Tuesday, November 28, 2006

Pharmacists Gag on Bent Spoon

The Australian Skeptic's Bent Spoon Award for 2006 went to the pharmacists of Australia. That's a lot of winners to share the trophy, but I don't think they'll be bickering. According to Skeptics, pharmacists "manage to forget their scientific training long enough to sell quackery and snake oil in places where consumers should expect to get real medical supplies and advice."

Well deserved. Go into practically any pharmacy (drugstore) these days and you'll wonder if you have apparated into The Apothecary of Diagon Alley. Pharmacists are suffering symptoms of gravely degenerate magical thinking - peddling the likes of Rescue Remedy for first aid. I've seen this taking pride of place on the front counter. Handy, I suppose, for peanut allergy victims or cardiac arrests. Many host in-house naturopaths, pushing fantasies like homeopathy. How can contradictory health advice harmoniously co-exist under the same roof? I guess when you're exposed to woo all day, it becomes an occupational hazard.
Whenever I have to wait for a script, I enjoy observing the dual reality. What wins when put to the test? The other night a girl, with an asthmatic cough and a cold, came in for advice. I held my breath - right before her was a fabulous array of homeopathy, aromatherapy, immunity boosters and detox kits. What would she get? The pharmacist reverted - told the girl to see her doctor and sold her a ventolin inhaler. But it wasn't a good testcase - the naturopath had gone home - they don't seem to do 'out-of-hours'.

It's probably about money. Pharmacies have lost out to supermarkets (in return they're trying to snatch turf from doctors - why can't everyone keep to their own patch?) But there's hope. According to Australian Doctor magazine (10th Nov '06) the Pharmacy Guild of Australia has concerns about the way the Therapeutic Goods Administration listing gives complementary medicines "pseudo justification for their efficacy". And a campaign is being waged by scientist Loretta Marron and University of Sydney's Prof Lesley Campbell, to de-list placebo products and those with "no basis in science". Should they succeed, 2,000 or so products will be delisted. It won't stop sales, but the lolly section of pharmacies may need extending.

Mind you, why wait for the TGA? Rumour has it Québec is developing a new code of ethics for pharmacists, including banishing non-pharmacist health counseling from the prescription desk.
Could there be a happy ending here? If Aussies cleaned up their shops, would Skeptics consider stripping the Bent Spoon from Australian pharmacists?

12 comments:

  1. EoR wonders why people accept magicians and witches cohabiting with pharmacists. He understands that people are confused about what is evidence-based, what is belief-based, and the difference between the two, but he can see how the principle could be extended to show its inherent inconsistency.

    There are already urban myths about enraged townsfolk running paediatricians out of town, confusing them with paedophiles. But why not have a paedophile in every paediatrician's office? It would be a one-stop shop. It would provide an 'alternative' or 'complementary' method of dealing with the child. EoR is sure the paedophiles, unlike the busy paediatricians, would be happy spending lots of time with the children, and would be much more touchy-feely and hands-on. They'd probably even be willing to do home visits (or scout camp or church choir visits) and make all sorts of promises.

    Homeopaths and naturopaths in pharmacies are the paedophiles of science.

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  2. Wish I could write like you...luvya Lucy J...and Eor, don't think paedophile would be a correct analogy. from Sandi

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  3. But naturopaths and homeopaths are pretending to be something they're not (ie evidence based, proven, effective).

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  4. Hi Sandi, thanks. Nice to hear from you. About the analogy...I liked EoR's example, but what/who would you suggest?

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  5. It is about money. I don't know about Australia (I do hope to visit someday) but in the US, the small pharmacy is gone, replaced by huge stores selling everything from groceries to wine to beauty products, with an alcove in the back for the pharmacist.

    The homeopathic products have a better profit margin than actual medications. What's a store manager to do?

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  6. I forgot -- I'm not anonymous, I'm Liz from I Speak of Dreams

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  7. Liz again.

    Orac recently had a good anti-homeopathy post.

    This article does bring up a question that I've always wondered about, though. In attempting to conduct a clinical trial of a homeopathic remedy, what, exactly, does an investigator use as a placebo? After all, think of the logistical difficulties involved. What if a molecule of the active ingredient came in contact with the placebo somehow? In the homeopath's world, the placebo might then be contaminated and have become an active treatment. Placebos and medications might have to be stored at a great distance from each other, to prevent the diffusion of even a molecule of the homeopathic remedy into the placebo. In either case, such a "contamination" could, a homeopath could argue, tend to decrease any treatment "effects" observed. Of course, to homeopaths, it isn't just the substance, but it's the preparation, the "succusation"; but, even so, given the ridiculousness of the basic concept behind homeopathy, the task of coming up with a suitable placebo control for clinical trials that will convince the homeopaths is not trivial.

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  8. Re: "an alcove in the back for the pharmacist" Is that like the janitor's cupboard?

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  9. Liz thanks for that Orac article - an excellent post. Homeopathy's persistence baffles me. I guess it shows how close to the brink of mass stupidity we live - frightening! We have education but it seems you can't teach people to reason.

    As for groceries in the pharmacy... Sounds weird but I suppose they're fresh vitamins, and I like the idea of wine (potions for calming and relaxing).

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  10. Liz again -- eor & Lucy, as we say over here, mi casa es su casa, come and visit and I'll take you to Rite Aid and or Long's Drugs & you can marvel at the non-pharmacy.

    It's not the janitor's closet, more like a storage shed.

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  11. Liz - thanks for the offer - I like the sound of a woo exchange.

    Your wine in pharmacies really gets me. I think the closest we have had (apart from the 'h' word and various alcohol-based lotions) is Gripe Water - used to pacify infants. But was reformulated a few years ago after bad publicity re alcohol content. Tasted like diluted Benedictine.

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  12. Loretta discussed these topics with me on radio a while back.

    http://blacktownnutrition.com/4our.mp3

    http://blacktownnutrition.com/RADIO/4bc.mp3

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