclusion: The retail medicine continues to have business model centered on the product and controlling the pharmaceutical practice model. To ensure autonomy and professional strengthening, it is necessary that pharmacy recognizes itself as a clinical profession and develops a stable professional identity.