Dennis Miller, R.Ph., is the author of The Shocking Truth About Pharmacy: A Pharmacist Reveals All the Disturbing Secrets.
I believe I’d serve humanity better by working at farmers’ markets rather than a drug store. So I’d rather practice “farmacy” than pharmacy.
Why Would Farmers’ Markets Be Better?
A few years ago, there was a movement to sell fresh fruits and vegetables in inner city drug stores because the residents very often live closer to drug stores than supermarkets. There was a recognition of the fact that inner city residents often did not have easy access to fresh fruits and vegetables and that drug stores could help fill that void.
I don’t know how that experiment turned out. I’ve never worked at a drug store that sold fresh fruits and vegetables even though I would have loved to have done so. From my perspective, it would be a major culture shock to see fresh fruits and vegetables being sold in drug stores.
Can Two Opposite Models of Health Co-exist in a Drug Store?
I have a hard time imagining how these two opposite models of health could co-exist in a drug store. How could a model of health based on pharmaceuticals co-exist with a model of health based on nutrition and fresh foods?
Would people subconsciously be drawn to the fresh foods section in a drug store and the colorful variety of fresh fruits and vegetables? Do people have an innate urge to eat real food? Or have Americans been so relentlessly assaulted by drug commercials on TV that we seek pharmaceuticals to improve our well-being rather than real food? Can you imagine your pharmacist recommending fresh fruits and vegetables rather than pills?
Multivitamin Pills versus Dietary and Lifestyle Changes:
One of the most frequent questions that pharmacy customers ask pharmacists is “I just don’t have any energy. Can you recommend something?” How would customers react if the pharmacist directed them to the fresh fruits and vegetables section in the drug store rather than to the vitamin section?
Laxatives versus high fiber foods: What if customers who asked for a recommendation for constipation were directed to high fiber fruits and vegetables rather than to laxative pills and powders?
Vitamin C tablets versus oranges: What if a customer mentioned a desire to increase his/her consumption of vitamin C and the pharmacist recommended fresh oranges rather than vitamin C pills?
OTC potassium supplements versus bananas: What if a customer asked a pharmacist about potassium supplements and the pharmacist recommended fresh bananas rather than OTC potassium tablets?
A Pharmacist Who Would Rather Practice “Farmacy” Instead of Pharmacy:
Here’s an e-mail I received from a pharmacist in response to one of my articles in Drug Topics, a popular pharmacy magazine. In my article I discussed my disillusionment with the pill-for-every-ill approach of modern medicine.
I agree with this pharmacist’s preference to practice “farmacy” instead of pharmacy.
“As a 55-year-old retail pharmacist, I think about this every day. In fact, I joked to my wife that I would prefer to practice ‘farmacy’ instead of pharmacy. Our diet and lifestyle make so much of what we treat preventable. We (our US population) eat too much sugar and meat and not enough fruits and vegetables. We don’t exercise. Smoking is just a given as far as something that one can give up and instantly see improvement.
“My typical encounter is an overweight customer in drive-through picking up their cholesterol, diabetes, blood pressure and pain pill. Often times a person picking up their asthma inhaler is smoking a cigarette. My thought is always ‘Why are we even playing this game?’ I hope it gets better but I doubt it. I am one of those who has gone vegetarian to avoid the same meds I dish out every day. Thanks again for the article and for listening to a pharmacist who struggles every day with the meaning of his job.
Andrew Weil, M.D., contrasts the importance of medication and diet (Mind Over Meds, New York: Little, Brown and Company, 2017, pp. 4-5 and 12)
“No responsible physician today would reject medication as a method of treating disease and maintaining health.
“But it is one method only. Many other interventions exist that do not involve drugs; sadly, they are not taught in conventional medical schools, and that is one reason that most doctors rely on medication. One example is dietary change. When I write a treatment plan for a patient, my first recommendations always concern diet: what not to eat, what to eat more of, how to change eating habits to improve health. As a primary treatment strategy, dietary change can be remarkably effective.
“I often ask doctors and medical students to compile a list of the medications they would take with them if they were to live on a desert island. My list would include aspirin, penicillin, morphine, prednisone, and a few other drugs whose effectiveness in our collective experience is great enough to make a favorable risk/benefit ratio. I would include none of the pharmaceutical products now so vigorously advertised on television, radio, and in print. My general opinion of those is that manufacturers consistently exaggerate their benefits and consistently downplay the harm they can cause.
