The role of hybrid healthcare enterprises in marginal communities: exploring Greek community pharmacies

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Abstract
Purpose: The paper argues that the Community Pharmacy (CP) is an example of a hybrid enterprise that spans across social fields. Using a Bourdieusian practice theory lens and longitudinal data, the research explores the role of these hybrid health enterprises in the marginal communities they serve. We pay regard to times of crises as the boundaries of these enterprises are challenged.Design/methodology/approach: In longitudinal qualitative research, we undertook three rounds of interviews with the same CPs between 2020 and 2024 in provincial Greece. Greece provided rich context to explore the impact of the 2009+ Sovereign Debt Crisis and the 2019+ COVID-19 crisis on healthcare and entrepreneurship social fields. Thirty-three interview transcripts were translated, transcribed and analysed, identifying key themes.Findings: As hybrid enterprises CPs take on a plurality of roles, with a public health identity central. They adapted to successive crises, demonstrating the resilience of these for-profit enterprises during difficult economic times and their ability to flexibly seize opportunities during challenging healthcare times. CPs maintain relational practices oriented on healthcare goods but take on other community-supporting practices that require high cultural capital.Originality/value: The paper contributes to theory by recognising CPs as a unique form of everyday enterprise; extending Bourdieusian practice theory to explain changing practice within marginal rural communities; and considering how CPs may inherit cultural capital responsibilities vacated by other professionals. The paper has recommendations for policy that could help these critical everyday healthcare entrepreneurs and marginal communities survive.

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