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Pharmacists: Questionable Practices
William T. Jarvis, Ph.D.
Drugstore pharmacists play special roles as health professionals.
Like other pharmacists, they occupy an important point of a triangle
with physicians and patients by providing information about medications.
Unlike practitioners in hospital pharmacies, drugstore pharmacists
are also engaged in rough-and-tumble businesses that must compete
with health-food stores, supermarkets, and others who sell dietary
supplements, nonprescription remedies, and weight-loss products.
As members of an ethical health profession, drugstore pharmacists
are faced with a dilemma. They must survive in an environment
- Their customers are generally ignorant about health and nutrition,
are searching for "magic bullets" to solve health problems,
and are highly vulnerable to exploitation.
- Their competitors are aggressive, not bound by professional
ethics, and are disdainful of consumer protection law and the
- Lawmakers and policy-makers have failed to impose uniform
standards for labeling and marketing of drugs (ie, articles
intended to prevent, alleviate or cure), thus creating a climate
of unfair competition that favors quackery.
- Many of their suppliers are engaged in public deception as
they create a demand for questionable and worthless products
through advertising and publicity.
Pharmacists are generally well educated enough to tell the
difference between products based upon science and those that
are scams. But the law of supply and demand is very real, and
they know that if dubious products aren't available in their drugstores,
consumers will simply get them elsewhere. Pharmacists may even
satisfy their consciences by reasoning that by keeping their customers
away from health food stores will lessen exposure to misguided
zealots who give dangerous health advice. Pharmacists have responded
to this dilemma in one of the following ways:
Revolution. Abandon the drugstore business
to operate professional pharmacies which can maintain scientific
standards. In this setting, pharmacists function as advisors
to physicians on pharmacology, new medications, drug interactions,
and serve patients as counselors on why and how to take medications.
Drugstores would no longer sell prescriptions, but would be variety
stores which also sell nonprescription drugs and home health
Education/Activist. Post disclaimers
throughout the store that will help educate consumers about dubious
products. Some may also undermine quackery by underselling the
competition on dubious products thus depriving them of profiting
from quackery. For example: Prior to the 1906 Pure Food &
Drug Act when patent medicines were the archetypes of today's
dubious dietary supplements, herbal and homeopathic remedies,
Topeka, Kansas druggist George (Pop) Stansfield hung a large
sign in his store stating: "We sell patent medicines, but
do not recommend them." Stansfield received nationwide attention
for his honesty .
Capitulation. Accept the current dismal
situation and passively sell whatever jobbers bring into the
drugstore. The downside of this approach is that prudent self-care
guidelines advise consumers to avoid drugstores that sell homeopathic
products, poorly labeled herbal remedies, and dietary supplements
that lack rationality and utility. Wise retailers will put positive
customers relations by helping them separate fact from fiction
ahead of the short-term profits of exploiting health fads.
Exploitation. Exploit the public's fascination
with health fads and sell whatever the law of supply and demand
dictates. This is being done in the name of New Age Drugstores,
selling homeopathics, offering nutritional counseling services
that promote dietary supplement sales, and more.
NCAHF believes that pharmacists are challenged more than any
other group of health professionals, because they must decide
between ethical conduct, the lure of profiting from quackery,
and the public's well-being. A survey found that pharmacists ranked
second only to the clergy by the public for ethics and honesty
. NCAHF believes that this level of public trust is worth preserving.
- Carson G. One For A man, Two For A Horse. Doubleday, 1961.
- Recommendation, Policy Committee, American Pharmaceutical
Association, on supplement usage. American Pharmacist NS28:61-62,
- Nelson M. Continuing education course: Health Fraud, Quackery
and Misinformation. Journal of Michigan Pharmacy, Dec 1990.
- O'Donnell J. Nutrition fraud, vitamins and obesity: Pharmacist's
responsibility. Journal of Pharmacy Practice, Oct 1988. (Explains
why consumers take vitamins; reviews scientific basis for supplementation
and unjustifiable practices; and discusses abuses associated
with weight control)
- Bidlack W. Nutrition quackery, selling health misinformation.
California Pharmacist, Feb 1989.
- Wilkes. Pharmaceutical advertisements in medical journals.
Annals of Internal Medicine 116:912-, 1992.
- Nelson M. Promotion, selling unnecessary supplements: Quackery
or ethical practice? American Pharmacist, Oct 1988. (Defines
quackery; shows that many pharmacies are involved. RPh's have
been found to be less than reliable sources of information. RPh's
are challenged to live up to the public's trust.)
- Nelson M. Survey of pharmacist recommendations for supplements
in USA/UK. Journal of Clinical Pharmacological Therapy 15:131-,
- The vitamin pushers. Consumer Reports March, 1986. (Discusses
the drug industry's and pharmacist's role in promoting supplement
use. Marketplace investigation found that 58% of pharmacists
gave inappropriate advice.)
- Barrett S. Vitamins: Is the public swallowing an unnecessary
pill? ACSH News & Views, March 1984. (Pharmacy educators
discuss the ethics of pharmacists selling unnecessary dietary
- Kalman. Proscribe or prescribe. Environmental Nutrition.
(Is your neighborhood pharmacy misleading you? An undercover
- Fads or facts: pharmacist's guide to controversial nutr products
Amer Pharm 1983;NS23:410-22.
- Yasgur J. Homeopathy: A sleeping giant? Pharmacy Times, Dec
1990. (Advocacy for homeopathy and naturopathy as an adjunct
to legitimate pharmacy.)
- Lowell JA. An irreverent look at The Vitamin Bible and its
author (Lowell) Nutrition Forum 3:46-47, 1986 (A review of the
book and it author, Earl Mindell, RPh, "PhD," whose
"doctoral degree" is from a nonaccredited school.)
- Over-the-counter advice. Self Health March, 1988. (Report
from the United Kingdom of 376 anonymous visits to over 200 pharmacies
to see what kind of service they offer.)
- Carton. Drugstores with a New Age twist. Boston Globe, Sept
6, 1993. (Anthony Harnett's dubious drugstore chain sells herbs,
homeopathy and other pseudomedicine.)
- Conference backs homeopathy The Pharmaceutical Journal 9/12/92.
(Report of debate at the British Pharmaceutical Conference on
the ethics of pharmacists selling homeopathic remedies. The group
backed quackery in the face of reason and professional responsibility.)
- Laskowski. Food for thought. American Druggist, May 1994.
(Advocates in-store nutrition program for pharmacies to build
stronger business. Promotes dubious electro-lipograph for body
composition assessment and using supplement company vitamin charts
- Homeopathy & pharmacy today. (U.S. Pharmacist/U of Wisconsin
Continuing Education course that advocates incorporation of homeopathy
© 1994, National Council Against Health
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This article was revised
on August 31, 2001.
With proper citation, this article may be reproduced for noncommercial