Professionalism and the Boundaries of Control: Pharmacists, Physicians and Dangerous Substances in Canada, 1840–1908

In the drive for the consolidation of professional authority, physicians in the nineteenth century sought to exert control over all associated occupations, and weaken the influence of competitors. Many historians have chronicled this process, as doctors and their associations sought to proscribe or eliminate competitors such as homeopaths, eclectics, chiropractors and Thomsonians. 1 Others have explored how physicians sought to subjugate allied occupations such as nursing, radiation technology and physical therapy. 2 Such studies consider power struggles in two contexts. First, doctors could and wanted to function without the interference of others in the health industry. Second, doctors sought to enforce a power structure that placed them at the top with all the other health care occupations beneath them, dependent upon the activities of the physicians to maintain their livelihoods. In both contexts, external factors and internal exigencies shaped the future identity of all occupational groups. 3 This paper examines the limits to the expansion of physicians' control over other medical professions. Using the example of the relationship between doctors and pharmacists in Canada from the middle of the nineteenth century to the beginning of the twentieth, it shows how pharmacists were able to curtail the supposed professional rapacity of physicians by using culturally resonant appeals to their own capability and professional 1 Paul Starr, The social transformation of American medicine: the rise of a sovereign profession and the making of a vast industry,The medical profession and alternative medicine in the Netherlands: its history and recent developments', Soc. Sci. Med., 1999, 48: 343±51. 3 Katherine Miller has discussed the dynamics of professional identity formation in`The evolution of professional identity: the case of osteopathic medicine', Soc. Specific case studies of identity formation are many, including Starr, op. cit., note 1 above; C David Naylor, `Rural protest and medical professionalism in turn-of-the-century Ontario',