Pharmacists Are Hired to Move Pills:
There are many pharmacists who believe strongly in a healthy diet. But their preference has little opportunity to manifest itself in a drug store.
Chain store pharmacists are hired to move pharmaceuticals. They are not hired to recommend approaches to health that do not involve pharmaceuticals. They are not hired to use their job as a platform to advocate for reform in the pharmaceutical industry. And they are most definitely not hired to proselytize about the importance of fresh nutritious foods in comparison to pharmaceuticals.
There Are Far Fewer Miracle Pills in the Pharmacy Than You’re Led to Believe.
Without a doubt, many drugs in the pharmacy are effective and even life-saving. This includes insulin, antibiotics, thyroid hormone, opioid-type pain relievers, naloxone (for opioid overdose), epinephrine (for allergic reactions to things like bee stings and peanuts), etc.
But most of the products in drug stores don’t come anywhere close to these pharmacy superstars. Many drugs today are quite good at altering numbers on various tests. For example, many drugs just do things like lower blood pressure, lower cholesterol, decrease tumor size, etc., without proof that they accomplish a more important goal such as an actual decrease in all-cause mortality.
I never felt comfortable in drug stores.
As a pharmacist, I always felt uncomfortable in drug stores. It took me a while to understand why. I finally realized that I totally disagree with the core underlying assumption of drug stores: There is a chemical solution for every human malady. For so many medical conditions, that approach never made sense to me. That especially applies to so-called “chronic diseases” and diseases of modern civilization.
Most of the prescriptions that pharmacists fill are to treat preventable diseases of modern civilization. My interest is in preventing disease, not in filling a never-ending tsunami of prescriptions. Why do so few pharmacists seem to share my concerns?
When I graduated from pharmacy school, I knew very little about health.
My experience in pharmacy school was a major shock to my perception of health. I entered pharmacy school expecting to learn about health in its widest context. What I encountered was, instead, a massive assault on human biology at the molecular and cellular levels by synthetic chemicals foreign to human evolution. And this assault is carried out by a drug industry completely unencumbered by ethics or morals.
I assumed that my pharmacy degree made me an expert on health. How wrong I was! A pharmacy degree ostensibly confers an expertise on pills and on the manipulation of delicate biological processes with synthetic chemicals. This degree most certainly does not confer an expertise on health.
Drug Stores vs. Farmers’ Markets:
After graduation from pharmacy school, I slowly realized that I resented the fact that drug stores do not inspire me or make me feel happy. Whenever I shop at farmers’ markets, I say to myself: “This is what health looks like” or “This is where health comes from.” I never felt that way in my decades working at drug stores.
Drug stores represent an outdated model of health based on attacking delicate biological processes with synthetic chemicals foreign to human evolution. Pharma has no sense of awe or appreciation for the infinite, miraculous and wondrous complexity of the human body. Pharma views the human body as a machine or collection of molecules and cells.
I grew ever more disillusioned shoveling out pills to treat preventable conditions. In fact, I dreaded working at drug stores because their existence is fundamentally at odds with my view of health. Drug stores are about treating disease. Farmers’ markets are about cultivating and maintaining health.
Fruits & Vegetables Last for Days or Weeks; Pharmaceuticals Last for Years.
The products displayed at farmers markets feel alive and are, in fact, typically very perishable, lasting only a few days or a few weeks. In contrast, the products on drug store shelves are mostly synthetic chemicals. Their expiration date is typically around 3 years from the date of manufacture.
Big Food wants to design their food-like substances so that they have shelf lives rivaling the products sold in hardware stores, auto parts stores, and furniture stores. Big Food would like their products to have the same shelf life as, say, a hammer sold at a hardware store. Reducing spoilage increases profits.
Workers at Farmers’ Markets Are Closer to the Natural World.
Unlike pharmaceuticals, fruits and vegetables are part of the natural world. Whereas I feel alive at a farmers’ market, I feel like an alien in drug stores, a fish out of water. Even the workers at farmers’ markets seem to be more down-to-earth and more genuine than the workers at drug stores. Drug store workers seem to lose their connection to the natural world as a result of being surrounded by such artificiality eight hours a day, 40 hours a week.
The Modern Drug Store Is an Example of Marketing Madness
It bothered me tremendously during my career in drug stores (I’m now retired) that almost none of the pharmacists I met seemed to realize that the modern drug store is the physical manifestation of a pharmaceutical industry that is out of control, unbounded by science or reason or fact, marketing run amuck, an orgy of products of dubious value, the triumph of treating symptoms rather than preventing disease, the conquest of marketing over science.
It scares me that pharmacists don’t seem to be able to see the drug store for what it is. How many of the products on drug store shelves are modern-day versions of snake oil with their shiny packages and sophisticated and costly marketing campaigns?
Our health care system is grossly distorted by its marriage to chemistry and pharmacology and its estrangement from anything that emphasizes our close connection to the natural world. The modern pharmacy is a deeply troubling amalgamation of science and marketing. For the last several decades, marketing has been the overwhelmingly dominant force in the world of pills. For their part, pharmacists have been complicit in expanding the pharmaceutical and chemical paradigm, rather than public health.
Are people less gullible today compared to 100 years ago?
Since the days of the Wild West, the selling of a wide variety of nostrums, liniments, salves, potions, elixirs and snake oils have been fertile ground for charlatans. How much of that embarrassing legacy remains in the modern drug store? Even though the products on drug store shelves today come with a veneer of science, human gullibility and susceptibility to snake oil salesmen seem likely to be as abundant today as they were a hundred years ago.
The modern drug store represents an even higher level of artificiality in comparison to the modern grocery store
Some people say that they’d never buy eighty to ninety percent of the products sold in a modern grocery store because the shelves are full of highly processed pseudo foods loaded with additives, preservatives, sugar, salt, trans fats, artificial colors, artificial flavors, stabilizers, anti-caking agents, emulsifiers, conditioners, etc. Perhaps you’ve heard that Hostess Twinkies can last years at room temperature.
Does a similar critique apply to a modern drug store? The overwhelming majority of products in drug stores are synthetic chemicals never before seen during the long course of human evolution. These drugs tinker with highly-refined and delicate biological processes that have been fine-tuned over hundreds of thousands or millions of years of evolution. For the most part, these drugs treat preventable diseases of modern civilization.
Are Big Food and Big Pharma Immoral?
Big Food has hoodwinked us into believing that heavily processed and additive-laden foods are healthy. Similarly, Big Pharma has hoodwinked us into believing that all their synthetic products are safe, effective and necessary.
“The most important thing is not medication; it’s sanitation”
Most people probably believe that modern medicine and pharmaceuticals are the primary reasons for the big increases in life expectancy in the last hundred years. Modern medicine has played a role, but that role has been modest compared to public health factors like better sanitation, better nutrition, better housing, cleaner water, etc. For example, see Ilana Strauss, “Does Medicine Actually Make People Live Longer?” HuffPost.com, Jan 10, 2019
“In the grand scheme of human longevity, ‘the contribution of modern medicine is minor,’ said Jan Vijg, a genetics professor at the Albert Einstein College of Medicine in New York. In fact, it’s barely moved the needle. …
“’The most important thing is not medication; it’s sanitation,’ [Daniel Lieberman, a professor of evolutionary biology at Harvard] said.
“’We can thank public health far more than we can thank medicines,’” Lieberman said, noting that by the time antibiotic use became widespread after World War II, mortality rates had already plummeted. …
Final Words:
I’d like to see drug stores sell fresh fruits and vegetables because the more access people have to fresh produce, the better. As regards other things I wish were sold in drug stores, why not include a book section with books on health and medical topics?
I strongly suspect that the drug stores would exercise editorial control by not stocking books that are critical of pills or Pharma. The health/medical books that are most insightful from my perspective are the many exposés of the pharmaceutical industry. But of course those books would make people less enthusiastic about swallowing pills.
Are Pharmacists Fulfilled by Shoveling Out Pills for Largely Preventable Conditions?
How can pharmacists be fulfilled by dispensing a never-ending torrent of prescriptions for conditions that are largely preventable? Why aren’t pharmacists more interested in disease prevention? Why aren’t pharmacists as uncomfortable in drug stores as I am filling prescriptions for largely preventable diseases of modern civilization? How many pharmacists feel that they would better serve humanity by working at a farmers’ market?
Dennis Miller, R.Ph. is the author of The Shocking Truth About Pharmacy: A Pharmacist Reveals All the Disturbing Secrets. The entire book is available for download from Amazon for 99 cents.
